rank 1 sem 1 Flashcards
- Chronic hyperplastic gingivitis
= hyperplasia due to fibrous connective tissue deposition, not inflammation
a. Tx: 1) Improve OH 2)gingivectomy in extreme case
DDx: drug induced gingival hyperplasia
https://www.msdmanuals.com/en-nz/professional/dental-disorders/periodontal-disorders/gingival-hyperplasia
- Drug related gingival hyperplasia
= self explanatory
a. Tx: 1) Stop drug 2) improve OH 3) gingivectomy in extreme case
DDX: chronic hyperplastic gingivitis
- Pyogenic granuloma
= soft, deep red swelling of granulation tissue caused by poor OH or local irritation/trauma
a. Tx: 1) remove irritant/trauma becomes fibrous excise
DDx: Pyogenic granuloma, pregnancy epulis, peripheral giant cell granuloma
- Peripheral giant cell granuloma
= identical presentation and cause as pyogenic granuloma, but CONTAIN OSTEOCLAST LIKE GIANT CELLS HISTOLOGICALLY – hence cause SLIGHT BONE RESORPT
a. Tx: same as pyogenic granuloma, but excision to TO PERIOSTEUM (this is why you must properly diagnose, or else bone resorption will continue if giant cells aren’t excised)
DDx: pyogenic granuloma
- Pregnancy epulis
= hormonally induce pyogenic granulomas during pregnancy
a. Tx: what till hormones wanebecome fibrousexcise
- Fibroepithelial polyp
= healed pyogenic granuloma not located on gingiva
a. Tx: excision
Looks identical to, but you wouldn’t DDx with fibrous epulis, b/c the latter only exists on gingiva
- Fibrous epulis
= same a a fibroepithelial polyp, but on gingiva
a. Tx: excision
- Denture-induced hyperplasia
= ill-fitting denture flange
a. Tx: 1) excise 2) fix denture
https://escholarship.org/content/qt99z2d3tc/1.jpg
- Inflammatory papillary hyperplasia
= ill-fitting denture base
a. Tx: 1) cant really excise all those tiny papules?
- Amalgam tattoo
= amalgam particles that have penetrated lamina propria and bind connective tissue
a. Tx: 1) can leave no risk 2) if aesthetics concern…. incise
Note: has to have amalgam filling nearby and history of soft tissue trauma during surgery. Otherwise not an amalgam tattoo and DDx include the below, and so you’d have to excise to exclude diagnosis of melanoma
DDX: Acquired melanocytic nevus, amalgam tattoo, Congenital melanocytic nevus, melanocytic macule, melanoma, blue nevus, physiological pigmentation
- Acquired melanocytic nevus
= benign melanocyte neoplasm very common on skin, but does rarely manifest on hard palate or gingiva
a. Tx: nothing 1/1million chance of malignant transformation
DDx: Acquired melanocytic nevus, amalgam tattoo, Congenital melanocytic nevus
- Congenital melanocytic nevus
= mole present at birth; benign melanocyte tumor
a. Tx: small – 1%, large 15% chance of malignant transformation excise large
DDx: Acquired melanocytic nevus, amalgam tattoo, Congenital melanocytic nevus
- Blue nevus
= blue mole; due to melanocyte dendrites extending deep into lamina propria
a. Tx: Excision – typically appears suddenly and grows fast, so needs to be excised to rule out melanoma
- Oral melanotic macule
= up-regulation of melanin by normal melanocytes post-trauma (is a macule - i.e. just change in color without elevation or depression
a. Tx: excise to rule out melanoma
- Melanoma
= melanocytes malignancy (when reading all the types, recall that melanocytes are located in the basal layer of mucosal epithelium, so that’s where the melanoma would always start); Tx for all is Excision with 3mm margin
5 types
a. Lentigo maligna = proliferate, but spread radially along basal layer of mucosal epithelim
i. Lentigo maligna melanoma = lentigo maligna that develops ability to vertical spread into lamina propria
b. Superficial spreading melanoma = melanoma that first vertically invades superficial epithelial layer, and once that’s complete, then starts vertical invasion of structures deep to basal membrane
c. Nodular melanoma = only vertical (HAS THE WORST PROGNOSIS OF THE BUNCH)
d. Acral lentiginous melanoma - ??? FUCK THIS ONE
