Sweep 3 Flashcards
Necrotizing Ulcerative Periodontitis: involvement of palatal mucosa leads to
necrotizing stomatitis
Incidence of LAP is ——– people at risk (14- to 15-year old)
1.3/1000
Primary herpetic gingivostomatitis-
[Through oral mucosal epithelium, virus penetrates a neural ending and travels to the
trigeminal ganglion.]
Primary herpetic gingivostomatitis-
Symptoms:
- painful severe gingivitis with redness
- ulcerations with serofibrinous exudate
- edema accompanied by stomatitis
Primary herpetic gingivostomatitis:
Characteristics:
- Incubation period is one week.
- Formation of vesicles, which rupture, coalesce
and leave fibrin-coated ulcers. - Healing within 10 to 14 days.
- Formation of vesicles, which rupture, coalesce
Primary herpetic gingivostomatitis may be
asymptomatic in childhood, but may also give rise severe gingivostomatitis (painful severe gingivitis with redness, ulcerations with serofibrinous exudate and edema.
Primary herpetic gingivostomatitis:
The incubation period is
1 week
Primary herpetic gingivostomatitis:
A characteristic feature is formation of
vesicles, which rupture, coalesce, and leave fibrin coated ulcers.
Fever and lymphadenopathy are other classic features.
Hereditary gingival fibromatosis- Possible mechanism(s):
TGF-1 favor the accumulation of ECM.
May be located on chromosome 2 in human.
- β-glucuronidase:
a lysosomal enzyme degrades proteoglycans and ground substance
- Elastase: a proteolytic enzyme found in lysosomal granules of
neutrophil
Near Infrared (NIR) Spectroscopy
Measure of oxygen saturation of the tissues
The wavelength region 500 to 600 nm is dominated by the absorption from oxygenated hemoglobin (HbO2) and deoxygenated hemoglobin (Hb)
Volpe-Manhold Index: Determines the
quantity of supragingival calculus
Volpe-Manhold Index measures
Lingual surfaces of lower anteriors (#22-27)
Volpe-Manhold Index: Quantity is determined in
mm of calculus along the 2 diagonal and the central lines drawn over the lingual surface of each tooth
Volpe-Manhold Index: Index, expressed in mm, is computed for tooth, subject, population
Most frequently used calculus index in
longitudinal studies
B-o-P is a valid indicator for periodontal ——–. However, it is a poor indicator of periodontal ———-.
stability
breakdown
The Extent and Severity Index (ESI):
Agreement
Disease is defined as attachment loss >1mm
The Extent and Severity Index (ESI):
Extent
Proportion of tooth sites in a patient showing signs of destructive periodontitis
The Extent and Severity Index (ESI):
Severity
Amount of attachment loss at the diseased sites, expressed as a mean value
Bacterial plaque induces gingivitis, but ——- determines if CP will develop
host response
Primary herpetic gingivostomatitis-
Symptoms:
- painful severe gingivitis with redness
- ulcerations with serofibrinous exudate
- edema accompanied by stomatitis
Primary herpetic gingivostomatitis-
Characteristics:
- Incubation period is one week.
- Formation of vesicles, which rupture, coalesce
and leave fibrin-coated ulcers. - Healing within 10 to 14 days.
- Formation of vesicles, which rupture, coalesce
Recurrent herpetic infections
herpes labialis
Vermilion border and/or the skin adjacent to it. 20-40% of individuals with primary infection.
Recurrent herpetic infections
Diagnosis:
- generally considered an ------------. - ulcers in ------------.
aphtous ulceration
attached gingiva and hard palate
Herpes zoster-
Clinical:
Small ulcers usually on the —————.
- Latent in the ------------. - ---------- lesions.
tongue, palatal and gingiva
dorsal root ganglion
Unilateral
Hereditary gingival fibromatosis possible mechs:
TGF-beta1 favor the accumulation of ECM.
May be located on chromosome 2 in human.
Pyogenic granuloma of pregnancy-
Commonly arises from the ———- and has a ————-.
proximal gingival tissues
pedunculated base
Nonperiodonittis related abscess:
Root morphology alterations
Iatrogenic (endodontic perforation)
External root resorption
Cemental tears
Lichen planus:
——— alone is common.
Oral involvement
Lichen planus:
> Characteristic skin lesions
(Wickham striae).
Lichen planus: Various clinical appearances.
[papular, reticular, plaque-like, atrophic, ulcerative, bullous]
:Oral Lichenoid Lesions: *
subepithelial,band-like accumulation of lymphocytes and macrophages characteristic of a type IV hypersensitivity reaction.
Oral Lichenoid Lesions: examples
Examples: lesions in contact with dental restorations
lesions associated with various types of medications (NSAIDs, diuretics, beta-blockers etc)
a group of systemic diseases (liver disease)
Oral Lichenoid Lesions: Treatment:
Take biopsy (handling is different than regular biopsy) Take sample for culture if questioning candida inf
(about 38% of OLP cases have secondary inf)
A traumatic dental plaque control
Topical corticosteroids to control pain, discomfort
Pemphigoid
A group of disorders in which
autoantibodies towards components of the basement membrane result in detachment of the epithelium from the connective tissue
Pemphigoid: Histology:
Autoantibody reactions against hemidesmosome and
lamina lucida components.
Pemphigoid: ————– may be involved in the pathogenesis.
Complement-mediated cell destructive processes
Pemphigoid: Three types:
-
Bullous
- Benign Mucous Membrane -
Cicatricial (Scar formation)
Pemphigoid: Nicholsky sign
[Rubbing of the gingiva creates bulla formation]
Pemphigoid treatment:
Treatment: Plaque removal with daily use of chlorhexidine and/or topical corticosteroid
Pemphigus vulgaris: Formation of ——- in skin and
mucous membranes.
intraepithelial bullae
Pemphigus vulgaris: Painful ———– lesions, erosions or ulcerations.
desquamative
Pemphigus vulgaris: ——— course with recurrent ——– formation. Typically in middle age or elderly.
Chronic
bulla
Pemphigus vulgaris: Histology:
Acantholysis (due to destruction of desmosomes) Pericellular epithelial deposits of IgG and C3.
Circulating autoantibodies against interepithelial adhesion molecules
Erythema multiforme: Acute, sometimes recurrent, ———— disease affecting both mucous membranes and skin.
vesiculobullous
Erythema multiforme: Oral involvement occurs as much as ————of cases.
25-60%
Erythema multiforme: Swollen lips often with extensive
crust formation of the
vermilion border.
Erythema multiforme: ——– that rupture and leave extensive ———-.
Bullae
ulcers
Erythema multiforme: Characteristic skin lesions
(iris appearance+bullae).
Erythema multiforme: Extensive necrosis:
Stevens-Johnson syndrome
oral, ocular, genital, skin
Erythema multiforme of palatal mucosa: appears to be a ————- precipitating by a wide range of factors including ————
cytotoxic immune reaction towards keratinocytes
herpes simplex virus and various drugs
Erythema multiforme of palatal mucosa: Treatment:
Plaque control, Local/systemic
Lupus erythematosus- Autoimmune connective tissue disorders in which
autoantibodies form to various cellular constituents
Lupus erythematosus- Central ——— area with small ——— surrounded by =———- with a periphery of ———–
(vascular lesion formed by dilatation of a group of small blood vessels)
atrophic
white dots
irradiating fine white striae
telangiectasia
Lupus erythematosus- Lesions can be ulcerated and cannot be differentiated from
leukoplakia or atrophic oral lichen planus
Lupus erythematosus- Together with characteristic skin lesions
(butterfly).
Lupus erythematosus- Histology:
Degeneration of ——— and increased width of the ————-.
Deposits of various———– along the basement
membrane.
basal cells
basement membrane
Ig.s, C3 and fibrin
Lupus erythematosus; Discoid forms
(mild chronic which affects skin and mucous membranes
Lupus erythematosus: Systemic forms of the disease
(can be fatal)
Fibroma/ focal fibrous hyperplasia:
► A focal fibrous hyperplasia caused by .
irritation
Fibroma/ focal fibrous hyperplasia: ———–nodules
Sessile, well-circumscribed smooth-surfaced
Fibromafocal fibrous hyperplasia: ► Cell———, ———- collagenous tissue.
poor
hyperplastic
Fibroma/focal fibrous hyperplasia: ► May show .
hyperkeratinization
Fibroma/focal fibrous hyperplasia: ► Differential diagnosis:
Giant cell fibroma.
Calcified fibroblastic granuloma:
►Differential diagnosis:
Pyogenic granuloma
Pyogenic granuloma: —- (may resemble purulence).
Ulcerated
► gingival margin.
Pyogenic granuloma: ► ———-, sometimes lobulated, sessile or pedunculated. Bleeding is common.
Reddish or bluish
Pyogenic granuloma: ► Highly ——- with chronic ———– cells.
vascular
inflammatory
Pyogenic granuloma: ► Differential diagnosis:
Pregnancy tumor.
Peripheral giant cell granuloma: location
Anywhere on the gingival mucosa.
Peripheral giant cell granuloma Forms:
- Pedunculated (has a stalk), sessile (broad base),
red or purple, commonly ulcerated.
Peripheral giant cell granuloma: Focal collection of ———— with a richly cellular and vascular ——— separated by ———-.
multi-nucleated osteoclast-like
giant cells
stroma
collageneous septa
Peripheral giant cell granuloma: - Probably originated from .
periodontal ligament
Peripheral giant cell granuloma: Differential diagnosis:
focal fibrous hyperplasia.
Periapical cemental dysplasia: ———- lesions.
Fibrous-osseous cemental
Periapical cemental dysplasia: ► Tooth is usually ——-.
► Usually ————–.
vital
no symptoms
Periapical cemental dysplasia: Periapical bone is replaced by ————- through a ———— phase.
cellular fibroblastic tissue
cementoblastic
Periapical cemental dysplasia: Differential diagnosis:
Cemento-ossifying fibroma and fibrous dysplasia.
Hemangioma: - Rather frequent tumors of ———–.
- ————, soft lesions of blue to red color.
oral mucosa
Flat or raised, sometimes lobulated
Hemangioma: - ———– but may bleed. - They blanch on ———-.
Asymptomatic
pressure
Hemangioma two types:
Capillary and cavernous types.
Hemangioma: Differential diagnosis:
Mucous cysts, pyogenic granuloma.
Osteosarcoma:
widening of pdl is common
Malignant lymphoma:
Primary malignant lymphoma is ——— in the oral cavity.
► It occurs among ———–
rare
HIV-infected patients frequently
Metastasis to the gingiva:
The majority are ———–.
► Soft tissue metastasis from ———-.
► Most of the metastasis cases are ———– and not ———–.
intraosseous
lung cancer
carcinoma, sarcoma
Benign cementoblastoma:
Slow-growing neoplasm forming hard tissue around the.
apex of a tooth
Benign cementoblastoma: ► Radiopacity typically surrounded by a
radiolucent margin
Ameloblastoma:
► Derived from ————. ► Well-circumscribed ————
odontogenic epithelium
radiolucency
Peripheral odontogenic tumors:
———- gingival lesions.
Non-ulcerated sessile or pedunculated
Peripheral odontogenic tumors: Generally detected in the
soft tissue around unerupted
teeth.
Peripheral odontogenic tumors: ► Histopathology is similar to
intraosseous forms of the tumors.
Verruca vulgaris (one type of papilloma):
Is less common in ——– compared to skin.
- ———— are main locations.
oral mucosa
Lips and palate
Verruca vulgaris (one type of papilloma): - -------------- lesion with a ------- surface.
Sessile, exophytic or raised
whitish
Verruca vulgaris (one type of papilloma): - ------------ surface with ------------ and elongated ------ ridges.
Papillomatous
hyperkeratinization
rete
Verruca vulgaris (one type of papilloma): - Associated with
HPV type 2 and 4.
Nevus
Pigmented lesion containing———— . ► rare in the oral mucosa, mostly seen in ———. ►
melanocytes in CT
palate
Nevus:
————– lesions or a tumor.
► ———— or no pigmentation.
Flat, slightly raised
Brown or black
Nevus:
► ————- located along the basal layer of epithelium.
Nevocellular or brown nevus
Nevus: Differential diagnosis:
Amalgam tattoo
