Oral Pathology Flashcards

(65 cards)

1
Q

What are the types of epithelial cysts

A

-Odontogenic
-Non-odontogenic

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2
Q

What are the types of odontogenic cysts

A

-Inflammatory
-Developmental

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3
Q

What are the types of inflammatory cysts

A

-Radicular
-Residual

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4
Q

What are the types of developmental cysts

A

-Odontogenic keratocyst
-Dentigerous cyst

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5
Q

What are the phases of cyst formation

A

-Source of epithelium
-Mechanism for epithelial proliferation
-Mechanism for continued growth

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6
Q

What are the sources of epithelium and which cysts use which source

A

-Hertwig’s root sheath (radicular and residual cysts)
-Reduced enamel epithelium (dentigerous cyst)
-Remnants of dental lamina (odontogenic keratocyst)

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7
Q

What are the mechanisms of continued cyst growth

A

-Internal hydraulic pressure (radicular, residual and developmental cysts)
-Bone resorption by cytokines (odontogenic keratocyst)
-Epithelial cell proliferation

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8
Q

What are the general clinical features of a cyst

A

-Swelling
-Pain if infection
-Displacement or loosening of teeth
-Eggshell crackling
-Signs of fluctuant

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9
Q

What are the features and treatment of a radicular cyst

A

-Associated with apex of non-vital tooth
-Unilocular, well defined, well corticated
-No resorption
-Treated with endo or surgical extraction

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10
Q

What are the features of a residual cyst

A

-Forms in an edentulous area
-Well-defined, oval radiolucency

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11
Q

What are the features and treatment of a dentigerous cyst

A

-Also called eruption cyst
-Found at the CEJ of unerupted teeth (8s and 3s)
-Unilocular, well corticated
-Treated with surgical excision or uncover tooth

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12
Q

What are the features and treatment of an odontogenic keratocyst?

A

-Found at the angle of the mandible
-Multilocular
-Associated with unerupted tooth

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13
Q

What is gorlin goltz syndrome

A

-Genetic disorder characterised by basal cell carcinoma
-Odontogenic keratocyst
-Pitting of palms, defects in spine and rib

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14
Q

What is a lateral periodontal cyst

A

-Associated with lateral roots of vital teeth
-Very small, round, well corticated
-Unilocular

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15
Q

What is a solitary bone cyst

A

-Associated with children and adolescents
-Occurs in the body of the mandible
-Monolocular, irregular outline

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16
Q

List non-neoplastic bone lesions

A

-Tori
-Bony exostosis

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17
Q

Describe tori

A

-Found in midline of hard palate or mandible
-Bony outgrowth
-Clear radiopacity on radiograph

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18
Q

List benign bone neoplasms

A

-Osteoma
-Gardener’s syndrome
-Chondroma
-Haemangioma (intraosseous)

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19
Q

List malignant bone neoplasms

A

-Myeloma (increased Bence-Jones protein)
-Lymphoma
-Metastases (from breast or lung)

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20
Q

Describe osteoma and gardener’s syndrome

A

-Osteoma is a slow growing benign tumour
-Common in mandible
-Gardener’s syndrome is when there are several osteomas of the jaw
-Gardener’s syndrome is genetic

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21
Q

What is a chondroma

A

-Benign neoplasm of cartilage
-Affects maxilla, mandible, palate

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22
Q

What is an intraosseous haemangioma

A

-Benign lesion of blood vessels
-More common in mandible than maxilla
-Causes mobility of teeth

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23
Q

What is a chondrosarcoma

A

-Formation of malignant cartilage
-Causes exfoliation of teeth
-Evidence of calcification representing cartilage formation
-Irregular bone destruction

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24
Q

What is an osteosarcoma

A

-Malignant tumour of the bone
-More common in mandible
-Rapid growth
-Parasthesia
-Loosening of teeth

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25
What is a myeloma
-Most common malignant tumour -Increased bence-jones protein in blood and urine -Pain, anaemia, infection -Punched out defects with radiolucent lesions
26
What is a lymphoma
-Pain and pathological fractures -Malignant neoplasm
27
What is alveolar osteitis
-Inflammation of the bone following failure of blood clot to form or premature loss of blood clot
28
What are the predisposing factors for alveolar osteitis
-Mandibular extractions -Traumatic extractions -Females -Oral contraceptive pills -Periodontitis -Smoking -Poor OH -Previous history of dry socket
29
Clinical affects of alveolar osteitis
-Pain -Halitosis -Granulation tissue forming from adjacent vital bone
30
Management of alveolar osteitis
-Irrigate socket with saline -Pack with Alvogyl -Analgesics -Review -Consider radiograph if concern of remaining tooth fragments in socket
31
How does alvogyl work
-Oxidised celloluse -Non-irritant antiseptic -Prevents bacterial and fungal infections -Contains medicament for pain-relief
32
What is osteomyelitis
-Infection of the medullary spaces -Can be due to bacterial infection of dental origin or extraction sites
33
What are the local predisposing factors for osteomyelitis
-Radiation to the jaw -Reduced blood flow and reduced healing -Paget's disease -Osteoporosis -Bisphosphonate medication
34
What are the systemic predisposing factors for osteomyelitis
-Immunosuppression -Diabetes -Leukaemia -Elderly -Corticosteroids -Chemotherapy
35
Symptoms of osteomyelitis
-Pain -Fever, malaise -Trismus (oedema of muscles of mastication) -Parasthesia -Pus
36
Complications of osteomyelitis
-Bacterial sepsis -Pathological fractures
37
Management of osteomyelitis
-Antibiotics -Pus sample to identify bacteria present -Surgery to remove necrotic bone
38
What is osteoradionecrosis
-Exposed radiated bone -More than 3 months -Without evidence of recurring tumour
39
How does radiation cause non-vital bone
-Thrombosis of the blood vessels suppling the bone -Causes loss of vitality -Aseptic necrosis
40
What are the symptoms of osteoradionecrosis
-Painful necrosis of the bone -If becomes infected, then spreads quickly -Sloughing of the soft tissues
41
What is the management of osteoradionecrosis
-Antibiotics (tocopherol or pentoxifylline) -Hyperbaric oxygen therapy -Surgical removal of the bone and reconstruction
42
What is MRONJ
-Medication related osteonecrosis of the jaw -Exposed bone for more than 8 weeks, probable through a fistula -Absence of radiation -Use of anti-resorptive or anti-angiogenic drugs -No metastases
43
Symptoms of MRONJ
-Pain -Discharge -Swelling
44
Aims of treatment in MRONJ
-Relieve pain -Control infection of bone and soft tissue -Minimise progression of bone necrosis
45
What is fibrous dysplasia
-Replacement of normal bone with poorly organised, immature bone and fibrous tissue
46
Clinical presentation of fibrous dysplasia
-Facial asymmetry -Associated with McCune Albright syndrome
47
What is paget's disease
-Abnormal bone remodelling -Caused by genetic and environmental factors
48
Dental relevance of Paget's disease
-Wider alveolar ridge -Poor fitting dentures -Derangement of the occlusion -Late stages can cause decreased vascularity and increased risk of osteomyelitis
49
What is cherubism
-Benign genetic condition affecting children -Bilateral enlargement of the maxilla and mandible
50
What is the treatment for cherubism
-Good OH -Extraction of unerupted teeth -Wait for growth cessation before surgical correction of facial deformities
51
What is ameloblastoma
-Benign neoplasm -Common in the mandible -Resorption of the soft tissues, painless, egg shell cracking
52
What is the treatment of ameloblastoma
Surgical excision with a high reoccurrence rate
53
What is the radiological appearance of ameloblastoma
-Soap bubble appearance -Borders are well defined and well corticated -Multilocular
54
What is the high risk area for oral SSC
-Floor of the mouth -Retromolar pad -Ventral surface of the tongue -Mandibular alveolus
55
How do oral cancers present
-Sore mouth ulcers non-healing -Indurated (firm) -Necrotic centre -Rolled borders -Red/white speckled -Non-homogenous -Bleeding/numbness in the mouth
56
Systemic manifestations of cancer
-Unexplained weight loss -Shortness of breath -Coughing up blood
57
Treatment options for oral cancers
-Surgery +/- radiotherapy -Chemoradiotherapy -Palliative care
58
List the major salivary glands and their salivary composition
Parotid - serous Submandibular - serous and mucous Sublingual - mucous
59
What is bacterial siladenitis
-Acute or chronic infection of salivary gland -Predisposing factor is reduced salivary flow -Staph. aureus infection
60
What are the risk factors for bacterial siladenitis
-Salivary gland stones/calculi -Diabetes -Sjorgrens syndrome -Hypothyroidism -Chronic renal failure -Medications
61
What are the clinical features of bacterial siladenitis
-Pus -Erythema and redness of the overlying soft tissue -Fever, malaise -Lymphadenopathy -Trismus
62
What is the management of bacterial siladenitis
-Antimicrobial therapy -Reverse predisposing factors -Good hydration -Good OH
63
What imaging options are used for bacterial siladenitis
-US -Sialography -MRI -CT Scan
64
What are the causes of viral siladenitis
-Mumps (paramyxovirus) -HIV -Cytomegalovirus
65
What is the clinical appearance of necrotising silometaplasia
-Occurs in hard palate -Crater-like ulceration -Indurated swelling -Surrounding erythema