common oral dx day 1 Flashcards

1
Q

Tori and Exostoses
* defined?
* types (dif terms?)

A
  • Benign, reactive bony protuberances arising from the cortical plate
  • Torus palatinus
  • Torus mandibularis
  • Exostosis
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2
Q

Palatal Torus
* More common than?
* % in US?
* gender ratio?
* common demo?
* tx?

A
  • More common than mandibular tori
  • 25% of US population
  • Females (2:1)
  • Asians and Inuits (Eskimo)
  • No treatment
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3
Q

describe this? if it was hard on palpation what is it likely?

A

mucosal colored sessile lobulated nodule located on the palatal midline
likely a palatal torus

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4
Q

palatal tori are covered with? complication?

A

covered with typical oral mucosa, can be ulcerated

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5
Q

describe? likely dx (hard palpation)

located on palate
A

ulcerated sessile nodule with keratotic border located at the palatal midline
likley palatal torus

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6
Q

when palatal tori are ulcerated what should be done?

A

should determine why this occured, possible trauma
if this ulceration persists >2wks= BIOPSY

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7
Q

most likely dx? dif?

A

palatal torus
could also be: osteoma or idi osteosclerosis

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8
Q

Mandidbular Torus
* commonality?
* % of US population
* Most are?
* # nodule(s)?
* gender?
* races?
* tx?

A
  • 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
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9
Q

most likely dx?

hard on palpation
A

mandibular torus

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10
Q

man tori can complicate what procedure?

A

PAs

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11
Q

mandibular tori are covered with? complication?

A

oral mucosa, can be ulcerated (same as palatal tori)

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12
Q

most likely dx? dif?

A

mandibular tori
could also be: idi osteosclerosis or osteoma

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13
Q
A

man tori

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14
Q

buccal extoses?

A

same as tori, but located on buccal can be diffuse or local

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15
Q
hard on palpation
A

buccal exotoses

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16
Q

describe this lesion? likely cause?

A

ulcerative lesion with a keratotic border on the lateral tongue
likley due to the malalgined mandibular teeth= traumatic ulcer

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17
Q

what should be done for traumatic ulcers?

A

remove local irritant and re-evaluate at 2 wks (if same biopsy indicated)

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18
Q

this histo is indicative of?

A

ulceration, note lack of epithelium on the L

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19
Q

Most common “tumor” of the oral cavity

A

Traumatic (Irritation) Fibroma

20
Q

Traumatic (Irritation) Fibroma
* results from?
* Not a true?

A
  • Inflammatory fibrous hyperplasia
  • Not a true neoplasm of fibroblasts - a reactive lesion rather than a true neoplasm
21
Q

describe, likely dx from so far?

A

sessile mucosal colored nodule located on the buccal mucosa
Traumatic (Irritation) Fibroma

22
Q

describe, likely dx from so far?

A

sessile keratotic nodule located on the buccal mucosa
Traumatic (Irritation) Fibroma

23
Q

how can traumatic fibromas appear?

A

sessile nodules that can be keratotic or mucosal colored

24
Q

biopsy from a buccal mucosa sessile nodule

A

traumatic fibroma

25
traumtic fibroma histo
fibroblast hyperplasia beneath typical epithelium
26
Giant Cell Fibroma * Distinct from? * Often exhibits? mistaken for? * can also app as?
* 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 * can also app as a papule
27
describe? likely dx?
mucosal colored nodule on the palate likley GCF
28
where could giant cell fibromas occur?
anywhere in the mouth
29
describe? what lesion can look this way?
mucosal colored papillary nodule located on the lingual frenum GCF
30
describe? what could this be?
white papillary nodule located on the buccal mucosa GCF
31
giant cell fibroma histo
multinucleated fibroblasts and elongated rete pegs
32
biopsy from mucosal colored papillary nodule located on the lingual frenum
giant cell fibroma
33
what dx does this cell indicate?
GCF, multi-nuc fibroblast
34
Epulis Fissuratum * Synonyms * what is it? * Associated with?
* Synonyms: – Inflammatory fibrous hyperplasia – Denture injury tumor – Fibrous epulis – Denture epulis * Redundant fibrous tissue * Associated with denture flange
35
epulis fissuratum
36
histo of epulis fissuratum
fibrous hyperplasia
37
Inflammatory Papillary Hyperplasia * Pathogenesis? * tx
* Denture papillomatosis * Poor oral hygiene combined with ill-fitting prosthesis, or keeping denture in too much * Surgical excision and correct prosthesis
38
why does inflammatory papillary hyperplasia app red?
overlying candidasis infection
39
how to tx inflam pap hyperplasia
new denture/tissue conditioner antifungals for denture and tissue for candidasis can also be removed prior to new prothesis
40
inflam pap hyper
41
Medication Associated Gingival Enlargement * Enlargement begins in? and forms? * clinical appearance? * Multiple drugs? * Severity is related to?
* 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
42
how can med related ging hyper be resolved
cannot be reverted with hygiene, must perform gingevectomy or consult for new Rx
43
common Rx of ging hyper
* Anticonvulsants– Dilantin (phenytoin) – 50% * Calcium channel blockers– Procardia (nifedipine) – 25% * Immunosupressants– Sandimmune (cyclosporin) – 25%
44
medication related ging hyper histo may resemble? dif how?
may look like GCF with elongated rete pegs but does not have multi nuc giant cells
45
Drug-Related Gingival Enlargement -Treatment
* Control local factors - anti-plaque agents (chlorhexidine) * Drug substitution * Drug therapy - folic acid, metronidazole, azithromycin * Surgical excision - gingivectomy