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Exam 2: DHHD 5002 > Huber 1 > Flashcards

Huber 1 Flashcards

1
Q

Characterization of Exostoses

A
  • Boney protuberances arising from the cortical plate.
  • Etiology: genetic, environmental
  • Asymptomatic – bony hard
  • Irritation (e.g. trauma, mucosal disease) may lead to initial awareness by patient
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2
Q

Categories of Exostoses

A

Further categorized by location:

  • Buccal exostoses
  • Palatal exostoses
  • Torus palatinus
  • Torus mandibularis
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3
Q

Features of Buccal/Palatal Exostoses

A
  • Incidence: widely variable; 0.1% - 69%
  • Usually bilateral
  • Gender: male > female
  • Treatment generally not indicated: Prosthodontic considerations, Chronic trauma
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4
Q

Features of Torus Palatinus (incidence, gender, race, age)

A
  • Exostosis on midline of hard palate
  • Incidence: common; 20-35% of population
  • Gender: female > male (2:1)
  • Ethnic variation: Asian, Inuit
  • Age: peak prevalence in young adults
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5
Q

Features of Torus Palatinus

radiograph, histology, treatment

A
  • Dynamic lesions; responsive to functional stress
  • Radiograph: radiopaque mass
  • Histology: dense viable lamellar cortical bone
  • Treatment: none required unless it interferes with a prosthesis
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6
Q

First awareness of Torus Palatinus by patient by _______.

A

Trauma or mucosal disease

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7
Q

Features of Torus Mandibularis

incicence, etiology, gender, race

A
  • Exotosis on lingual mandibular cortex
  • Incidence: common; 7-10% of population
  • Etiology: genetic, environmental
  • Bilateral: 90%
  • Gender: male > female
  • Ethnic variation: Asians, Inuits
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8
Q

Features of Torus Mandibularis

age, radiograph, histology, treatment, prognosis

A
  • Age: peak prevalence in young adults
  • Dynamic lesions; responsive to functional stress
  • Radiograph: radiopaque mass
  • Histology: dense lamellar cortical bone
  • Treatment: none required unless it interferes with a prosthesis
  • Prognosis: good, benign condition
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9
Q

Characteristics of Stafne Defect

description, radiograph, incidence, gener age

A
  • Focal lingual mandibular bone concavity
  • Pseudocystic radiolucent lesion
  • Incidence: uncommon (0.3% of population)
  • Gender: male > female
  • Age: adults
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10
Q

Features of Stafne Defect

symptoms, location

A
  • Asymptomatic
  • Stable (static bone cyst)
  • Unilateral
  • Mandibular angle
  • Below mandibular canal
  • Variant: anterior salivary gland depression
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11
Q

Radiographic findings and diagnosis of Stafne Defect

A 
•	Radiographic findings: 
o	Unilocular radiolucency
o	Well circumscribed
o	Corticated borders
•	Diagnosis: established by radiologic presentation.
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12
Q

Histology and Treatment of Stafne Defect

A

• Histology:
o Rarely indicated
 Salivary gland parenchyma; usually submandibular gland
 Soft tissue elements
• Treatment: none required
• Prognosis: good

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13
Q

Characteristics of Nasolabial Cyst

where, derived, when, who

A
  • Arises in the upper lip lateral to the midline
  • Derived from epithelium of the nasolacrimal duct
  • 4th-5th decades
  • Females > males
  • 10% occur bilaterally
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14
Q

Histology and Treatment of Nasolabial Cyst

A

• Histopathologic features
o Lined by pseudostratified columnar epithelium with goblet cells and cilia
o Cuboidal epithelium and squamous metaplasia may be seen
• Treatment
o Surgical excision
o Recurrence is rare

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15
Q

Characterizations of Nasopalatine Duct Cyst (Incisive Canal Cyst)
(when, who, symptoms)

A
  • Most common non-odontogenic cyst; occurs in 1% of the population
  • Arises from cystic degeneration of remnants of the nasopalatine duct
  • 4th-6th decades
  • Males > females
  • Common presenting symptoms: swelling of the anterior palate, drainage, pain
  • Some cases are asymptomatic and discovered on routine radiographs
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16
Q

Radiographic findings of Nasopalatine Duct Cyst

A

• Radiographic findings
o Well-circumscribed radiolucency in the midline of the anterior maxilla between or apical to the central incisor teeth
o May be heart shaped due to superimposition of the nasal spine
o Should be greater than 6 mm. in size

17
Q

Histopathologic features and Treatment of Nasopalatine Duct Cyst

A

• Histopathologic features
o Lined by stratified squamous epithelium, pseudostratified columnar epithelium, columnar epithelium, or cuboidal epithelium
o Cyst wall may contain arteries, veins, nerves, and cartilage
• Treatment
o Surgical enucleation
o Recurrence is rare

18
Q

Characteristics of Dermoid Cyst

what, who, symptoms

A

• Classified as a benign cystic form of a teratoma (does not contain all 3 germ layers)
o Forme fruste (incomplete manifestation of a disease)
• The epidermoid cyst of the oral mucosa represents the simplest expression of a teratoma
• Children and young adults
• Slowly growing and painless
• Doughy or rubbery mass that retains pitting after application of pressure

19
Q

Location of Dermoid Cyst

A
  • Occurs in the midline of the floor of the mouth above or below the geniohyoid muscle
  • Above the geniohyoid muscle: sublingual swelling may displace the tongue toward the roof of the mouth
  • Below the geniohyoid muscle: submental swelling may cause a “double chin” appearance
20
Q

Histopathologic features of Dermoid Cyst

A

• Histopathologic features
o Lined by orthokeratinized stratified squamous epithelium
o Lumen contains keratin
o Cyst wall contains adnexal structures
o Epidermoid cyst of the oral mucosa is similar but no adnexal structures are seen in the cyst wall

21
Q

Treatment of Dermoid Cyst

A

Treatment
o Surgical removal
 Above the geniohyoid muscle: intraoral approach
 Below the geniohyoid muscle: extraoral approach
o Recurrence is uncommon

22
Q

Characteristics of Thyroglossal Duct Cyst

A
  • Arises from cystic degeneration of remnants of the thyroglossal duct
  • Develops in the midline from the foramen cecum to the suprasternal notch
  • 60%-80% develop below the hyoid bone
  • 50% occur before age 20
  • Females = males
  • Painless, fluctuant, movable swelling
  • Most are smaller than 3 cm.
  • If it is attached to the hyoid bone, it will move vertically during swallowing or protrusion of the tongue
23
Q

Histopathologic features of Thyroglossal Duct Cyst

A

• Histopathologic features
o Lined by columnar epithelium or stratified squamous epithelium
o Thyroid tissue may be seen in the cyst wall

24
Q

Treatment of Thyroglossal Duct Cyst

A

• Treatment
o Surgical excision including a segment of the hyoid bone and adjacent muscle
o With this procedure, the recurrence rate is < 10%
o Papillary thyroid adenocarcinoma develops in 1%-2% of patients

25
Characteristics of Brachial Cleft Cyst (Cervical Lymphoepithelial Cyst)
* Develops from remnants of the branchial arches * 95% arise from the 2nd branchial arch; 5% from the 1st, 3rd, and 4th branchial arches * Occurs in the upper lateral neck anterior or deep to the sternocleidomastoid muscle * 10-40 years of age * Soft, fluctuant mass ranging from 1-10 cm. in diameter
26
Histopathologic features and Treatment of Brachial Cleft Cyst
• Histopathologic features o 90% are lined by stratified squamous epithelium o May be lined by respiratory epithelium o Cyst wall contains lymphoid tissue and germinal centers • Treatment o Surgical removal o Recurrence is rare
27
Characterizations of Oral Lymphoepithelial Cyst
* Arises from an obstructed tonsillar crypt that fills up with keratin OR from salivary gland epithelium or surface mucosal epithelium trapped in lymphoid tissue * Young adults * Floor of the mouth > ventral tongue and lateral tongue * Usually < 1 cm. in size * Submucosal mass * Firm or soft to palpation
28
Histopathologic features and Treatment of Oral Lymphoepithelial Cyst
• Histopathologic features o Lined by stratified squamous epithelium o Cyst lumen contains keratin o Cyst wall contains lymphoid tissue and germinal centers • Treatment o Surgical excision o Recurrence is rare
29
Characteristics of Amalgam Tattoo
* Implantation of amalgam into the oral mucosa following a mucosal abrasion * Similar findings can be seen with pencil graphite, coal and metal dust, and broken disks and dental burs * Presents as black, blue, or gray macules * Most common on the gingiva, alveolar mucosa, and buccal mucosa * Radiographs may reveal radiopaque metallic fragments
30
Histopathologic features and Treatment of Amalgam Tattoo
• Histopathologic features o Silver salts of amalgam stain the reticulin fibers around nerves and blood vessels o Chronic inflammation with granuloma formation may be seen around the amalgam • Treatment and prognosis o Usually none if the lesion can be diagnosed clinically o A biopsy is indicated if the lesion cannot be diagnosed clinically or to rule out a melanocytic neoplasm
31
Characteristics of White Sponge Nevus
* Due to a defect in the normal keratinization of the oral mucosa * Autosomal dominant * First appears at birth or in early childhood * May develop during adolescence * Involves the buccal mucosa bilaterally along with the ventral tongue, labial mucosa, soft palate, alveolar mucosa, and floor of the mouth
32
Histopathologic features and Treatment of White Sponge Nevus
• Histopathologic features o Hyperparakeratosis and acanthosis o Eosinophilic condensation in the perinuclear region of the epithelial cells o Condensed material represents keratin tonofilaments o Diagnosis may be established with a cytologic smear • Treatment and prognosis o None necessary o Prognosis is good
33
Characteristics of Erythema Migrans
* Also known as geographic tongue, benign migratory glossitis * Common benign condition that primarily affects the tongue; 1%-3% of the population; F > M * Etiology is unknown but may represent a hypersensitivity to an environmental factor * Tongue may be sensitive to hot or spicy foods * May be seen in combination with fissured tongue
34
Histopathologic features and Treatment of Erythema Migrans
• Histopathologic features o Features are reminiscent of those seen in psoriasis o Munro abscesses o Hyperparakeratosis, spongiosis, acanthosis, elongation of the rete ridges • Treatment and prognosis o None indicated o Topical steroids may be used if burning or tenderness is noted
35
_______ is an inherently complex advancing process regulated by sequential and reciprocal interactions between the epithelial and mesenchymal tissues, during which the simple oral ectoderm thickens, buds, grows and folds to form the complex shape of the tooth crown.
Tooth Morphogenesis
36
Name three mutations to various genes required for normal tooth development can alter enamel and / or dentin development
o Amelogenesis imperfecta (AI) o Dentinogenesis imperfecta (DGI) o Dentin dysplasia (DD)
37
Dentin dysplasia type I
o Disruption of proper root dentin organization o AD inheritance pattern; rare 1:100,000 o Enamel and coronal dentin are clinically normal o Affected radicular dentin results in variable root alterations o Phenotype more severe in deciduous teeth o Defective root formation associated with early tooth loss
38
Dentin dysplasia type II
o Blue-to-amber-to brown discoloration of deciduous teeth o Radiographic findings of bulbous crowns, cervical constriction, thin roots, pulpal obliteration o Permanent teeth appear normal, but radiographs reveal pulpal enlargement with frequent extension (thistle tube-shape) o Phenotype is very similar to that of DG-II and DG-III and all are attributable to mutations to DSPP o *** Many now consider DD type II, DG-II and DG-III to represent a spectrum of the same disease ***

Exam 2: DHHD 5002 (10 decks)

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