Normal and Hyperplastic Oral Mucosa Flashcards
The lamina propria contains:
FCT which contains:
- Fibroblasts
- ECM with-
- Collagens
- Proteoglycans
- Glycoproteins
- Elastin
The epithelium and lamina propria are together known as the oral mucosa. Where is the basement membrane located?
Between them.
The epithelium and lamina propria are together known as the oral mucosa. Below this is the sub mucosa, which contains:
- FCT
- Fat
- Blood vessels
- Minor salivary glands
Depending on the site, there may be muscle or bone beneath the submucosa.
What parts of the mouth have no submucosa?
Gingiva, hard palate - oral mucosa is attached directly to periosteum
List the compartments of the epithelium of the oral mucosa
- Basal compartment
- Maturation compartment
- Keratin compartment (usually)
Cells found in the basal layer of the SSE
- Stem cells
- Melanocytes
- Langehans cells
What is the maturation layer of the SSE also called?
Prickle ell layer
Flatten as they rise and lose nuclei
Example of a place in the mouth there is no keratin
Floor of mouth
Proteins in Desmosomes:
- Plakoglobulin
- Desmoplakin
- Desmogleins
Epithelial cells are attached to the basement membrane via:
Hemi-desmosomes.
Proteins in hemi-desmosomes -
BP-230, BP-180
4 factors which influence the colour of the mucosa
- Vascularity of underlying CT
- Melanin pigmentation
- Thickness of the maturation compartment
- Thickness of keratin compartment
1 example of epithelial hyperplasia:
- Frictional keratosis
7 examples of mucosal hyperplasia
- Pyogenic granuloma
- Pregnancy epulis
- Fibrous epulis
- Fibro-epithelial polyp
- Denture-induced hyperplastic tissue
- Papillary hyperplastia of the palate
- Giant cell epulis (peripheral giant cell granuloma)
Soft reddish swelling on the interdental papilla, usually with an ulcerated surface which may be covered by a yellowish slough. Relatively painless
Pyogenic granuloma.
Inflammatory vascular lesion usually on gingivae.
Management of pyogenic granuloma:
Excisional biopsy. Removal of local factors.
Pyogenic granulomas may mature to form a:
Fibrous epulis
Pyogenic granuloma occuring in a pregnant female:
Pregnancy epulis
Management of pregnancy epulis:
Unless causing significant problems tx of a pregnancy epulis should be deferred until after birth when it will likely decrease and resolve.
Common fibrous mass occurring in the gingival margin. Pedunculated or sessile mass, which feels firm and is of similar colour to the adjacent gingivae.
Usually painless.
Fibrous epulis.
Btoh pyogenic granulomas and fibrous epulis may be ulcerated and covered in a yellowish slough
True or false
True
Management of fibrous epulis:
Excisional biopsy and remove local factors eg overhangs, rough restos.
What is the difference between a fibrous epulis and a fibro-epithelial polyp?
Fibro-epithelial polyp used for solitary nodules occurring in sites other than the gingiva.
Where do fibro-epithalial polyps usually occur?
Occlusal line of the buccal mucosa or lateral margin of tongue.
What is denture induced hyperplastic tissue
Folds of hyperplastic tissue which develop at the periphery of an ill-fitting denture. Shoudl reduce if denture adjusted or removed, but if extensive might need to be surgically removed to allow provision of new dentures.
Relatively common lesion which presents as a bluish or purple gingival mass. Thought to be a form of hyperplasia with proliferation of multi-nucleated cells.
Giant cell epulis (or peripheral giant cell granuloma)
Why are radiographs necessary before management of a peripheral giant cell granuloma?
To ensure no intra-bony pathology (exclude a central giant cell granuloma).
Lesion is then excised in total.
For multiple peipheral giant cell granulomas or any central giant cell granulomas, what condition should be excluded:
Hyperparathyroidism
How often does the epithelium turnover?
every 50-70 days
functions of the oral mucosa:
- Barrier (trauma, microbes, toxins)
- Sensory (touch, temp, taste)
- Secretory (IgA)
What age changes occur in the oral mucosa:
- Reduction in epithelial thickness
- Loss of elasticity
- Loss of innervation and blood supply
- Salivary gland atrophy and fibrosis
