Clinical 2

Question 1

How do you differentiate between a squamous papilloma and Condyloma acuminatum?

Answer 1

Cannot distinguish clinically or microscopically.

DNA hybridisation is required for definitive classification of an oral wart.

Question 2

Does an oral wart need to be removed?

Answer 2

No treatment necessary due to low infectivity and clinical significance. Can be removed if poses a problem or aesthetically objectionable.

Recurrence/multiple lesions seen in HIV/immunocompromised pts

Question 3

What is papillary hyperplasia?

Answer 3

• Multiple erythematous and oedematous papillary projections, producing an overall cobblestone appearance.
• Almost always on palate, due to ill-fitting removable prosthesis (overgrowth of C. albicans implicated)
• Mx: Surgical removal prior to a new denture, denture care instructions, topical antifungs

Question 4

What is Condyloma Latum

Answer 4

• one of many variable expressions of secondary syphilis
• potentially infectious
• Mx - systemic antibiotics to eliminate systemic disease.
• oral lesions regress once systemic disease is under control

Question 5

Does focal epithelial hyperplasia require treatment?

Answer 5

No - clinically insignificant, spontaneous regression may occur

Question 6

How does verrucous carcinoma compare with melanoma in terms of prognosis

Answer 6

Excellent - verrucous carcinoma has a high level of differentiation and rarely metastasises

Melanoma has a very poor survival rate.

Question 7

Verrucous carcinoma.
Aetiology.
Clinical Features.

Answer 7

Aetiology - HPV (types 16 & 18) may be involved

Clinical Features - slow growing verrucous patch, locally destructive (pushes into tissues rather than infiltrates)

Question 8

What is Crohn’s disease and what are the oral manifestations?

Answer 8

Crohn’s disease - regional enteritis, inflammatory condition involving all layers of the gut.

• abdominal pain, cramps and diarrhoea
• complications - malabsorption of nutrients –> deficiencies
• orally - papillary folds and aphthous ulcers

Question 9

Why are cysts abundant in the jaws?

Answer 9

Due to the abundance of epithelial rests associated with tooth formation.

Question 10

List the non-odontogenic cysts of the jaws

Answer 10

• Nasolabial cyst

- Nasopalatal duct cyst

Question 11

List the pseudocysts of the jaws

Answer 11

• aneurysmal bone cyst
• traumatic bone cyst
• Staphne’s bone cyst (static bone cyst)
• focal osteoporotic bone marrow defect