Common Oral Diseases Part I Flashcards
what are tori and exostoses
benign, reactive bony protuberances arising from the cortical plate
what are the types of tori and exostoses
- torus palatinus
- torus mandibularis
- exostosis
are palatal tori or mandibular tori more common
palatal tori
what is the predeliction for palatal tori
- 25% of US population
-2:1 females - asians and inuits
what is the tx for palatal tori
none
what is the predilection for mandibular tori
- 10% of US population
-most are bilateral - single or multiple nodules
- slight male gender predominance
- asians and inuits
- no treatment
what is the most common tumor of the oral cavity
traumatic irritation fibroma
what type of hyperplasia is traumatic irritation fibroma
inflammatory fibrous hyperplasia
are traumatic irritation fibromas a neoplasm
no it is a reactive lesion rather than a true neoplasm
what is a giant cell fibroma
- distinct from irritation fibroma
- may not be associated with an identifiable source of chronic irritation and occurs at younger age
what does a giant cell fibroma look like clinically and what is it commonly mistaken for
- often has a papillary surface
- clincially mistaken for papilloma
what are the synonyms for epulis fissuratum
- inflammatory fibrous hyperplasia
- denture injury tumor
- fibrous epulis
- denture epulis
what is epulis fissuratum
- redundant fibrous tissue
- associated with denture flange
what is another name for inflammatory papillary hyperplasia
- denture papillomatosis
what is the cause of inflammatory papillary hyperplasia
poor oral hygiene combined with ill-fitting prosthesis
what is the treatment for inflammatory papillary hyperplasia
- surgical excision and correct prosthesis
describe medication associated gingival enlargement
- enlargement begins in the interdental papillae and forms pseudopockets
- non-specific clinical appearance
severity of medication associated gingival enlargement is related to:
patient susceptibility and local factors
what medications are associated with gingival elargement and what percentage of each patients that take it will get it
- anticonvulsants: dilantin (phenytoin) - 50%
- calcium channel blockers: procardia (nifedipine)- 25%
- immunosuppressants: sandimmune (cyclosporin) - 25%
what are the treatment options for drug related gingival enlargement
- control local factors such as anti plaque agents with chlorhexidine
- drug substitution
- drug therapy- folic acid, metronidazole, azithromycin
- surgical excision- gingivectomy
what is a pyogenic granuloma
a reactive vascular lesion - essentially a capillary hemangioma
what is the predilection for pyogenic granuloma and why
females because of vascular effects of hormones
why is the name pyogenic granuloma a misnomer
it is unrelated to infection and it is not pyogenic and is not a true granuloma
what type of growth is seen with pyogenic granuloma
rapid
where are pyogenic granulomas seen
gingiva is most common site but not limited to gingiva
- occurs throughout the body on any skin or mucosal surface
what are the clinical variants of pyogenic granuloma
- pyogenic granuloma
- granuloma gravidarum
- epulis granulomatosum
- pulp polyp
what is the pregnancy tumor
granuloma gravidarum
what is a granuloma gravidarum and what is the tx
- a clinical variant of pyogenic granuloma
- may involute without tx post partum and undergo fibrous maturation
describe peripheral ossifying fibroma, who is affected, where it is found
- reactive lesion- not a neoplasm
- teenagers and young adults
- occurs exclusively on the gingiva
- fibrous hyperplasia with osseous metaplasia- may appear radiopaque
- may recur and may move teeth
are peripheral ossifying fibromas related to central ossifying fibroma
no
describe peripheral giant cell granuloma, who it affects, where it occurs
- reactive lesion- not a neoplasm
- older adults
- occurs exclusively on gingiva and edentulous alveolar ridge
- contains hemosiderin- may be bluish purple
- may recur
what are the types of human papilloma virsu
- squamous papilloma
- verruca vulgaris
- condyloma acuminatum
describe a squamous papilloma
- solitary lesion in adult
- pedunculated, exophytic papule
- numerous surface projections
describe verruca vulgaris
- skin of hands in children
- multiple clustered lesions common
- white, verrucoid surface
- autoinoculation of oral mucosa
describe condyloma acuminatum
- venereal wart- STD
- multiple, clustered lesions are common
- sessile, pink exophytic mass, larger than squamous papilloma
what are the low risk subtypes of condyloma acuminatum and HPV
6 and 11
what are the high risk subtypes of HPV and condyloma acuminatum
16 and 18
what is the lowest virulence and infectivity to highest virulence and infectivity of the HPV types
squamous papilloma < verruca vulgaris < condyloma acuminatum
what is primary herpetic gingivostomatitis
intital exposure to virus in an individual without immunity
when does primary herpetic gingivostomatitis usually occur
at young age after physical contact with infected individual
what percentage of the US has antibodies to HSV
80%
primary herpetic gingivostomatitis is a mostly _______ disease
subclinical
describe the symptoms of primary herpetic gingivostomatitis
-flu-like illness with fever, malaise, arthralgia, headache
- cervical lymphadenopathy
what are the clinical forms of recurrent aphthous stomatitis
- minor
- major
- herpetiform
what systemic diseases look like aphthous like lesions
- Behcet’s syndrome
- Reiter’s syndrome
- IBS: ulcerative colitis and Crohn’s
- malabsorption syndromes: gluten sensitive enteropathy
- cyclic neutropenia
- HIV/ AIDS
what are the types of gingivitis
- plaque associated gingivitis
- necrotizing ulcerative gingivitis
- medication induced gingivitis
- allergic gingivitis
- specific infection related gingivitis
- dermatosis related gingivitis
what is an example of allergic gingivitis
plasma cell gingivitis
what is an example of specific infection related gingivitis
herpes simplex virus
what is an example of dermatosis related gingivitis
desquamative gingivitis
what systemic diseases manifest as periodontitis
- DM
- HIV
- neutropenia
- leukocyte dysfunction syndromes
- papillon-lefevre syndrom
what is neutropenia
decreased numbers of leukocytes
what is hairy tongue
- elongated filliform papillae
- exogenous pigmentation may impart a brown or black appearance
what is hairy tongue caused by
- heavy smoking
- antibiotic therapy
what are fordyce granules and when do they appear
- ectopic sebaceous glands
- starts at puberty
what is a leukoplakia
a white patch or plaque that cant be characterized clinically or pathologically as any other disease
what is erythroplakia
a red patch or plaque that cant be characterized clinically or pathologically as any other disease
what is an ulcer
a loss of continuity of the epithelium that penetrates to the underlying CT
describe oral melanotic macule and what location is most common
- focal increase in melanin
- normal number of melanocytes
- lower lip vermillion most common
what are the clinical types of lichen planus
- reticular lichen planus
- erosive lichen planus
describe reticular lichen planus
- bilateral asymptomatic white lesions of posterior buccal mucosa - Wickham striae
- also papules and plaques
what are the types of geographic tongue
- benign migratory glossitis
- erythema areata migrans
- stomatitis areata migrans
- wandering rash of the tongue
what is the cause of geographic tongue
- unknown
- but could be hypersensitivity to an environmental factor
where is geographic tongue commonly seen
at tip and lateral border of tongue
describe red geographic tongue
- multiple erythematous zones
- atrophy of filiform papillae
describe white geographic tongue
- elevated, yellow-white, serpiginous border
what is the histopathology for geographic tongue
- psoriasiform mucositis- resembles psoriasis
- exocytosis of neutrophils into epithelium
- munro microabscesses
what are the 3 lesions that appear on the gums
- pyogenic granuloma
- peripheral ossifying granuloma
- peripheral giant cell granuloma
what is the histo appearance of a peripheral giant cell granuloma
chocolate chip cookies
all bump on the gums tend to:
recur
what surfaces do primary herpetic gingivostomatitis lesions occur
all types of surfaces
what nerve complex is affected in the secondary herpes simplex infection
trigeminal ganglion
where is secondary herpes seen
on bound down keratinized mucosa
what cells are associated with herpes blisters
tzank cells
what is the typical presentation of recurrent apthous stomatitis
yellow center with erythematous halo
what is the progression of recurrent aphthous stomatitis lesion
erythematous macule -> ulceration -> fibrinous membrane
what surfaces are recurrent aphthous stomatitis lesions found on
non-bound down mucosa or non keratinized
describe pseudomembranous candidiasis
white cottage cheese like appearance
-> if wiped off it will leave an erythematous base
what medium is used to examine candidiasis and why
sabauraud agar because has a low pH and gentamycin to inhibit bacterial growth
does hyperplastic candidiasis wipe off
no
where is central papillary atrophy seen and what is another name for it
- AKA median rhomboid glossitis
- in midline and dorsal surface of the tongue
what is another name for atrophic candidiasis and what is its clinical appearance
- erythematous candidiasis
- bright red
what is the diff dx for mucocele
mucoepidermoid carcinoma
what is the clinical appearance of necrotizing ulcerative gingivitis
punched out interdental papilla
where are foliate papillae and lingual tonsils found
on posterior lateral tongue
what has the same histology as an oral lymphoeithelial cyst
brachial cleft cysts
is actinic chelitis malignant and what causes it
- considered pre malignant
- sun damage etiology
what can erosive lichen planus be confused for
disformative gingivitis
