Oral Pathology 1 Flashcards
What oral pathology is associated with “strawberry tongue?” And which papillae is inflamed and hyperplastic?
Scarlet Fever
Fungiform papillae
How is a Turner Tooth formed? And which tooth does it most likely occur on?
Trauma infection on developing tooth bud
- Mandibular pre-molars
Which versions of the human papilloma virus are shown to cause cancer?
HPV 16, 18
What pathology is associated with a “ground glass appearance” seen on a radiograph?
Fibrous dysplasia
What pathology is associated with a “cotton wool appearance” seen on a radiograph?
Paget’s disease of bone
Which medication is associated with intrinsic tooth staining?
Tetracyclines
What is the etiology of condyloma acuminatum?
HPV
Describe candidiasis.
- Opportunistic infection “yeast”
- White, wipeable “patch” with red base
- “Thrush” in newborns/infants
Describe median rhomboid glossitis.
- Red atrophy of FILIFORM papillae
- Midline tongue, junction of anterior 2/3 and posterior 1/3 at tuberculum impar
- Caused by chronic candidaisis
What pathology is associated with wandering transected nerve with scar tissue, which presents as a painful or tender lump or nodule?
Traumatic Neuroma
What pathology is similar in appearance to a pyogenic granuloma, but is often “liver-colored” and contains multinucleated giant cells?
Peripheral giant cell granuloma
What is the most common connective tissue tumor?
Fibroma
Describe Luekoplakia.
- White patch that does NOT wipe off
- Cytology smear does not help determine specific diagnosis - do biopsy
What type of luekoplakia is more likely to have severe dysplasia or worse and undergo malignant transformation to carcinoma?
Erythroplakia
Tx - incisional biopsy
What is the most common site of squamous cell carcinoma?
Mid-lateral border of the tongue
Where is the most common site for metastatic disease of the bone to show orally?
Posterior mandible - usually a lucency without sclerotic border
Describe monomorphic adenoma.
Most common found on upper lip
Asymptomatic, not a “mucocele” of the lower lip
What is luekodema?
Intracellular edema of cells, often seen in African Americans, to test for this - pull on buccal mucosa to see if it disappears or dissipates. - No Tx necessary
What is verrucous carcinoma?
“Snuffer’s cancer”
- Large, elevated, papillary often associated with smokeless tobacco, in buccal vestibule
- No tendency to metastasize
What tumor suppressor gene is most commonly associated with squamous cell carcinoma?
p53 tumor suppressor gene
What is the most common tumor of salivary gland origin?
Pleomorphic adenoma
most commonly found on the palate
What salivary gland tumor is most likely to show perineural invasion?
Adenoid cystic carcinoma
What is the most common true odontogenic tumor, that shows a multilocular radiolucency?
Ameloblastoma - often associated with impacted teeth
What presents as a radiopacity with a radiolucent rim and can either be compound or complex?
Odontomas
- Compound - indentifiable toothlets (anterior maxilla)
- Complex - unidentifiable mass (posterior of jaws)
What shows snow flake calcifications in the radiolucency surrounding the crown and a portion of the impacted tooth’s root?
Adenomatoid odontogenix tumor (AOT)
What are the radiographic presentations of amelogensis imperfecta?
Enamel is missing, pulp chambers and root canals appear normal
What is the clinical and radiographic presentations of dentinogenesis imperfecta?
Opalescent dentin - blue sclera
- lack pulp chambers and root canals, bell-shaped crown with constricted cervical region
What pathology presents with multi-locular, bilateral lucencies, often seen in young people and causes jaw expansion?
Cherubism
Describe fibrous dysplasia.
- Unilateral mandibular or maxillary expansion, “teeth don’t fit”
- Painless swelling
- Cafe au lait pigmentation
- Ground glass appearance - Xrays
- Tx - cosmetic bone shaving
How will teeth test when they’re associated with condensing osteitis?
Nonvital - Tx = RCT
What pathology is associated with scalloped margins seen on radiographs? And what is the treatment?
Traumatic bone cyst - spontaneous healing without treatment following exploratory surgery (psuedocyst)
What are some key characteristics of Paget’s disease of bone?
- Bilateral maxilla affected
- Bone can undergo malignant transformation (osteosarcoma)
- Cotton wool appearance
- 50% hypercementosis
What is the Hand-Schuller-Christian traid?
- Diabetes insipidus
- Exopthalmos
- Bone Lesions
* *Often seen in Langerhans Cell Disease
What tumor/cyst is rarely seen on radiographs and why?
Nasolabial cyst - usually in soft tissue, not bone
What are some key characteristics of Odontogenic Keratocysts?
- Radiolucent multilocular lesion with a high recurrence.
What pathology is associated with bifid ribs and calcification of the falx cerebri?
Nevoid basal cell carcinoma syndrome
What is morsicatio buccarum?
Cheek nibbling -
White rough, tissue tags above and below occlusal plane (linea alba)
What are some characteristics with Gardner syndrome?
- Multiple facial osteomas & skin nodules
- Hyperdontia, unerupted teeth
- Multiple GI polyps –> colon carcinoma
Which way will a jaw deviate upon opening in patients with temporomandibular dysfunction?
Toward the painful side opening
Which was does the TMJ disc move and why?
Anteriorly and medially - due to the contraction of the lateral pterygoid muscle
What lesion are considered “target or bulls-eye lesions?”
Erythema Multiforme
What is Stevens-Johnson sydrome?
Erythema multiforme major
- Eye (conjuntiva), mouth (labial mucosa), genitalia
What demonstrates immunoglobulin fluorescence intraepithelial cementing substance, as well as a positive Nikolsky sign?
Pemphigus Vulgaris
What is associated with induration of the soft tissues and generalized widening of the PDL space?
Scleroderma (Progressive systemic sclerosis)
What happens in benign migratory glossitis?
- Depapillated areas of tongue (filiform papillae atrophied), wit keratin & epithelial debris
What is the treatment for Geographic tongue?
Dexamethasone (corticosteroid rinse)
Where do basal cell carcinomas present?
Ulcer of the upper lip, elsewhere on sun-exposed face with raised margins (does not occur intra-orally)
What presents as a slight radiopaque, dome-shaped, emanating from floor of maxillary sinus?
Antral pseudocyst
What can arise from dentigerous cysts?
Unicystic ameloblastomas
What presents as a pericoronal radiolucency attached at CEJ of unerupted tooth, and also what is a good differential diagnosis?
- Dentigerous cyst
- Ameloblastoma
- Residual cyst
- Odontogenic keratocyst
- Odontogenic myxoma
What describes the elongation and/or calcification of the stylohyoid ligament?
Eagle Syndrome -
Head and neck pain is elicited by chewing, yawning and opening mouth
What are some common signs seen in patients with Crohn’s disease?
- Granulomatous gingivitis
- Aphthous-like ulcers
- Rectal bleeding (intestinal skip lesions of small intestine)
