MF SYNDROMES & PATHOLOGY Flashcards
- Develops in 1st trimester (4 weeks) due to 1st and 2nd branchial arch
- Condyle structure varies in severity but most severe has no TMJ
- 2nd most common craniofacial defect (CLP is 1st)
- Unilateral mainly but some are bilateral
- Correct with distraction osteogenesis
- Causes: environmental, genetic, no blood supply to 1st and 2nd arch
Hemifacial microsomia
Which syndromes have delayed eruption?
Aperts, Cleidocranial, Crouzons, Downs, Gardners, Progeria, or any endocrine disorders (hypo)
(NOT hemifacial microsomia)
Which syndromes have supernumeraries?
Cleidocranial dysplasia, Gardners (also CLP)
Osteomas, supernumerary teeth, sebaceous cysts, wormian bones, missing/hypoplastic clavicles
Cleidocranial dysplasia
Most common supernumeraries
Mesiodens > 3rd molars > laterals
(have them removed before ortho tx)
Missing teeth?
Ectodermal dysplasia
Ectopic eruption?
1-3% erupting into E space and canines
FBN1-Fibrillin 1 defect
Marfan Syndrome
F>M, occurs in 1%, can be reticular, erosive, desquamative on buccal mucosa, sores with burning or pain
Extremities: purple, pruritic, polygonal papulues
Lichen Planus
(NOT rheumatoid arthritis, AB treatment NO, treat with corticosteroids)
Hypoplastic maxilla, hyperplastic orbital rims, hypertelorism, class III, early surgery to release suture required. Coronal suture fuses at 2 years old but completely closes in adulthood.
Crouzon/Apert
Mental retardation, syndactyly, and autosomal dominant
Apert ONLY
Fusion of coronal suture (Bradyocephalic)
Crouzon
Coronal + Metopic + Sagittal (Dolichocephalic)
Apert
Neural crest cells fail to migrate to first and second branchial arch = both maxilla and mandible hypoplastic. NO mental retardation. Ear malformation, retruded mandible very obtuse with large antegonial notch, malar deficiencies, downward sloping eyes
Treacher Collins
Retrognathic mandible (hypoplastic/severe), posterior tongue position, respiratory problems (cyanosis at birth), lack of chin, prominence, cleft palate NOT cleft lip
Pierre Robins
Mental retardation, vascular problems, macroglossia, Class III, narrow arch, crossbites, periodontal disease, more likely to develop leukemia, simian crease in hand
Down syndrome
Autosomal dominant, occurs in 1:8000, affects both primary AND permanent dentition, blue sclera
Dentinogenesis Imperfecta
Drooping lower lip?
Facial nerve damaged
Paresthesia?
Inferior alveolar nerve damaged
Cause by pituitary adenoma, increase in growth hormone after fusion of epiphyseal plate, large sella and frontal sinus is affected more (causes frontal bossing)
Acromegaly
Increase in growth hormone before fusion of epiphyseal plates, large pituitary gland, mandibular prognathism
Gigantism
- More infectious: Hep B or HIV?
- Vaccines for Hep B (DNA) and Hep C (RNA)?
- Hep B (difficult to contract HIV)
- Hep B vaccine, Hep C no vaccine
Most are asymptomatic
Patients have weekly injection of interferon; epidemiology RNA
Hep C
Missing tooth and derived from enamel organ; does not have keratin lining like OKC
Primordial cyst
25-40% associated with unerupted tooth and derived from dental lamina
OKC
Posterior mandible, scalloping between teeth (well defined borders), no epithelial lining, unicystic
Traumatic/simple bone cyst
Uncommon odontogenic tumor, posterior mandible, radical resection of affected bony segment, unicystic are less common and less affressive than multicystic, 1% of all oral tumors, 18% of odontogenic tumors
Ameloblastomas
Pupil dilation and vessel constriction
Amphetamines
Mu, kappa, delta receptors, pupil constriction
Opioids
______ resorption on endo-treated teeth than normal vital teeth. Can be moved ______.
Most likely related to history of resorption if pre-existing or length of treatment during; NOT gender related (Houston)
- Less
- Immediately
- Condition that causes root resorption?
- Worst place to have RR?
- Most common in…
- Severe is defined as…
- Shamoshima, hypothyroid, hypoparathyroid, IL-B
- Upper lateral incisors
- Hispanics > Caucasians > Asians
- 4mm or 1/3 of original root length
Apexification: _______ root fracture
Increased
Best way to treat 1 wall defect
Extrude/upright
Bonds to hyproxyapatite in bone and inhibits resorption
- Parenteral vs oral?
Prevent relapse, determine if osteonecrosis by radiograph, decreases osteoclast activity, effect on osteoblasts is they can’t function in inflammatory environment
Bisphosphonates
- Parenteral contraindicated
- Oral okay
Midfacial cleft/Ora-facial clefting
Hypertelorism
Syndrome occurs in the 1st stage of craniofacial development
Fetal Alcohol Syndrome
2nd stage?
Anencephaly
3rd stage
Hemifacial/Treacher Collins
4th stage
CL/CP
5th stage
Aperts/Crouzons
Failure to fuse median nasal process and maxillary process
CL/P
- Lip 6 weeks, Palate 8-10 weeks
- Lip closure?
- Alveolar graft?
- Missing teeth?
- Most common in…
- Prevalence?
- 3 months old
- 1/2-2/3 root development of canine
- Upper Bs most common
- Native American > Asian > Caucausian > AA
- 1:700 CL/P
Failure to fuse sagittal suture, dolichocephalic head - long AP
Scaphocephaly
Most common benign salivary tumor
Pleomorphic adenoma
Most common odontogenic tumor
Odontoma
Hemophilia A or B more common? Give tylenol for pain, no premedication for ortho, but yes for extractions
Hemophilia A
No antibiotic prophylaxis for…
Mitral valve prolapse
Premedication?
- 1 hr before (2g Amoxicilin or 600mg Clindamycin)
- History of infective endocarditis
- Banding, removal, and TADs
Increase in lower facial height, lip apart posture, narrow alar base, and self-reported mouth breathing. Intraorally, clinicians see narrow maxillary arch with high palatal vault and a posterior crossbite with a Class II dental malocclusion
Adenoid facies (long face syndrome)
Bilateral anterior open bite?
Osteoarthritis/degenerative arthritis
Unilateral posterior open bite, shift to affected side, seen in young women, unknown cause but could be due to estrogen dysfunction
Idiopathic condylar resorption
