Intro Flashcards
What does an OMP do?
Studies causes of diseases, mechanisms which produce them, sites where they occur, and the resulting morphologic and functional alterations. Dx disease using clinical radiographic, microscopic, biochemical, or other exams
What is a differential dx?
- Distinguishing of a disease or condition from others presenting with similar signs and symptoms
- Based on pt information, create a list of possible dx’s for an oral lesion
- Purpose: Determines the appropriate next step in patient management
surface lesions of oral mucosa
- Involve portions of mucosa
- Do not exceed 2-3mm in thickness
- 3 categories of surface lesions
- White
- Pigmented (brown, blue, red, gray, black)
- Red
What are the two categories of ST enlargements?
- Reactive enlargements
- Tumors
Tumor
- By definition, a tumor is a neoplasm
- Tumors/neoplasms show persistent and progressive growth
- In decision tree, “tumor” is based on clinical behavior, not microscopic features
Features of ST enlargements
- Usually regress, sometimes painful
- Relatively rapid growth rate (hours to weeks)
- Sometimes fluctuate in size
- Sometimes associated with tender lymphadenopathy & systemic manifestations (but not always)
- Once it’s determined that an enlargement is reactive, then determine what the lesion is reacting to i.e. pulpal necrosis, perio, injury, trauma etc
Features of tumors
- Persistent and progressive
- Usually asymptomatic, at least early in development
- Growth rate varies from weeks to years
- If a soft tissue enlargement is a tumor, next determine if benign or malignant
Benign tumors features
- Slow growing
- Overlying mucosa is normal
- Sometimes freely-movable (not attached to surrounding structures)
- Asymptomatic
- Does not metastasize
4 categories of benign tumors
- Epithelial
-
Mesenchymal
- Nerve, SM, skeletal muscle, vasculature, lymphoid tissue, fibrous tissue
- Salivary gland
-
ST cysts
- History and clinical features are similar to benign tumors
Malignant tumors features
- Rapidly growing (wks-mo)
- Overlying mucosa is sometimes ulcerated
- Fixed to surrounding structures
- More often symptomatic
- Has the ability to metastasize
Complete and accurate description required for:
Medicolegal documentation and determination of clinical dx/differential dx
Elementary lesions
- Elementary lesions are morphologic alterations
- Generic terms used to describe diseases
- Several diseases can affect the oral cavity
- Various diseases are clinically similar
- Identifying elementary lesions is a necessary step toward dx’ing diseases
Macule
- Flat change in color
- <1cm
Patch
- Flat change in color
- >1cm
What is a pseudomembrane?
Removable plaque
Papule
- Solid raised lesion
- <1cm
Plaque
- Solid, slightly raised, flat or bumpy
- Fixed, not removable
Nodule
- Solid raised lesion
- >1cm
Tumor
- Solid raised lesion
- >5cm
Vesicle
- Raised, fluid-filled lesion
- <1cm
Bulla
- Raised, fluid-filled lesion
- >1cm
Pustule
- Raised, contains purulent (pus) material
Erosion
Lesion with partial loss of epithelium
Ulcer
Lesion with complete loss of epithelium
