Lec 6: Reactive Epithelial Cysts Flashcards
Fissured tongue: cause and clinical findings?
Cause: Hereditary is strong contributor Incidence increases with age Clinical Findings: Sometimes associated with geographic tongue
Fissured tongue–Significance and Management?
Variation of normal
Usually asymptomatic and no treatment needed
Encourage patient to brush tongue to remove debris
AKNYLOGLOSSIA is characterized by?
short lingual frenum
LINGUAL THYROID–cause?
Failure of thyroid gland to descend properly
GINGIVAL FIBROMATOSIS is?
Slowly progressive gingival enlargement
Caused by collagenous overgrowth of gingival tissue
Gingival Fibromatosis treatment?
Treatment: gingivectomy and rigorous oral hygiene
2 categories of soft tissue enlargements
Reactive
Tumors
“Tumor” means enlargement and is based on clinical features of being ____ and ____ and not on microscopic criteria
persistent and progressive
Reactive lesions examples (2)
Necrotizing silometaplasia (covered in SG lecture)
Mucocele (covered in SG lecture)
PARULIS/SINUS TRACK aka
“gum boil”, periodontal abscess
PARULIS/SINUS TRACK is a?
A gingival abscess secondary to periapical pathosis
Focus of pus in the gingiva
PARULIS/SINUS TRACK treatment?
Treating the underlying condition (periodontal pocket or nonvital tooth) achieves resolution of gingival abscess
IRRITATION FIBROMA(FIBROUS HYPERPLASIA)–caused by?
chronic irritation or trauma
IRRITATION FIBROMA(FIBROUS HYPERPLASIA)–clinical features?
Well-circumscribed, slowly growing
Smooth-surfaced, sessile, pink nodule
Typically firm
May be ulcerated or inflamed
IRRITATION FIBROMA(FIBROUS HYPERPLASIA)–treatment?
surgical excision
Denture-Leaf Fibroma:
Occurs on hard palate under a denture
INFLAMMATORY PAPILLARY HYPERPLASIA represents both?
Represents both fibrous and epithelial hyperplasia
INFLAMMATORY PAPILLARY HYPERPLASIA cause reactive process to?
Poorly fitting Dentures
Wearing dentures 24h/day
INFLAMMATORY PAPILLARY HYPERPLASIA clinical features?
Numerous red, edematous papillary projections
Associated with denture
INFLAMMATORY PAPILLARY HYPERPLASIA–therapeutic management?
Discontinue wearing denture 24h/day
Antifungal medication if candidosis is present
Excise large lesions
Construct new denture or reline/rebase existing denture
DRUG-RELATED GINGIVAL HYPERPLASIA–what drugs for this affect collagen remodeling and degradation?
Anticonvulsants: Phenytoin (dilantin); young
Calcium channel blockers: Nifedipine; middle-aged
Cyclosporine: broad age range
Soft Tissue EnlargementsBenign Tumors–usually grows slow or fast?
Usually slowly growing (months to years)
Soft Tissue EnlargementsMalignant Tumors–usually grows slow or fast?
Rapidly growing (weeks to months)
Categories of Benign Tumors
Epithelial
Mesenchymal
Salivary gland
Soft tissue cysts
Soft tissue cysts:
historical and clinical features are similar to those of benign tumors. Cysts are typically compressible
Papilloma
Pedunculated
Multiple finger-like projections with a pedunculated base
VERRUCA VULGARIS clinical features?
Similar to papilloma but verruca has a sessile base
More common on skin
CONDYLOMA ACUMINATUM–clinical features?
Usually multiple lesions
Most common in anogenital area
Typically sexually transmitted
CONDYLOMA ACUMINATUM–high risk HPV strands?
HPV 16,18, 31
Seborrheic keratosis is benign proliferation of
epidermal basal cells
Does seborrheic keratosis occur in the mouth?
NO
The ______ of soft tissue cysts can be a clue to diagnosis then determine what the lesion is reacting to:
location
A cyst consists of what 3 layers?
- Connective tissue wall
- Epithelial layer (lining)
- Lumen–often are fluid-filled, but not always
Cyst clinically, they are often ______
compressible
A SPACE-OCCUPYING LESION WITH an outer wall of fibrous connective tissue that surrounds a central cavity called the?
cyst
Epidermoid Cyst is a?
Keratin-filled cyst derived from hair follicle
Epidermoid (dermoid) cyst is most commonly found in the?
floor of the mouth (intraorally)
Gingival Cyst of the Adult occurs on?
attached gingiva anterior to first molars
Lymphoepithelial Cyst are what color?
yellow or white in color
Lymphoepithelial Cyst are almost always located:
Lateral and ventral tongue
Floor of the mouth
Thyroglossal Tract Cyst 60-80% of cases are?
below hyoid bone
Thyroglossal tract cyst occurs in?
the midline of the neck
Thyroglossal tract cyst characterized by?
Painless, fluctuant, movable swelling
All cysts are treated by?
excision
Reactive vs. Tumor
Reactive if take away the cause will regress but tumor will progress and persist unless removed.
Benign warty tumors of the Squamous Epithelium
Papilloma
Verruca vulgaris
Condyloma
HPV’s that has higher risk for cancer and associated with Condyloma?
16, 18, 31
What grows slowly and mimic benign tumors?
Soft tissue cysts
What cyst is at the floor of the mouth?
Epidermoid cyst
