Exam 1 Flashcards

Question

Answer 1

Dens Invaginatus (dens-in-dente) (Frequency: Maxillary Permanent lateral incisors \> central incisors \> premolars \> canines \> molars)

Answer 2

Pilar Cyst * Occur on the scalp and derived from hair follicle * F\>M * Tx = conservative surgical excision

Answer 3

Impetigo (Caused by GAS and Staph aureus, bullous and nonbullous forms, increased prevalence in HIV and immunocompromised) The nonbullous form is more common, school aged children, contagious, amber colored crusts. The bullous form is more in infants, can lead to meningitis or pneumonia, the bullae can rupture and develop a thin brown crust "lacquer."

Answer 4

Lupus Vulgaris This is Tuberculosis of the skin. Tuberculosis is caused by Mycobacterium tuberculosis, is acid fast, hits immunocompromised, spreads airborne. With TB, you can get painless, chronic ulcerations on tongue and palate, which is similar to syphilis, but oral cancer is usually painful. The histology shows granulomas with caseating granulomatous inflammation, which is a granuloma with a central area of necrosis, and multinucleated giant cells (macrophages).

Answer 5

Buccal Exostoses

Answer 6

Maternal alcohol Folic Acid deficiency Corticosteroid use Anticonvulsant therapy

Answer 7

Hypoplastic Amelogenesis Imperfecta

Answer 8

Osteomyelitis (This is chronic osteomyelitis. Usually due to bacterial infection. Result in: Expanding lytic destruction, Suppuration, Sequestra formation (The pooling of inflamed/broken bone). Uncommon in developed countries. Most cases arise after odontogenic infections or traumatic facture. 75% in Males, mostly mandible Symptoms of acute infection: Fever Lymphadenopathy Sensitivity Soft tissue swelling Acute infection doesn’t produce XRAY changes During acute infection, fragments of necrotic bone may become surrounded by new, vital bone = **involucrum**

Answer 9

Coronoid Hyperplasia (The mandible deviates toward the affected side on opening)

Answer 10

Syphilis * Caused by Treponema pallidum * Primarily through sexual contact and from mother to fetus * 6x more common in men and African Americans * Primary syphilis - characterized by the chancre that develops at the site of inoculation (3-90 days after inoculation) - oral lesions are only 2%, more common in anus and genitalia. * Secondary Syphilis * AKA disseminated syphilis 4-10 weeks after initial infection Systemic symptoms: Painless lymphadenopathy ALWAYS: diffuse, painless, maculopapular, cutaneous, widespread rash * Tertiary Syphilis * After 2nd stage, patients enter latent syphilis and are free of lesions/symptoms for 1-30 years 30% of pts progress to tertiary syphilis after latent syphilis Possible cardiac complications Aneurysm of the ascending aorta Congestive heart failure CNS involvement Paralysis Psychosis Death Ocular lesions Tongue lesions (syphilitic glossitis) Gumma – characteristic; scattered foci of granulomatous inflammation Intraoral lesions usually affect the palate or tongue * Congenital Syphilis - Hutchinson's Triad + Mulberry Molars

Answer 11

Localized juvenile spongiotic gingival hyperplasia (The Nickname is Wright’s Lesion (his professor)) ## Footnote “Localized Juvenile Spongiotic Gingivitis” Idiopathic, but it has been suggested that the alteration represents an isolated patch of exteriorized junctional or sulcular epithelium that may be altered secondarily by local factors (mouth breathing) The most common presentation is a small bright red velvety or papillary alteration that often bleeds easily upon manipulation Predilection for the maxillary anterior facial gingiva with a female predominance. Vast majority occur under 20 with a median age of 12 years.

Answer 12

Matrix is laid down appropriately but no mineralization occurs.

Answer 13

Dentin Dysplasia Type I | (Rootless teeth, mobile clinically)

Answer 14

Dentinogenesis Imperfecta

Answer 15

Sinusitis * Caused by blockage of the **ostiomeatal complex**. * Acute can become chronic * Calcification can occur in chronic = antrolith * Maxillary sinusitis: * Increased pain when head is upright * Decreased pain when patient is supine * \*A sinus infection should be strongly considered when patients complain of pain form several teeth. (Due to seasonal allergies, because the root tips sit next to the sinuses and can cause referred pain) * Radiographic imaging helps diagnose chronic disease * Sinus is cloudy with increased density * Treatment of acute sinusitis: * Self-limiting * Treatment of chronic sinusitis: * Antibiotics * If unresponsive, surgical correction to enlarge the ostial openings * Surgery should try to be avoided in children * Decreased distance between orbit and brain

Answer 16

This is really South American Blastomycosis * Paracoccidioides brasiliensis * Nine-banded **armadillo** harbors the organism (similar to the situation seen with leprosy) * Thought to be attributable to a protective effect of female hormones (because β-estradiol inhibits the transformation of the hyphal form of the organism to the pathogenic yeast form. * Most patients infected are employed in agriculture * Generally self-limiting * Histology: granulomatous inflammation (characterized by collections of macrophages and multinucleated giant cells. * **The organism often show multiple daughter buds on the parent cell, resulting in an appearance described as resembling “mickey mouse” or the spokes of a ship’s steering wheel (“mariner’s wheel”) (This is on boards a lot)**

Answer 17

Periapical Cyst (Inflammatory stimulation of epithelium in the area (Rests of Malassez), Can be found on side of the root – Lateral apical periodontal cyst. Cyst remains following extraction of the tooth – Residual apical periodontal cyst. The histology has white areas with epithelium around it)

Answer 18

The proliferation of ectomesenchyme on both sides of each placode.

Answer 19

Drug-Related Gingival Overgrowth ## Footnote Abnormal growth of gingival tissues secondary to use of systemic medication: Cyclosporine (transplant therapy) ~25% Phenytoin (anticonvulsant) ~50% (meaning half of patients with Phenytoin get this) Nifedipine (calcium channel blocker) ~25

Answer 20

* Caused by Bartonella henselae * Begins in the skin; classically spreads to adjacent lymph nodes * Most common cause of chronic **regional lymphadenopathy** in children * Arises after contact with a domestic cat or kitten * Scratches * Licks * Bites * 80% occur in patients younger than 21 * Primary lesions adjacent to eye can result in a conjunctival granuloma with preauricular lymphadenopathy = **oculoglandular syndrome of Parinaud** * Diagnosed via serologic tests * Self-limiting condition; palliative treatment only unless severely involved, then ABX are appropriate * Resolves in 4 months

Answer 21

6 months to 15 years

Answer 22

* Aka Mucormycosis * Found on decaying organic material * Most important to oral health care provider = rhinocerebral form * Growth is enhanced by iron * Patients at risk: * **Diabetic patients who are uncontrolled (Ketoacidosis inhibits iron binding to transferrin, allowing serum iron levels to rise)** * Patients taking deferoxamine (iron-chelating agent) * Immunocompromised patients * Presenting symptoms of rhinocerebral zygomycosis are varied: * Nasal obstruction * Bloody nasal discharge * Facial pain/HA * Facial swelling/cellulitis * Visual disturbances/proptosis * If untreated, massive tissue destruction may result * **Appears black and necrotic** * Treatment * Radical surgical debridement * High doses of amphotericin B * 60% of patients with rhinocerebral zygomycosis succumb to their disease

Answer 23

Acute Atrophic Candidiasis * “Antibiotic sore mouth” – follows a course of broad-spectrum ABX * Mouth feels as though a hot liquid scalded it * Diffuse loss of filiform papillae of dorsal tongue (appears bald). * Similar appearance symptomology is noted in xerostomia patients

Answer 24

Concrescence (Union of two adjacent teeth by cementum alone without confluence of underlying dentin.)

Answer 25

Intraoral Sinus Tract | (Also known as "Parulis" or "gum boil")

Answer 26

Failure of fusion of the medial nasal processes, which are both involved with formation of the primary palate.

Answer 27

Abrasion (Wearing away of tooth structure, most commonly with tooth brushing. Demastication: exhibits features of both attrition and abrasion. (chewing tobacco between opposing teeth))

Answer 28

Lingual Thyroid (Thyroid gland begins as an epithelial proliferation in the floor of the pharyngeal gut during week 3-4 of embryogenesis, If primitive gland doesn’t descend normally, ectopic thyroid can be found between the foramen cecum and the epiglottis, Dx is established via thyroid scan (using iodine isotopes or technetium-99m), CT, and/or MRI, biopsy is avoided due to hemorrhage)

Answer 29

* Most common systemic fungal infection in US * Caused by Histoplasma capsulatum * Dimorphic * Yeast at body temperature in human host * Mold in natural environment * Found in humid areas with soil enriched by bird or bat excrement * Endemic in the **Ohio and Mississippi River Valley** * Up to 90% of people in these areas are infected * Airborne spores are inhaled, passed into the terminal passages of the lungs, and germinate * 99% of those infected have either no symptoms or such mild symptoms that the patient doesn’t seek medical care * Mild symptoms are flulike and can last for 1-2w * Most who become exposed are healthy and inhale a small number of sporesP * Patients: * Older * Debilitated * Immunocompromised * Up to 10% of AIDS patients develop disseminated disease in endemic areas * Most oral lesions occur with disseminated form * Appears as a solitary, variably painful ulceration of several weeks duration * Ulcerated lesions have firm, **rolled margins** * Clinically indistinguishable from malignancy (When it has rolled margins) * May appear erythematous or white with an irregular surface * Histopathology shows granulomatous inflammation * Treatment - Acute * None or palliative care * Treatment - Chronic * Require treatment despite the fact that 50% recover spontaneously * Pulmonary damage is progressive if untreated * 20% succumb to untreated disease * Treatment of choice is IV amphotericin B, but can cause kidney damage * Treatment – disseminated * 90% will succumb to disease if untreated * Amphotericin B is treatment of choice

Answer 30

Apert Syndrome (Downward slant lateral palpebral fissures-so the outside of the eye slants down. A in Aspert for Angled. Syndactyly of 2nd, 3rd, and 4th digits of hands and feet (webbing of the hands and feet) Mental retardation)

Answer 31

Hyperdontia (Mesiodens is an example. You have too many teeth.

Answer 32

Taurodontism (An enlargement of the body and pulp chamber of a multi-rooted tooth, with apical displacement of the pulpal floor. Can be isolated or syndromic. The 3 syndromes associated with this are 1)Kleinfelter's Syndrome, 2)Amelogenesis Imperfecta, and 3)Tricho-dento-osseus syndrome)

Answer 33

* Nystatin (antifungal) * Oral use as suspension or lozenge * Bitter taste, so sugar is added * **Don’t use in xerostomia-related candidiasis** * Effectiveness depends on direct contact so multiple daily doses are necessary * Amphotericin B * IV treatment for life-threatening systemic fungal infections * Imidazole Agents – Clotrimazole * One brand name is Mycelex * Formulated as a troche (lozenge) * Effectiveness depends on direct contact so multiple daily doses are necessary * Very few side effects * Candidiasis should resolve easily following antifungal therapy * If infection recurs after treatment, investigate possible predisposing factors

Answer 34

Gemination (This is an example of bilateral gemination. Single enlarged tooth or joined tooth in which the tooth count is normal when the anomalous tooth is counted as one)

Answer 35

Condensing Osteitis Localized area of bone sclerosis associated with apices of teeth with pulpitis (The bone tries to get hard and form bone and become more radiopaque to get rid of the infection and protect itself). Association with inflammation is critical in diagnosis (radiographically identical to idiopathic osteosclerosis). XRAY changes: Increased RO adjacent to tooth apex that has a thickened PDL or apical inflammatory lesion No RL border (distinguishes from focal cemento-osseous dysplasia) Not separated from apex (distinguishes from idiopathic osteosclerosis) No clinical expansion of bone 85% regress after odontogenic infection is eliminated Residual areas are termed bone scars

Answer 36

By marked accumulation of keratin on the filiform papilla of the dorsal tongue. Most patients are heavy smokers.

Answer 37

Papillon-Lefevre Syndrome * Autosomal recessive (This is a rarity, know it) * Mutation and loss of function of cathepsin C gene (on chromosome 11) * Predominantly demonstrates oral and dermatologic manifestations * Accelerated periodontitis (defect in neutrophil function) * Teeth “floating in air” * Actinobacillus actinomycetemcomitans * Palmar plantar keratotis (tylosis)

Answer 38

Bohn's Nodules (Likely occur from epithelial remnants from the minor salivary glands)

Answer 39

Regional Odontodysplasia

Answer 40

Nasopalatine Duct Cyst (Most common non-odontogenic cyst of oral cavity. 6mm diameter is upper limit of normal size for incisive foramen. Biopsy is mandatory because the lesion cannot be diagnosed radiographically. It would be called cysts of the incisive papilla if it rested just in the soft tissue, without bony involvement)

Answer 41

Crouzon Syndrome * Characterized by craniosynostosis (premature closing of the cranial sutures) * Brachycephaly (short head), scaphocephaly (boat-shaped head), trigonocephaly (triangle head) * Most severe cases demonstrate a “**cloverleaf**” skull (kleeblatt-schadel deformity) * Ocular proptosis, underdeveloped maxilla * Skull x-ray= “beaten-metal” pattern * Mutation: fibroblast growth factor receptor 2 (FGFR-2) on chromosome 10q26

Answer 42

Progressive Hemifacial Atrophy (Atrophy affecting one side of the face History of trauma in some cases Recent reports consider borelia spp. infection (Lyme disease) in the cause)

Answer 43

Globulomaxillary Radiolucency (Their location is found in the anterior maxilla, usually between the cuspid and lateral incisor. The two most common radiolucencies in that region are the radicular cysts and periapical granulomas)

Answer 44

Van der Woude Syndrome (Greatest significance of paramedian lip pits AD – autosomal dominant CL + CP Paramedian lip pits Most common form of syndromic clefting – It is the most common syndrome that you see, and it has clefting, but only makes up 2% of all CL & CP)

Answer 45

The merging of the medial nasal processes

Answer 46

Peg Laterals

Answer 47

Turner's Hypoplasia (Enamel defects seen in permanent teeth caused by periapical inflammatory disease of the overlying deciduous tooth, limited to one tooth. Turner's Tooth. Most commonly seen in the permanent bicuspids because of their relationship to the overlying deciduous molars)

Answer 48

Angular Cheilitis * Can be a component of chronic multifocal, but usually occurs alone * Older patients with reduced vertical dimension * Accentuated folds at the corners of the mouth where saliva can pool * Severity waxes and wanes * Etiology * 20% C. albicans alone * 20% Staphylococcus aureus alone * 60% Combination of both * Infection may more extensively involve the perioral skin * Usually due to chronic lip licking * Clinical pattern is termed cheilocandidiasis (Happens when patients lick their mouth and lips a lot)

Answer 49

Epidermoid Cyst * Often arise after localized inflammation of the **hair follicle** * Occur in acne-prone areas of the back (adults), head (kids), & neck * M\>F * Nodular, fluctuant, subcutaneous lesion * White or yellow unless inflamed

Answer 50

Nasopalatine Duct Cyst

Answer 51

Pierre Robin Sequence 1 .CP 2. Mandibular Micrognathia 3. Glossoptosis (downward displacement of the tongue)

Answer 52

Formed from the maxillary processes of the first branchial arches. It eventually makes up 90% of the hard and soft palates.

Answer 53

14th week gestation through 12 months of age

Answer 54

Hypercementosis (Non neoplastic deposition of excessive cementum that is continuous with the normal radicular cementum. Associated with Paget's Disease)

Answer 55

Native Americans \> Asians \> Caucasians \> African Americans

Answer 56

Lymphoepithelial Cyst

Answer 57

* Caused by Candida albicans * Exists in two forms – dimorphism * Yeast form – innocuous * Hyphal form – invasion of host tissue (It is the hyphal form that causes the white plaque that we wipe off and the burning in the tissues) * By far the most common oral fungal infection in humans * Variety of clinical manifestations * Up to 50% carry the organism in their mouth in health * Rate increases with age * Mostly an opportunistic infection, but healthy patients may develop infection

Answer 58

* Noninvasive and invasive forms * Noninvasive affects a normal host * Allergic reaction affecting the sinuses (allergic fungal sinusistis) * Large mass of fungal hyphae is called an aspergilloma * Invasive infection: * Localized can occur in normal host * Extensive involvement in immunocompromised patients * Present worldwide * Second in frequency to candidiasis * Two most common species: * A. fumigatus (90%) * A. flavus * If this mass undergoes dystrophic calcification, an **antrolith** can be seen via XRAY * Treatment: * Noninvasive, immunocompetent: surgical debridement * Allergic fungal sinusitis: surgical debridement + corticosteroids * Locally invasive, immunocompetent: debridement + antifungal

Answer 59

* AKA **San Joaquin Valley Fever** * Caused by Coccidioides immitis * **Saprophytic** organism (lives on dead/decaying organic matter) * Dimorphic * Mold in natural environment * Yeast in infected host tissues * Athrospores are produced by the mold, become airborne, and can be inhaled * Endemic areas: * **Southwestern US** * Mexico * 60% of those infected are asymptomatic * Occasionally, pts may have a hypersensitivity reaction which causes development of an erythema multiforme-like cutaneous reaction or erythema nodosum * **Erythema nodosum** affects the legs and is characterized by multiple painful inflammatory nodules – this reaction occurring in conjunction with coccidioidomycosis is termed **valley fever**

Answer 60

* Caused by Cryptococcus neoformans * Lives in **pigeon excrement** * Grows in yeast in both the soil and infected tissue * **Prominent mucopolysaccharide capsule** that protects it from host defense * Primary infection is asymptomatic * Most patients who are diagnosed have immune suppression * 10% of AIDS pts will acquire this infection * Dissemination is common in immunocompromised patients * For disseminated cryptococcosis, the most frequent site of involvement = meninges

Answer 61

Macroglossia (Most commonly caused by vascular malformations, muscular hypertrophy, down syndrome, Beckwith-Wiedmann Syndrome)

Answer 62

Hereditary Hypohidrotic Ectodermal Dysplasi

Answer 63

Double Lip (which is characteristic of Ascher Syndrome) Ascher Syndrome 1. Double Lip 2. Blepharochalasis 3. Nontoxic Thyroid Enlargement

Answer 64

* 1. Pseudomembranous (Cottage Cheese, can wipe off clinically) * 2. Erythematous (Bright red patch, usually under denture, and this is more common than pseudomembranous actually) * Median rhomboid glossitis * Chronic multifocal * Angular cheilitis * Denture stomatitis * Acute atrophic (“Antibiotic sore mouth”) * 3. Chronic Hyperplastic * 4. Mucocutaneous

Answer 65

* Uncommon disease (histoplasmosis is 10x more common) * Caused by Blastomyces dermatitidis * Dimorphic * Grows as yeasts at body temperature * Grows as mold in rich, moist soil * Found in eastern areas of the US and into Canada * Male:female 9:1 * Likely due to a greater degree of outdoor activity in men where the organisms grow * Occurrence in immunocompromised patients is rare * Acquired by inhalation of spores after a rain, spores grow in alveoli of lungs * Acute blastomycosis symptoms resemble pneumonia * Chronic blastomycosis symptoms resemble tuberculosis * Oral lesions result from extrapulmonary dissemination or local inoculation * Lesions may be irregular with an erythematous or white surface * Lesions may appear as ulcerations with irregular rolled borders with variable degrees of pain * All oral lesions are indistinguishable from SCCA clinically * Histology – be aware infection can induce a benign reaction of the epithelium termed **pseudoepitheliomatous (pseudocarcinomatous) hyperplasia** – this looks like cancer to the untrained eye (**Know this pseudo term, PEH, for blastomycosis**)

Answer 66

Scarlet Fever (This is a sequelae, along with rheumatic fever, rheymatic heart disease, and acute glomerulonephritis, of Strep throat and tonsillitis) Strep throat is usually caused by GAS, influenza, and EBV, but the majority are usually just caused by a virus. Scarlet Fever gives you a white strawberry tongue the first 2 days, and then a red strawberry tongue from days 4-5, which is erythematous dorsal surface with hyperplastic fungiform papillae. You can also get skin erythema called Pastia's lines. Treat it with oral penicillin.

Answer 67

Abfraction (loss of tooth structure from occlusal stresses that create repeated tooth flexure.)

Answer 68

Thyroglossal Duct Cyst * Develop from **epithelial remnants** of the thyroglossal tract * 50% are diagnosed before age 20 * Presents as a painless, fluctuant, movable swelling at or near midline, usually inferior to the hyoid bone * Fistulous tracts to the skin develop in 1/3 of cases * Tx = surgical removal; 10% recurrence * 1% = carcinoma

Answer 69

* Cornebacterium diphtheriae * Humans are sole reservoir * Affects mucosal tissues first * Tissue necrosis and cardiac complications * Lethal exotoxin produced by the bacteria

Answer 70

Actinomycosis * Bacterial infection * Actinomyces israelii * Colonization can occur in healthy patients: * Tonsillar crypts * Plaque * Carious dentin * 55% of cases of actinomycosis are diagnosed in the cervicofacial region * Treatment: long-term high dose antibiotics * Suppurative reaction of infection may discharge yellow material * Represent colonies of bacteria; termed sulfur granules

Answer 71

Stafne Defect (Lingual mandibular salivary gland depression, it is one of the only things we see that happens below the inferior alveolar canal, cysts tumors (which this isn’t) rarely go beneath the canal, Has a corticated rim on the x-ray)

Answer 72

It is a main arterial branch that extends up into the superficial submucosal tissues without a reduction in its diameter. It is almost always found on backside of upper lip and cheek.

Answer 73

Cleft Lip (Defective fusion of the medial nasal process with the maxillary process, 80% of cases are unilateral)

Answer 74

Geographic Tongue (Remember that it is called erythema migrans when it is not found on the tongue, and might end up looking like leukoedema, often patients with fissured tongue are affected, usually doesn't, but may burn or hurt)

Answer 75

Commissural Lip Pits (Mucosal invaginations that occur at the corners of the mouth on the vermilion border, but not associated with facial or palatal clefts)

Answer 76

Epstein's Pearls (Palatal cysts of newborns) The definition of a cyst is a pathologic cavity (often filled with fluid) that is lined by epithelium. They increase in size due to elevated hydrostatic luminal pressure

Answer 77

Cutaneous Sinus Tract * Typically an enlarged nodular mass * Red lesion with other shades of yellow, white, purple * Mandibular teeth most commonly because of the muscle attachment.

Answer 78

Push on it with glass to see if it blanches and becomes normal when blood flow doesn't go there, if not, most likely a hematoma.

Answer 79

Ludwig's Angina (A form of cellulitis, which is a sequelae of periapical pathology. Rapidly swelling of the sublingual, submandibular, and submental spaces May extend to the spaces around the throat and close off the airway DEATH CAN OCCUR It creates massive swelling of the neck Sublingual involvement causes swelling and elevation of the tongue (“woody tongue”) Submandibular space spread causes enlargement and tenderness of the neck (“bull neck”) Symptoms: Pain Restricted neck movement Dysphagia, dysphonia, dysarthria Drooling Sore throat Respiratory obstruction

Answer 80

Tonsilloliths When the tonsillar crypts become filled with desquamated keratin and foreign material. Can be colonized with Actinomyces species. Only termed tonsillolith when it undergoes dystrophic calcification. No treatment unelss symptomatic, gargle salt water if you want.

Answer 81

Attrition (Loss of tooth structure caused by tooth-tooth contact. (bruxism))

Answer 82

Hypocalcified Amelogenesis Imperfecta (Amelogenesis Imperfecta on radiographs looks like sharp pointy teeth with thin enamel with radiographs)

Answer 83

Hypomaturation Amelogenesis Imperfecta

Answer 84

Regional Odontodysplasia (A localized, non-hereditary developmental abnormality of teeth with extensive adverse effects on the formation of enamel, dentin, and pulp. (Clinically, they will have an area of unerrupted teeth, and radiographically, they will have ghost teeth))

Answer 85

Torus Palatinus. Occur in the midline of the hard palate.

Answer 86

Lymphoepithelial Cyst (These are lymphoid aggregates most commonly found on floor of mouth, ventral tongue, and soft palate) * Waldeyer’s ring (palatine tonsils, lingual tonsils, pharyngeal adenoids)

Answer 87

Noma * Derived from the Greek “nomein”, meaning to devour * Rapidly progressive * Polymicrobial * Fusobacterium necrophorum * Prevotella intermedia * Opportunistic infection * Frequently begins as NUG

Answer 88

Males = CP + CL Females = CPO

Answer 89

Periapical Scar (The defect created by periapical inflammatory lesions may fill with dense collagenous tissue. If the histology is all pink, no cells, than it is most likely a scar)

Answer 90

Cavernous Sinus Thrombosis Another form of cellulitis often associated with dental infections (Typically results from abscess of a maxillary anterior or premolar tooth. Canine is most often the source of the infection. It appears as an edematous periorbital enlargement

Answer 91

Congenital Syphilis (Caused by Treponema pallidum, Hutchinson's incisors, mulberry molars. The Hutchinson's triad is 1. Hutchinson's Teeth 2. Interstitial Keratitis (Corneal Scarring) 3. 8th Nerve Deafness)

Answer 92

The maxillary lateral incisors

Answer 93

Plasma Cell Gingivitis ## Footnote Distinctive pattern of gingival inflammation Most cases related to hypersensitivity (Big Red chewing gum from the cinnamon aldehyde) Patients usually experience a rapid onset of sore mouth

Answer 94

Fusion (Single enlarged tooth or joined tooth in which the tooth count reveals a missing tooth when the anomalous tooth is counted as one.)

Answer 95

1. Sinus Tract 2. Osteomyelitis 3. Cellulitis (Ludwig's Angina and Cavernous Sinus Thrombosis) 4. Condensing Osteitis

Answer 96

Desquamative Gingivitis (Used to describe gingival epithelium that spontaneously sloughs or can be removed with minor manipulation. The five different differentials of Desquamative Gingivitis are: 1) Lichen Planus 2) Mucous membrane pemphigoid 3) Pemphigus Vulgaris 4) Systemic Lupus Erythematosis 5) Hypersensitivity

Answer 97

Branchial Cleft Cyst (Cervical Lymphoepithelial Cyst) * Occurs in upper lateral neck along anterior border of SCM as a soft, fluctuant mass in pts ages 20-40 * 2/3 occur on L neck * Tx is surgical removal

Answer 98

Hypocalcified Amelogenesis Imperfecta (Amelogenesis Imperfecta on radiographs looks like sharp pointy teeth with thin enamel with radiographs)

Answer 99

Submucous Palatal Cleft (Surface is intact, but defect exists in the underlying musculature of the soft palate, bluish midline discoloration, Cleft palate is failure of palatal shelves to fuse, minimal manifestation of cleft palate is bifid uvula, also present here, most clefting involves CL and CP, while syndromic clefting is usually just CP)

Answer 100

Gingival Fibromatosis Slowly progressive gingival enlargement caused by a collagenous overgrowth of the gingival fibrous connective tissue. Other common findings: Hypertrichosis (Excess hair) Generalized aggressive periodontitis Epilepsy Mental retardation Growth hormone deficiency

Answer 101

Dens Evaginatus (Usually on premolars, usually bilateral, and more on mandibular, very prevalent in Native American nation)

Answer 102

Nasiolabial Cyst (Appears as a swelling of the upper lip, lateral to midline, resulting in elevation of ala of the nose)

Answer 103

The failure of fusion of the maxillary process with the lateral nasal process. Always associated with CP as well.

Answer 104

Hemihyperplasia * Rare developmental anomaly * Assymetric overgrowth of one or more body parts (unilateral macroglossia) * Associated syndromes: Beckwith-Wiedemann syndrome, neurofibromatosis, proteus syndrome

Answer 105

Paramedian Lip Pits (Congenital invaginations of the lower lip, usually bilateral)

Answer 106

* Neisseria Gonorrhoeae * Most common infectious disease in US * Sexual Contact * Purulent Discharge, dysuria

Answer 107

Dentin Dysplasia Type II (Pulp chambers are thistle-tubed shaped. Very similar to dentinogenesis imperfecta. Also has blue-to-amber-brown translucence)

Answer 108

Segmental Odontomaxillary Dysplasia * Painless, unilateral **enlargement of the maxillary bone**, along with **overgrowth** of overlying gingiva * One or both of the developing **maxillary premolars** are frequently missing.

Answer 109

Chronic Multifocal Candidiasis One of the 5 types of Erythematous Candidiasis * Median rhomboid glossitis + signs of infection at other sites * Jxn of hard and soft palate (“kissing lesion”) * Angles of the mouth (Angular cheilitis) (Red lesion, sometimes a little white, but expect this on clinical portion of exam)

Answer 110

Periapical Granuloma (The most common periapical pathosis. Mass of inflamed granulation tissue at the apex of a nonvital tooth. Phoenix abscess= secondary acute inflammatory changes within a periapical granuloma. Plasma cells and lymphocytes = granuloma. Histology has mixed with like a spider web)

Answer 111

Torus Mandibularis

Answer 112

Erosion (Erosion from dental exposure to gastric secretions is termed perimolysis.)

Answer 113

Leukoedema (Noticeable in African Americans, if you stretch the skin and it disappears, then it is most likely leukoedema, if not, then most likely leukoplakia, lichen planus, or erythema migrans (which is geographic tongue not found on the tongue))

Answer 114

Dermoid Cyst * These are benign, cystic forms of teratoma (Occur at midline as a submucosal, fluctuant swelling at the FOM – ventral floor of mouth)

Answer 115

Hypodontia (The definition is missing one or more teeth. Oligodontia is missing 6+ teeth, but is still a form of hypodontia. absence of a deciduous tooth= likely to miss the associated permanent tooth. (Because they form from the same dental lamina, 3rd molars most commonly affected, then 2nd premolars and lateral incisors)

Answer 116

Riga-Fede Disease

Answer 117

Mucocutaneous Candidiasis * Rare group of immunologic disorders * Young patients can develop the following * Endocrine-candidiasis syndrome * Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) syndrome * 10% have malignancies such as oral or esophageal carcinoma * Iron-deficiency anemia * **Oral lesions are white plaques that do not rub off** * Similar to chronic hyperplastic candidiasis

Answer 118

Periapical Abscess (If the histology is all blue with a bunch of cells, probably an abscess. Accumulation of acute inflammatory cells at the apex of a nonvital tooth)

Answer 119

Condylar Hyperplasia (You get a deviation towards the opposite side (right condylar hyperplasia = deviation to left) even when you don’t open)

Answer 120

Torus Mandibularis. Develop along lingual aspect of mandible.

Answer 121

Concrescence