Exam 2; Gingival Diseases 2 Flashcards
What are the characteristics of lichen planus
characteristic skin lesions (wickham striae)
oral involvement alone is common
various clinical appearances
any area of the oral mucosa
This is a small, inflammatory, congested spot on the skin, a pimple
papula
this is a mesh; in the form of a network
reticular
this is a patch on the skin or on a mucous surface
plaque
This is wasting, a decrease in the size of tissue
atrophy
This is affected with an ulcer, open sore or lesion of the skin or mucosa accompanied by the sloughing of inflamed necrotic tissue
ulcerative
This is a large blister or skin vesicle filled with fluid
bulla
Lichen plans can also look like this
oral lichenoid lesions
What are three examples of oral lichenoid lesions
lesions in contact with dental restorations
lesions associated with various types of restorations
a group of systemic diseases
What is the treatment for oral lichenoid lesions
biopsy
take sample for culture if questioning candida
traumatic plaque control
topical corticosteroids to control pain, discomfort
This is a group of disorders in which autoantibodies towards components of the basement membrane result in detachment of the epithelium from the connective tissue
pemphigoid
What is the histology behind pemphigoid
autoantibody reactions against hemidesmosomes and lama lucida components
Pemphigoid results in deposits of what things
C3
IgG
other Ig’s
What are the three types of pemphigoids
bullous
benign mucous membrane
cicatrical (scar formation)
What is the nicholsky sign
rubbing of the gingiva creates bulla formation
What is the treatment for pemphigoid
plaque removal with daily use of chlorahexidine and/or topical corticosteroid
This results from the formation of intraepithelial bullae in the skin and mucous membranes; painful desquamative lesions, erosions, or ulcerations
pemphigus vulgaris
Which group of people is more susceptible to pemphigus vulgaris
strong genetic background in Jewish and Mediterranean
typically in the middle aged or elderly
What is the histology being pemphigus vulgaris
acantholysis (due to destruction of the desmosomes)
pericellular epithelial deposits of IgG and C3
circulating autoantibodies against intraepithelial adhesion molecules
This is an acute, sometimes recurrent vesiculobullous disease affecting both mucous membranes and the skin; swollen lips often with extensive crust formation of the vermillion border; oral involvement in 25-60% of cases
erythema multiforme
What are the characteristics of erythema multiforme
bullae that rupture and leave extensive ulcers
characteristic skin lesions (iris appearance + bulla)
extensive necrosis; Stevens-Johnson
may occur at any age buy mostly young individuals
Erythema multiforme appears to be a cytotoxic immune response towards what
keratinocytes precipitating by a wide range of factors including herpex simplex and various drugs
What is the treatment of erythema multiforme
plaque control; local/systemic
This is an autoimmune connective tissue disorders in which autoantibodies form to various cellular constituents
lupus erythematous
What is the clinical manifestation of lupus erythematous
central atrophic area with small white dots surrounded by irradiating fine white striae with a periphery of telangiectasia; butterfly lesions
lesions can be ulcerated and cannot be differentiated from leukoplakia or atrophic oral lichen planus
What is the histology of lupus erythematous
degeneration of basal cells and increased width of the basement membrane
deposits of Ig’s, C3, and fibrin along the basement membrane
What are some examples of drug induced mucocutaenous disorders
gingival hyperplasia erythema multiform oral ulceration epithelial atrophy, superficial sloughing intense erythema
What are some drugs that can cause mucocutaneous disorders
immunosuppressants calcium channel blockers anti-epipleptic anti-malarial anti-neoplastic methotrexate
This GI disease can cause chronic granulomatous infiltrates of the wall of gastrointestinal tract
Crohn’s disease
This hematological disorder can cause swelling, petechia, and erythema of the gingiva, 69% of patients with this have oral signs
leukemia
This reactive process of the periodontal soft tissue is sessile, well-circumscribed smooth-surfaced modules
fibroma/focal fibrous hyperplasia
What is the histology behind a fibroma
cell-poor, hyper plastic collagenous tissue
may show hyperkeratinization
What could fibroma be differentially diagnosed as
giant cell fibroma
This reactive process of the periodontal soft tissue is often reddish, and ulcerated reactive lesion with highly cell-rich areas below uncharted sites; fibrous proliferation in which bone or cementum like hard tissue is formed
calcified fibroblastic granuloma
This reactive process of the periodontal soft tissue is ulcerated, at the gingival margins, reddish or bluish, sometimes lobulated, sessile or pedunculate; bleeding is common
high vascular with chronic inflammatory cells
pyogenic granuloma
This reactive process of the periodontal soft tissue can be found anywhere on the gingival mucosa, pedunculate or sessile, red or purple, commonly ulcerated; a focal collection of multi-nucleated osteoclast-like giant cells with richly cellular and vascular stroma separated by collagenous septa; probably originated from PDL
peripheral giant cell granuloma
This reactive process of the periodontal hard tissue usually has no symptoms, vital tooth, fibrous-osseus cement lesions
the perioapical bone is replaced by cellular fibroblastic tissue through cementoblastic phase
periapical cemental dysplasia
This benign neoplasm of the periodontal soft tissue is a rather frequent tumor of oral mucosa, flat or raised, sometime lobulated, soft lesions of blue - red color; asymptomatic by may bleed, blanch on pressure; capillary or cavernous types
hemangioma
This benign neoplasm of the periodontal soft tissue is a pigmented lesion containing melanocytes in the CT, mostly seen in the palate, flat, slightly raised lesions or tumors, brown or black; located along the basal layer of epithelium
nevus
This benign neoplasm of the periodontal soft tissue is exophytic, pedunculate, or sessile lesions, reddish/normal or whitish/grey in color
granular/moruloid or filiform/digitated surface
papilloma; HPV is commonly found
This benign neoplasm of the periodontal soft tissue is less common in oral mucosa than the skin; lips and palate are main location; sessile, exophytic or raised lesion with a whitish surface
papillomatous surface with hyperkeratinization and elongated rete pegs
HPV 2 or 4
verruca vulgaris
This benign neoplasm of the periodontal soft tissue is non-ulcerated sessile or pedunculate gingival lesions
generally detected in the soft tiara around unerupted teeth
histopathology similar to intraossesus forms of tumors
peripheral odontogenic tumors
This benign neoplasm of the periodontal hard tissue is derived from odontogenic epithelium and has well-circumscribed radiolucency
ameoloblastoma
This benign neoplasm of the periodontal hard tissue is derived from the PDL, presumable from epithelial rests of Malassez
often associated with lateral root surface
rare
squamous odontogenic tumor
This benign neoplasm of the periodontal hard tissue is a slow growing neoplasm forming hard tissue around the apex of a tooth
radiolucency typically surrounded by a radiolucent margin
benign cementoblastoma
This malignant neoplasm of the periodontal soft tissue is found on the mandible, posterior to premolars; nodular lesions often with ulceration and surrounding leukoplakia
regional lymph-node metastasis is common
squamous cell carcinoma
These malignant neoplasms of the periodontal soft tissue are the majority of times intradoses; most are carcinoma and not sarcoma
metastasis of the gingiva
This malignant neoplasm of the periodontal soft tissue is a skin lesion followed by oral lesions, gingiva is the second most after palate, re-occurance with AIDS
kaposi’s sarcoma
This malignant neoplasm of the periodontal soft tissue is rare in the oral cavity and occurs frequently among HIV-infected patients
malignant lymphoma
This malignant neoplasm of the periodontal hard tissue diagnosis required clinical and radiographic examinations, 7% occur in the jaw, widening of the PDL is common
osteosarcoma
This malignant neoplasm of the periodontal hard tissue is found 10-20% of the time in the jaws, associated with swelling, tenderness, pain, and loosening of teeth
langerhans cell disease (histiocytosis X)
What is the difference between an tumor and a cyst
tumor = growth of tissue, something bad cyst = empty sac, sometimes filled with fluid, need to remove all cell layers
What is the histology being lichen plants
Sub epithelial band-like accumulation of lymphocytes
Type IV hypersensitivity
Fibrin in basement membrane
What is deposited in lichen planus
IgM
C3
C4
C5
