Pathology Flashcards
Induced by stress, involves the dorsal and lateral borders of tongue; loss of filiform papilla (filiform papilla are atrophic), burning sensation, erythematous patches surrounded by white or yellow perimeter.
Geographic Tongue (benign migratory glossitis)
Associated with tobacco use, chemical rinses, alcohol or certain foods, dorsal surface, asymptomatic, filiform papilla become elongated, result from antibiotic, corticosteroid or radiation therapies, poor OH, TX is brushing tongue.
Hairy Tongue
Dorsal surface, variant of normal, TX is brushing tongue with a soft tooth brush.
Fissured Tongue
Ventral surface, red to purple enlarged vessels, observed in patient >60 years old.
Lingual Varicosities
Associated w/fungal infections from candida albicans, erythematoous area at the midline of the dorsal surface of the tongue anterior to the circumvallate papilla, seen in immuno-compromised individuals, no specific TX.
Median Rhomboid Glossitis
Enlarged tongue, described in patients with acromegaly.
Macroglossia
Trisomy 21; incidence increases with increased maternal age, fissured tongue, macroglossia, mouth breathing, decreased dental caries possibly due to hyper salivation, taurodontism, gingival and periodontal disease, crowding of teeth.
Down Syndrome
Tongue-tied, caused by a short lingual frenum.
Ankyloglossia
Benign lesion on hard palate of heavy smokers, the raised red dots represent the duct openings of minor salivary glands, coarse, white, wrinkled appearance.
Nicotine Stomatitis
Most common oral fungal infection from candida albicans, can occur in patient’s who are diabetics, HIV infection, Xerostomia, denture wearers, chemotherapy, and antibiotic therapy.
Candidiasis
What systemic administrated meds are used for candidiasis?
Ketoconazole and fluconazole (Diflucan)
White plaques that wipe off w/underlying red mucosa, burning or metallic taste, “thrush”, effects infants and elderly.
Pseudomembranous Candidiasis
2nd most common candidiasis and also known as acute atrophic candidiaisis, red mucosa
Erythematous
Erythematous mucosa, mucosa covered by the partial or denture, asymptomatic, usually women, denture stomatitis.
Chronic Atrophic Candidiasis
Redness or fissuring at the labial commissures, nutritional deficiencies such as insufficient riboflavin-Vitamin B2, persons who frequently lick their lips.
Angular Cheilitis
Erythematous area at the midline of dorsal of tongue, asymptomatic, immune-compromised patients.
Median Rhomboid Glossitis
Benign anomaly, gray to white film on buccal mucosa, stretching the mucosa makes the opalescence less noticeable, common in african americans.
Leuukoedema
“White Line”, hyperkeratotic, antero-posteriorly on the buccal mucosa along the occlusal plane, may be bilateral, may be prominent in patient with bruising or clenching habit (type A personalities?)
Linea Alba
White patch or plaque of oral mucosa that cannot be wiped off, related to use of tobacco, can range from hyperkeratosis to squamous cell carcinoma.
Leukoplakia
Etiologic agent appears to be Epstein-Barr virus in association with HIV, associated with patients with low CD4 counts, white patch seen on the lateral border of the tongue (may be the first oral manifestation of HIV disease), benign lesion
Hairy Leukoplakia
Flat, brown lesion. “oral freckle”, seen on lower lip also intraoral, monitor size and changes.
Melanotic Macule
Most common pigmented lesion, amalgam particles in soft tissues, refer to radiographic images.
Amalgam Tattoo
intraoral sebacceous (oil) glands, small yellow nodules on buccal mucosa and vermilion, seen after puberty.
Fordyce granules
Dilated superficial veins
Varicosities
Insufficient production of adrenal steroids due to destruction of the adrenal gland, diffuse pigmentation of the skin, melanotic macules on buccal mucosa, gingiva may extend to the tongue and lips, also petechiae are seen on the palate, bronzing, tinted skin.
Addison’s Disease
Most common tumor of the oral cavity, painless, result of chronic trauma such as cheek biting, smooth, pink, firm elevated nodule (a small node, cluster of cells), TX includes surgical excision.
Irritation/Traumatic Fibroma (New Growth)
Caused by human papilloma virus (HPV), pedunculate (stalk-like), warty, soft lesion, cauliflower-like appearance, TX is surgical excision, usually do not recur, on soft palate and uvula/
Papilloma
Can cause cutaneous or skin warts (Verruca)
HPV
White, papillary exophytic lesion.
Verruca Vulgaris
Common vascular lesion, considered developmental due to limited growth potential, tongue is the most common intramural location, when they occur on the tongue macroglossia can result, Girls>Boys.
Hemangioma
due to Ill-fitting denture in vestibule along the denture border, dense, fibrous CT, surface is often ulcerated, TX is surgical removal of excess tissue and construction of new denture.
Epulis Fissuratum
Form of denture stomatitis, always associated with removable appliance, palatal mucosa is covered w/red papillary projections; granular appearance, no fungal infection.
Papillary Hyperplasia of the palate.
commonly occurring intraoral lesion seen as result of injury, usually ulcerated, soft to the touch, bleeds easily, vascular appearance, common on gingiva where plaque or calculus forms. “pregnancy tumor”, TX is surgical excision, and may rear if the agent remains.
Pyogenic Granuloma
Seen on gingiva or alveolar process (usually anterior to the molars), dark red in color due to numerous blood vessels, more frequently <30 years, Women>men, TX by surgical excision and generally do not recur.
Peripheral Giant Cell GRanuloma
Rounded gingival margin, begins in the interdental papilla, increase bulk of attached and free gingiva, may be generalized or localized, caused by local irritants, hormonal changes, certain meds, or hereditary causes.
Gingival Hyperplasia
What meds cause Gingival Hyperplasia?
Phenytoin (Dilantin), Calcium Channel Blockers (procardia, nifedipine) for HTN, and cyclosporine for transplant meds.
“Pulp Polyp”, occurs in teeth w/large, open carious lesions, red or pink nodule of tissue is seen protruding from the pulp chamber, asymptomatic, TX includes endodontic therapy or extraction of the foot.
Chronic Hyperplastic Pulpitis
Characteristic skin lesion is the bull’s eye (target) lesion that demonstrates circles of erythema and normal skin tones. Oral lesions commonly present as ulcers on the lateral borders of the tongue, or crusted and bleeding lips, hemorrhagic crusting.
Erythema Multiforme
Most severe from of erythema multiform, two mucosal surfaces involved (genital mucosa and mucosa of the eyes may be involved).
Stevens-Johnson Syndrome
Benign, chronic disease that affects the skin and oral mucosa, lace-like white lines, commonly seen on the buccal mucosa, The slender fine lines are termed Wickham’s strain, cause is unknown, erosive lesions increase with stress.
Lichen Planus
Chronic, progressive w/periods of remission in between, most common lesion is the “butterfly” rash over the nose, diagnosis is based on multi-organ involvement, TX include ASA and NSAIDs.
Lupus
Ulcerated lesion due to trauma and healing usually lasts 7-14 days unless the trauma persists.
Traumatic Ulcer
Painful, recurring ulcers, only on movable mucosa o0f the oral cavity (the mucosa not covering bone), minor, major, or herpetiform (Clusters), caused by trauma, emotional stress, or certain foods, non-keratinized mucosa includes the tongue, soft palate, floor of mouth, buccal and lingual mucosa.
Aphthous Ulcer
What does HSV Type 1 cause?
Oral Infections
What does HSV Type 2 Cause?
Genital infections
Initial infection, characterized by painful, erythematous, swollen gingiva and multiple tiny vesicles that progress into ulcers, commonly seen in children under age 6, lesions heal in 1-2 weeks.
Primary Herpetic Gingivostomatitis
What’s the typical route of HSV?
Physical contact with an infected person.
Why does HSV recur?
It persists in a latent stage, found in the trigeminal ganglion.
What is the most common type of recurrent oral herpes?
Herpes Labials that occurs on the vermilion border of the lips, often referred to as a “cold sore” or “fever blister”. Also seen intraorally on keratinized mucosa fixed to bone such as the hard palate or gingiva; “bound-down mucosa”.
How is recurrent HSV treated?
Antiviral drugs such as acyclovir
Painful infection of the fingers, primary or recurrent infection, may last 4-6 weeks.
Herpetic Whitlow
Caused by the coxsackie virus, seen on the soft palate, usually accompanied by fever, malaise, and flu-like symptoms, resolves w/o treatment
Herpangina
Caused by the coxsackie virus, seen in young children, ulcerative vesicles, merciless typically appear on feet, toes, hands and fingers as well, TX not required.
Hands-Foot-Mouth Disease
Infectious Mononucleosis
Caused by Epstein-Barr Virus, palatal petechiae is a oral manifestation, transmitted by kissing and contact with saliva. Clinical symptoms include sore throat, fever, lymphadenopathy, and fatigue.
Varicella-Zoster Infections
Caused by varicella zoster virus, transmission is via inhalation of contaminated droplets, very contagious virus.
What are the primary and secondary Varicella Zoster Infections?
Primary is varicella or chickenpox
Secondary is herpes zoster or shingles
Torus (Tori)
Bony RO mass seen on the lingual surface of mandible and in the midline of the hard palate.
Exostoses
Bony protuberance on facial and buccal surfaces of the jaw.
Odontoma
Most common odontogenic tumor, TX is excision
Periapical Cemental Dysplasia (Cementoma)
Middle age, african american females, seen at apex of vital teeth, usually mandibular anterior, No TX required.
Common in middle age, african american females, dense sclerotic masses of bone or cementum can be seen in all four quadrants
Florid Osseous Dysplasia (Florid cemento-osseous dysplasia)
Common in men older than 50, enlargement of the bone and spaces between the teeth are seen, cotton-wool radiopacities.
Paget’s Disease (Osteitis deformans)
Common in men older than 60, originates in bone marrow, fatal, symptoms are anemia, painful bone lesions, “punched out” radiolucencies in the jaw.
Multiple Myeloma
Cyst
Epithelial-lined cavity or sac often filled with straw-colored fluid.
Odontogenic Cyst
Cyst in which the lining of the lumen is derived from epithelium produced during tooth development.
Seen at apex of a necrotic tooth, well-defined funicular radiolucency, asymptomatic, most common cysts of the jaws, tooth needs extracted or endodontic TX
Radicular Cyst (Periapical cyst)
Residual Cyst
Radicular cyst that was “left behind” and TX is removal of cyst.
Intraosseous
Within bone, central
Extraosseous
In soft tissue, peripheral
Primordial Cyst
Occurs in place of a tooth.
Dentigerous Cyst (Follicular cyst)
Around the crown of an impacted or unerupted tooth, commonly seen w/mandibular 3rd molars and max. canines, 2nd to 3rd decade of life, halo appearance around tooth radiographically, TX is removal of tooth and enucleation.
Odontogenic Keratocyst (OKC)
Uniocular OR multiocular radiolucency, high recurrence rate, benign but aggressive behavior, can move teeth and cause resorption, and 3rd molars.
Common location is between the roots of mandibular premolars, cannot probe this area, males>females.
Lateral periodontal cyst
Seen between maxillary lateral incisor and canine, causing divergence of the roots, inverted pear shape radiographically.
Globulomaxillary cyst
Oval radiolucency in the midline of the anterior maxilla, “heart-shaped” due to presence of anterior nasal spine, asymptomatic, TX is surgical enucleation
Nasopalatine duct cyst (incisive canal cyst)
Nasolacrimal Cyst (Nasolabial Cyst)
Often lifts the ala of the nose, see swelling over the maxillary canine region.
Calcifying Odontogenic Cyst (Gorlin Cyst)
Goblet Cells
Mucocele
Lower lip most common site, bluish-pink fluid-filled nodule, common in adolescents and children, TX is excision.
Ranula
“Mucocele of the floor of the mouth”, caused by obstruction of Wharton’s duct, bluish appearance compared to a frog’s belly.
Sialolithiasis
Salivary stones, wharton’s duct is the most common site.
Benign Mixed Tumor (Pleomorphic Adenoma)
Most common tumor of the salivary glands, Parotid gland most common location, Most common intramural site is the posterior hard palate, TX surgical excision.
Submandibular salivary gland depression (Stafne’s Bone Cyst, Static Bone Cyst)
Seen below the inferior alveolar canal toward the mandibular angle, ovoid radiolucency, no TX.
Autoimmune disorder in which the immune cells attack the exocrine system, dry mouth, dry eyes, halitosis, so of tongue papillae, increased caries, periodontal disease, and calculus.
Sjogren’s Syndrome
Etiology is meds, radiation TX, aging and the peak age is 50 and 90% of cases are women.
Xerostomia
Actinic Keratosis
Pre-malignant skin lesion that may transform into squamous cell carcinoma, commonly seen on sun-exposed skin, scaly plaques.
Actinic Cheilitis
Pre-malignant lesion of the lower lip, crusted, red, white, ulcerated, glossy, pale, hard to differentiate lip border.
Squamous cell carcinoma
Most common form of oral cancer, malignant tumor of squamous epithelium, white plaque (leukoplakia) then become an exophytic ulcerative mass-be suspicious of a red and white lesion; indurated lesion (hardened), seen on lateral border of the tongue and floor of the mouth. Do not recommend an alcohol mouth wash for patient’s with oral cancer.
Gemination
Two teeth or two crowns within a single root, tooth count is normal.
Fusion
Joining of 2 developing tooth germs resulting in a single, large tooth. Tooth count is one tooth less than normal.
Concrescence
Teeth joined by cementum only, common in maxillary second and third molars.
Dilaceration
Bend in a tooth (root or crown)
Dens in Dente (dens invaginatus)
“tooth within a tooth”, most common in maxillary lateral incisor, accentuation of the lingual pit, may be bilateral.
Large pulp chamber, furcation more apical, elongated crown, people with down’s syndrome, and “bulls tooth”
Taurodontism
Seen on the bifurcation or trifurcation areas, problem in cases of periodontal disease.
Enamel Pearls (Ectopic enamel)
Physiologic wearing of teeth, tooth-to-toothcontact, bruxism is a pathologic form of attrition.
Attrition
Pathologic wearing of teeth, examples; pipe smokers or aggressive tooth brushing.
Abrasion
Seen in adults, wedge-shaped lesions at cervical areas of teeth.
Abfraction
Loss of tooth structure from a chemical process, shiny, glossy look results from vomiting, bulimia, acidic foods, and patients w/GERD
Erosion
Small teeth, maxillary lateral incisor is most common “peg lateral”
Microdontia
large teeth
Macrodontia
Space between two adjacent teeth, due to high frenum attachment and muscle pull
Diastema
Complete absence of teeth
Anodontia
A syndrome where complete anodontia may be seen, partial anodontia is more typical w/conical-shaped teeth.
Ectodermal Dysplasia
Extra teeth in the dentition; hyperdontia, mesiodens is most common followed by maxillary molar area.
Supernumerary Teeth
Endogenous stain, instead during tooth development, can be fluorescent to yellow, gray or brown.
Tetracycline Staining
Amelogenesis Imperfecta
Hereditary disorder of enamel formation, see enamel hypoplasia, pits, grooves, soft enamel, teeth can darken or be discolored.
Dentinogenesis Imperfecta
Heriditary disorder of dentin, discoloration of teeth gives the name opalescent dentin, enamel is structurally normal but fractures easily due to poor dentinal support, radiographically see obliterated pulp chambers and crowns.
Internal Resorption
Result of pulpal injury, or no apparent cause. Teeth may appear pink due to proximity of the pulp to the surface and the pulp becomes enlarged, TX is endodontic therapy.
Systemic hypoplasia of teeth.
Syphilis infection affects the permanent incisors and first molars: Hutchinson’s incisors (Screw Driver) and Mulberry molars (Many cusps).
Levels of fluoride > 1 ppm during crown formation may result in fluorosis.
Local hypoplasia of teeth.
Resulting hypoplastic or hypocalcified permanent tooth is Turner’s tooth.
The absence of ameloblasts during development.
