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Oral Path > Differential diagnosis ( kumar's review and Neviel Book) > Flashcards

Differential diagnosis ( kumar's review and Neviel Book) Flashcards

1
Q

Solitary pigmented
lesion

DDx

Kumar lecture

A
  1. Amalgam tattoo
  2. Melanocytic nevus
  3. Melanotic macule
  4. Post‐inflammatory melanosis
  5. Melanoma
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2
Q

Nodule on gingiva
(3P’s)

DDx

Kumar lecture

A
  • Pyogenic granuloma
  • Peripheral ossifying fibroma
  • Peripheral giant cell granuloma
  • Fibroma
  • Parulis (not interproximal though)
  • Gingival cyst (not interproximal though)
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3
Q

White Patch‐
Leukoplakia
(Oral Potentially
Malignant Disorder)

A

• Epithelial hyperplasia
• Epithelial hyperkeratosis
• Epithelial dysplasia
• Carcinoma‐in‐situ
• Squamous cell carcinoma
*Other white patches with an explanation (NOT OPMD)
• Hyperplastic candidiasis
• Frictional keratosis
• Oral hairy leukoplakia

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4
Q

Solitary non‐healing
ulcer

DDx

Kumar lecture

A
  • Squamous cell carcinoma
  • Traumatic ulcer
  • Fungal ulcer
  • Tuberculosis ulcer
  • Major aphthous ulcer (immune related)
  • Syphilitic chancre
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5
Q

Multilocular lesion

DDx

Kumar lecture

A

MACHO

  • M‐myxoma
  • A‐ameloblastoma
  • C‐central giant cell granuloma
  • H‐hemangioma
  • O‐odontogenic keratocyst
  • Cherubism (bilaterally)
  • Intra‐osseous mucoepidermoid carcinoma
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6
Q

Radiolucency at
apex of decayed
tooth

DDx

Kumar lecture

A
  • Periapical/radicular cyst
  • Periapical/radicular granuloma
  • Periapical/radicular abscess
  • Periapical/radicular scar
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7
Q

Well‐defined
radiolucency
around crown
impacted molar
post. md

DDx

Kumar lecture

A
  • D‐Dentigerous cyst
  • O‐Odontogenic keratocyst
  • A‐Ameloblastoma
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8
Q

Non‐ulcerated soft
tissue swelling in
tongue (or
submucosal)

DDx

Kumar lecture

A
  • Granular cell tumor
  • Neurofibroma
  • Neuroma
  • Schwannoma
  • Deep hemangioma
  • Fibroma
  • Deep lipoma
  • Include salivary gland neoplasm
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9
Q

Petechiae on palate

A
  • • Scarlet fever
  • • Infectious mononucleosis
  • • Trauma

• NOT nicotine stomatitis

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10
Q

Swollen tonsils

DDx

Kumar lecture

A
  • Infectious mononucleosis
  • Streptococcal tonsillitis
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11
Q

Palatal lesions

DDx

Kumar lecture

A
  • Necrotizing sialometaplasia
  • Nicotine stomatitis
  • Papillary hyperplasia of the palate
  • Denture stomatitis
  • Gumma
  • Median palatine cyst
  • Salivary gland tumor
  • Cocaine abuse
  • Leprosy
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12
Q

Swelling of palate
midline

DDx

Kumar Lecture

A

 Torus
 Median Palatal Cyst

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13
Q

Swelling of palate

DDx

Kumar Lecture

(not midline)

A

  • Pleomorphic adenoma
  • Adenoid cystic carcinoma (pain)
  • Mucoepidermoid carcinoma (blue hue)
  • Odontogenic tumor
  • Abscess
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14
Q

Skull film

DDx

Kumar Lecture

A
  • • Paget
  • • Sickle cell anemia
  • • Thalassemia
  • • Multiple myeloma
  • • Hand Schuller
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15
Q

Perioral crusts

DDx

Kumar Lecture

A
  • Impetigo (amber/cornflakes stuck on skin)
  • Recurrent herpes
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16
Q

Crops of coalescing
ulcers

A
  • Recurrent herpes on palate/gingiva ( infectious category)
  • Herpetiform aphthous (inflmatory category)
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17
Q

Conical teeth

DDx

Kumar Lecture

A
  • Ellis van Creveld (chondroectodermal dysplasia)
  • Hypohidrotic ectodermal dysplasia
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18
Q

Low Risk HPV
Tumors

A
  • Verruca vulgaris (common wart)
  • Squamous papilloma
  • Condyloma acuminatum
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19
Q

High risk HPV

DDx

Kumar Lecture

A
  • Oropharyngeal squamous cell carcinoma
  • Cervical cancer
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20
Q

Angular cheilitis
cause

A
  • Candida
  • Iron deficiency
  • B12 deficiency
  • Pernicious anemia
  • Folic acid deficiency
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21
Q

Multiple melanotic
macules

DDx

Kumar

A
  • Peutz Jeghers
  • Addison disease
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22
Q

Benign fibroosseous
lesions

DDx

Kumar

A
  • Central cemento‐ossifying fibroma (neoplasm)
  • Periapical cemento‐osseous dysplasia
  • Florid cemento‐osseous dysplasia
  • Focal cemento‐osseous dysplasia
  • Fibrous dysplasia
  • All have same histopathology therefore need an xray
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23
Q

Sun exposure

DDx

Kumar

A
  • Basal cell carcinoma
  • Actinic cheilitis
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24
Q

Recessive

DDx

Kumar

A
  • Papillon Lefevre (autosomal)
  • Chondroectodermal dysplasia (autosomal)
  • Hypophosphatasia (autosomal)
  • Hypohidrotic ectodermal dysplasia (X‐linked)
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25
Q

Café‐au‐lait
pigmentation

ddx

Kumar

A
  • Polyostotic fibrous dysplasia
  • Neurofibromatosis of von Recklinghausen
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26
Q

Looks like
periodontitis

DDx

Kumar

A
  • Langerhans cell disease
  • Papillon Lefevre
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27
Q

Teeth “floating in
air” in childrenalveolar
bone loss

DDx

A
  • Juvenile periodontitis
  • Langerhans cell disease
  • Papillon Lefevre
  • Cyclic neutropenia/Agranulocytosis
  • Burkitt’s lymphoma
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28
Q

Face/Angle swelling

List of dx

A
  • Sjogren (parotid)
  • Pleomorphic adenoma (parotid)
  • Warthin tumor (parotid)
  • Ameloblastoma (mandible)
  • Cherubism (bilateral)
  • Fibrous dysplasia (unilateral)
  • Mumps (bilateral usu.)
  • HIV (lymphoepithelial cysts)
  • Bulimia
  • Alcoholism
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29
Q

These are Intra osseous pathologies, what are the their Extra Osseous counterpart ?

• Lateral periodontal cyst
• Dentigerous cyst
• Central giant cell granuloma

A
  • Lateral periodontal cyst‐Gingival cyst
  • Dentigerous cyst‐Eruption cyst
  • Central giant cell granuloma‐Peripheral giant cell granuloma
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30
Q

Tumors that sound
benign but are
malignant

A
  • Melanoma
  • Lymphoma
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31
Q

Same under
microscope

ddx

A

• Congenital epulis

• Granular cell tumor

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32
Q

Desquamative
gingivitis

ddx

A

• Erosive lichen planus

• Mucous membrane pemphigoid

• Pemphigus vulgaris

• Erythema multiforme

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33
Q

What are the Differential for the following:
• Glossitis
• Angular cheilitis
• Atrophy of papillae on tongue
• Pallor

A

1) Iron deficiency anemia

2) Pernicious anemia

3) Folic acid and B12 deficiency

4) Celiac sprue

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34
Q

What are the Differential for
gingival bleeding?

A

• Aplastic anemia
• Polycythemia
• Leukemia
• Thrombocytopenic purpura
• Hemophilia

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35
Q

Drugs that cause
gingival
enlargement
(gingival hyperplasia)

A

• Cyclosporine
• Phenytoin
• Nifedipine

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36
Q

Gingival
enlargement

A

• Leukemia
• Drug induced

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37
Q

Associations
With what the following are assoiciated?
• Heart shape
• Scalloping
• Ghost teeth
• Ghost cells

A

• Heart shape‐Nasopalatine canal cyst
• Scalloping‐traumatic bone cyst
• Ghost teeth‐regional odontodysplasia
• Ghost cells‐calcifying odontogenic cyst

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38
Q

Associations
With what the following are assoiciated?

• X looks like a “t”
• Snow capped
• Pebbly
• Pearly doughnut with ulcer and telangiectactic blood vessels•

A

• X looks like a “t”‐Turner

• Snow capped‐amelogenesis imperfecta

• Pebbly‐Verrucous carcinoma, lymphangioma

• Pearly doughnut with ulcer and telangiectactic blood vessels‐basal cell carcinoma

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39
Q

Associations
With what the following are assoiciated?
• Swiss cheese
• Tennis raquet, step ladder
• Bag of marbles

A
  • Swiss cheese‐adenoid cystic carcinoma
  • Tennis raquet, step ladder‐myxoma
  • Bag of marbles‐compound odontoma
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40
Q

Associations
With what the following are assoiciated?

• Hair on end
• Mosaic jigsaw
• Cobblestone
• Sunray spiculated pattern

A
  • Hair on end‐thalassemia and sickle cell anemia
  • Mosaic jigsaw‐Paget histology
  • Cobblestone‐Crohn, papillary hyperplasia
  • Sunray spiculated pattern‐Osteosarcoma
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41
Q

Malignancy
Association
With what the following are assoiciated?
• Gardner syndrome
• Gorlin
• Multiple endocrine neoplasia
• Neurofibromatosis of von Recklinghausen

A

• Gardner syndrome‐Malignant GI polyps

  • Gorlin – Basal cell carcinoma
  • Multiple endocrine neoplasia –Medullary thyroid carcinoma
  • Neurofibromatosis of von Recklinghausen‐Malignant transformation of neurofibromas
42
Q

What we can find in the xray of the following?
• Amelogenesis imperfecta‐
• Dentinogenesis imperfecta‐
• Dentin dysplasia type 1
• Dentin dysplasia type 2

A

• Amelogenesis imperfecta‐ “crown preps” and taurodontism

• Dentinogenesis imperfecta‐bulbous crown no root canal, shell teeth

• Dentin dysplasia type 1‐ “rootless teeth”

• Dentin dysplasia type 2‐ “thistle tube”

43
Q

Polyps‐benign or
malignant?

• Gardner
• Peutz Jegher‐

A
  • Gardner (malignant)
  • Peutz Jegher (benign)
44
Q

What syndrom has Opalescent

• Teeth =
• Mucosa=

A
  • OpalescentTeeth=Dentinogenesis imperfecta and osteogenesis imperfecta
  • Opalescent Mucosa=Leukoedema
45
Q

What are other names for the followings?

**• Ellis van Creveld
• Gorlin
• Treacher Collin
**

A

  • Ellis van Creveld‐Chondroectodermal dysplasia
  • Gorlin‐Nevoid basal cell carcinoma

• Treacher Collin‐Mandibulofacial dysostosis
\

46
Q

What are other names for the followings?

• Osler Rendu Parkes Weber
• Canon
• Pindborg

A

  • Osler Rendu Parkes Weber – Hereditary hemorrhagic telangiectasia
  • Canon‐White sponge nevus
  • Pindborg tumor‐Calcifying epithelial odontogenic tumor
47
Q

The following cells are found when:

• Neutrophil –
• B lymphocyte –
• Plasma cell –

A
  • *•** Neutrophil – acute inflammation
  • *• B lymphocyte** – makes plasma cells (chronic)
  • *• Plasma cell** – makes antibodies (chronic)
48
Q

The following cells are found when:

• Macrophage –
• Eosinophil and Langerhan cell –
• Eosinophil‐
• Mast cell –

A

• Macrophage – phagocytosis (both acute and chronic)

• Eosinophil and Langerhans cell – Langerhans cell disease

• Eosinophil ‐ allergy

• Mast cell – allergy

49
Q

What are the synonymous names of the following

• Stafne bone cyst
• Traumatic bone cyst
• White sponge nevus

A

• Stafne bone cyst – Static bone cyst=saliv.gland

• Traumatic bone cyst –Simple bone cyst=empty

• White sponge nevus – Canon disease

50
Q

What are the synonymous names of the following:

• Gorlin syndrome
• Benign migratory glossitis
• Wart
• Canker sore
\

A

• Gorlin syndrome – Nevoid basal cell carcinoma syndrome

• Benign migratory glossitis – Geographic tongue –Erythema migrans

• Wart – Verruca vulgaris

• Canker sore – Minor aphthous ulcer

51
Q

What are the synonymous names of the following:

  • Dens in dente
  • Freckle
  • Birth mark
  • Mole
A

• Dens in dente – Dens invaginatus ‐Tooth within a tooth

  • Freckle‐Ephelis‐ Melanotic macule (NOT MACULE ALONE)
  • Birth mark‐Nevus‐Melanocytic nevus
  • Mole‐Melanocytic nevus
52
Q

What are Descriptive associations of the following:
• Explosive onset
• Gets larger and smaller
• Attached mucosa

A
  • Explosive onset – Erythema multiforme
  • Gets larger and smaller – mucocele
  • Attached mucosa – Recurrent herpes
53
Q

What are Descriptive associations of the following:

  • Movable mucosa
  • Urticaria
  • Angioedema
A

• Movable mucosa – Aphthous ulcers

• Urticaria – superficial

• Angioedema – deep

54
Q

What are Descriptive associations of the following:

  • Female/max/canine?
  • Compound odontoma
  • Complex odontoma
A

• Female/max/canine?‐Adenomatoid odontogenic tumor

• Compound odontoma‐anterior max

• Complex odontoma‐posterior md

55
Q

What are Descriptive associations of the following:

  • Yellow with superficial blood vessels
  • Most common malignant soft tissue tumor of head and neck children
  • Cluster of coalescing ulcers unilateral
A

• Yellow with superficial blood vessels‐lipoma

• Most common malignant soft tissue tumor of head and neck childrenrhabdomyosarcoma

• Cluster of coalescing ulcers unilateral‐recurrent intraoral herpes

56
Q

What are the following classic pics related to?
• Draining sinus at angle
• Loss of primary teeth
• Hole in palate

A

• Draining sinus at angle –actinomycosis

  • Loss of primary teeth‐ hypophosphatasia
  • Hole in palate‐Gumma
57
Q

Common Errors

A
  • Dysplasia‐microscopic term
  • Leukoplakia‐clinical term
  • Pericoronitis‐clinical term not radiographic
  • Varicella zoster virus‐chicken pox/herpes zoster
  • Oral hairy leukoplakia CORRUGATED‐ EBV
  • Mucocele (granulation tissue lined) vs mucous cyst (epithelial lined)
58
Q

White Lesions: Can Be Scraped Off

DDx

Bold and underlines most likely

Bold second most likely

italic least likely

Neivel book

A
  • White coated tongue May be scraped off slightly, with dif!culty
  • Pseudomembranous candidiasis “Milk curd” or “cottage cheese” appearance; may leave red base when rubbed off
  • Morsicatio Surface may appear to be peeling off
  • Toothpaste or mouthwash reaction Filmy whiteness; leaves normal appearing mucosa when rubbed off
  • Thermal burn Example: pizza burn
  • Sloughing traumatic lesion Example: cotton roll “burn”
  • Chemical burn Example: aspirin burn secondary to direct application for toothache
  • Secondary syphilis Mucous patch; may be only partially scraped off
  • Diphtheria Gray-white pseudomembrane of oropharynx
59
Q

White Lesions: Cannot Be Scraped Off

DDx

(long list just know what’s relevant to us)

Bold and underlines most likely

Bold second most likely

italic least likely

A
  • Linea alba Buccal mucosa along occlusal plane
  • Leukoedema Primarily in blacks; milky white alteration of buccal mucosa
    bilaterally; disappears when stretched
  • Leukoplakia May show benign hyperkeratosis, epithelial dysplasia, or invasive carcinoma
  • Tobacco pouch keratosis Usually in mandibular vestibule; associated with use of snuff or chewing tobacco
  • White coated tongue Diffuse involvement of dorsal tongue
  • Lichen planus Wickham’s striae; typically bilateral on buccal mucosa
  • Morsicatio Most common on anterior buccal mucosa, labial mucosa, and
    lateral border of tongue; exhibits ragged surface
  • Actinic cheilosis Pale, gray-white, scaly alteration of lower lip; usually in older men with history of chronic sun exposure; precancerous
  • Nicotine stomatitis Usually associated with pipe smoking; occurs on hard palate
  • Hairy leukoplakia Usually lateral border of tongue; rough surface with vertical !ssures; usually associated with HIV infection
  • Hyperplastic candidiasis Most commonly affects anterior buccal mucosa
  • Lupus erythematosus Most common on buccal mucosa; may mimic lichen planus or leukoplakia; associated skin lesions usually present
  • Skin graft History of previous surgery
  • Submucous fibrosis More common in South Asia; associated with betel quid chewing
  • White sponge nevus Hereditary; onset in childhood; generalized lesions, especially buccal mucosa
  • Hereditary benign intraepithelial dyskeratosis Hereditary; onset in childhood; generalized lesions, especially buccal mucosa; ocular involvement possible
  • Pachyonychia congenita Hereditary; onset in childhood; most common on dorsal tongue and areas of trauma; nail, palmar, and plantar changes also present
  • Dyskeratosis congenita Hereditary; onset in childhood; dystrophic nail changes
  • Uremic stomatitis Renal failur
60
Q

Red Lesions

Bold and underlines most likely

Bold second most likely

italic least likely

A
  • Pharyngitis Examples: strep throat, viral pharyngitis
  • Traumatic erythema Caused by local irritation
  • Denture stomatitis Denture-bearing palatal mucosa
  • Erythematous candidiasis Example: central papillary atrophy (median rhomboid glossitis)
  • Erythema migrans Geographic tongue (cases with absence of white borders); continually changing pattern; rarely involves other mucosal sites
  • Angular cheilitis Erythema and cracking at labial commissures
  • Thermal burns Example: caused by hot liquids
  • Erythroplakia Usually shows epithelial dysplasia or carcinoma
  • Anemia Atrophic, red tongue; can be due to pernicious anemia, ironde
    deficiency anemia, hypovitaminosis B
  • Hemangioma Develops in younger patients; may blanch; may show bluish hue
  • Lupus erythematosus Usually with associated skin lesions
  • Scarlet fever Secondary to B-hemolytic streptococcal infection; strawberry/ raspberry tongue
  • Plasma cell gingivitis Allergic reaction usually related to “avoring agents
  • Radiation mucositis Patient currently undergoing radiotherapy
61
Q

White and Red Lesions

DDx

Bold and underlines most likely

Bold second most likely

italic least likely

A
  • Erythema migrans Geographic tongue; continually changing pattern; rarely involves other oral mucosal sites
  • Candidiasis White component may be rubbed off
  • Lichen planus Atrophic or erosive forms; Wickham’s striae; typically bilateral on buccal mucosa
  • Burns Examples: pizza burn, aspirin burn, other chemical burns; white
    component may be rubbed off
  • Actinic cheilosis Pale, gray-white and red alteration to lower lip; usually in older men with history of chronic sun exposure
  • Erythroleukoplakia Usually shows epithelial dysplasia or carcinoma
  • Cinnamon reaction Related to cinnamon “avored gum; typically on buccal mucosa and lateral tongue
  • Nicotine stomatitis Usually associated with pipe smoking; occurs on hard palate
  • Lupus erythematosus Most common on buccal mucosa; may mimic lichen planus or leukoplakia; associated skin lesions usually present
  • Scarlet fever Secondary to B-hemolytic streptococcal infection; strawberry/ raspberry tongue
  • Verruciform xanthoma Most common on gingiva and hard palate; surface may be papillary
62
Q

Yellow Lesions

ddx

A
  • Fordyce granules Sebaceous glands; usually multiple submucosal papules on buccal mucosa or upper lip vermilion
  • Super facial abscess Example: parulis from nonvital tooth
  • Accessory lymphoid aggregate Most common in oropharynx and “oor of mouth; may exhibit orange hue
  • Lymphoepithelial cyst Most common on lingual and palatine tonsils, and “oor of mouth;
  • may be yellow-white
  • Lipoma Most common on buccal mucosa; soft to palpation 488
  • Jaundice Generalized discoloration, especially involving soft palate and “ floor of mouth; sclera usually affected also
  • Verruciform xanthoma Most common on gingiva and hard palate; surface may be rough or papillary
  • Pyostomatitis vegetans “Snail-track” pustules; associated with in”ammatory bowel disease
63
Q

Blue and/or Purple Lesions

A
  • Varicosities Especially after 45 years of age; most common on ventral tongue and lips
  • Submucosal hemorrhage Petechial, Ecchymotic, and Telangiectatic Lesions
  • Amalgam tattoo Most common on gingiva; blue-gray; radiopaque amalgam particles sometimes discovered on radiographs
  • Mucocele Especially on lower labial mucosa; typically pale blue; cyclic swelling and rupturing often exhibited
  • Eruption cyst Overlying an erupting tooth
  • Salivary duct cyst Usually pale blue
  • Hemangioma Usually red-purple; may blanch under pressure; onset in younger patients
  • Ranula Pale blue, “uctuant swelling of lateral “oor of mouth
  • Kaposi sarcoma Especially in AIDS patients; usually purple; most common on palate and maxillary gingiva
  • Nasopalatine duct cyst Midline of anterior palate
  • Salivary gland tumors Especially mucoepidermoid carcinoma and pleomorphic adenoma; usually pale blue; most common on posterior lateral palate
  • Gingival cyst of the adult Most common in mandibular bicuspid-cuspid region
  • Blue nevus Most common on hard palate
64
Q

Soft Tissue Masses (Lumps and Bumps): Midline Neck Lesions

DDX

A
  • Thyroid gland enlargement Examples: goiter, thyroid tumor
  • Thyroglossal duct cyst May move up and down with tongue motion
  • Dermoid cyst Soft and fluctuant
  • Plunging ranula Soft and compressible
65
Q

Brown, Gray, and/or Black Lesions

A
  • Racial pigmentation Most common on attached gingiva in darker complexioned patients
  • Amalgam tattoo Most common on gingiva; usually slate-gray to black; opaque amalgam particles may be found on radiographs
  • Black/brown hairy tongue Discoloration and elongation of filiform papillae
  • Melanotic macule Brown; most common on lower lip
  • Smoker’s melanosis Most common on anterior facial gingiva
  • Non-amalgam tattoo Example: graphite from pencil
  • Melanocytic nevus Most common on hard palate; can beflat or raised
  • Melanoma Most common on hard palate and maxillary gingiva; may show mixture of deep blue, brown, black, and other colors
  • Oral melanoacanthoma Rapidly enlarging pigmented lesion; usually occurs in blacks
  • Drug ingestion Examples: chloroquine, chlorpromazine, minocycline; especially on hard palate
  • Peutz-Jeghers syndrome Freckle-like lesions of vermilion and perioral skin; intestinal polyps; hereditary
  • Addison disease Chronic adrenal insuf!ciency; associated with bronzing of skin
  • Neuro!bromatosis type I Café au lait pigmentation; cutaneous neuro!bromas
  • McCune-Albright syndrome Café au lait pigmentation; polyostotic !brous dysplasia; endocrine disorders
  • Heavy metal poisoning Typically along marginal gingiva (e.g., lead, bismuth, silver)
  • Melanotic neuroectodermal tumor of infancy:Anterior maxilla; destroys underlying bone
66
Q

Papillary Growths: Focal or Diffuse

A
  • Hairy tongue Usually brown or black discoloration; hyperkeratotic elongation of !liform papillae on posterior dorsal tongue
  • Papilloma Can be white or pink; most common on soft palate and tongue; usually pedunculated
  • Inflammatory papillary hyperplasia Usually involves midportion of hard palate beneath denture
  • Leukoplakia (some variants) Examples: proliferative verrucous leukoplakia, granular or nodular
    leukoplakia
  • Squamous cell carcinoma Examples with papillary surface changes
  • Giant cell fibroma Usually in children and young adults; most common on gingiva
  • Verruca vulgaris Common wart; especially in younger patients; most common on labial mucosa
  • Hairy leukoplakia Usually lateral border of tongue; rough surface with vertical fissures; usually associated with HIV infection
  • Verruciform xanthoma Most common on gingiva and hard palate
  • Verrucous carcinoma Especially in older patients with long history of snuff or chewing tobacco use; especially in mandibular vestibule and buccal mucosa; may be white or red
  • Condyloma acuminatum Venereal wart; broad-based lesions with blunted projections; frequently multiple
  • Multifocal epithelial hyperplasia Usually multiple, “at-topped papular lesions; usually in children; most common in Native Americans and Inuit; color may vary from normal to white
  • Darier’s disease Most commonly appears as pebbly appearance of hard palate; associated crusty, greasy skin lesions; hereditary
  • Acanthosis nigricans (malignant type) Most commonly appears as generalized pebbly alteration of upper lip; pigmented, pebbly skin changes
67
Q

Petechial, Ecchymotic, and Telangiectatic Lesions

DDx

Bold and underlines most likely

Bold second most likely

italic least likely

A
  • Nonspecific trauma History of injury to lesional site
  • Upper respiratory infections Soft palate petechiae
  • Infectious mononucleosis Soft palate petechiae; tonsillitis and/or pharyngitis may be present
  • Idiopathic thrombocytopenic purpura Areas of trauma; gingival bleeding possibly present
  • Trauma from fellatio Posterior palatal petechiae or ecchymosis
  • Hemophilia Hereditary; childhood onset; gingival bleeding may be present
  • Leukemia Caused by secondary thrombocytopenia; gingival bleeding may be present
  • Hereditary hemorrhagic telangiectasia Multiple, pinhead-sized telangiectasias; possible history of nosebleeds or gastrointestinal bleeding
  • CREST syndrome Multiple, pinhead-sized telangiectasias; Calcinosis cutis, Raynaud’s phenomenon, Esophageal motility defect, Sclerodactyly, Telangiectasias
68
Q

Generalized Gingival Enlargement

A
  • Hyperplastic gingivitis Examples: associated with puberty, pregnancy, diabetes
  • Drug-related gingival hyperplasia Examples: phenytoin, calcium-channel blockers, cyclosporine; may be fibrotic
  • Gingival fibromatosis May be hereditary; onset in childhood
  • Leukemic infiltrate Usually boggy and hemorrhagic
  • Wegener granulomatosis “Strawberry” gingivitis; may have palatal ulceration and destruction; lung and kidney involvement
  • Scurvy Vitamin C deficiency
69
Q

Vesiculoerosive and Ulcerative Lesions: Acute (Short Duration and Sudden Onset)

DDx

A
  • Traumatic ulcer Mild-to-moderate pain; history of local trauma
  • Aphthous stomatitis Extremely painful; may be single or multiple; nonkeratinized movable mucosa; often recurs
  • Recurrent herpes labialis Vermilion and labial skin; begins as multiple vesicles; often recurs
  • Primary herpetic gingivostomatitis Fever and malaise; children and young adults; multiple vesicles; gingiva consistently affect
  • Necrotizing ulcerative gingivitis (NUG) Painful destruction of gingival papillae; fetid odor; mostly in teenagers and young adults
    Mucosal burns Chemical or thermal
  • Recurrent intraoral herpes simplex Gingiva or hard palate (except in immunocompromised); focal cluster of vesicles and shallow ulcers
  • Allergic reactions Example: Caused by topical medications or dental materials;
    erythema and vesicles
  • Erythema multiforme / Stevens-Johnson syndrome
    Predominantly in children and young adults; multiple blisters and
    ulcers; often crusting, hemorrhagic lip lesions; may have
    associated “target” skin lesions or involvement of ocular and
    genital mucosa
  • Herpangina Especially in children; multiple small ulcers on soft palate and tonsillar pillars
  • Varicella (chickenpox) Associated with skin eruption; few oral vesicles and ulcers; usually in children
  • Herpes zoster Unilateral involvement along nerve distribution; usually middle-aged and older adults; painful vesicles and ulcers
  • Hand-foot-and-mouth disease Especially in children; multiple vesicles and ulcers; associated vesicles on hands and feet
  • Necrotizing sialometaplasia Usually posterior lateral hard palate; prior swelling may be present; deep crater-like ulcer; may be only minimal pain
  • Anesthetic necrosis Usually at site of palatal injection
  • Primary syphilis Chancre at site of inoculation; usually painless with lean ulcer bed
  • Behçet syndrome Aphthous-like ulcers; genital ulcers and ocular in”ammation
70
Q

Vesiculoerosive and Ulcerative Lesions: Chronic (Long Duration)

A
  • Erosive lichen planus Associated with white striae; usually in middle-aged and older adults; most common on buccal mucosa and gingiva
  • (“desquamative gingivitis”)
  • Traumatic granuloma Solitary, non-healing ulcer
  • Squamous cell carcinoma Usually in middle-aged and older adults; usually indurated and may have rolled border; may be painless
  • Mucous membrane pemphigoid Most common in middle-aged and older women; most commonly presents as a “desquamative gingivitis”; may involve ocular and genital mucosa
  • Lupus erythematosus May have associated red and white change; usually with skin involvement
  • Pemphigus vulgaris Usually in middle-aged and older patients; multiple oral blisters and ulcers usually precede skin lesions
  • Deep fungal infections Examples: histoplasmosis, blastomycosis; may be painless
  • Tuberculosis Associated mass may be present; may be painless
  • Sarcoidosis May be associated with erythematous macules or plaques; may be painless
  • Epidermolysis bullosa Hereditary (except epidermolysis bullosa acquisita); onset in infancy and childhood; multiple skin and oral blisters or ulcers in areas of trauma; may result in extensive scarring
  • Pyostomatitis vegetans Yellowish “snail-track” pustules; associated with in”ammatory bowel disease
  • Wegener granulomatosis Usually palatal ulceration and destruction; associated lung and kidney involvement may be present; may show “strawberry gingivitis”
  • Extranodal NK/T-cell lymphoma, nasal-type (midline lethal granuloma) Palatal lymphoma with ulceration and destruction of underlying bone; may be painless
  • Noma Gangrenous necrosis secondary to necrotizing ulcerative gingivitis; usually in malnourished children or immunocompromised
  • individuals
  • Tertiary syphilis Gumma; associated mass may be present; may be painless; may perforate palate
71
Q

Soft Tissue Masses (Lumps and Bumps): Hard or Soft Palate

DDx

A
  • Palatal abscess Associated with nonvital tooth
  • Leaf-like denture fibroma Pedunculated hyperplastic growth beneath ill-fitting denture
  • Salivary gland tumors Especially pleomorphic adenoma, mucoepidermoid carcinoma,
  • adenoid cystic carcinoma, polymorphous low-gradeadenocarcinoma; may have bluish hue
  • Nasopalatine duct cyst Fluctuant swelling of anterior midline palate
  • Lymphoma Often boggy and edematous; may have bluish hue; may be
    bilateral
  • Kaposi sarcoma Usually purple; may be multiple; usually associated with AIDS
  • Other mesenchymal tumors Examples: fibroma, hemangioma, neurofibroma
  • Squamous cell carcinoma Tumor with rough, granular, irregular surface; occasionally arises from maxillary sinus
  • Mucocele/salivary duct cyst Usually has bluish hue
  • Melanocytic nevus/ melanoma Usually pigmented
  • Necrotizing sialometaplasia Early stage lesion; often associated with pain or paresthesia
  • Adenomatoid hyperplasia of minor salivary glands Asymptomatic, painless mass
72
Q

Soft Tissue Masses (Lumps and Bumps): Tongue

A
  • Fibroma Usually normal in color; most common on margins of tongue
  • Squamous cell carcinoma Tumor with rough, granular, irregular surface; usually lateral or ventral border
  • Mucocele Usually anterior ventral surface; usually bluish or clear color
  • Pyogenic granuloma Usually red, ulcerated, easily bleeding
  • Granular cell tumor Dome-shaped; usually on dorsum of tongue
  • Other mesenchymal tumors Examples: lymphangioma, hemangioma, neurofibroma, osseous choristoma
  • Salivary gland tumors Especially mucoepidermoid carcinoma and adenoid cystic carcinoma
  • Lingual thyroid Usually posterior midline of dorsal surface; usually in women
73
Q

Soft Tissue Masses (Lumps and Bumps): Floor of Mouth

A
  • Ranula/mucocele Typically a pale blue, “uctuant swelling
  • Sialolith Usually hard mass in submandibular duct; may be associated with tender swelling of affected gland; radiopaque mass
  • Lymphoepithelial cyst Small, yellow-white submucosal lesion
  • Squamous cell carcinoma Tumor with rough, granular, irregular surface
  • Epidermoid or dermoid cyst Midline yellow-white submucosal lesion
  • Salivary gland tumors Especially mucoepidermoid carcinoma
  • Mesenchymal tumors Examples: lipoma, neuro!broma, hemangioma
74
Q

Soft Tissue Masses (Lumps and Bumps): Gingiva/Alveolar Mucosa

A
  • Parulis Fistula from nonvital tooth
  • Epulis fissuratum Ill-fitting denture
  • Pyogenic granuloma Usually red, ulcerated, easily bleeding; increased frequency in pregnant women
  • Peripheral ossifying fibroma May be red or normal in color; may be ulcerated
  • Fibroma Usually normal in color
  • Peripheral giant cell granuloma Reddish purple; frequently ulcerated
  • Squamous cell carcinoma Tumor with rough, granular, irregular surface
  • Metastatic tumors May be painful and destroy bone
  • Gingival cyst of the adult Most common in mandibular bicuspid-cuspid region; may be blue
  • Traumatic neuroma Edentulous mandible in mental foramen area; often painful to palpation
  • Kaposi sarcoma Especially in AIDS patients; usually purple
  • Peripheral odontogenic tumors Example: peripheral ameloblastoma
  • Congenital epulis Usually in females; especially anterior maxilla 50
  • Melanotic neuroectodermal tumor of infancy Anterior maxilla; destroys underlying bone; may be pigmented
  • Other mesenchymal tumors Examples: hemangioma, neuro!broma
75
Q

Soft Tissue Masses (Lumps and Bumps): Buccal Mucosa

A
  • Fibroma Usually normal in color; along occlusal plane
  • Lipoma May be yellow; soft to palpation
  • Mucocele Typically pale blue; often exhibits cyclic swelling and rupturing
  • Hyperplastic lymph node Usually buccinator node; movable submucosal mass
  • Other mesenchymal tumors, Examples: hemangioma, neuro!broma Chapter
  • Squamous cell carcinoma Tumor with rough, granular, irregular surface
  • Salivary gland tumor Pleomorphic adenoma and mucoepidermoid carcinoma most common
76
Q

Soft Tissue Masses (Lumps and Bumps): Upper Lip

A
  • Fibroma Usually normal in color
  • Minor gland sialolith Small, hard submucosal mass: may be tender
  • Salivary gland tumor Usually canalicular adenoma (older than age 40) or pleomorphic adenoma (younger than age 40)
  • Salivary duct cyst May be bluish
  • Other mesenchymal tumors Examples: hemangioma, neuro!broma, schwannoma
  • Nasolabial cyst Fluctuant swelling of lateral labial vestibule
77
Q

Soft Tissue Masses (Lumps and Bumps): Lateral Neck Lesions

Bold and underlines most likely

Bold second most likely

italic least likely

A
  • Reactive lymphadenopathy Secondary to oral and maxillofacial infection; often tender to palpation
  • Epidermoid cyst Soft and movable
  • Lipoma Soft mass
  • Metastatic carcinoma Deposits from oral and pharyngeal carcinomas; usually indurated and painless; may be fixed
  • Lymphoma May be unilateral or bilateral; usually painless; Hodgkin and non-Hodgkin types
  • Infectious mononucleosis Fatigue; sore throat; tender lymph nodes
  • Salivary gland tumors Arising from submandibular gland or tail of parotid gland
  • Submandibular sialadenitis Example: secondary to sialolithiasis
  • Branchial cleft cyst Soft and “uctuant; most common in young adults
  • Granulomatous diseases Examples: tuberculosis, sarcoidosis
  • Cat-scratch disease History of exposure to cat
  • Cystic hygroma Infants; soft and “uctuant
  • Plunging ranula Soft and compressible
  • Other mesenchymal tumors Examples: neuro!broma, carotid body tumor
78
Q

Soft Tissue Masses (Lumps and Bumps): Lower Lip

A
  • Mucocele Typically pale blue; often exhibits cyclic swelling and rupturing; labial mucosa only
  • Fibroma Usually normal in color
  • Pyogenic granuloma Red, ulcerated, bleeds easily; usually on vermilion border
  • Squamous cell carcinoma Tumor with rough, granular, irregular surface; usually on vermilion border
  • Other mesenchymal tumors Examples: hemangioma, neuro!broma, lipoma Chapter
  • Salivary duct cyst May be bluish; labial mucosa only
  • Salivary gland tumor Usually mucoepidermoid carcinoma Chapter
  • Keratoacanthoma Volcano-shaped mass with central keratin plug; rapid development; vermilion border only
79
Q

Unilocular Radiolucencies: Pericoronal Location

A
  • Hyperplastic dental follicle 5 mm in thickness
  • Eruption cyst Bluish swelling overlying erupting tooth
  • Odontogenic keratocyst —
  • Orthokeratinized odontogenic cyst —
  • Ameloblastoma Especially unicystic type
  • Ameloblastic fibroma Usually in younger patients
  • Adenomatoid odontogenic tumor Usually in anterior region of jaws; most often with maxillary canine; usually in teenagers
  • Calcifying odontogenic cyst Gorlin cyst
  • Carcinoma arising in dentigerous cyst Mostly in older adults
  • Intraosseous mucoepidermoid carcinoma Mostly in posterior mandible
  • Other odontogenic lesions Examples: calcifying epithelial odontogenic tumor, odontogenic myxoma, central odontogenic !broma
80
Q

Unilocular Radiolucencies: Other Locations

ddx

A
  • Developing tooth bud Within alveolar bone —
  • Lateral radicular cyst Nonvital tooth; lateral canal
  • Nasopalatine duct cyst Between and apical to maxillary central incisors; palatal swelling may occur
  • Lateral periodontal cyst Especially in mandibular bicuspid-cuspid region
  • Residual (periapical) cyst Edentulous area
  • Odontogenic keratocyst —
  • Central giant cell granuloma Especially in anterior mandible
  • Stafne bone defect Angle of mandible below mandibular canal
  • Cemento-osseous dysplasia Early stage; usually in young adult and middle-aged black women; usually in mandible
  • Central ossifying !broma Early-stage lesion
  • Ameloblastoma Especially unicystic type
  • Buccal bifurcation cyst Buccal aspect of erupting mandibular !rst or second molar
  • Other odontogenic cysts and tumors Examples: ameloblastic !broma, central odontogenic fibroma, calcifying odontogenic cyst Chapter
  • Langerhans cell histiocytosis “Histiocytosis X”; usually in children or young adults
  • Melanotic neuroectodermal tumor of infancy Anterior maxilla; may be pigmented
  • Median palatal cyst Clinical midline swelling of hard palate
  • Schwannoma/ neurofibroma Usually associated with mandibular nerve
81
Q

Multilocular Radiolucencies

A
  • Odontogenic keratocyst —
  • Ameloblastoma Especially in posterior mandible; often associated with impacted tooth
  • Central giant cell granuloma Especially in anterior mandible
  • Ameloblastic fibroma Especially in young patients
  • Odontogenic myxoma “Cobweb” trabeculation 679 * Central odontogenic !broma —
  • Calcifying epithelial odontogenic tumor Often associated with impacted tooth
  • Orthokeratinized odontogenic cyst Often associated with impacted tooth
  • Lateral periodontal cyst (botryoid type) Especially in mandibular bicuspid-causpid region
  • Calcifying odontogenic cyst Especially in cases with minimal or no calcifications; often associated with impacted tooth
  • Central hemangioma/ arteriovenous malformation Especially in younger patients; may have honeycombed radiographic appearance; may pulsate
  • Aneurysmal bone cyst Especially in younger patients
  • Cherubism Hereditary; onset in childhood; multiple quadrants involved
  • Hyperparathyroidism (brown tumor) Usually elevated serum calcium levels
  • Intraosseous mucoepidermoid carcinoma Usually in posterior mandible
  • Fibrous dysplasia Very rarely on panoramic !lms of mandibular lesions
82
Q

Unilocular Radiolucencies:Periapical Location

DDX

A
  • Periapical granuloma Nonvital tooth
  • Periapical cyst Nonvital tooth
  • Periapical cementoosseous dysplasia (early) Especially in black females; usually apical to mandibular anteriors; teeth are vital
  • Periapical scar Usually endodontically treated tooth with destruction of cortical plate
  • Dentin dysplasia type I Multiple periapical granulomas or cysts; shortened, malformed roots
83
Q

Radiolucencies: Poorly Defined or Ragged Borders

DDx

Bold and underlines most likely

Bold second most likely

italic least likely

A
  • Periapical granuloma or cyst Nonvital tooth
  • Focal osteoporotic marrow defect Especially edentulous areas in posterior mandible; more common in females
  • Osteomyelitis Usually painful or tender
  • Medication-related osteonecrosis of the jaw Exposed necrotic bone; most often associated with bisphosphonate drugs
  • Simple bone cyst Mandibular lesion that scallops up between roots of teeth; usually in younger patients
  • Metastatic tumors Painful; paresthesia; usually in older adults
  • Osteoradionecrosis History of radiation therapy; painful
  • Multiple myeloma May be painful; in older adults
  • Primary intraosseous carcinomas Odontogenic or salivary origin
  • Osteosarcoma Often painful; usually in young adults
  • Chondrosarcoma —
  • Ewing sarcoma Usually in children
  • Other primary bone malignancies Examples: !brosarcoma, lymphoma —
  • Desmoplastic fibroma of bone Especially in younger patients
  • Massive osteolysis Phantom (vanishing) bone disease
84
Q

Radiopacities: Poorly Demarcated Borders

DDx

A
  • Cemento-osseous dysplasia Late stage lesions; especially in middle-aged and older black women; usually in mandible
  • Medication-related osteonecrosis of the jaw Sclerosis of alveolar crestal bone; exposed necrotic bone; most often associated with bisphosphonate drugs
  • Condensing osteitis Usually at apex of nonvital tooth
  • Sclerosing osteomyelitis May be painful
  • Fibrous dysplasia “Ground glass” appearance; onset usually in younger patients
  • Paget disease of bone “Cotton wool” appearance; late-stage lesions; in older patients
  • Proliferative periostitis “Onion-skin” cortical change; in younger patients; often associated
  • with nonvital tooth
  • Osteosarcoma May have “sunburst” cortical change; frequently painful; usually in young adults
  • Chondrosarcoma —
85
Q

Radiopacities: Multifocal or Generalized

DDx

A
  • Florid cemento-osseous dysplasia Late-stage lesions; especially in middle-aged and older black women; usually in mandible
  • Medication-related osteonecrosis of the jaw Multifocal sites of involvement; sclerosis of alveolar crestal bone; exposed necrotic bone; most often associated with bisphosphonate drugs
  • Idiopathic osteosclerosis Occasionally may be multifocal
  • Paget disease of bone “Cotton wool” appearance; late-stage lesions; in older patients; more common in maxilla
  • Gardner syndrome Multiple osteomas; epidermoid cysts; gastrointestinal polyps with high tendency toward malignant transformation; hereditary
  • Polyostotic fibrous dysplasia “Ground glass” appearance; onset usually in younger patients; may be associated with café au lait skin pigmentation and endocrine abnormalities (McCune-Albright syndrome)
  • Osteopetrosis Hereditary; recessive form may be associated with secondary osteomyelitis, visual and hearing impairment
86
Q

Mixed Radiolucent/Radiopaque Lesions: Well-Demarcated Borders

A
  • Developing tooth —
  • Cemento-osseous dysplasia Intermediate-stage lesions; especially in middle-aged black women; usually in mandible
  • Odontoma Compound or complex type; in younger patients; may prevent eruption of teeth
  • Central ossifying fibroma —
  • Ameloblastic fibroodontoma Usually in children
  • Adenomatoid odontogenic tumor Usually in anterior region of jaws; most often with maxillary canine; usually in teenagers
  • Calcifying epithelial odontogenic tumor Pindborg tumor; often associated with impacted tooth; may show “driven snow” opacities
  • Calcifying odontogenic cyst Gorlin cyst; may be associated with odontoma
  • Osteoblastoma/osteoid osteoma Intermediate-stage lesion; usually in younger patients; often painful
  • Cementoblastoma Intermediate-stage lesion; attached to tooth root
87
Q

Mixed Radiolucent/Radiopaque Lesions: Poorly Demarcated borders

A
  • Medication-related osteonecrosis of the jaw Exposed necrotic bone; most often associated with bisphosphonate drugs
  • Osteomyelitis With sequestrum formation or with sclerosing type; often painful
  • Metastatic carcinoma Especially prostate and breast carcinomas; may be painful
  • Osteosarcoma/ chondrosarcoma May be painful
88
Q

Mixed Radiolucent/Radiopaque Lesions: Multifocal or Generalized

DDx

A
  • Florid cemento-osseous dysplasia Intermediate-stage lesions; especially in middle-aged black women; usually in mandible
  • Medication-related osteonecrosis of the jaw Exposed necrotic bone; most often associated with bisphosphonate drugs
  • Paget disease of bone In older patients; more common in maxilla
89
Q

Unique Radiographic Appearances: “Ground Glass” (Frosted Glass) Radiopacities

A
  • Fibrous dysplasia Onset usually in younger patients
  • Hyperparathyroidism May cause loss of lamina dura
90
Q

Unique Radiographic Appearances: “Cotton Wool” Radiopacities

Ddx

A
  • Cemento-osseous dysplasia Especially in middle-aged black women; usually in mandible
  • Paget disease of bone In older patients; more common in maxilla
  • Gardner syndrome Multiple osteomas; epidermoid cysts; gastrointestinal polyps with high tendency toward malignant transformation; hereditary
  • Gigantiform cementoma Hereditary; facial enlargement may be present
91
Q

Unique Radiographic Appearances: “Sunburst” Radiopacities

A
  • Osteosarcoma Often painful; usually in young adults
  • Intraosseous hemangioma Especially in younger patients
92
Q

Unique Radiographic Appearances: “Onion-Skin” Radiopacities

DDx

A
  • Proliferative periostitis In younger patients; often associated with nonvital tooth; best seen with occlusal radiograph
  • Ewing sarcoma In young children
  • Langerhans cell histiocytosis “Histiocytosis X”; usually in children or young adults
93
Q

Soft Tissue Radiopacities

A
  • Amalgam tattoo Markedly radiopaque; associated with surface discoloration
  • Other foreign bodies Examples: bullet fragments, shotgun pellets —
  • Sialolith Glandular pain may be present while patient is eating
  • Tonsilloliths Superimposed on mandibular ramus
  • Phlebolith May occur in varicosities or hemangiomas
  • Calcified lymph nodes Example: tuberculosis
  • Osseous and cartilaginous choristomas Most common on tongue
  • Calcinosis cutis May be seen with systemic sclerosis (especially CREST syndrome)
  • Myositis ossificans Reactive calcification in muscle
94
Q

Hyperdontia (Extra Teeth)

DDx

A
  • Idiopathic supernumerary teeth Mesiodens, paramolar, distomolar
  • Cleft lip and palate Extra lateral incisor or canine 1
  • Gardner syndrome Osteomas and gastrointestinal polyps
  • Cleidocranial dysplasia Hypoplastic or missing clavicles; failure of tooth eruption
95
Q

Macrodontia (Larger Than Normal Teeth)

A
  • Fusion Joining of two tooth germs
  • Gemination Incomplete splitting of a tooth germ
  • Idiopathic macrodontia —
  • Facial hemihyperplasia* Affected side only; nondental tissues also enlarged
  • Gigantism Abnormally tall stature
96
Q

Microdontia (Smaller Than Normal Teeth)

DDx

A
  • Supernumerary teeth Mesiodens; fourth molars
  • Peg-shaped lateral incisors Cone-shaped teeth
  • Dens invaginatus Cone-shaped teeth; tendency for pulpal death and periapical pathosis
  • Idiopathic microdontia Usually generalized
  • Hereditary hypohidrotic ectodermal dysplasia
  • Cone-shaped teeth; sparse, blond hair; diminished sweating
  • Radiotherapy during childhood Stunted tooth development
  • Congenital syphilis Hutchinson’s incisors
  • Hypopituitarism Associated dwarfism
97
Q

Malformed Crown

DDx

A
  • Mesiodens and other supernumeraries Cone-shaped teeth or microdont
  • Environmental enamel hypoplasia Example: high fever during tooth development
  • Peg-shaped lateral incisors Cone-shaped teeth
  • Dens invaginatus Cone-shaped teeth; tendency toward pulpal death and periapical pathosis
  • Turner tooth Infection or trauma to associated primary tooth
  • Fusion or gemination “Double” tooth
  • Talon cusp Extra cusp on lingual of anterior tooth
  • Dens evaginatus Extra cusp on occlusal of premolar tooth
  • Amelogenesis imperfecta Hereditary defect in enamel formation
  • Dentinogenesis imperfecta Fracturing away of enamel due to hereditary defect in dentin formation; gray-yellow opalescent teeth; calcified pulp chambers
  • Regional odontodysplasia Poor tooth formation in a focal area; “ghost teeth”
  • Congenital syphilis Hutchinson’s incisors; mulberry molars
  • Vitamin D–resistant rickets Hereditary condition; high pulp horns
  • Renal osteodystrophy Abnormal calcium and phosphate metabolism
  • Hypoparathyroidism Possible associated endocrine-candidiasis syndrome
  • Pseudohypoparathyroidism —
  • Epidermolysis bullosa Hereditary blistering skin disease
  • Radiotherapy during childhood Stunted tooth development
  • Globodontia Associated with otodental syndrome
  • Lobodontia Cusp anatomy resembles teeth of carnivores
98
Q

Enamel Loss After Tooth Formation

A

F. Enamel Loss After Tooth Formation
*** Caries — —
*** Trauma Fractured tooth —
*** Attrition Physiologic loss of tooth structure 55
*** Abrasion Pathologic loss of tooth structure 56
** Erosion Chemical loss of tooth structure 56
* Dentinogenesis imperfecta Hereditary defect in dentin formation; poor junction between
enamel and dentin
98
* Amelogenesis imperfecta Hereditary defect in enamel formation; especially hypocalcified
types
92

99
Q

Extrinsic Staining of Teeth

DDx

A
  • Tobacco Black or brown
  • Coffee, tea, and cola drinks Brown or black
  • Chromogenic bacteria Brown, black, green, or orange 63
  • Chlorhexidine Yellow-brown 63
100
Q

H. Intrinsic Discoloration (“Staining”) of Teeth

A
  • Aging Yellow-brown; less translucency —
  • Death of pulp Gray-black; less translucency
  • Fluorosis White; yellow-brown; brown; mottled
  • Tetracycline Yellow-brown; yellow fluorescence
  • Internal resorption “Pink tooth of Mummery”

Oral Path (23 decks)

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