Physical and Chemical Injuries

Question 1

what is linea alba and what is it associated with

Answer 1

• common alteration on the buccal mucosa
• associated with pressure or frictional irritation

Question 2

what are the clinical features of linea alba

Answer 2

-bilateral white line at the level of the occlusal plane
- may appear scalloped
- common

Question 3

what is the tx for linea alba

Answer 3

not indicated

Question 4

what are the other names for chronic mucosal chewing

Answer 4

• moriscatio buccarum
• moriscatio laborium

Question 5

when is chronic mucosal chewing observed

Answer 5

stress/psychologic

Question 6

what are the clinical features of chronic mucosal chewing

Answer 6

• thickened, shredded white areas
• most common on buccal mucosa
• may have areas of erythema or ulceration

Question 7

what is the treatment for chornic mucosal chewing

Answer 7

not indicated

Question 8

what is traumatic ulceration caused by

Answer 8

acute or chronic injuries such as sharp cusp on tooth

Question 9

what are iatrogenic ulcers

Answer 9

ulcers caused by medical intervention such as trauma from dental instrument

Question 10

what are the clinical features of traumatic ulcerations

Answer 10

• most commmon on tongue, lips, buccal mucosa
• area of erythema and fibrinous exudate
• often appears crater like
• may have hyperkeratotic collar

Question 11

what is the differential dx for traumatic ulceration

Answer 11

• deep fungal infection
• syphilitic ulcer
• squamous cell carcinoma

Question 12

what is the tx for traumatic ulceration

Answer 12

• remove source of irritation if present
• biopsy for longstanding lesions

Question 13

what makes the histopathology of TUGSE unique

Answer 13

lots of eosinophils

Question 14

electrical burns are ______ of all burn admissions in the hospital

Answer 14

5%

Question 15

what are the clinical feautres of electrical burns

Answer 15

• most common site in adults: hands
• most common sites in kids: oral cavity- lips most frequent
• charred areas that become necrotic

Question 16

why do you need to treat electrical burns with cosmetic surgery

Answer 16

microstomia can occur

Question 17

what is the differnetial dx for chronic mucosal chewing

Answer 17

candidiasis

Question 18

what do thermal burns occur from

Answer 18

hot foods and beverages

Question 19

what are the clinical features of thermal burns

Answer 19

• most common on palate or posterior buccal mucosa
• zones of erythema and ulceration
• necrotic epithelium

Question 20

what is the tx for electrical and thermal burns

Answer 20

• prophylactic antibiotic for severe cases
• appliances to prevent microstomia
• surgical intervention

Question 21

what do chemicals and drugs placed in the oral cavity cause

Answer 21

caustic injuries

Question 22

what chemicals and drugs are placed in the oral cavity that are dental related

Answer 22

silver nitrate
- formocresol
- sodium hypochlorite
- acid etch materials

Question 23

what can aspirin chemical burns cause

Answer 23

mucosal necrosis

Question 24

what is the clinical presentation of an aspirin chemical burn

Answer 24

• white areas of epithelial necrosis
• may slough off

Question 25

what is the tx for chemical burns from aspirin

Answer 25

prevent exposure, limit use

Question 26

what is the clinical presentation of oral trauma from sexual acts

Answer 26

- palatal petechiae - fibrous hyperplasia

Question 27

what is the differential dx for oral trauma from sexual acts

Answer 27

- trauma - violent coughing -platelet abnormalities - viral infections- mononucleosis

Question 27

what is the tx for oral trauma from sexual acts

Answer 27

not indicated

Question 28

what is an amalgam tatoo

Answer 28

implantation of dental amalgam in oral mucosa

Question 29

what are the ways amalgam tatoos can be incorporated

Answer 29

- after restorative procedure - fractured amalgam restorations - contaminated dental floss - endodontic treatment

Question 30

what is the differential dx for amalgam tatoo

Answer 30

melanotic macule - melanoma - tattoos - graphite

Question 31

what is the tx for amalgam tatoo

Answer 31

none if diagnosis confirmed - otherwise biopsy if indicated

Question 32

what are the oral complications of cancer therapy

Answer 32

- anticancer therapy may result in damage to normal tissue - oral cavity is a common site for cancer complications - related to radiation and chemotherapy

Question 33

what are the clinical features of oral complications of cancer therapy

Answer 33

- mucositis - hemorrhage - xerostomia

Question 34

describe mucositis in complications of cancer therapy

Answer 34

- 80% of patients treated with head and neck radiaiton - atrophic mucosa- ulcerations and epithelial necrosis - edema and erythema

Question 35

what is the treatment for mucositis

Answer 35

topical anesthetics, pain medications, coating agents

Question 36

describe hemorrhage as a complication of cancer therapy

Answer 36

- usually secondary to thrombocytopenia - develops from bone marrow suppression

Question 37

describe xerostomia as a complication of cancer therapy

Answer 37

- salivary galnds are sensitive to radiation therapy - xerostomia related caries -

Question 38

what is the tx for xerostomia

Answer 38

sugarless candy, medications, fluoride trays

Question 39

what SE is common with xerostomia

Answer 39

halitosis

Question 40

which glands are affected more from radiation: mucous or serous

Answer 40

serous- such as parotid

Question 41

what medications cause gingival hyperplasia and what are they each prescribed for

Answer 41

- phenytoin: anti seizure medication - nifedipine: calcium channel blocker - cyclosporine: immunosuppressant

Question 42

what is the clinical presentation of drug related gingival hyperplasia

Answer 42

- gingival enlargement originates in the interdental papillae - spreads across tooth surface - edentulous areas usually not affected

Question 43

what is the tx for drug related gingival hyperplasia

Answer 43

- discontinue of offending medication - oral hygiene - surgery

Question 44

what are the other names for denture epulis

Answer 44

- epulis fissuratum - inflammatory fibrous hyperplasia

Question 45

what is the clinical presentation of denture epulis

Answer 45

- folds of hyperplastic tissue in alveolar vestibule - firm and fibrous - may be erythematous

Question 46

what is the tx for denture epulis

Answer 46

- surgical removal - denture should be remade or relined

Question 47

when does submucosal hemorrhage arise

Answer 47

from traumatic event resulting in hemorhhage within tissues

Question 48

what are the non traumatic causes of submucosal hemorrhage

Answer 48

- anticoagulant therapy - thrombocytopenia - viral infections - hemorrhagic disease

Question 49

what are the clinical features of submucosal hemorrhage

Answer 49

- petechiae - purpura - ecchymosis - hematoma

Question 50

what are petechiae

Answer 50

minute hemorrhages on skin or mucosa

Question 51

what are purpura

Answer 51

slightly larger area of hemorrhage 4-10mm

Question 52

what are ecchymosis

Answer 52

hemorrhage greater than 1 cm

Question 53

what is a hematoma

Answer 53

hemorrhage that produces a large mass

Question 54

what is the treatment for submucosal hemorrhage

Answer 54

- may resolve spontaneously - directed at treating the underlying cause

Question 55

what medications cause drug related discoloration

Answer 55

- minocycline - AIDS medications - estrogen - ketoconazole

Question 56

what are the clinical features of drug related discolorations

Answer 56

- diffuse melanosis of mucosal surfaces - most common in females because of interaction with sex hormones

Question 57

what is the treatment of drug related discolorations

Answer 57

discontinue medication usually results in regression over time

Question 58

where does drug related discoloration occur usually

Answer 58

at the MGJ as a dark band

Question 59

what is myospherulosis

Answer 59

-topical antibiotic in petroleum base produced a foreign body reaction - surgical extraction site

Question 60

what are the clinical features of myospherulosis

Answer 60

- extraction surgical site- mandibular molars - occasional facial swelling - radiograph - circumscribed radioluceny

Question 61

what is the tx for myospherulosis

Answer 61

surgical removal

Question 62

what is the histopathology for myospherulosis

Answer 62

circular cyst like structure that looks like a "bag of marbles" and is brown