Physical and Chemical Injuries Flashcards
extremely common white line located on the buccal mucosa at the level of the occlusal plane
linea alba
are lina albas usually bilateral or on one side?
bilateral
ragged superfical keratosis that is associated with cheek chewing
morsicatio buccarum
where is moriscatio buccarum located?
anterior buccal mucosa; symmetrically distributed above and below the plane of occlusion
*tongue or labial mucosa may show similar alterations
is there ulceration with moriscatio buccarum?
no
common lesion of any age group
traumatic ulcer
what are the most common sites for traumatic ulcer?
buccal mucosa, labial mucosa, tongue
what is the clinical appearance of a traumatic ulcer
removable, yellowish-white fibrinopurulent membrane; surounded by variable erythema and hyperkeratotic border
what is the tx for traumatic ulcer
eliminate sources out trauma
- biopsy could be indicated
- possible excision
*no corticosteroids
coagulation necrosis on the palatal mucosa or anterior tongue
thermal injury
what does a severe thermal injury present as?
subepithelial vesicle/bulla formation if severe enough
how long does thermal injury last for
quick
what are the most common sources of chemical injury
- aspirin
- hydrogen peroxide
- phenol
what is the clinical appearance of chemical injury?
white surface change due to coagulation necrosis of epithelium
how long does a chemical injury take to heal?
heals rapidly
variety of mechanisms by which these drugs interfere with cellular metabolism; rapidly dividing cells (such as oral mucosa) primarily affected
chemotherapy-related epithelial necrosis
when doees chemotherapy-related epithelial necrosis start?
within the first few days of chemo
when does chemotherapy-related epithelial necrosis resolve?
2-3 weeks after cessation of chemo
injury that occurs secondary to ionizing radiation used to treat malignancies in head and neck region
radiation mucositis
where does radiation mucositis affect?
involves tissue within the field of radiation
*causes damage to rapidly dividing basal cells of oral mucosa
when does radiation mucositis end?
2-3 weeks after therapy ends
first identifies with BISPHOSPHONATES, now other resporptive agents and other meds associated with osteonecrosis
medication-related osteonecrosis of the jaws (MRONJ)
What do bisphosphonates do?
bind to bone and inhibit its degradation (resorption) by inhibiting osteoclast function
*dec bone turnover
what three things do you need to dx MRONJ?
- current or previous tx with a bisphosphonate or other associated agent
- exposed bone in the maxillofacial region, persisting for more than 8 weeks
- no history of radiation therapy to the jaws
what is the tx for BRONJ?
- 89% associated with INTRVENOUS therapy - treating malignancy
- 11% associated with ORAL therapy - treating osteoporosis
*involves the mandible over the maxilla 2:1
what is the prevalence of BRONJ in cancer pts treated with Bisphosphonates
5%
*prevalance in osteoporosis pts treated with BPs is 10-100 fold lower
what types of measures for treating MRONJ are favored?
conservative measures
*minimal debridement, antibiotics, antibacterial agents
what is the px for MRONJ?
GUARDED
bisphosphonates (can)/(should never) be stopped without consulting prescribing physician
should never
*risks associated with cancer and osteoporosis virtually always outweigh those of ONJ
what is the most common type of foreign body tattoo?
amalgam (graphite)
what might an amalgam tattoo require?
a biopsy to rule out melanocytic lesions
melanin production in the oral mucosa may serve as a protective response against harmful substances in tobacco smoke. shows up as light brown, diffuse melanin pigmentation of the oral mucosa.
smokers melanosis
where is smokers melanosis most commonly seen
anterior facial gingiva
what does the extent/intensity of pigmentation of smokers melanosis depend on
number of cigs smoked per day
type of discoloration of the oral mucosa that is associated with multiple meds whose clinical presentation may be diffuse or unique pattern
drug-related discoloration of the oral mucosa
what does discontinuing meds result in for drug related discolorations of the oral mucosa?
gradual fading
focal superficial sequestration of a fragment of cortical bone that may be secondary to trauma.
oral ulceration with bone sequestration
where are oral ulcerations with bone sequestrations usually found?
anatomic sites in which a bony prominence is covered by thin mucosal surface
*lingual surface posterior mandible along mylohyoid ridge
what is the tx of oral ulceration with bone sequestration?
spontaneous loss or surgical removal of the dead bone results in rapid healing
dome-shaped, faintly radiopaque lesion arising from the floor of the maxillay sinus
antral pseudocyst
how common are antral pseudocysts?
common (1.5-14% of population)
what causes antral pseudocysts?
inflammatory exudate accumulates under sinus mucosa and causes elevation
what is the tx for antral pseudocysts?
harmless process, no treatment necessary beyond periodic radiographic follow-up
