Developmental Disorders Flashcards
Commisural Lip pits occur in what % of the adult population?
Occur in 12-20% of adults
What are the characteristics of Commisural lip pits?
Unilateral or bilateral
1 to 4 mm in depth
Asymptomatic and innocuous
No treatment is generally necessary
what is a “double lip”?
Rare anomaly
Redundant fold of tissue on the mucosal side of the lip
Usually unnoticeable when lips at rest, but becomes visible when patient smiles
How do patients develop double lips? why would a dentist treat these lesions?
- Congenital vs. acquired origins
- Tx: excise for aesthetic purposes
_______________ are Ectopic (normal structure, wrong location) SEBACEOUS glands that occur on the oral mucosa
Fordyce Granules
T/F: Double lips and Fordyce Granules are statistically rare lesions
FALSE
over 80% of population has Fordyce Granules
name the clinical characteristics of Fordyce Granules:
- Multiple small yellow or whitish-yellow papules, often clustered together
- Most common locations: Buccal mucosa, upper lip vermilion
- Seen more frequently in adults than children
- NO treatment necessary
what is a “Leukoedema”? where are they most commonly found?
A) Diffuse grayish or milky white appearance to oral mucosa, with surface folds or wrinkles
B) BUCCAL mucosa most common, often BILATERAL
C) more common in smokers, dark skinned people
Describe the histology of Leukoedemas
fluid accumulation within the epithelial cells of the SPINOUS layer
how can a suspected Leukoedema be clinically confirmed?
whitish appearance disappears when the mucosa is stretched/distended
Describe MICROglossia:
characteristics, treatment, et cetera
Abnormally small tongue
relatively rare condition
May be a component of any one of several syndromes
Orthodontic care to manage collapsed dental arches
what conditions can cause MACROglossia?
Congenital or acquired
- Down syndrome, Beckwith-Wiedemann syndrome, vascular malformations, lymphangioma, amyloidosis, hypothyroidism
list the characteristics of Ankyloglossia:
Also known as “Tongue-tie”
Abbreviated or absent lingual frenum
2 to 4% of neonates
Speech problems are probably exaggerated
Frenectomy may be necessary if mucogingival stress is evident
_______________ is a rare developmental problem due to failure of migration of thyroid anlage
what group is at greatest risk for this condition?
Lingual Thyroid
WAY MORE common in FEMALES
in patients with lingual thyroids, there will be a mass in what location?
foramen cecum area
how can a lingual thyroid be diagnosed?
Diagnosis can be made by radioactive iodine scan
Biopsy may not be necessary
Evaluate for thyroid tissue in neck
why is the excision of a lingual thyroid more necessary in MALES?
risk for malignancy
Fissured Tongues are almost exclusively found in what population group?
Adults
what causes “coated tongue” (hairy tongue)?
how is it treated?
Elongation of the filiform papillae on the dorsal tongue (accumulation of keratin)
treated with use of tongue scraper
T/F: coated tongue is associated with smoking
true
in a patient with hairy/coated tongue, what can cause the papillae to become discolored?
Pigment-producing bacteria
Staining from tobacco
what are the characteristics of a “Varix”?
Abnormally dilated and tortuous veins (think varicose veins)
Often seen in older adults
Thought to be secondary to age-related degeneration or laxity in elastic support of vessel walls
where are Varix mostly found?
ventral and lateral tongue, buccal mucosa, labial mucosa, lip vermilion
SUBLINGUAL = most common site
how is a Diascopy test performed?
performed by applying pressure and observing color changes (vascular lesions will “blanch”)
why would you treat a Varix?
may undergo surgical excision to confirm diagnosis (due to thrombus formation) or for aesthetic purposes
A ___________ is the most common vascular abnormality
Caliber
Persistent Artery
Calibers are found almost exclusively in what are of the mouth?
lip mucosa
more common on upper lip
clinical features of a Caliber include:
Linear, arcuate, or papular lesion (“seagull in flight”)
Normal to bluish in color
Pulsation
No treatment necessary
what are Exostoses? name some common forms of these
- Benign bony protruberances
- Asymptomatic, unless secondarily traumatized
- examples: – buccal exostoses, torus palatinus, torus mandibularis
exostoses arise from what structure during development?
cortical plate
what are the main clinical concerns of a torus palatinus?
denture fabrication and traumatic ulcers (mucosa stretched thin and easy to ulcerate)
T/F: most mandibular tori (torus mandibularis) are bilateral in presentation
true
what type of tori are especially problematic when trying to take radiographs?
mandibular tori
list the characteristics of a “Stafne Defect”
A) AKA “Stafne cyst” and “lingual mandibular salivary gland defect”
B) Asymptomatic, discovered on routine panoramic radiograph
C) more prevalent in Adult males
what is the appearance of a Stafne defect in a radiograph?
- well-demarcated radiolucency
- below the mandibular canal
(radiolucency on border of posterior mandible)
what are the characteristics of Nasolabial Cysts?
- rare
- Upper lip, lateral to midline; along nasolabial groove
- The ala of the nose may be elevated
- 3:1 female-to-male ratio; 10% bilateral
why are nasiolabial cysts usually biopsied and removed?
risk for metaplasia
what type of epithelium typically lines a nasolabial cyst?
USUALLY pseudostratified columnar epithelial lining
_____________ are the most common non-odontogenic developmental cyst of the jaws
Incisive Canal Cyst
Incisive canal cysts develop from epithelial remnants of the _______________.
where do these cysts usually occur?
nasopalatine duct
Occurs at the apices of (usually vital) maxillary central incisors
what “classic” shape do most incisive canal cysts look like on radiographs?
“inverted pear” or “heart shaped” lesion
due to resistance from adj tooth roods and nasal spine
what is the presentation/cause of a cyst of the incisive papilla?
- its a type of incisive canal cyst
- the cyst may develop entirely within soft tissue with no bony involvement
- presents as swelling of the papilla
Epidermoid Cyst/Milia are caused by what? where are they usually found?
- characterized by production of orthokeratin by a cystic lining that resembles the epidermis
- Usually affect the skin: face or back
what is a “Milia”?
1) simply, very small epidermoid cysts
2) Often occur in clusters/multiple; periorbital location
3) Resolve spontaneously by self-marsupialization
list the characteristics of “Dermoid Cysts”
1) Uncommon; lined by epidermis-like epithelium
2) cyst wall contains ADNEXAL elements
3) Benign cystic form of TERATOMA
where are dermoid cysts usually found?
floor of mouth, usually midline
- Above geniohyoid-hard to swallow
- Below geniohyoid-looks like double chin
list the characteristics of Thyroglossal duct cycts
1) Rare; midline of the neck
2) arises from remnants of thyroglossal tract
3) 50% develop BEFORE 20 years of age
4) 2-10cm (most less than 3cm)
the “Sistrunk procedure” is used to treat what condition?
Thyroglossal duct cysts
- surgery removes cyst, plus part of hyoid bone
- prevents recurrence of cyst
________________ are a cervical variant of lymphoepithelial cyst
Branchial Cleft Cysts
what are the clinical signs of brachial cleft cysts?
Fluctuant swelling of lateral neck
Usually anterior to the sternocleidomastoid
Most are on left side
what type of cyst arises from epithelial rests trapped in oral lymphoid tissue?
Oral Lymphoepithelial Cyst
where are Oral lymphoepithelial cysts usually found?
- Waldeyer’s ring or accessory lymphoid aggregates
- floor of mouth (50%), ventro-lateral tongue, tonsillar pillar
what are the clinical features of oral lymphoepithelial cysts?
Soft to firm, white-yellow nodule
Usually
if the incisive canal is larger than ______mm, it is assumed to be an incisive canal cyst
larger than 6mm
what are the histological characteristics of brachial cleft cysts?
form of lymphoepithelial cyst
- lymphoid tissue in wall
- lined by pseudostratified epithelium
