common oral dx day 1

Question 1

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

Answer 1

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

Question 2

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

Answer 2

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

Question 3

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

Answer 3

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

Question 4

palatal tori are covered with? complication?

Answer 4

covered with typical oral mucosa, can be ulcerated

Question 5

describe? likely dx (hard palpation)

located on palate

Answer 5

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

Question 6

when palatal tori are ulcerated what should be done?

Answer 6

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

Question 7

most likely dx? dif?

Answer 7

palatal torus
could also be: osteoma or idi osteosclerosis

Question 8

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

Answer 8

• 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

Question 9

most likely dx?

hard on palpation

Answer 9

mandibular torus

Question 10

man tori can complicate what procedure?

Answer 10

PAs

Question 11

mandibular tori are covered with? complication?

Answer 11

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

Question 12

most likely dx? dif?

Answer 12

mandibular tori
could also be: idi osteosclerosis or osteoma

Question 13

Answer 13

man tori

Question 14

buccal extoses?

Answer 14

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

Question 15

hard on palpation

Answer 15

buccal exotoses

Question 16

describe this lesion? likely cause?

Answer 16

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

Question 17

what should be done for traumatic ulcers?

Answer 17

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

Question 18

this histo is indicative of?

Answer 18

ulceration, note lack of epithelium on the L

Question 19

Most common “tumor” of the oral cavity

Answer 19

Traumatic (Irritation) Fibroma

Question 20

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

Answer 20

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

Question 21

describe, likely dx from so far?

Answer 21

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

Question 22

describe, likely dx from so far?

Answer 22

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

Question 23

how can traumatic fibromas appear?

Answer 23

sessile nodules that can be keratotic or mucosal colored

Question 24

biopsy from a buccal mucosa sessile nodule

Answer 24

traumatic fibroma

Question 25

traumtic fibroma histo

Answer 25

fibroblast hyperplasia beneath typical epithelium

Question 26

Giant Cell Fibroma * Distinct from? * Often exhibits? mistaken for? * can also app as?

Answer 26

* 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

Question 27

describe? likely dx?

Answer 27

mucosal colored nodule on the palate likley GCF

Question 28

where could giant cell fibromas occur?

Answer 28

anywhere in the mouth

Question 29

describe? what lesion can look this way?

Answer 29

mucosal colored papillary nodule located on the lingual frenum GCF

Question 30

describe? what could this be?

Answer 30

white papillary nodule located on the buccal mucosa GCF

Question 31

giant cell fibroma histo

Answer 31

multinucleated fibroblasts and elongated rete pegs

Question 32

biopsy from mucosal colored papillary nodule located on the lingual frenum

Answer 32

giant cell fibroma

Question 33

what dx does this cell indicate?

Answer 33

GCF, multi-nuc fibroblast

Question 34

Epulis Fissuratum * Synonyms * what is it? * Associated with?

Answer 34

* Synonyms: – Inflammatory fibrous hyperplasia – Denture injury tumor – Fibrous epulis – Denture epulis * Redundant fibrous tissue * Associated with denture flange

Question 35

Answer 35

epulis fissuratum

Question 36

histo of epulis fissuratum

Answer 36

fibrous hyperplasia

Question 37

Inflammatory Papillary Hyperplasia * Pathogenesis? * tx

Answer 37

* Denture papillomatosis * Poor oral hygiene combined with ill-fitting prosthesis, or keeping denture in too much * Surgical excision and correct prosthesis

Question 38

why does inflammatory papillary hyperplasia app red?

Answer 38

overlying candidasis infection

Question 39

how to tx inflam pap hyperplasia

Answer 39

new denture/tissue conditioner antifungals for denture and tissue for candidasis can also be removed prior to new prothesis

Question 40

Answer 40

inflam pap hyper

Question 41

Medication Associated Gingival Enlargement * Enlargement begins in? and forms? * clinical appearance? * Multiple drugs? * Severity is related to?

Answer 41

* 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

Question 42

how can med related ging hyper be resolved

Answer 42

cannot be reverted with hygiene, must perform gingevectomy or consult for new Rx

Question 43

common Rx of ging hyper

Answer 43

* Anticonvulsants– Dilantin (phenytoin) – 50% * Calcium channel blockers– Procardia (nifedipine) – 25% * Immunosupressants– Sandimmune (cyclosporin) – 25%

Question 44

medication related ging hyper histo may resemble? dif how?

Answer 44

may look like GCF with elongated rete pegs but does not have multi nuc giant cells

Question 45

Drug-Related Gingival Enlargement -Treatment

Answer 45

* Control local factors - anti-plaque agents (chlorhexidine) * Drug substitution * Drug therapy - folic acid, metronidazole, azithromycin * Surgical excision - gingivectomy