Common Oral Diseases Flashcards
Tori and Exostoses
(4)
- Benign, reactive bony protuberances arising
from the cortical plate - Torus palatinus
- Torus mandibularis
- Exostosis
Palatal Torus
(5)
- More common than mandibular tori
- 25% of US population
- Females (2:1)
- Asians and Inuits (Eskimo)
- No treatment
Mandidbular Torus
(7)
- Less common than palatal tori
- 10% of US population
- Most are bilateral
- Single or multiple nodules
- Slight male gender predominance
- Asians and Inuits
- No treatment
Traumatic (Irritation) Fibroma
(3)
- Most common “tumor” of the oral cavity
- Inflammatory fibrous hyperplasia
- Not a true neoplasm of fibroblasts - a
reactive lesion rather than a true neoplasm
Giant Cell Fibroma
(2)
- Distinct from irritation fibroma – may not be
associated with an identifiable source of
chronic irritation and occurs at younger age - Often exhibits a papillary surface and may be
clinically mistaken for papilloma
Epulis Fissuratum
* Synonyms
(4)
– Inflammatory fibrous hyperplasia
– Denture injury tumor
– Fibrous epulis
– Denture epulis
Epulis Fissuratum
(2)
- Redundant fibrous tissue
- Associated with denture flange
Inflammatory Papillary Hyperplasia
(3)
- Denture papillomatosis
- Poor oral hygiene combined with ill-fitting
prosthesis - Surgical excision and correct prosthesis
Medication Associated
Gingival Enlargement
(4)
- Enlargement begins in the interdental
papillae and forms pseudopockets - Non-specific clinical appearance
- Multiple drugs are synergistic
- Severity is related to patient susceptibility
and local factors
Medication Associated
with Gingival Enlargement
(3)
- Anticonvulsants
- Calcium channel blockers
- Immunosupressants
- Anticonvulsants
– Dilantin (phenytoin) – 50%
- Calcium channel blockers
– Procardia (nifedipine) – 25%
- Immunosupressants
– Sandimmune (cyclosporin) – 25%
Drug-Related Gingival Enlargement -
Treatment
(4)
- Control local factors - anti-plaque agents
(chlorhexidine) - Drug substitution
- Drug therapy - folic acid, metronidazole,
azithromycin - Surgical excision - gingivectomy
Pyogenic Granuloma
(5)
- A reactive vascular lesion - essentially a capillary
hemangioma - Definite female predilection - vascular effects of
hormones - Name is a misnomer. It is unrelated to infection. It is not
“pyogenic” and is not a true granuloma - May exhibit rapid growth
- Gingiva most common site, but not limited to gingiva. It
occurs throughout the body on any skin or mucosal
surface
Clinical Variants of
Pyogenic Granuloma
(4)
- Pyogenic granuloma
- Granuloma gravidarum
- Epulis granulomatosum
- Pulp polyp
- Granuloma gravidarum
– Pregnancy tumor
Granuloma Gravidarum:
Pregnancy Tumor
(2)
- A clinical variant of pyogenic granuloma
- May involute without treatment post
partum and undergo fibrous maturation
Peripheral Ossifying Fibroma
(7)
age, where, 5 facts
- Reactive lesion – not a neoplasm
- Teenagers and young adults
- Not related to
central ossifying fibroma - Occurs exclusively on the gingiva
- Fibrous hyperplasia with osseous metaplasia - may
appear radio-opaque - May recur
- May move teeth
Peripheral Giant Cell Granuloma
(5)
- Reactive lesion – not a neoplasm
- Older adults
- Occurs exclusively on gingiva and edentulous
alveolar ridge - Contains hemosiderin - may be bluish-purple
- May recur
Human Papilloma Virus
(3)
- Squamous papilloma
- Verruca vulgaris
- Condyloma acuminatum
Squamous Papilloma
(3)
- Solitary lesion in adult
- Pedunculated, exophytic papule
- Numerous surface projections
Verruca Vulgaris
(4)
- Skin of hands in children
- Multiple, clustered lesions common
- White, verrucoid surface
- Autoinoculation of oral mucosa
Condyloma Acuminatum
(5)
- Venereal wart - sexually-transmitted disease
- Multiple, clustered lesions common
- Sessile, pink exophytic mass, larger than squamous
papilloma - Low risk sub-types 6 and 11 frequently found
(vaccine) - High-risk sub-types 16 and 18 may also be present
Low virulence to High virulence and infectivity
Squamous Papilloma
Verruca Vulgaris
Condyloma Acuminatum
Primary Herpetic Gingivostomatitis
(3)
- Initial exposure to virus in an individual
without immunity - Generally occurs at young age after physical
contact with infected individual - Mostly subclinical disease - 80% of US
population has antibodies to HSV
Primary Herpetic Gingivostomatitis
Symptoms (2)
- Flu-like illness with fever, malaise,
arthralgia, headache - Cervical lymphadenopathy
Clinical Forms of Recurrent
Aphthous Stomatitis
(3)
- Minor
- Major
- Herpetiform
Aphthous-like Lesions may be
Associated with Systemic Disease
(6)
- Behcet’s Syndrome
- Reiter’s Syndrome
- Inflammatory Bowel Disease
- Malabsorption Syndromes
- Cyclic Neutropenia
- HIV / AIDS
- Inflammatory Bowel Disease
(2)
– Ulcerative colitis
– Crohn’s Disease
- Malabsorption Syndromes
(1)
– Gluten Sensitive Enteropathy
Types of Gingivitis
(6)
- Plaque-associated gingivitis
- Necrotizing ulcerative gingivitis
- Medication-induced gingivitis
- Allergic gingivitis
- Specific infection-related gingivitis
- Dermatosis-related gingivitis
- Necrotizing ulcerative gingivitis
– NUG
- Medication-induced gingivitis
– Drug-related gingival hyperplasia
- Allergic gingivitis
– Plasma cell gingivitis
- Specific infection-related gingivitis
– Herpes Simplex Virus
- Dermatosis-related gingivitis
– Desquamative gingivitis
Periodontitis as a Manifestation of
Systemic Disease
(5)
- Diabetes mellitus
- Human Immunodeficiency Virus infection
- Decreased numbers of leukocytes
- Abnormal function of leukocytes
- Papillon-Lefevre Syndrome
- Decreased numbers of leukocytes
– Neutropenia
- Abnormal function of leukocytes
– Leukocyte dysfunction syndromes
Hairy Tongue
(3)
- Elongated filliform papillae
- Exogenous pigmentation may impart a brown
or black appearance - Various associated factors
Hairy Tongue
* Various associated factors
(2)
– Heavy smoking
– Antibiotic therapy
Fordyce Granules
(2)
- Ectopic sebaceous glands
- Development stimulated at puberty
Leukoplakia
- A white patch or plaque that can’t be
characterized clinically or pathologically
as any other disease.
Erythroplakia
- A red patch or plaque that can’t be
characterized clinically or pathologically
as any other disease.
Ulcer
- A loss of continuity of the epithelium
that penetrates to the the underlying
connective tissue
Oral Melanotic Macule
(3)
- Focal increase in melanin
- Normal number of melanocytes
- Lower lip vermillion most common
Clinical Types Lichen Planus
(2)
- Reticular lichen planus
- Erosive lichen planus
Reticular Lichen Planus
(2)
- Bilateral asymptomatic white lesions of
posterior buccal mucosa (Wickham striae) - Also papules and plaques
Geographic Tongue
(4)
- Benign Migratory Glossitis
- Erythema Areata Migrans
- Stomatitis Areata Migrans
- Wandering Rash of the Tongue
Geographic Tongue
(4)
- Cause unknown
– Hypersensitivity to environmental factor ? - Common at tip and lateral border
- Red
- White
Geographic Tongue
* Red
– Multiple erythematous zones
– Atrophy of filliform papillae
Geographic Tongue
* White
- Elevated, yellow-white, serpiginous border
Histopathology: Geographic Tongue
(3)
- Psoriasiform mucositis
– Resembles psoriasis - Exocytosis of neutrophils into epithelium
- Munro microabscesses
