Benign Fibroproliferative Lesions

Question 1

In general firm and pink lesions are made of? Soft and red?

Answer 1

Dense fibrous connective tissue

Granulation tissue

Question 2

Localized hyperplasias are typically in response to?

Answer 2

Trauma or repeated irritation

Question 3

Describe the appearance of a pyogenic granuloma in terms of color, pedunculated or sessile, growth rate.

Answer 3

Fiery red nodule that can be pedunculated or sessile. Tends to grow very quickly

Question 4

Where can pyogenic granulomas occur and what may cover them?

Answer 4

Anywhere in the mouth. Can be covered by a fibropurulent pseudomembrane

Question 5

What can pyogenic granulomas become as they mature?

Answer 5

Irritation fibromas

Question 6

What tissues are seen in a pyogenic granuloma? Describe the appearance of the overlying SSE

Answer 6

Granulation tissue with acute or chronic inflammatory cells

The overlying SSE is typically atrophic and or ulcerated

Question 7

What is the classification for the particularly prominent areas of gingival enlargement seen in hyper plastic gingivitis?

Answer 7

Localized hyperplastic gingivitis. They can resemble pyogenic granulomas

Question 8

What is a pregnancy tumor and what causes them?

Answer 8

A pyogenic granuloma that appears during pregnancy. The hormone changes causes an increased response to local irritants

Question 9

What can trigger a post-extraction granuloma, i.e. epulis granulomatosum? What is the ddx?

Answer 9

Fragments of alveolar bone in the empty socket. These can also be aggressive tumors

Question 10

What color is a typical irritation fibroma?

Answer 10

usually normal colored or slightly paler than the surrounding mucosa

Question 11

Are irritation fibromas sessile or pedunculated? Attached or unattached?

Answer 11

Usually sessile more often than pedunculated. They are attached to the connective tissue

Question 12

What tissues make up an irritation fibroma? The SSE covering the lesion can be described as?

Answer 12

Dense fibrous connective tissue. The covering is hyper plastic and sometimes keratinized

Question 13

What is another name for denture hyperplasia?

Answer 13

Epulis fissuratum

Question 14

What is an epulis fissuratum lesion composed of?

Answer 14

Collagenous fibrous connective tissue with areas of granulation tissue

Question 15

Most cases of palatal papillary hyperplasia occur due to?

Answer 15

Upper denture use

Question 16

What are causes of palatal papillary hyperplasia in non-denture wearers?

Answer 16

Local predisposing factors and being immunocompromised

Question 17

Palatal papillary hyperplasia gives the palate a ____ appearance?

Answer 17

Cobblestone

Question 18

What tissues are seen in palatal papillary hyperplasia?

Answer 18

Proliferating epithelium covering inflamed granulation tissue. Candidal hyphae are sometimes seen

Question 19

Where is peripheral ossifying fibroma typically seen?

Answer 19

On the interdental gingiva

Question 20

What does the lesion look like?

Answer 20

Typically a firm, well-defined, red or pink nodule

Question 21

How can an ossifying fibroma be distinguished radiographically from irritation fibroma?

Answer 21

The extensive calcified tissue may cause irregular opacities to appear

Question 22

What is seen histologically that allows one to make the diagnosis of peripheral ossifying fibroma?

Answer 22

Fibrous connective tissue containing osteoid, bone, or cementum

Question 23

Why do peripheral ossifying fibromas have a higher recurrence rate than irritation fibromas and PGs?

Answer 23

they arise from deeper tissues like the PDL or alveolar crest

Question 24

What is parulis?

Answer 24

Abscess in the gingiva derived from an acute infection of a non-vital tooth

Question 25

Where is a parulis typically seen and what color is it?

Answer 25

Red or yellow and forms at the mucogingival junction

Question 26

What is non-specific inflammatory gingival hyperplasia?

Answer 26

Associated with plaque, scurvy, or hormonal imbalance. Tend to be red

Question 27

What is non-specific fibrous gingival hyperplasia?

Answer 27

Associated with drugs and inherited abnormalities leading to enlargement without local irritants. Pink and firm enlargement

Question 28

Foreign body reactions present as?

Answer 28

Sessile nodules

Question 29

When viewed under polarized light the foreign substance may appear?

Answer 29

Birefringent

Question 30

What tissues are seen in foreign body reactions?

Answer 30

Inflamed granulation tissue with giant cells

Question 31

What are pseudo sarcomatous reactive hyperplasias? What are they often mistaken for?

Answer 31

Rapidly growing ill-defined enlargements

Often mistaken for malignancies, initial microscopic investigation suggests sarcoma

Question 32

Herniated sinus lining occurs where?

Answer 32

At the site of recent tooth extraction

Question 33

Foliate papillitis is what structure? They contain what kind of tissue?

Answer 33

Vestigial lingual papillae. They contain lymphoid tissue

Question 34

Transient lingual papillitis presents as? Is it painful?

Answer 34

One to several small red or yellow papule on the anterior surface of the tongue. Moderately painful

Question 35

What is the name of a blood blister which only lasts a few minutes and then spontaneously ruptures?

Answer 35

Angina bullosa hemorrhagica

Question 36

Fibromatoses typically affect who?

Answer 36

Juveniles or young adults

Question 37

What is seen histologically in fibromatoses?

Answer 37

Proliferation of bland spindle cells with variable amounts of collagen

Question 38

How do you treat fibromatoses?

Answer 38

Wide excision

Question 39

Giant cell lesions are sessile or pedunculate?

Answer 39

Either

Question 40

New PGCLs are what color and consistency? Older ones?

Answer 40

Violet to dark red and soft, old lesions are pink and firm

Question 41

What can a PGCL cause on an edentulous ridge?

Answer 41

Cuffing of bone