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Peds 4 > Surgical Pathologies > Flashcards

Surgical Pathologies Flashcards

1
Q

What are the tumor lesions of the alveolar crest? (6)

A
  1. Odontoma
  2. Cementoma
  3. Ameloblastic fibroma
  4. Follicular cysts
  5. Haemorrhagic-aneurysmal bone cysts
  6. Aneurismal bone cysts
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2
Q

What is an odontoma?

A

Tumour-like malformation

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3
Q

What is an odontoma produced by?

A

excessive proliferation of the cells of the dental organ

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4
Q

What is an odontoma composed of?

A

composed of more than one type of tissue

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5
Q

What is a compound odontoma?

A

composed of multiple, generally small, tooth-like

structures on x-ray and microscopically

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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

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7
Q

Clinical symptoms of odontoma? (3)

A
  • Asymptomatic.
  • Small.
  • Of slow growth.
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8
Q

How do we diagnosis odontoma? (2)

A
  • clinic

- radiograph

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9
Q

What is the treatment of an odontoma?

A

Surgical removal before they produce eruption problems.

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10
Q

What is a cementoma?

A

Excessive proliferation of the cement in the apical area

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11
Q

Where is a cementoma more frequent?

A

More frequent in the mandible, at the premolars

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12
Q

What are the clinical symptoms of cementoma? (2)

A
  • Asymptomatic

- Tooth may erupt without problems

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13
Q

How do you diagnose a cementoma? (2)

A
  • clinic

- radiograph

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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.
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15
Q

What do we see radiographically on a cementoma? (5)

A
  • Radiopacity.
  • Circular.
  • Solitary.
  • Well defined lesion.
  • Surrounded by a radiolucent halo.
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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
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17
Q

Who does ameloblastic fibroma affect?

A

predominantly young individuals

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18
Q

Ameloblastic fibroma is a varity os the ____

A

Complex odontoma

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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.
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20
Q

Ameloblastic fibroma diagnosis? (2)

A
  • clinical

- radiographic

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21
Q

What do you see radiographically with an ameloblastic fibroma ?

A

well-defined unilocular/multilocular radiolucent lesion, with
sclerotic radiopaque margins.

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22
Q

What is the treatment for ameloblastic fibroma? (2)

A
  • complete extirpation

- it rarely suffers relapses

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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

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24
Q

What teeth commonly have a follicular cyst? (3)

A

Upper canine > 1st and 2nd premolar > 3rd molar

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25
Q

How do you diagnose a follicular cyst?

A

Radiograph

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26
Q

What is the treatment of a follicular cyst? (2)

A
  • removal of the cyst.

- sometimes necessary to remove the affected tooth

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27
Q

What is a heamorrhagic-aneurysmal bone cyst (HABCs)?

A

Rare, benign, non-neoplastic, expansive and vascular locally destructive lesions

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28
Q

HBACs are generally considered ____

A

sequelae of an earlier trauma causing an overflow of blood into the bone

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29
Q

HBACs usually appear …. ? (2)

A

At the mandibular symphysis and at the molar and premolar area

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30
Q

HBACs do not intercede in the ____

A

eruption of the adjacent teeth

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31
Q

HBACs radiographically look like…?

A

radiotransparencies of variable size and shape, sometimes appearing between the dental roots

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32
Q

What is the treatment of HBACs?

A

careful curettage of the bone walls, with satisfactory
results characterized by progressive bone regeneration and the absence of
relapses

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33
Q

What is an aneurysmal bone cyst (ABC)?

A

rare benign lesions of bone

which are infrequent in craniofacial skeleton

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34
Q

ABCs are characterized by…

A

Rapid growth pattern with resultant bone expansion and facial asymmetry

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35
Q

ABCs are composed of ____ spaces separated by _____

A
  • blood-filled spaces
  • connective tissue septa containing fibroblasts,
    osteoclast-type giant cells and reactive woven bone
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36
Q

Where do ABCs occur?

A
  • 50% in the long bones

- 20% in the vertebral column

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37
Q

ABCs are more commonly found in…

A

The mandible than the maxilla

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38
Q

Age and gender affectation of ABCs? (2)

A
  • younger people under 20 years of age

- no gender predilection

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39
Q

ABCs symptoms? (3)

A
  • 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
Q

ABCs radiographic evidence? (2)

A
  • radiolucent, radiopaque or mixed

- roots may be displaced

41
Q

ABC treatment? (3)

A
  • surgical removal
  • contained in a fibrous capsule
  • may bleed a lot
42
Q

What are the salivary gland pathologies? (6)

A
  1. Mucocele
  2. Ranula
  3. Sialadenitis
  4. Mumps
  5. Chronic sialadenitis
  6. Congenital absence of the
    salivary glands
43
Q

What is a mucocele?

A

Pseudocyst that has no epithelial shell

44
Q

What is the most common benign lesion of the salivary glands?

A

Mucocele

45
Q

What are the classifications of mucocele? (2)

A
  • By extravasation: caused by a trauma.

* By retention: caused by an obstruction

46
Q

Where is a mucocele found? (3)

A

Lower lip > oral mucosa > upper lip

47
Q

Mucocele clinical symptoms? (2)

A
  • 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
Q

Mucocele treatment?

A

surgical removal if it is recurrent

49
Q

What is a ranula?

A

Retention cyst of the sublingual salivary gland

50
Q

Etiology of ranula? (2)

A
  • Toddler and small children: congenit

* Older children and teenagers: traumatic

51
Q

Differential diagnosis of ranula?

A

Lymphatic malformation

52
Q

Ranula clincal symptoms? (4)

A
  • Not painful
  • Recurrent
  • Rare to suffer infection
  • They do not change of size
53
Q

Ranula treatment?

A
  • 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
Q

What is sialadenitis?

A

inflammation of the major salivary glands, usually bilateral

55
Q

Etiology of sialadenitis? (3)

A
  • Viral
  • Bacterial
  • Bilateral autoimmune parotitis
56
Q

Viral etiology of sialadenitis? (3)

A
  • Mumps
  • CMV
  • HIV
57
Q

Bacterial etiology of sialadenitis? (2)

A
  • Retrogressive

- the salivary glands are infected by bacteria present in the mouth

58
Q

What does a sialogram for Bilateral autoimmune parotitis show?

A

snow storm image

59
Q

What are the types of sialadenitis? (2)

A
  • acute

- chronic

60
Q

What is the treatment of sialadenitis? (3)

A
  • analgesic
  • antibiotics
  • hydration
61
Q

What are the mumps?

A

Inflammation of the parotid gland

62
Q

Etiology of mumps? (4)

A
  • Paramixovirus
  • flu
  • Coxsackie A virus
  • HIV
63
Q

When does mumps occur?

A

ages 5 - 15

64
Q

Clinical symptoms of mumps?(8)

A 
• 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
Q

Mumps treatment? (3)

A
  • Rest
  • Isolation -> contagious
  • Analgesics
66
Q

What causes chronic sialadenitis? (3)

A

Physical pbstruction of the gland:

  • calculus OR
  • stenosis
67
Q

Chronic sialadenitis clinical symptoms? (2)

A
  • Pain while eating

* Pain constantly if it is over infected

68
Q

When does recurrent presentation of chronic sialadenitis occur?

A

During childhood

69
Q

Treatment of chronic siadenitis? (4)

A
  • Antibiotic
  • Antiinflammatory
  • Calculus excision
  • Salivary gland excision
70
Q

When do we suspect congenital absence of the salivary glands? (4)

A

when externes caries appear in not frequent locations

71
Q

How do we diagnose congenital absence of the salivary glands? (4)

A
  • Occlusal and panoramic x-ray
  • Sialography
  • Tomography, magnetic resonance and ecography
  • Gammagraphy
72
Q

What is seen on an xray of congenital absence of the salivary glands?

A

several calculus will be seen

73
Q

What is seen in a sialography with congenital absence of the salivary glands?

A

Stenosis of the conducts and alteration in the gland architecture

74
Q

What is seen in a gammagraphy with congenital absence of the salivary glands?

A

The glands activity

75
Q

What are the general factors of impacted teeth? (4)

A
  • Syndromes
  • Genetic
  • hormonal
  • unknown
76
Q

What are the local factors of impacted teeth? (2)

A
  • mechanic obstruction

- absence of space

77
Q

What are the clinical symptoms of impacted teeth? (3)

A
  • eruption delay
  • teeth in a fan or interincisal diastema (mesiodens)
  • ectopic eruption
78
Q

What is seen radiographically for impacted teeth? (3)

A
  • Cysts
  • Root reabsorptions
  • Ectopic eruption
79
Q

Treatment of impacted teeth: before the treatment? (4)

A

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
Q

Impacted teeth treatment?

A
  • Extraction (super numerary, thrd molars)

- Surgical exposure and orthodontic traction

81
Q

When do you treat impacted canines, upper incisors, premolars and molars?

A

2/3 of root development or before the apical closure (afterwards it is very difficult)

82
Q

When do you treat impacted molars?

A

½ radicular development.

Later there will be bigger risk of dilacerated roots, hooked roots.

83
Q

What frenulums exist? (3)

A
  1. Upper labial frenulum
  2. Lower labial frenulum
  3. Lingual frenulum
84
Q

What is the upper labial frenulum?

A

Fibroelastic band of tissue that originates at the lip and is
inserted in the adhered gingiva at the midline.

85
Q

Histology of the frenulum?

A

Mucosa and connective tissue with elastic fibers

86
Q

What do we do in primary dentition with an upper labial frenulum?

A

NEVER REMOVE IN PRIMARY DENTITION

87
Q

What do we do in permanent dentition with an upper labial frenulum?

A

• 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
Q

When do we do the upper labial frenulum treatment?

A

We usually wait until the permanent canines have erupted.

89
Q

Upper labial frenulum treatment if the central incisors have erupted and there isn’t enough space for the lateral incisors?

A

Do it before the lateral incisors have erupted

90
Q

Upper labial frenulum treatment if the lateral incisors have erupted and there isn’t enough space for the canines?

A

do it before the canines have erupted

91
Q

What is the treatment for an upper labial frenulum?

A

Frenectomy and orthodontic treatment

92
Q

What is a romboid frenectomy? (5)

A
  • 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
Q

A lower labial frenulum will be pathological if: (7)

A 
• 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
Q

Lingual frenulum ankyloglosia: (4)

A
  • 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
Q

Treatment of lingual frenulum? (5)

A
  1. Bilateral nerve block
  2. Traction with suture
  3. Bisturi or electrobisturi
  4. Complete resection
  5. Check lingual mobility

Peds 4 (5 decks)

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