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Oral Pathology > LO 6 > Flashcards

LO 6 Flashcards

1
Q

Describe developmental disorders

A
  1. A failure during the process of cell division and differentiation into various tissues and structures
  2. Some may be identified clinically, by radiographic examination, biopsy, or histologic examination
  3. Inherited disorder - Caused by an abnormality in genetic makeup
  4. Congenital disorder - Present at birth (May be inherited or developmental); The cause of most congenital abnormalities is unknown
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2
Q

Describe Ankyloglossia (Developmental Soft Tissue Abnormalities)

A
  1. An extensive adhesion of the tongue to the floor of the mouth
  2. Can affect feeding and speech
  3. Treatment - Frenectomy
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3
Q

Describe Lingual Thyroid (Developmental Soft Tissue Abnormalities)

A
  1. A small mass of thyroid tissue located on the tongue
  2. Results from the failure of the primitive thyroid tissue to migrate from its developmental location in the area of the foramen cecum on the posterior portion of the tongue to its normal position in the neck
  3. Treatment - It may be removed if it is obstructive, provided the patient has other functioning thyroid tissue
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4
Q

Describe developmental cysts

A
  1. An abnormal fluid-filled epithelium-lined sac or cavity
  2. Most common oral cyst - Radicular cyst (periapical cyst) or Residual cyst
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5
Q

Developmental cysts are classified as __________ or ____________

A
  1. Odontogenic
  2. Nonodontogenic
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6
Q

What information is needed to classify cysts?

A
  1. Location
  2. Cause
  3. Origin of the epithelial cells
  4. Histologic appearance
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7
Q

Describe developmental cysts’ relationship to bone and soft tissue

A
  1. They can cause expansion of bone
  2. Intraosseous cysts: Occur within bone
  3. Extraosseous cysts: Occur in soft tissue
  4. Cysts within bone generally appear as well-circumscribed radiolucencies
  5. They may appear as unilocular or multilocular
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8
Q

Describe Odontogenic: Dentigerous
Cysts (Follicular Cysts)

A
  1. Forms around the crown of an unerupted or developing tooth
  2. The epithelial lining originates from the reduced enamel epithelium after the crown has formed and calcified
  3. Most commonly occurs around the crown of an unerupted or impacted third molar
  4. Radiographic - A well-defined, unilocular radiolucency around the crown of an unerupted or impacted tooth
  5. Histologic - The lumen is most characteristically lined with cuboidal epithelium surrounded by a wall of connective tissue
  6. Treatment - Removal of the cyst (There is some risk of cystic transformation into a neoplasm)
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9
Q

Describe an odontogenic eruption cyst

A
  1. Similar to a dentigerous cyst
  2. Found in the soft tissue around the crown of an erupting tooth
  3. Occurs only on primary teeth, fairly common
  4. Pain associated with inflammation only, very small risk of infection
  5. No treatment
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10
Q

Describe an odontogenic Primordial Cyst

A
  1. Develops in place of a tooth
  2. Most commonly in place of a third molar
  3. Most often seen in young adults and discovered on radiographic examination
  4. Histology - The lumen is lined by stratified squamous epithelium surrounded by parallel bundles of collagen fibers; It may prove to be an odontogenic keratocyst or a lateral periodontal cyst
  5. Treatment - Surgical removal; The risk of recurrence depends on the diagnosis
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11
Q

Describe a Keratocyst (OKC)

A
  1. Histology - The lumen is lined by epithelium; Most often seen in the mandibular third molar region
  2. Can move teeth and cause resorption
  3. Treatment - Because of the high recurrence rate, surgical excision and osseous curettage are recommended
  4. Radiographic - Frequently appears as a well-defined, multilocular, radiolucent lesion; High recurrence rate!
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12
Q

Describe a Calcifying Odontogenic Cyst (COC)

A
  1. A nonaggressive, cystic lesion lined by odontogenic epithelium
  2. Closely resembles an ameloblastoma
  3. Has a characteristic feature called ghost cells
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13
Q

Describe a Lateral Periodontal Cyst

A
  1. Lateral periodontal cyst is most often seen in the mandibular cuspid and premolar area
  2. It is an asymptomatic, unilocular or multilocular radiolucent lesion on the lateral surface of a tooth root
  3. Botryoid odontogenic cyst = multilocular variant of lateral periodontal cyst
  4. Lateral periodontal cyst is found most often in males
  5. Histology - A gingival cyst has the same type of lining as the lateral periodontal cyst but is located in the soft tissue; A thin band of stratified squamous epithelium lines the gingival cyst
  6. Treatment - Surgical excision
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14
Q

Describe Glandular Odontogenic Cysts (GOC)

A
  1. Microscopic appearance: Multicystic lesions
  2. Eosinophilic cuboidal cells on the surface of the epithelium
  3. Columnar cells with cilia
  4. Intraepithelial microcysts
  5. Affects males and females
  6. Most common 50-59 years
  7. Appears similar to ameloblastoma or odontogenic keratocyst (OKC)
  8. High recurrence rate
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15
Q

Describe Nasopalatine Canal Cyst (Incisive Canal Cyst)

A
  1. Located within the nasopalatine canal or the incisive papilla
  2. More common for males
  3. 40-60 years old
  4. Usually asymptomatic
  5. May see a small, pink bulge near the apices and between the roots of the maxillary central incisors on the lingual surface
  6. Radiographic - A well-defined, radiolucent lesion; May be oval or heart-shaped
  7. Histology - Lined by epithelium varying from stratified squamous to pseudostratified ciliated columnar epithelium; Client might have salty taste
  8. Treatment - Surgical excision
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16
Q

Describe a Median Palatine Cyst

A
  1. A well-defined, unilocular radiolucency
  2. Located in the midline of the hard palate
  3. Histology - Lined with stratified, squamous epithelium surrounded by dense fibrous connective tissue
  4. Treatment - Surgical removal
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17
Q

Describe Nasolabial Cysts

A
  1. A soft tissue cyst
  2. Thought to originate from the lower anterior portion of the nasolacrimal duct
  3. Observed in adults 40 to 50 years of age
  4. 4:1 ratio in favor of females
  5. Clinical - An expansion or swelling in the mucobuccal fold in the area of the maxillary canine and the floor of the nose
  6. Histology - Lined with pseudostratified, ciliated columnar epithelium and multiple goblet cells
  7. Treatment - Surgical excision
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18
Q

Describe Lymphoepithelial Cysts

A
  1. Most commonly found in major salivary glands
  2. A stratified squamous epithelial lining surrounded by a well-circumscribed component of lymphoid tissue
  3. Appears to arise from epithelium trapped in a lymph node during development
  4. Most commonly found intraorally on the floor of the mouth and the lateral borders of the tongue
  5. Appears as a pinkish-yellow raised nodule
  6. Treatment - Surgical excision
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19
Q

Describe Epidermal Cysts

A
  1. A raised nodule on the skin of the face or neck
  2. May be noted intraorally on occasion
  3. Histology - Lined by keratinizing epithelium that resembles the epithelium of the skin; The lumen is usually filled with keratin scales
  4. Treatment - Surgical excision
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20
Q

Describe Dermoid Cysts

A
  1. A developmental cyst often present at birth or noted in young children
  2. It is usually found on the floor of the mouth when it is located in the oral cavity
  3. May cause tongue displacement
  4. May have a doughy consistency when palpated
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21
Q

Describe Thyroglossal Tract (Duct) Cysts

A
  1. Forms along the tract the thyroid gland follows in development
  2. Found in young individuals (<20 years of age)
  3. No sex predilection
  4. Treatment - Excision of the cyst and tract
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22
Q

Describe Globulomaxillary Cysts

A
  1. A well-defined, pear-shaped radiolucency
  2. Located between the roots of the maxillary lateral incisor and cuspid
  3. Treatment - Surgical removal
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23
Q

Describe Pseudocysts

A
  1. Not true cysts because they are not lined by epithelium
  2. Static bone cyst
  3. Simple bone cyst
  4. Aneurysmal bone cyst
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24
Q

Describe Stafne Defect

A
  1. A pseudocyst
  2. Not a pathologic cavity
  3. Clinically: An anatomic depression on the posterior lingual area of the mandible
  4. No treatment
  5. A well-defined, cystlike radiolucency
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25
Q

Describe Simple Bone Cysts

A
  1. A pathologic cavity in bone that is not lined with epithelium
  2. May be associated with trauma
  3. Radiographic - A well-defined unilocular or multilocular radiolucency; Characteristically shows scalloping around roots of teeth
  4. Treatment - Curettage on the wall lining the void
26
Q

Describe Aneurysmal Bone Cysts

A
  1. A pseudocyst
  2. Consists of blood-filled spaces surrounded by multinucleated giant cells and fibrous connective tissue
  3. Radiographic - Multilocular appearance: “Honeycomb,” “soap bubble”; Usually seen in persons less than 30 years old; Slight predilection for females
  4. Treatment - Surgical excision
27
Q

list the types of abnormalities in the number of teeth

A
  1. Anodontia
  2. Hypodontia
  3. Supernumerary teeth
28
Q

Describe Anodontia

A
  1. The congenital lack of teeth
  2. Total anodontia is lack of all teeth
  3. May be associated with ectodermal dysplasia
29
Q

Describe Hypodontia

A
  1. The lack of one or more teeth
  2. The most common missing permanent teeth are - Mandibular and maxillary third molars; Maxillary lateral incisors; Mandibular second premolars
  3. The most common missing deciduous tooth is the mandibular incisor
  4. Tends to be familial
  5. May be a component of a syndrome
  6. Treatment - May require prosthetic replacement; Orthodontic evaluation and treatment may be necessary
30
Q

Describe Supernumerary Teeth

A
  1. Extra teeth
  2. May result from formation of extra tooth buds in the dental lamina or from the cleavage of already existing tooth buds
  3. already existing tooth buds
    May occur in either deciduous or permanent dentition
  4. Most often seen in the maxilla
31
Q

Describe mesiodens

A
  1. The most common supernumerary tooth
  2. Located between the maxillary incisors
  3. May be inverted when seen on radiographs
32
Q

Describe distomolars

A
  1. The second most common supernumerary tooth
  2. Located distal to the third molar
33
Q

Describe treatment for Supernumerary Teeth

A
  1. Erupted teeth may require removal if they cause crowding, malposition of adjacent teeth, or noneruption of normal teeth
  2. Nonerupted teeth should be extracted because a risk exists for cyst development around the crown
  3. Multiple supernumerary teeth may be associated with cleidocranial dysplasia or Gardner syndrome
34
Q

List the abnormalities in the size of teeth

A
  1. Microdontia
  2. Macrodontia
35
Q

Describe Microdontia

A
  1. One or more teeth is (are) smaller than normal
  2. Microdontia involving a single tooth is far more common
  3. Maxillary lateral incisor and maxillary third molar are the most commonly involved teeth
  4. True generalized microdontia - Seen in a pituitary dwarf; all teeth are smaller than normal
  5. Generalized relative microdontia - Normal-size teeth appear small in a large jaw
36
Q

Describe macrodontia

A
  1. One or more teeth are larger than normal
  2. True generalized macrodontia - Seen in cases of pituitary gigantism
  3. Relative generalized macrodontia - Large teeth in a small jaw
  4. Large teeth in a small jaw
    Macrodontia affecting a single tooth - May be seen in cases of facial hemihypertrophy
37
Q

List abnormalities of the shape of teeth

A
  1. Gemination
  2. Fusion
  3. Concrescence
  4. Dilaceration
  5. Enamel pearl
  6. Talon cusp
  7. Taurodontism
  8. Dens in dente
  9. Dens evaginatus
  10. Supernumerary roots
38
Q

Describe gemination

A
  1. A single tooth germ attempts to divide in two
  2. Appears as two crowns joined together by a notched incisal area
  3. Radiographically, usually one single root and one common pulp canal exist
  4. The patient has a full complement of teeth
39
Q

Describe fusion

A
  1. The union of two normally separate adjacent tooth germs
  2. Appears as a single large crown that occurs in place of two normal teeth
  3. Radiographically, either separate or fused roots and root canals are seen
  4. The patient is usually short one tooth
40
Q

Describe Hypercementosis

A
  1. Excessive cementum on the roots of the teeth
  2. Occurs in adults; incidence and amount increase with age
  3. Feature associated with several local and systemic factors
  4. No treatment necessary
41
Q

Describe Concrescence

A
  1. Two adjacent teeth are united by cementum
  2. Usually discovered on radiograph
42
Q

Describe Dilaceration

A
  1. An abnormal curve or bend in the root of a tooth
  2. Usually discovered on radiograph
  3. May cause a problem if the tooth must be removed or a root canal performed
43
Q

Describe Enamel Pearls

A
  1. A small, spherical enamel projection on a root surface
  2. Usually found on maxillary molars
  3. Radiographically, it appears as a small, spherical radiopacity
  4. Removal may be necessary if periodontal problems occur in the furcation
44
Q

Describe Talon Cusps

A
  1. An accessory cusp located in the cingulum area of a maxillary or mandibular permanent incisor
  2. Contains a pulp horn
  3. May interfere with occlusion
45
Q

Describe Taurodontism

A
  1. The teeth have elongated pulp chambers and short roots
  2. May occur in both deciduous and permanent dentition
  3. Identified on radiographs
  4. Resemble teeth of bulls
46
Q

Describe Dens Invaginatus

A
  1. Occurs when the enamel organ invaginates into the crown of a tooth before mineralization
  2. Radiographically, it appears as a toothlike structure within a tooth
  3. Vulnerable to caries, pulpal infection, and necrosis
47
Q

Describe Dens Evaginatus

A
  1. An accessory enamel cusp found on the occlusal tooth surface
  2. Most often seen on mandibular premolars
  3. May cause occlusal problems
48
Q

Describe Supernumerary Roots

A
  1. May involve any tooth
  2. Most commonly, maxillary and mandibular third molars if multirooted teeth are involved
  3. May become clinically significant if removal or endodontia is necessary
49
Q

List the abnormalities of tooth structure

A
  1. Enamel hypoplasia
  2. Enamel hypocalcification
  3. Endogenous staining of teeth
  4. Regional odontodysplasia
50
Q

Describe Enamel Hypoplasia

A
  1. The incomplete or defective formation of enamel

May be due to many factors, including:
1. Amelogenesis imperfecta
2. Febrile (fever causing) illness (measles, chickenpox, scarlet fever)
3. Vitamin deficiency
4. Infection of a deciduous tooth
5. Ingestion of fluoride
6. Congenital syphilis
7. Birth injury, premature birth
8. Idiopathic factors

51
Q

Describe Enamel Hypoplasia Caused by
Febrile Illness or Vitamin Deficiency

A
  1. Ameloblasts are one of the most sensitive cell groups in the body
  2. Any serious systemic disease or severe nutritional deficiency can produce enamel hypoplasia
52
Q

Describe Enamel Hypoplasia Resulting
from Local Infection or Trauma

A
  1. Enamel hypoplasia of an adult tooth may result from infection of a deciduous tooth
  2. A single tooth is usually affected; it is referred to as a Turner tooth
  3. The color of the enamel may range from yellow to brown, or severe pitting and deformity may be involved
  4. Ultrasonics/air polishers contraindicated due to fragility of enamel
  5. Caries risk should be evaluated
53
Q

Describe Enamel Hypoplasia Resulting
from Fluoride Ingestion

A
  1. Affected teeth exhibit a mottled discoloration of enamel
  2. Ingestion of water with two to three times the recommended amount of fluoride leads to white flecks and chalky opaque areas of enamel
  3. Four times the recommended amount of fluoride causes brown or black staining
54
Q

Describe Enamel Hypoplasia Resulting
from Congenital Syphilis

A
  1. Congenital syphilis is transmitted from an infected mother to her fetus via the placenta
  2. Hutchinson incisors are shaped like screwdrivers
  3. Mulberry molars have a berrylike appearance
55
Q

Describe Enamel Hypoplasia Resulting from Birth Injury, Premature Birth, or Idiopathic Factors

A
  1. Enamel hypoplasia may occur as a result of trauma or injury at the time of birth
  2. Even a mild illness or systemic problem can result in enamel hypoplasia
56
Q

Describe Enamel Hypocalcification

A
  1. A developmental anomaly resulting in a disturbance in the maturation of the enamel matrix
  2. Usually appears as a chalky, white spot on the middle third of smooth crowns
  3. The underlying enamel may be soft and susceptible to caries
57
Q

Describe Endogenous Staining of Teeth

A
  1. The result of deposition of substances circulating systemically during tooth development

May be due to:
1. Tetracycline stain also known as black bone staining - can cross placental barrier
2. Erythroblastosis fetalis: Rh incompatibility
3. Neonatal liver disease
4. Congenital porphyria: An inherited metabolic disease

58
Q

Describe Regional Odontodysplasia
(Ghost Teeth)

A
  1. Exhibit a marked reduction in radiodensity and a characteristic ghostlike appearance
  2. Very thin enamel and dentin are present
  3. Usually treated by extraction
59
Q

List Abnormalities of Tooth Eruption

A
  1. Impacted teeth cannot erupt because of an obstruction
  2. Embedded teeth do not erupt because of lack of eruptive force
  3. Ankylosed teeth
60
Q

Describe Impacted and Embedded Teeth

A
  1. Any tooth can be impacted
  2. Third-molar impactions are classified according to the position of the tooth
  3. Teeth can be completely impacted in bone or they may be partially impacted
  4. Partially impacted teeth are prone to infection
  5. Impacted teeth may be surgically removed to prevent odontogenic cyst and tumor formation or damage to adjacent teeth
  6. The optimal time is between 12 and 24 years of age
61
Q

Describe Ankylosed Teeth

A
  1. Tooth cementum fused to bone
  2. Prevents exfoliation of the deciduous tooth and eruption of the underlying adult tooth
  3. The ankylosed deciduous tooth appears submerged and has a different sound when percussed (a kind of dull thud)
  4. The periodontal ligament space is lacking
  5. Difficult to extract - Removal of deciduous teeth is necessary for eruption of the adult successor; Removal of adult teeth may be necessary to prevent malocclusion, caries, and periodontal disease

Oral Pathology (11 decks)

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