Surgical Pathologies Flashcards
(95 cards)
1
Q
What are the tumor lesions of the alveolar crest? (6)
A
- Odontoma
- Cementoma
- Ameloblastic fibroma
- Follicular cysts
- Haemorrhagic-aneurysmal bone cysts
- Aneurismal bone cysts
2
Q
What is an odontoma?
A
Tumour-like malformation
3
Q
What is an odontoma produced by?
A
excessive proliferation of the cells of the dental organ
4
Q
What is an odontoma composed of?
A
composed of more than one type of tissue
5
Q
What is a compound odontoma?
A
composed of multiple, generally small, tooth-like
structures on x-ray and microscopically
6
Q
What is a complex odontoma?
A
Conglomerate mass of dental tissue and does not resemble a properly formed tooth or teeth on x-ray or under the microscope
7
Q
Clinical symptoms of odontoma? (3)
A
- Asymptomatic.
- Small.
- Of slow growth.
8
Q
How do we diagnosis odontoma? (2)
A
- clinic
- radiograph
9
Q
What is the treatment of an odontoma?
A
Surgical removal before they produce eruption problems.
10
Q
What is a cementoma?
A
Excessive proliferation of the cement in the apical area
11
Q
Where is a cementoma more frequent?
A
More frequent in the mandible, at the premolars
12
Q
What are the clinical symptoms of cementoma? (2)
A
- Asymptomatic
- Tooth may erupt without problems
13
Q
How do you diagnose a cementoma? (2)
A
- clinic
- radiograph
14
Q
How do you treat a cementoma? (3)
A
- Observation and control.
- Surgical extraction of the tooth with the cementoma.
- Apicectomy with root canal treatment.
15
Q
What do we see radiographically on a cementoma? (5)
A
- Radiopacity.
- Circular.
- Solitary.
- Well defined lesion.
- Surrounded by a radiolucent halo.
16
Q
What is an ameloblastic fibroma? (2)
A
- Benign tumor of mixed odontogenic origin
- Neoplastic proliferation of mesenchymal and epithelial components,
with no formation of hard dental tissues
17
Q
Who does ameloblastic fibroma affect?
A
predominantly young individuals
18
Q
Ameloblastic fibroma is a varity os the ____
A
Complex odontoma
19
Q
Ameloblastic fibroma clinical symptoms? (4)
A
- It appears mainly in children.
- At the posterior teeth of the mandible.
- Slow growth.
- It produces dental retentions.
20
Q
Ameloblastic fibroma diagnosis? (2)
A
- clinical
- radiographic
21
Q
What do you see radiographically with an ameloblastic fibroma ?
A
well-defined unilocular/multilocular radiolucent lesion, with
sclerotic radiopaque margins.
22
Q
What is the treatment for ameloblastic fibroma? (2)
A
- complete extirpation
- it rarely suffers relapses
23
Q
What is a follicular/dentigerous cyst?
A
Odontogenic cysts that encloses the crown of an unerupted tooth by expansion of the follicle and is attached to its neck
24
Q
What teeth commonly have a follicular cyst? (3)
A
Upper canine > 1st and 2nd premolar > 3rd molar
25
How do you diagnose a follicular cyst?
Radiograph
26
What is the treatment of a follicular cyst? (2)
- removal of the cyst.
| - sometimes necessary to remove the affected tooth
27
What is a heamorrhagic-aneurysmal bone cyst (HABCs)?
Rare, benign, non-neoplastic, expansive and vascular locally destructive lesions
28
HBACs are generally considered ____
sequelae of an earlier trauma causing an overflow of blood into the bone
29
HBACs usually appear .... ? (2)
At the mandibular symphysis and at the molar and premolar area
30
HBACs do not intercede in the ____
eruption of the adjacent teeth
31
HBACs radiographically look like...?
radiotransparencies of variable size and shape, sometimes appearing between the dental roots
32
What is the treatment of HBACs?
careful curettage of the bone walls, with satisfactory
results characterized by progressive bone regeneration and the absence of
relapses
33
What is an aneurysmal bone cyst (ABC)?
rare benign lesions of bone
| which are infrequent in craniofacial skeleton
34
ABCs are characterized by...
Rapid growth pattern with resultant bone expansion and facial asymmetry
35
ABCs are composed of ____ spaces separated by _____
- blood-filled spaces
- connective tissue septa containing fibroblasts,
osteoclast-type giant cells and reactive woven bone
36
Where do ABCs occur?
- 50% in the long bones
| - 20% in the vertebral column
37
ABCs are more commonly found in...
The mandible than the maxilla
38
Age and gender affectation of ABCs? (2)
- younger people under 20 years of age
| - no gender predilection
39
ABCs symptoms? (3)
- bone expanded, appears sytic resembling a honeycomb or soap bubble and is eccentrically balooned
- may be perforation of the cortex
- Periosteal reaction may be evident
40
ABCs radiographic evidence? (2)
- radiolucent, radiopaque or mixed
| - roots may be displaced
41
ABC treatment? (3)
- surgical removal
- contained in a fibrous capsule
- may bleed a lot
42
What are the salivary gland pathologies? (6)
1. Mucocele
2. Ranula
3. Sialadenitis
4. Mumps
5. Chronic sialadenitis
6. Congenital absence of the
salivary glands
43
What is a mucocele?
Pseudocyst that has no epithelial shell
44
What is the most common benign lesion of the salivary glands?
Mucocele
45
What are the classifications of mucocele? (2)
* By extravasation: caused by a trauma.
| * By retention: caused by an obstruction
46
Where is a mucocele found? (3)
Lower lip > oral mucosa > upper lip
47
Mucocele clinical symptoms? (2)
* Recurrent swelling with spontaneous drainage by rupture.
| * Asymptomatic vesicle or bulla with a pink or bluish color, and their size may vary from 1 mm to several centimetres.
48
Mucocele treatment?
surgical removal if it is recurrent
49
What is a ranula?
Retention cyst of the sublingual salivary gland
50
Etiology of ranula? (2)
* Toddler and small children: congenit
| * Older children and teenagers: traumatic
51
Differential diagnosis of ranula?
Lymphatic malformation
52
Ranula clincal symptoms? (4)
* Not painful
* Recurrent
* Rare to suffer infection
* They do not change of size
53
Ranula treatment?
- small children: wait
- Small ranula: surgical removal
- big ranula: marsupialization
- Be careful not to wound the conducts, glands, blood vessels and nerves
- If there is continuous relapse of the ranula, excision of the sublingual gland.
54
What is sialadenitis?
inflammation of the major salivary glands, usually bilateral
55
Etiology of sialadenitis? (3)
- Viral
- Bacterial
- Bilateral autoimmune parotitis
56
Viral etiology of sialadenitis? (3)
- Mumps
- CMV
- HIV
57
Bacterial etiology of sialadenitis? (2)
- Retrogressive
| - the salivary glands are infected by bacteria present in the mouth
58
What does a sialogram for Bilateral autoimmune parotitis show?
snow storm image
59
What are the types of sialadenitis? (2)
- acute
| - chronic
60
What is the treatment of sialadenitis? (3)
- analgesic
- antibiotics
- hydration
61
What are the mumps?
Inflammation of the parotid gland
62
Etiology of mumps? (4)
- Paramixovirus
- flu
- Coxsackie A virus
- HIV
63
When does mumps occur?
ages 5 - 15
64
Clinical symptoms of mumps?(8)
```
• Swelling
• Fever
• Headache
• Pain when swallowing food
• Painful palpation
• Elastic resistance with no
fluctuation
• Redeness of the Stenon conduct
• It may produce sterility in men
```
65
Mumps treatment? (3)
* Rest
* Isolation -> contagious
* Analgesics
66
What causes chronic sialadenitis? (3)
Physical pbstruction of the gland:
- calculus OR
- stenosis
67
Chronic sialadenitis clinical symptoms? (2)
* Pain while eating
| * Pain constantly if it is over infected
68
When does recurrent presentation of chronic sialadenitis occur?
During childhood
69
Treatment of chronic siadenitis? (4)
* Antibiotic
* Antiinflammatory
* Calculus excision
* Salivary gland excision
70
When do we suspect congenital absence of the salivary glands? (4)
when externes caries appear in not frequent locations
71
How do we diagnose congenital absence of the salivary glands? (4)
- Occlusal and panoramic x-ray
- Sialography
- Tomography, magnetic resonance and ecography
- Gammagraphy
72
What is seen on an xray of congenital absence of the salivary glands?
several calculus will be seen
73
What is seen in a sialography with congenital absence of the salivary glands?
Stenosis of the conducts and alteration in the gland architecture
74
What is seen in a gammagraphy with congenital absence of the salivary glands?
The glands activity
75
What are the general factors of impacted teeth? (4)
- Syndromes
- Genetic
- hormonal
- unknown
76
What are the local factors of impacted teeth? (2)
- mechanic obstruction
| - absence of space
77
What are the clinical symptoms of impacted teeth? (3)
- eruption delay
- teeth in a fan or interincisal diastema (mesiodens)
- ectopic eruption
78
What is seen radiographically for impacted teeth? (3)
* Cysts
* Root reabsorptions
* Ectopic eruption
79
Treatment of impacted teeth: before the treatment? (4)
Do an X-ray to verify the tooth position:
• The canine is palatal or buccal
• The second premolar frequently in palatal
```
We also determine the root development and establish the orthodontic
treatment plan (plan traction and space recovery)
```
80
Impacted teeth treatment?
- Extraction (super numerary, thrd molars)
| - Surgical exposure and orthodontic traction
81
When do you treat impacted canines, upper incisors, premolars and molars?
2/3 of root development or before the apical closure (afterwards it is very difficult)
82
When do you treat impacted molars?
½ radicular development.
Later there will be bigger risk of dilacerated roots, hooked roots.
83
What frenulums exist? (3)
1. Upper labial frenulum
2. Lower labial frenulum
3. Lingual frenulum
84
What is the upper labial frenulum?
Fibroelastic band of tissue that originates at the lip and is
inserted in the adhered gingiva at the midline.
85
Histology of the frenulum?
Mucosa and connective tissue with elastic fibers
86
What do we do in primary dentition with an upper labial frenulum?
NEVER REMOVE IN PRIMARY DENTITION
87
What do we do in permanent dentition with an upper labial frenulum?
• Examine it if there is an interincisal diastema bigger than 1 mm.
• Check if there is a real frenulum hypertrophy doing the
papilla exam.
88
When do we do the upper labial frenulum treatment?
We usually wait until the permanent canines have erupted.
89
Upper labial frenulum treatment if the central incisors have erupted and there isn't enough space for the lateral incisors?
Do it before the lateral incisors have erupted
90
Upper labial frenulum treatment if the lateral incisors have erupted and there isn't enough space for the canines?
do it before the canines have erupted
91
What is the treatment for an upper labial frenulum?
Frenectomy and orthodontic treatment
92
What is a romboid frenectomy? (5)
* Apply cold on the area intermittently (for 2-3 hours after the surgery)
* Liquid or semiliquid diet for 3-4 days
* Avoid to pull the lip upwards
* Oral hygiene with saline solution
* Mandatory prescrption of: antibiotic, antinflamatoriy y analgesic.
93
A lower labial frenulum will be pathological if: (7)
```
• There is high insertion over the papilla
• It limits the lower labial movements
• It produces an accumulation of bacterial
plaque
• Chronic inflammation
• Periodontal bags
• Reatraction of the adhered
gingiva
• Bone loss
```
94
Lingual frenulum ankyloglosia: (4)
* There is compromised lingual mobility
* There is difficulty to eat and to pronounce the R and the S
* When they bring the tongue to the palate the tongue has a bifid aspect
* They cannot take the tongue out of the mouth
95
Treatment of lingual frenulum? (5)
1. Bilateral nerve block
2. Traction with suture
3. Bisturi or electrobisturi
4. Complete resection
5. Check lingual mobility
