Lec 1: Course Intro & Descriptions Flashcards
Oral Pathology definition
Specialty of dentistry and pathology which deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions
What does an OMP do?
Studies the causes of diseases, mechanisms which produce them, sites where they occur and the resulting morphologic and functional alterations.
Diagnose disease using clinical, radiographic, microscopic, biochemical or other examinations
An oral pathologist diagnoses disease using clinical, ____, ______, biochemical or other examinations
radiographic, microscopic
What kinds of diseases do OMPs diagnose and manage?
oral soft tissue, bony
salivary glands
oral manifestations of systemic diseases
head and neck pain
The purpose of clinical differential diagnosis determines
the appropriate next step in patient management.
Decision tree
encourages the clinician to make a series of step-by-step decisions and consider a number of different lesions when formulating a clinical differential diagnosis
The Hail Mary Pass
Making your one best diagnostic guess by simply looking at the lesion
Surface lesions of oral mucosa do not exceed
2-3 mm in thickness
3 categories of surface lesions:
White
Pigmented (brown, blue, red, gray, black)
Red
Lumps and Bumps
2 categories:
Reactive enlargements
Tumor
tumor aka
neoplasm
tumors/neoplasm show
persistent and progressive growth
In decision tree, “tumor” is based on ______, not _____features
clinical behavior; microscopic
Reactive Soft Tissue 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 an enlargement is reactive, then determine
what the lesion is reacting to, eg. pulpal necrosis, periodontitis, injury or trauma
Tumor features
- 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 it is?
benign or malignant
Benign tumor features
Usually slowly growing (months-years)
Overlying mucosa is normal
Sometimes freely-movable (not attached to surrounding structures)
Asymptomatic
Benign tumors 4 categories
Epithelial
Mesenchymal
Salivary gland
Soft tissue cysts
Malignant tumor features
Rapidly growing (weeks-months)
Overlying mucosa is sometimes ulcerated
Fixed to surrounding structures
More often symptomatic
Complete and accurate description required for:
Medicolegal documentation
Determination of clinical diagnosis
Development of differential diagnosis
Elementary lesion are:
morphologic alterations
Generic terms used to describe diseases
Several diseases can affect the oral cavity
Various diseases are clinically similar
Identification of elementary lesions is a necessary step toward the diagnosis of diseases
Macule
Flat change in color <1cm
Patch
Flat change in color > 1 cm
Plaque
Solid, slightly raised, flat or bumpy
Pseudomembrane
Removable plaque
Papule
Solid raised lesion < 1 cm
Nodule
Solid raised lesion > 1 cm
Tumor
Solid raised lesion > 5 cm
Does tumor equal cancer?
NO
Vesicle
Raised, fluid-filled, lesion < 1 cm
Bulla
Raised, fluid-filled, lesion > 1 cm
Pustule
Raised, contains purulent (pus) material
Erosion
Lesion with partial loss of epithelium
Ulcer
Lesion with complete loss of epithelium
An elementary lesion can have the appearance of being (3)
Flat
Elevated
Depressed
Flat can be a
macule or patch
Elevated can be
fluid-filled
solid
Depressed
Erosion
Ulcer
A=
A = Anatomic location
B=
B = Border
C=
C = Color, Consistency, Configuration
D=
D = Diameter, Distribution
E=
E = Elementary lesion
Anatomic lesions around lips
Upper, lower, commissure, vermillion, labial mucosa
Anatomic lesions around papilla
Near tooth #, mucobuccal fold, parotid papilla
Anatomic lesions around gums
Free, attached, near tooth #, maxillary, mandibular
Anatomic lesions around tongue
Ant 1/3, mid 1/3, post 1/3, dorsal, ventral, lat borders
Anatomic lesions under tongue
Lingual frenum, sublingual folds, near tooth #
Anatomic lesions at roof of mouth
Hard, soft, midline, incisive papilla
Anatomic lesions back of throat
Pillars, midline, uvula
Border limits
Well-defined or poorly defined
Border contours
regular or irregular
Consistency examples
soft, firm, hard
Configuration surface
smooth, papillary, granular (small grains or particles), ulcerated, verrucous (trumpy), warty (numerous surface projections)
Only this type of lesion has a base?
elevated
Types of bases
pedunculated, sessile, not applicable
pedunculated
stalk base (base is smaller than mass)
sessile
broad base (base is equal to or larger than mass)
Diameter is measured in
centimeters
