common oral dx day 1 Flashcards
Tori and Exostoses
* defined?
* types (dif terms?)
- Benign, reactive bony protuberances arising from the cortical plate
- Torus palatinus
- Torus mandibularis
- Exostosis
Palatal Torus
* More common than?
* % in US?
* gender ratio?
* common demo?
* tx?
- More common than mandibular tori
- 25% of US population
- Females (2:1)
- Asians and Inuits (Eskimo)
- No treatment
describe this? if it was hard on palpation what is it likely?
mucosal colored sessile lobulated nodule located on the palatal midline
likely a palatal torus
palatal tori are covered with? complication?
covered with typical oral mucosa, can be ulcerated
describe? likely dx (hard palpation)
ulcerated sessile nodule with keratotic border located at the palatal midline
likley palatal torus
when palatal tori are ulcerated what should be done?
should determine why this occured, possible trauma
if this ulceration persists >2wks= BIOPSY
most likely dx? dif?
palatal torus
could also be: osteoma or idi osteosclerosis
Mandidbular Torus
* commonality?
* % of US population
* Most are?
* # nodule(s)?
* gender?
* races?
* tx?
- 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
most likely dx?
mandibular torus
man tori can complicate what procedure?
PAs
mandibular tori are covered with? complication?
oral mucosa, can be ulcerated (same as palatal tori)
most likely dx? dif?
mandibular tori
could also be: idi osteosclerosis or osteoma
man tori
buccal extoses?
same as tori, but located on buccal can be diffuse or local
buccal exotoses
describe this lesion? likely cause?
ulcerative lesion with a keratotic border on the lateral tongue
likley due to the malalgined mandibular teeth= traumatic ulcer
what should be done for traumatic ulcers?
remove local irritant and re-evaluate at 2 wks (if same biopsy indicated)
this histo is indicative of?
ulceration, note lack of epithelium on the L
Most common “tumor” of the oral cavity
Traumatic (Irritation) Fibroma
Traumatic (Irritation) Fibroma
* results from?
* Not a true?
- Inflammatory fibrous hyperplasia
- Not a true neoplasm of fibroblasts - a reactive lesion rather than a true neoplasm
describe, likely dx from so far?
sessile mucosal colored nodule located on the buccal mucosa
Traumatic (Irritation) Fibroma
describe, likely dx from so far?
sessile keratotic nodule located on the buccal mucosa
Traumatic (Irritation) Fibroma
how can traumatic fibromas appear?
sessile nodules that can be keratotic or mucosal colored
biopsy from a buccal mucosa sessile nodule
traumatic fibroma
traumtic fibroma histo
fibroblast hyperplasia beneath typical epithelium
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
describe? likely dx?
mucosal colored nodule on the palate
likley GCF
where could giant cell fibromas occur?
anywhere in the mouth
describe? what lesion can look this way?
mucosal colored papillary nodule located on the lingual frenum
GCF
describe? what could this be?
white papillary nodule located on the buccal mucosa
GCF
giant cell fibroma histo
multinucleated fibroblasts and elongated rete pegs
biopsy from mucosal colored papillary nodule located on the lingual frenum
giant cell fibroma
what dx does this cell indicate?
GCF, multi-nuc fibroblast
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
epulis fissuratum
histo of epulis fissuratum
fibrous hyperplasia
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
why does inflammatory papillary hyperplasia app red?
overlying candidasis infection
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
inflam pap hyper
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
how can med related ging hyper be resolved
cannot be reverted with hygiene, must perform gingevectomy or consult for new Rx
common Rx of ging hyper
- Anticonvulsants– Dilantin (phenytoin) – 50%
- Calcium channel blockers– Procardia (nifedipine) – 25%
- Immunosupressants– Sandimmune (cyclosporin) – 25%
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
Drug-Related Gingival Enlargement -Treatment
- Control local factors - anti-plaque agents (chlorhexidine)
- Drug substitution
- Drug therapy - folic acid, metronidazole, azithromycin
- Surgical excision - gingivectomy
