Reactive Lesions of the Oral Mucosa

Question 1

what type of epithelium is found on the cheek?

Answer 1

non-keratinised

Question 2

What type of epithelium is found on the palate?

Answer 2

keratinised

Question 3

what type of epithelium is located in the oral cavity?

Answer 3

stratified squamous

Question 4

How does keratinised mucosa appear?

Answer 4

• no glycogen
• tightly bound
• no muscles found underneath

Question 5

What is the function of keratinised mucosa?

Answer 5

protection

Question 6

What are the gross subtypes of mucosa found within the oral cavity?

Answer 6

• lining
• masticatory
• gustatory

Question 7

Give an example of keratosis commonly seen in the oral cavity?

Answer 7

linea alba

Question 8

What is acanthosis?

Answer 8

hyperplasia of stratum spinosum (spinus cell layer)

Question 9

What are elongated rete ridges?

Answer 9

hyperplasia of basal cells

Question 10

What causes white lesions in the mouth to look white?

Answer 10

• keratosis (parakeratosis)
• acanthosis

Question 11

What is atrophy?

Answer 11

• reduction in viable layers of mucosa
• epithelium becomes thinner
• BVs show through (red lesion)

Question 12

what is erosion of mucosa?

Answer 12

partial thickness loss

Question 13

what is ulceration of mucosa?

Answer 13

full thickness loss with fibrin on surface (fibrin causes yellow colour)

Question 14

what is intercellular oedema called?

Answer 14

spongiosis

Question 15

What is the difference between a vesicle and a bulla?

Answer 15

• vesicle is smaller clinically
• bulla is larger clinically

Question 16

What is dysplasia?

Answer 16

disordered maturation [growth] in a tissue
- has the potential to become malignant
- can only be detected with a microscope

Question 17

What is atypia?

Answer 17

occurs at a cellular level (change within cells)

Question 18

What is the difference between cellular atypia and cellular dysplasia?

Answer 18

Dysplasia = change at tissue level

Atypia = change at cellular level

Question 19

How does mucosa change as we age?

Answer 19

progressive atrophy

Question 20

What nutritional deficiencies can cause atrophy of mucosa?

Answer 20

• iron
• vitamin B12
• folate
  [haematinics]

Question 21

Why is mucosal atrophy bad?

Answer 21

predisposes patient to infection (allows entry of pathogens/carcinogens etc)

Question 22

What are some examples of reactions that occur when mucosa experiences trauma?

Answer 22

• inflammation
• keratosis
• ulceration
• fibrous tissue formation
• formation of vesicles and bulla

Question 23

What are epulides?

Answer 23

Soft tissue swellings on gingiva only!
- reaction to chronic inflammation/chronic trauma

Question 24

How do fibrous epulis appear?

Answer 24

firm nodule with normal coloured erosion

Question 25

How does a vascular epulis appear?

Answer 25

blood vessels in granulation tissue

Question 26

What is a giant cell?

Answer 26

fused macrophages that team up to destroy unphagocytosable material such as:
- local chronic irritation
- infective agents = TB bacillus
- hormonal stimulation of cells

Question 27

What is an example of a reactive hyperplastic lesion?

Answer 27

traumatic fibroma (fibroepithelial polyp)

Question 28

Where are fibroepithelial polyps normally found?

Answer 28

• cheek
• lip
• tongue

Question 29

What is a leaf fibroma?

Answer 29

Squashed polyp
- commonly found under ill-fitting dentures

Question 30

What can cause papillary hyperplasia?

Answer 30

ill fitting and unclean denture

Question 31

What medications can cause drug-induced fibrous overgrowth?

Answer 31

• anti-hypertensives (calcium channel blockers)
• anti-epileptics (phenytoin)
• immunosuppressants (cyclosporin)

Question 32

What causes gingivitis in pregnancy?

Answer 32

increased progesterone levels