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Oral Path Powerpoints > Oral Path Info > Flashcards

Oral Path Info Flashcards

1
Q

Dentigerous Cyst (and hyperplastic dental follicle) Cause Commonality Most often which teeth Treatment

A

Cyst originating by separation of follicle. Fluid between reduced enamel epithelium and tooth crown Most common developmental cyst Mandibular 3rd molars Treatment: enucleation of cyst

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2
Q

Peripheral Ossifying Fibroma Originates from what Age and predilection Common region, exclusively on what Treatment

A

Originates from interdental papilla Age 15, 2/3 are female 50% in incisor/canine region Exclusively on gingiva Treatment: excision down to periosteum and scale adjacent teeth/ 15% RECUR from improper treatment

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3
Q

Mucous Membrane Pemphigoid Etiology Pathognomonic characteristic Most significant complication Treatment

A

Mucocutaneous autoimmune disease - Antibodies directed against Basement membrane Intraoral blister is pathognomonic Ocular involvement is most significant complication - can lead to blindness Treatment - possible referral to ophthalmologist Topical corticosteroids

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4
Q

Central Giant Cell Granuloma Neoplastic lesion? More common in which area Appearance is similar to what condition Treatment

A

Non-neoplastic More common in anterior jaw, midline Similar to Cherubism Treatment: Curettage with a 20% recurrence rate

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5
Q

Racial pigmentation Location Treatment

A

Most common on attached gingiva in darker complexioned patients Do nothing

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6
Q

Lichen Planus Def Identifiable characteristic 2 forms If confined to gingiva, called what Treatment Contraindications/risks of treatment

A

Chronic dermatologic disease Wickham striae Erosive and Reticular Gingiva - Desquamative gingivitis Treatment - Oral topical corticosteroids only when ulcerated - too much corticosteroids lead to candida, pain, burning Diabetics - steroids increase glucose

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7
Q

Fordyce Granules What is it Percent of population Where

A

Ectopic sebaceous glands 80% of population Buccal mucosa and lateral portion of vermillion of upper lip

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8
Q

Odontoma Commonality Types symptoms/discovered when Age Considered to be (what type of clinical description) Treatment

A

Most common odontogenic tumor Complex: Mass of enamel and dentin Compound: tooth like structures Asymptomatic, discovered on radiograph for failure of tooth eruption Age 15 considered to be a hamartoma Treatment: local excision, doesn’t recur

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9
Q

Torus/Exostoses Etiology Best known ones Other types Treatment

A

Localized bony protuberance arising form cortical plate Best known: Torus palatinus, torus Mandibularis Others: buccal exostoses, palatal exostoses, solitary exostoses Treatment: no treatment except removal if trauma is an issue (dentures)

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10
Q

Epulis Fissuratum Cause Appearance Location Associated with what condition (bump on the gums) Treatment

A

Hyperplasia of fibrous connective tissue in association with flange of ill-fitting denture Appearance: single or multiple folds of hyperplastic tissue in alveolar vestibule. Firm and fibrous, can be ulcerated and erythematous Facial aspect of alveolar ridge Also called Inflammatory Fibrous Hyperplasia Treatment: surgical removal, remake or reline denture

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11
Q

Mucocele Caused by Filled with what Most common location Treatment

A

Caused by trauma, rupture of salivary gland duct Mucin-filled Lower lip most common location Treatment: surgical excision with duct of minor salivary gland

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12
Q

Pemphigus Vulgaris Etiology Histo - 2 Treatment

A

Autoimmune disease - antibodies directed against desmosomes Histo: Acantholysis, Tzanck cells Treatment: Referral to dermatologist Corticosteroids

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13
Q

Adenomatoid Odontogenic Tumor (AOT) Radiographic term age Region of mouth, male female Origin Treatment

A

Snowflake Calcifications Age 10-20 (uncommon over 30) Mx>Md, F>M Tumor of odontogenic epithelium Treatment: enucleation

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14
Q

Lichen Planus Histo features - 4 (specific name of one feature) Treatment/Biopsy

A

Histo: 1. Pointed, saw tooth rete ridges 2. Band-like infiltrate of lymphocytes 3. Degenerating keratinocytes - Civatte bodies 4. Destruction of basal layer Bilateral and asymptomatic - no biopsy or treatment Asymmetric or symptomatic - biopsy and topical corticosteroids

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15
Q

Mucocele Most common locations Caused by Treatment Locations vs more serious conditions

A

Lower lip (most common), floor of mouth, anterior/ventral tongue, buccal mucosa Spillage of mucin into soft tissue, usually from trauma rupturing salivary gland duct Surgical excision with adjacent salivary duct Lower lip - benign mucoceles Upper lip - more likely to be salivary gland tumor Retromolar - tend to be mucoepidermoid carcinoma

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16
Q

Squamous Papilloma Cause Clinical Appearance - form, color, size Location Treatment

A

HPV types 6 and 11 Pedunculated, Exophytic, white red mucosal colored, enlarges to 5mm Tongue, lips, soft palate Treatment: Conservative surgical excision

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17
Q

Antral Pseudocyst How common Symptoms Increased prevalence during when Develops due to what

A

2-15% of population Asymptomatic Increase during winter months Due to accumulation of serum exudate (not mucous) beneath maxillary sinus mucosa

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18
Q

Odontogenic Keratocyst Etiology Recurrence Uni or multilocular Age Evaluate for what other condition Histo Treatment

A

Arises from cell rests of dental lamina 30% recurrence rate - up to 10 yrs after Both uni and multi-locular Young pts, less than 20 Evaluate for Gorlin Syndrome Histo: Palisading basement membrane Treatment: enucleate and curettage

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19
Q

Erythroleukoplakia Caused by Treatment Biopsy reveals what

A

Tobacco, Alcohol, Sanguinaria, UV, Microorganisms (syphilis, candida) Biopsy reveals advanced dysplasia Premalignant lesion

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20
Q

Angular Cheilitits Def Caused by what Treatment

A

Accentuated folds at corners of mouth C. Albicans or Staph Aureus Treatment: Antifungal

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21
Q

Lichen Planus Etiology 4 Ps of skin lesions Characteristic manifestation What two forms - which is more common

A

Common, chronic, immunologically mediated dermatologic disease Ps - Purple, Pruritic, Polygonal, Papules Wickham’s Striae - Lace-like network of white lines Two forms: Reticular (more common) Erosive

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22
Q

White Coated Tongue Scraped? Etiology - accumulation of what Causes Treatment

A

Can be Scraped Accumulation of bacteria and desquamated epithelial cells Lack of oral hygiene, High carb diet Periodic scraping/brushing

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23
Q

Peripheral Giant Cell Granuloma Cause age and predilection Distinct clinical/radiograph characteristic Similar to but different how, from what condition Treatment

A

Reactive lesion caused by irritation/trauma 35 yrs, 60% female Cupping resorption of alveolar bone Looks like Pyogenic granuloma, but more blue or purple Treatment: surgical excision down to bone, scale adjacent teeth 10% RECUR

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24
Q

Sialolith Cause Risk factors Most common location, why Symptoms Diagnose with what Treatment - 5

A

Calcifications developed in salivary duct Risk: mucous plug, bacteria, chronic blockage, xerostomia Location: Submandibular gland - long and tortuous duct with thick secretions Symptoms: Pain or swelling at meal time Dx: Radiograph, ultrasound, CT Treatment: Gentle massage, increased fluid intake, moist heat, sialogogue, surgery

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25
Q

Melanotic Macule types Oral counterpart to what Etiology Treatment

A

Oral counterpart to ephelis Etiology: brown asymptomatic macule produced by a focal increase in melanin production Treatment: can’t be distinguished clinically from early melanoma, biopsy required

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26
Q

Periapical cemento-osseous dysplasia Mostly in which gender Ethnicity Region in mouth Appearance of PDL Treatment

A

90% female 70% African American Periapical region of anterior mandible PDL will be intact, lesion not fused to roots Treatment: diagnosis definitive from clinical and radiograph exam, no biopsy required (same for florid)

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27
Q

Denture Stomatitis A type of what condition Caused by what Treatment

A

Type of Erythematous Candidiasis Caused by candida, not removing denture Treatment: Treat both denture and soft tissues Antifungal mouth rinse, soak denture in Nystatin

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28
Q

Ameloblastic Fibro-Odontoma (AFO) Age Location in mouth Origin Treatment

A

Age 10 Posterior jaw MIxed odontogenic tumor (odontogenic epithelium and odontogenic ectomesenchyme) Treatment: Conservative curettage

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29
Q

Geographic tongue also called what if not on tongue Kind of condition Symptoms Common in patients with what

A

Benign migratory glossitis Erythema migrans Inflammatory condition Burning / Pain Patients with fissured tongue

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30
Q

Focal Cemento-Osseous dysplasia Mostly in which gender Age Ethnicity Treatment

A

90% in females Average age 40 More common in caucasians Treatment: require biopsy, features are less specific

31
Q

When to treat cemento-osseous dysplasia

A

When radiolucent, lesions don’t cause problems When radiopaque, lesions can be hypovascular and prone to necrosis and secondary infection frequent recall

32
Q

Lateral Periodontal cyst Arises from what type of cyst Intrabony counterpart to what Common region Treatment

A

Arises from rests of dental lamina Developmental odontogenic cyst Counterpart to gingival cyst of the adult Mandibular/Premolar/Canine/Lateral incisor area Treatment: Conservative enucleation

33
Q

Nasopalatine duct cyst Etiology Commonality Treatment

A

Two passageways persist in midline between primary and secondary palates Most common non-odontogenic cyst Treatment: NEVER sit and watch Biopsy is mandatory surgical enucleation

34
Q

Recurrent Herpes Location Caused by Virus lies latent where Prodrome occurs when Always on what tissue Treatment/Healing

A

Indurated lesions on lip and keratinized bound mucosa HSV type 1 Trigeminal nerve Prodrome 6-24 hours before outbreak Intraoral lesions always on keratinized bound tissue Treatment: heals in 7 - 10 days Acyclovir for severe cases (shorten outbreak duration and lessen severity)

35
Q

Traumatic Ulcer Acute or Chronic trauma? Injuring usually from what Appearance Location Treatment When to biopsy Traumatic ulcer of tongue

A

Both acute or chronic Injury from dentition Erythema surrounding central removable, yellow fibrinopurulent membrane -Lips, tongue, buccal mucosa -remove source of trauma, topical analgesics Biopsy if not gone in 2-4 weeks TUGSE - traumatic ulcer on tongue

36
Q

Leukoplakia Def Causes Treatment Severities 80% of time it is what condition

A

Intraoral white plaque that does not rub off and cannot be identified as any well known entity Tabacco (80% are smokers), Alcohol, Sanguinaria, UV radiation, Microorganisms (treponema pallidum), Trauma Biopsy Mild dysplasia (lower 1/3 altered), Moderate dysplasia (lower 1/2), Severe dysplasia (aboe 1/2) This condition is precancerous 80% is hyperkeratotis PVL is highest risk of cancer

37
Q

Fibroma Cause Commonality Most common location Treatment

A

Caused by reactive hyperplasia of fibrous connective tissue from local irritation or trauma Most common tumor of oral cavity Buccal mucosa along bite line Treatment: conservative surgical excision MUST submit excised tissue for microscopic examination

38
Q

Parulis What Inflamed what kind of tissue Other names Treatment

A

Periapical abscess forms pus, follows least resistance, point of exit Subacutely inflamed granulation tissue Also called bum boil or intraoral sinus tract Treatment: Drainage, Gutta percha to find source of infection, extraction or endo treatment resolves infection

39
Q

Periapical Cyst Cause originate from what Symptoms Radiograph Growth speed Relation to removal of tooth Location Treatment

A

Inflammatory stimulation of epithelium in area From Rests of Malassez Asymptomatic with no pulpal response Radiographically identical to periapical granuloma Slow growth or static Can be residual upon affected tooth removal Can be found on side of root: lateral apical periodontal cyst RCT or extraction

40
Q

Pseudomembranous Candidiasis Known as what Resembles what Most common locations Scraped? Causes - 3

A

Thrush Resembles cottage cheese Buccal mucosa, palate, dorsal tongue Can scrape off - Broad spectrum antibiotics, impaired immune system (Leukemia, HIV, Infants), Asthma inhalers

41
Q

Black/Brown Hairy tongue Accumulation of what, which papilla Associated with what possible causes Symptoms/signs Treatment

A

Accumulation of keratin on filiform papilla Associated with Smoking, poor hygiene, antibiotics, radiation - Gagging, bad taste, halitosis, esthetics - Tongue Brushing/scraping with oral hygiene instruction

42
Q

Inflammatory Papillary Hyperplasia Cause clinical appearance symptoms Treatment

A

Caused by Ill fitting denture, Poor denture hygiene, Wearing it 24 hrs appearance: erythematous tissue, pebbly or papillary surface Asymptomatic Treatment: Removal of denture, Antifungal may help, surgical removal if lesions are advanced

43
Q

Leukoedema Location - Uni or bilateral Cause Treatment Test Ethnic Relation

A

Bilateral buccal mucosa, doesn’t rub off Caused by - variation of normal edematous swelling No treatment Stretch cheek, disappears up to 90% of African Americans - melanin

44
Q

Bump on the gums differential

A

Pyogenic Granuloma Peripheral Ossifying Fibroma Peripheral Giant Cell Granuloma Inflammatory Fibrous Hyperplasia

45
Q

Tonsilloliths Location Made of what Where on radiograph Secondary results, can promote what negative condition Symptoms Treatment

A

Pharyngeal tonsillar crypts Desquamated keratin and foreign material Midportion of ascending ramus on radiograph Secondarily colonized with bacteria, calcify, smell, promote recurrent tonsillar infections Asymptomatic Treatment: Gargle warm salt water, water jet, enucleation, excision

46
Q

Residual cyst Etiology Arises from what, why As cyst ages, what happens Treatment

A

Cyst that persists at site of previous tooth extraction Arises from rests of malassez stimulated by inflammation and infection Aging causes cellular components to degenerate, can lead to dystrophic calcification and central luminal radiolucency Treatment: surgical excision

47
Q

Traumatic Bone cyst Filled with what X-ray term True cyst? Etiology Treatment

A

Filled with fluid Scalloping Not a true cyst Trauma-hemorrhage theory most accepted - trauma doesn’t fracture, intraosseous hematoma, doesn’t repair correctly, liquifies Treatment: surgical exploration and curettage

48
Q

Primary Herpetic Gingivostomatitis Relation to HSV 1 Age Tissue type Risks to self Relation to eyes Treatment

A

Most common symptom of primary HSV 1 infection Majority occur before age 5 Both movable and non-movable mucosa Can self inoculate Leading infectious cause of blindness Treatment: Acyclovir - early treatment is more effective and shortens episode lengths

49
Q

Morsicatio Buccarum Other kinds Uni or Bilateral Length of time to wait/test

A

Labiorum, Linguarum Bilateral 2 weeks

50
Q

Eruption cyst analog to what etiology age treatment

A

Soft tissue analogue of dentigerous cyst Etiology - separation of dental follicle form around the crown of erupting tooth Usually under 10 yrs Treatment: Cysts usually rupture spontaneously, if not, excision of roof of cyst to permit eruption of tooth

51
Q

Varicosities Detected by what Treatment

A

Detected by blanching No treatment unless on lips or buccal mucosa - for thrombus or esthetics

52
Q

Idiopathic Osteosclerosis What Treatment

A

Focal area of increased radiodensity of unknown cause Treatment: no treatment. Biopsy if symptoms exist or if cortical expansion

53
Q

Lymphoepithelial Cyst What is it Colors Symptoms Size Location Treatment

A

Lesion within oral lymphoid tissue, submucosal mass White or yellow Asymptomatic Less than 1 cm in diameter Most common on lingual and palatine tonsils and FOM Waldeyer’s ring (palatine tonsils, lingual tonsils, pharyngeal adenoids), ventral tongue, soft palate Treatment: surgical excision (biopsy) or clinical diagnosis

54
Q

Stafne Defect Cause Def Location

A

Caused by portion of submandibular salivary gland Focal concavity of cortical bone Lingual surface of mandible, below mandibular canal

55
Q

Condensing Osteitis Distinguishing factor PDL appearance Distinguished from cemento-osseous dysplasia how Treatment

A

Associated with infection/Large restoration Thickened PDL No RL border, not cemento-osseous dysplasia Treatment: 85% regress after infection is eliminated

56
Q

Tobacco Pouch Keratosis Appearance of teeth Does not include Treatment - effective for how many, time period When to take biopsy

A

brown/black stain on teeth is common, localized No Induration, ulceration, or pain Habit cessation or switch sides of tobacco 2 weeks Biopsy if persists for 6 weeks

57
Q

Calcifying Odontogenic Cyst (COC) AKA Age Origin Cause Treatment

A

AKA Gorlin cyst age 35 Rests of Series and Malassez Unknown cause Simple enucleation or surgical excision

58
Q

Calcifying Epithelial Odontogenic tumor (CEOT) AKA Radiograph key term Age Location in mouth Histo and lab test Origin Treatment

A

AKA Pindborg tumor Driven snow pattern Avg. age is 40 Md>Mx, Post>Ant, F=M Liesegang rings (amyloid-like areas), Positive Congo Red test Tumor of Odontogenic Epithelium Treatment: conservative local resection with a narrow rim of bone or curettage

59
Q

Smoker’s Melanosis Etiology Treatment

A

Melanin production stimulated by nicotine - Cessation of smoking with biopsy if found in unexpected location or clinical changes

60
Q

Differential for midline radiograph lesions

A

Central Giant Cell Granuloma Ameloblastoma OKC GOC

61
Q

Linea Alba Location Causes How common

A

buccal mucosa, occlusal plane Pressure, irritation, sucking 10% of population

62
Q

Ameloblastoma Commonality Mostly occur in which region (except for which form) Uni or multilocular Bone formation Histo Treatment - most common procedure and size of cut

A

Most common clinically significant odontogenic tumor 85% occur in mandible molar ascending ramus region - except desmoplastic which occurs in anterior maxilla Multilocular RL Buccal-Lingual coritcal expansion Histo: Palisading basal layer Treatment: Varies, most common is marginal resection 1.5 cm beyond radiographic lesion

63
Q

Hypersensitivity type of reaction Two types - diffuse, localized, triggers

A

Allergic reaction -Contact stomatitis from cinnamon Toothpaste - diffuse Gum/candy - localized Plasma cell gingivitis - most cases related to hypersensitivity (Big red gum) Allergic reaction to cinnamaldehyde

64
Q

Desquamative Gingivitis Describes what Differential Biopsy?

A

Describes gingival epithelium that spontaneously sloughs or can be removed with minor manipulation Lichen Planus Pemphigoid Pemphigus Hypersensitivity reaction Biopsy required

65
Q

Drug related gingival hyperplasia Most common medications, used for what Treatment

A

Phenytoin (50%) - anticonvulsant, common in young pts Nifedipine (25%) - Calcium channel blocker Cyclosporine (25%) - Transplant therapy Brushing and flossing can help Change medication if possible

66
Q

Lymphoid hyperplasia other names what is it Typical cause Appearance Tenderness Location When to biopsy

A

Lingual Tonsil, Accessory Lymphoid Aggregates Enlargement of lymphoid tissue Typically from infection Discrete, submucosal swellings, yellow or normal color Non-tender Most common in oropharynx - Base of tongue Lateral tongue, lymph nodes, Soft palate, WALDEYER’S RING Biopsy when unilateral

67
Q

Amalgam Tatto Locations Treatment Other causes of tattooing

A

Gingiva, alveolar and buccal mucosa Treatment - biopsy only if radiograph is negative to rule out melanoma Other: pencil graphite, coal dust, metal dust, broken carborundum disks, burs, intentional tattooing

68
Q

Florid cemento-osseous dysplasia More common in which gender Ethnicity Uni or bi lateral Treatment

A

90% female 90% African American Tendency to be bilateral and symmetrical Treatment: diagnosis definitive from clinical and radiograph exam, no biopsy required (same for Periapical)

69
Q

Abcess Etiology - accumulation of what where Treatment

A

Accumulation of acute inflammatory cells (neutrophils) at apex Treatment: Root canal therapy

70
Q

Lipoma What Commonality Location Treatment

A

Benign tumor of fat Most common mesenchymal neoplasm 50% occur in buccal mucosa Surgical excision

71
Q

Periapical Granuloma How often is pulp involved in periapical lesion Pulpal irritants Commonality Symptoms Type of inflammation Cell types Radiographic features Treatment

A

95% pulpal involvement Bacteria, Mechanical, Thermal Most common periapical pathosis Most are asymptomatic with no pulpal response Chronic inflammation Plasma cells and lymphocytes Loss of lamina dura at root tip, root resorption possible Treat with RCT or extraction

72
Q

Aphthous Stomatitis AKA Caused by Occurs where Types Age Treatment

A

AKA - Recurrent Aphthous Ulcer or Canker Sore No universal etiology - may be allergy or immune dysfunction -Exclusively on movable mucosa Minor (85%), Major (10%), Herpetiform (5%) Usually in younger patients Treatment: no treatment or OTC meds Magic Mouthwash or prescribed corticosteroids

73
Q

Pyogenic Granuloma True Granuloma? Cause AKA Predilection for who, when Clinical features Age of lesion and color Treatment

A

Not a true granuloma Reactive lesion to local irritation or trauma, poor oral hygiene AKA Pregnancy tumor Female predilection, Pregnancy 1st trimester Clinical: proliferating capillaries, bleeds easily Young lesions: Red, Old: Pink Treatment: Surgical Excision, extending to periosteum Pregnancy - defer treatment unless esthetic problem

Oral Path Powerpoints (1 decks)

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