Developmental Disorders Flashcards
Commissural Lip Pits
Occur in 12-20%, fairly common in adults
unilateral or bilateral?’
1-4mm in depth
asymptomatic and innocuous
no treatment is generally necessary
fairly common
both - most of the time found bilaterally though
kind of develop later in life
salivary dcts sometimes empty into them
Double Lip
rare anomaly
redundant fold of tissue on the _ side of the lip
congenital vs. acquired?
mucosal side
both - could be caused by biting and hyperplasia
usually unnoticeable when lips at rest, but becomes visible when patient smiles
Tx - may excise for aesthetic purposes
Ectopic (normal structure, wrong location) SEBACEOUS glands that occur on the oral mucosa
extremely common (reported in more than 80% of the population)
fordyce granules
sebaceous glands normally occur on skin associated with hair structures
Fordyce Granules - ectopic sebaceous glands
multiple small yellow or whitish-yellow papules, often clustered together
most common locations?
buccal mucosa, lip vermilion (exterior mucosa part of lip)
seen more frequently in adults than children (puberty may stimulate growth)
no treatment
Diffuse grayish or milky white appearance to oral mucosa, with surface folds or wrinkles
leukoedema
buccal mucosa most common, often bilateral
overall very common - especially in people with more melanin content in their skin - black population 70-80%
Histopathology - fluid accumulation within the epithelial cells of the spinous layer
whitish appearance disappears when the mucosa is stretched/distended (goes back to normal pink smooth surface)
leukoedema
buccal mucosa, bilateral
uncommon condition
abnormally small tongue
may be a component of any one of several syndromes
ortho care to manage collapsed dental arches
microglossia
the tongue is very important to develop the arch form
aglossia = complete absence of tongue
uncommon; enlargement of tongue may be caused by a wide variety of condition
congenital or acquired
down syndrome, Beckwith-Wiedemann, vascular malformations, lymphangioma, amyloidosis, hypothyroidism
macroglossia
aka tongue-tie
abbreviated or absent lingual frenum
2-10% of neonates
speech problems are probably exaggerated
ankyloglossia
speech problems are probably exaggerated
frenectomy may be necessary if mucogingival stress is evident
rare developmental problem due to failure of migration of thyroid anlage (base, embyro)
mass develops in foramen cecum area
females/males ?
lingual thyroid
could be only functioning thyroid gland!! biopsy often avoided
more common in females
consider excision in males - leads to thyroid cancer in males
dx - thyroid scan using radioactive iodine
fissured tongue
common variation of normal
seen in 5% of population (children and adults)
30% of older adults
varies in severity, from midline fissure to extensive arborized pattern)
tx? symptoms?
no tx necessary
usually no symptoms - so if hurting or something we need to be thinking something else
epithelium is intact
strong association with geographic tongue
20% of fissured tongue patients have this
yellowish whitish border that waxes and wanes in intensity, benign inflammatory condition
common condition - occurs 1-3% population
etiopathogenesis unknown; believed to be _ mediated
benign migratory glossitis
(geographic tongue, erythema migrans)
immune mediated
generally affects the tongue - but can also be in other spots
no tx
Coated Tongue (Hairy Tongue)
common condition
Elongation of the _ papillae on dorsal tongue (accumulation of keratin)
papillae can become discolored (pigment-producing bacteria, staining from tobacco)
tx?
filiform papillae
increase production or decreased removal of keratin
often associated with smoking
tx = none or tongue scraper
it is excess keration
abnormally dilated and tortuous veins
often seen in older adults
thought to be secondary to age-related degeneration or laxity in elastic support of vessel walls
varix
plural = varices
ventral and lateral tongue, buccal mucosa, labial mucosa, lip vermillion
sublingual varices - normal anatomy usually
buccal, labial, lip - pathology
may become secondarily thrombosed
no tx
what is a diascopy
put pressure (clear glass or plastic) to lesion and observe color change
varices - work because can push blood out of vessel
if a thrombosed varix - clot forms, dilates and diascopy doesn’t work) - so we surgically excise
if weren’t positive on Varix after diascopy- we excise because there are very similar looking clinically
DD may include
mucocele, salivary gland neoplasms (such as mucoepidermoid carcinoma), or melanotic macule
soft non-tender, salivary gland lesion - under mucosal surface, duct becomes injured and can’t excrete saliva
80% on lower lip
vascular appearance - blue purpleish
mucocele
80% - lower lip
common vascular anomaly
main arterial branch extends superficially, without reduction in its diameter
normally large diameter arteries are deep to surface
older adults - could be do to soft tissue relaxation
almost exclusively on lip mucosa - most common?
Caliber-Persistent Artery
upper>lower
midline upper lip most common
linear, arcuate, or papular lesion (seagull in flight)
normal to bluish in color
pulsation - unique feature
no tx
caliber-persistent artery
midline upper lip
benign bony protruberance
debated pathogeneis; genetic vs. environemtnal
it is multifactorial
asymptomaticm unless secondarily traumatized
Exostoses
buccal exostoses, torus palatinus, torus mandibularis
no tx generally necessary
surgical removal if repeatedly exposed to trauma or if getting removable prosthesis
can biopsy to confirm homogeneity in the bone
Adults, male predilection
asymptomatic, discovered on routine panoramic radiograph
well-demarcated radiolucency below the mandibular canal, posterior mandbile - houses salivary tissue
asymptomatic
Ct scan helps confirm the dx
Stafne Defect (Stafne cyst and lingual mandibular salivary gland depression) - not a true cyst
occasinally examples in the anterior mandible have been identified ( if here we are probably going to biospy)
these typically are not suspected clinically and are usually explored surgically
cavity or space lined by epithelium
cyst
rare soft tissue cyst, no radiographic change
adults; 3:1 female to male ratio
upper lip, lateral to midline, along nasolabial groove, 10% bilateral
the ala of the nose may be elevated
nasolabial cyst
soft tissue cyst - no hard tissue
lateral aspect of ala nost to commissure
Nasolabial Cyst
Tx - Biopsy, surgical removal, recurrence?
variable histopathology - pseudostratified ciliated columnar epithelial lining, cuboidal epithelium and squamous metaplasia not uncommon
recurrence is rare
