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Oral Pathology > Test 1 > Flashcards

Test 1 Flashcards

1
Q

What is pathology?

A

Study of tissues under abnormal conditions, the nature of a disease and its causes, development and consequences.

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2
Q

Pathology addresses what 4 components of disease?

A

Cause/etiology
Mechanisms of development
Structural alterations of cells
Consequences of changes

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3
Q

What is a site of structural and functional change in body tissues that is produced by disease or injury?

A

Lesion

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4
Q

What is a manisfestation?

A

A symptom or sign of an ailment/disease

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5
Q

What is the study of the development of disease?

A

Pathogenesis

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6
Q

What is the study of changes of normal mechanical, physiological, and biomechanical functions, either caused by a disease or resulting from an abnormal sundrome?

A

Pathopysiology

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7
Q

What is oral pathology?

A

Specificly abnormalaities in the oral cavity

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8
Q

What is a traumatic ulcer?

A

Trauma to an area

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9
Q

What is a butterfly rash of the bridge of the nose?

A

Lupus (autoimmune disease)

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10
Q

Why must DH study oral pathology?

A

Legal
Professional
Ethical

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11
Q

What is the role of the dental hygienist in regards to oral pathology?

A

Identifying
Interpreting
Reporting

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12
Q

Accurate descriptions of oral pathology abnormalities must include:

A

Location
Distribution
Physical characteristics

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13
Q

What is the most important part of the oral pathology abnormality description?

A

Location

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14
Q

How should the location of an abnormality be recorded?

A

Precise anatomical location related to a head/neck and oral landmarks

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15
Q

What is distribution in relation to an abnormality description?

A

Number of present (single vs multiple, generalized or localized, unilateral or bilateral)

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16
Q

What must be included in the physical characteristics of an oral pathology abnormality?

A

Category/classification
Size
Colour
Surface texture
Consistency
Attachment to the surface

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17
Q

What category/classification is a solid, raised lesion that is less than 5mm in diameter? (Solid raised bump)

A

Papule

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18
Q

What is category/classification is a solid, raised lesion that is greater than 5mm in diameter (solid elevated, circumscribed lesion greater than 5mm)

A

Nodule

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19
Q

Category/classification: What is a deep and solid elevation 1-2cm wide or greater?

A

Tumor

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20
Q

Category/classification: What is a lesion that is slightly elevated, a flat raised area greater than 1cm in diameter?

A

Plaque

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21
Q

Category/classification: What is a blister filled with purulent exudate, circumscribed blister filled with a collection of pus ranging from 0.1 to 2cm?

A

Pustule

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22
Q

Category/classification: What is a superficial blister, 5mm or less in diameter, usually filled with clear fluid?

A

Vesicle

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23
Q

Category/classification: What is a large fluid filled blister over 5mm?

A

Bulla/Bullae

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24
Q

Category/classification: What is a closed sac lined by the epithelium located in the dermis, subcutaneous tissue, or bone?

A

Cyst

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25
Q

Category/classification: What is a serum filled papule or plaque?

A

Wheal (hives)

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26
Q

Category/classification: What is a lesion characterized by the surface epithelium and frequently some of the underlying connective tissue? Often appears depressed or excavated.

A

Ulcer

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27
Q

Category/classification: What is a superficial lesion, often raisin secondary to rupture of a vesicle or bulla, that is characterized by partial or total loss of the surface epithelium?

A

Erosion

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28
Q

Category/classification: What is a shallow linear crack in the epidermis often associated with hypersalivation, xerostomia, and dehydration?

A

Fissure

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29
Q

Category/classification: What is the thinning of tissue layers, decrease in size of cells/loss of tissue?

A

Atrophy

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30
Q

Category/classification: What is a permanent mark from wound healing?

A

Scar

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31
Q

Category/classification: What is a flat, circumscribed, discoloured area 5mm to 1cm?

A

Macule

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32
Q

Category/classification: What is a larger flat, discoloured area?

A

Patch

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33
Q

Category/classification: What is dried blood area approximate to the edge of the area?

A

Crust/scab

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34
Q

Category/classification: What are red spots, pinpoint to area of hemorrhage, broken blood vessels?

A

Petechiae

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35
Q

Category/classification: What is a non elevated area of hemorrhage, larger than a petechia?

A

Ecchymosis

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36
Q

Surface texture: What is a central depression?

A

Crater

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37
Q

Surface texture: What is a hard covering, composed of dried serum, pus, blood, or combination?

A

Crust

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38
Q

Surface texture: What is hardness of tissue from increased number of surrounding epithelial cells?

A

Induration

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39
Q

Surface texture: Having rough surface containing small nodulations or elevated projections?

A

Papillary

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40
Q

Surface texture: What is loose membranous surface layer of exudate containing microorganisms formed during inflammatory reaction?

A

Pseudomembrane

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41
Q

Surface texture: What is a deep lesion that pushes up and stretches surface tissue?

A

Smooth

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42
Q

Surface texture: What is having rough, wart like surface with multiple irregular folds?

A

Verrucous

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43
Q

Lesion consistency: What is adipose tissue, loose connective tissue, or glandular tissue that is composed mainly of cells without much intervening fibrous connective tissue?

A

Soft

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44
Q

Lesion consistency: What is harder than the adjacent softer oral mucosa or skin, indicating presence of increased fibrous connective tissue comparable to cartilage?

A

Firm

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45
Q

Lesion consistency: What contains bone or other calcified material?

A

Hard

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46
Q

What type of tissue attachment is this?

A

Sessile

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47
Q

What type of tissue attachment is this?

A

Pedunculated

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48
Q

What category/classification is this?

A

Papule

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49
Q

What category/classification is this?

A

Nodule

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50
Q

What category/classification is this?

A

Tumor

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51
Q

What category/classification is this?

A

Plaque

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52
Q

What category/classification is this?

A

Pustule

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53
Q

What category/classification is this?

A

Vesicle

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54
Q

What category/classification is this?

A

Bulla/Bullae

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55
Q

What category/classification is this?

A

Cyst

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56
Q

What category/classification is this?

A

Wheal (hives)

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57
Q

What category/classification is this?

A

Ulcer

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58
Q

What category/classification is this?

A

Erosion

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59
Q

What category/classification is this?

A

Erosion

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60
Q

What category/classification is this?

A

Fissure

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61
Q

What category/classification is this?

A

Atrophy

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62
Q

What category/classification is this?

A

Atrophy

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63
Q

What category/classification is this?

A

Scar

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64
Q

What category/classification is this?

A

Macule

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65
Q

What category/classification is this?

A

Patch

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66
Q

What category/classification is this?

A

Crust/scab

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67
Q

What category/classification is this?

A

Petechiae

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68
Q

What category/classification is this?

A

Ecchymosis

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69
Q

What is the surface texture?

A

Smooth

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70
Q

What is the surface texture?

A

Papillary

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71
Q

What is the surface texture?

A

Fissured

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72
Q

What is the surface texture?

A

Verrucous

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73
Q

What is the surface texture?

A

Cratered

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74
Q

What is the surface texture?

A

Pseudomembranous

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75
Q

What is the surface texture?

A

Indurated

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76
Q

Describe the lesion

A

Coricated and uni-locular

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77
Q

Describe the lesion

A

Multi-locular

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78
Q

Describe the lesion

A

Focal opacity

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79
Q

Describe the lesion

A

Ground glass

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80
Q

What is tissue reflectance for?

A

To locate abnormal cells

81
Q

How does tissue reflectance work?

A

Light provides a blue white illumination and abnormal cells reflect the light appearing bright white after a client has rinsed with flavoured acetic acid

82
Q

What’s an example of a tissue reflectance system?

A

Micorlux

83
Q

What is autofluorescence for?

A

To detect abnormal cells

84
Q

How does autofluoresence work?

A

Hand held unit emits a cone of blue light under which healthy tissues appear pale green and abnormal lesions appear dark green/black

85
Q

What is an example of an autofluorescence system?

A

VELScope

86
Q

What is toluidine blue stain for?

A

To detect abnormal tissue

87
Q

How does toluidine blue stain work?

A

Topical application to suspected site will allow the blue dye to define the margins needed for biopsy

88
Q

What is the drawback of toluidine blue stain?

A

Inflammatory cells will also pick up stain

89
Q

What is the dental hygienist’s role in oral cancer screening?

A

Interpreting the findings - creating a list of possible manifestation or lesions or diseases that fit the data/information

90
Q

What does MIND stand for?

A

Metabolic
Inflammatory
Neoplasm
Developmental

91
Q

What subcategories are under metabolic?

A

Compromised organ system
Hormonal
Nutritional

92
Q

What subcategories are under inflammatory?

A

Trauma
Reactive
Infection
Immunologic

93
Q

What subcategories are under neoplasms?

A

Benign
Premalignant
Malignant

94
Q

What subcategories are under developmental?

A

Genetic
Acquired

95
Q

What are the 12 questions for the client with oral lesions?

A
  1. How long?
  2. Has it happened before?
  3. Anywhere else in the mouth?
  4. Painful?
  5. Getting worse?
  6. Treatments you’ve tried?
  7. Constant or changing?
  8. Injury?
  9. Anywhere else outside the mouth?
  10. Anyone else in your family have it?
  11. How’s your general health?
  12. Taking any meds?
96
Q

What is derived from clinical appearance and palpation of the lesion?

A

Diagnosis

97
Q

Radiographs provide sufficient information to establish the

A

Diagnosis

98
Q

How can laboratory diagnosis be accomplished?

A

With lab tests including blood chemistries and urinalysis.

99
Q

What is surgical diagnosis?

A

Surgical intervention providing conclusive evidence of the diagnosis when the lesion is opened.

100
Q

What is therapeutic diagnosis?

A

Prescribing therapeutic drugs and observing the results based on clinical and historical information.

101
Q

What is microscopic diagnosis?

A

Microscopic evaluation of a biopsy specimen taken from the lesion which is often the main component of the definitive diagnosis.

102
Q

What are the reasons for a biopsy?

A

Highly reliable and accurate
Provides a microscopic examination
Rules out or confirms malignancy
Allows for a definitive diagnosis

103
Q

What is the complete removal biopsy of a small lesion (less than 1 cm)?

A

Excision biopsy

104
Q

What is removed during an excision biopsy?

A

The entire lesion plus a rim of surrounding normal tissue with a scalpel

105
Q

What is the extra normal tissue surrounding a lesion that is removed in an excision biopsy referred to as?

A

Safety margin

106
Q

What type of biopsy is the removal of only a small portion of the whole lesion plus a small section/rim of surrounding tissue with a scalpel?

A

Incision biopsy

107
Q

During an incision biopsy, which is preferred, a narrow and deep incision or a broad and shallow?

A

Narrow and deep is preferrable

108
Q

What is a needle biopsy?

A

A need aspiration of tissue from a needle inserted into the tumor

109
Q

What is a punch biopsy?

A

Basically a hole punch for tissue

110
Q

What is an exfoliatative cytology sample?

A

Pre-biopsy tool that involves the scraping of the surface of a soft tissue lesion which is then examined under a microscope

111
Q

What needs to be done if an exfoliatative cytology samples comes back as abnormal?

A

A biopsy

112
Q

Why is an exfoliatative cytology sample not ideal?

A

It only evaluated superficial cells

113
Q

What is a transepithelial cytology sample?

A

A pre-biopsy tool that is a brush painlessly collecting cells from full thickness (penetrates to the basement membrane)

114
Q

What should be done if a positive result comes from a transepithelial cytology?

A

Biopsy

115
Q

What must the DH do in regards to reporting lesions?

A

Make appropriate referrals to other health care professionals

116
Q

How to care for a client with a lesion?

A

Inform the client of the lesion
Create a written record
Take intra oral photos
Provide referral and written instructions for client
Follow up with client after referral

117
Q

What information is required in a client referral?

A

Client details (name, address, contact info, birthday)
Medical history (including meds, allergies)
Social history (tobacco use etc)
Detailed description of lesion (MCATSS)
Differential or working diagnosis
Referring clinician details (name, title, address, contact info)

118
Q

What is microdontia?

A

Tiny teeth

119
Q

What is macrodontia?

A

Giant teeth

120
Q

What is adontonia?

A

Congenital absence of all teeth

121
Q

What is hypodontia?

A

Genetically missing some teeth

122
Q

Where is partial anodontia most common?

A

3rd molars max more often than mand

123
Q

What is the 2nd most common area for partial anodontia?

A

Max laterals

124
Q

What is the third most common area for partial anodontia?

A

Mandibular 2nd premolars

125
Q

What teeth are the least likely to be congenitally missing?

A

Canines

126
Q

90% of supernumerary teeth occur in

A

The maxilla

127
Q

What are the most common areas for supernumerary teeth?

A

Max laterals or max third molars

128
Q

What is a tooth erupting between the max centrals?

A

Mesiodens

129
Q

Which teeth have the most variable crown shape?

A

Maxillary 3rd molars followed by mandiabular 3rd molars

130
Q

What is a paramolar?

A

A supernumerary premolar

131
Q

What is the most commonly seen anomally with the max laterals?

A

Peg laterals

132
Q

What is a small supernumerary molar found distal to the 8’s?

A

Distomolar

133
Q

What are dwarfed roots?

A

What it sounds like. Stumpy roots

134
Q

What is a dilaceration root?

A

Abnormal curve in the root

135
Q

What is root gemination?

A

Single tooth germ attempts to divide. 1 root, two crowns

136
Q

What is root fusion?

A

Union of two adjoining tooth buds that looks like one large tooth. 2 roots, one crown

137
Q

What is excessive cementum on the roots of the teeth?

A

Hypercementosis

138
Q

What is abnormal development of the enamel?

A

Enamel dysplasia

139
Q

What is incomplete or defective formation of enamel from environmental factors, nutrition, infections, chemical ingestion, trauma, or hereditary factors?

A

Enamel hypoplasia

140
Q

What is an inherited defect in enamel formation?

A

Amelogenesis

141
Q

What is ankylosis?

A

Teeth in which bone had fused to cementum/dentin

142
Q

What are supernumerary roots?

A

Extra roots

143
Q

What is the loss of tooth surface from excessive acid?

A

Erosion

144
Q

What is the loss of tooth surface from wear?

A

Abrasion

145
Q

What is internal resorption?

A

Inside the root resorbing. Inflammatory response in the pulp that destroys dentin due to trauma, injury, inflammatory, hormonal, infection, etc.

146
Q

What is external resorption?

A

Top of the root resorbing from pressure on the tooth (ortho)

147
Q

What is complete cleft lip?

A

Involves the roof of the mouth into the sinus/nose

148
Q

What is incomplete cleft lip?

A

Doesn’t reach all the way up into the nose/root of mouth.

149
Q

Is cleft lip more common in males or females?

A

Males

150
Q

___% of cleft lips are unilateral and ___% are bilateral.

A

85%
15%

151
Q

True or False: Midline clefts are common

A

False. Midline clefts are rare.

152
Q

What are paramedian lip pits?

A

Congenital bilateral (usually) depressions in the lips

153
Q

When do paramedian lip pits develop?

A

6 weeks in utero

154
Q

Is there treatment for paramedian lip pits?

A

No

155
Q

What are commissural (lip) pits?

A

Indentation of the corner of the lips (little dimples I have)

156
Q

What causes commissural pits?

A

Failure of fusion of the mand and max

157
Q

What is the pendulous fold of excess labial mucosa/tissue on the inner aspect of the lip?

A

Double lip

158
Q

What causes double lip?

A

Developmental or trauma

159
Q

What is a maxillary frenum mucosal tag?

A

Small, pink, tissue tag on the frenum

160
Q

What causes maxillary frenum mucosal tags?

A

Developmental or trauma

161
Q

What is microglossia?

A

Tiny tongue

162
Q

What is macroglossia?

A

Giant tongue

163
Q

What is ankyloglossia?

A

Tongue tie

164
Q

What is a cleft tongue (bifid)?

A

Snake tongue. Groove or split running lengthwise along the tip of the tongue

165
Q

What causes cleft tongue?

A

Incomplete fusion of the distal tongue buds

166
Q

What else has been reported to be associated with cleft tongue?

A

Maternal diabetes

167
Q

What causes hairy tongue?

A

Smoking, antibiotics, extended hydrogen peroxide rinsing

168
Q

What is geographic tongue?

A

Benign migratory glossitis - loss of fill form papilla in one or multiple areas

169
Q

What are lingual varicostities?

A

Dark blue/purple like veins under the tongue. Result of venous dilation which is a part of aging

170
Q

What is lingual thyroid nodule?

A

Thyroid tissue becomes trapped in tongue tissues and doesn’t migrate anterior to trachea

171
Q

What is white sponge nevus/nevi?

A

Defect in the maturation and exfoliation of the mucosa epithelium

172
Q

What does white sponge nevi look like?

A

White, folded, spongey plaques

173
Q

What are ectopic sebaceous glands that may or may not contain the hair follicle that have become trapped during the fusion of the max and mand processes?

A

Fordyce granules

174
Q

What is leukoedema?

A

Spongosis (fluid accumulation) of the middle cell layer of the epidermis

175
Q

What is hereditary gingival fibromatosis?

A

Hyperplastic enlargement of the gingiva, overgrowth of connective tissue

176
Q

What are retrocuspid papillae?

A

Firm, round papule 1-4mm in diameter, pink and smooth under the lingual of the lower cuspids.

177
Q

What is micrognathia?

A

Tiny jaw

178
Q

What syndromes are associated with micognathia?

A

Apert
Crouzons
Pierre Robin
Treacher Collins

179
Q

What is macrognathia?

A

Giant jaw (think chin twins)

180
Q

Syndromes associate with macrognathia?

A

Cherubism
Fibrous dysplasia
Acromegaly

181
Q

What is cleft palate?

A

Like cleft lip but only affects the palate

182
Q

What does TMJ involve?

A

The two joints that attach the mandible to the skull

183
Q

Where do TMD symptoms originate from?

A

The joint itself or the muscles around the joint

184
Q

Some research suggest that as many as ___% of all adults have at least one sign of TMD.

A

70%

185
Q

How many adults describe accompanying symptoms with TMD?

A

25%

186
Q

How many adults seek treatment for TMD?

A

5%

187
Q

Who are the majority of patients with TMD?

A

Females between 20-40 years old

188
Q

Some researchers suggest what hormones may have a role in TMD pathogenesis?

A

Female sex hormones

189
Q

What comorbid conditions are often associate with TMD?

A

Depression
Rheumatoid arthritis
Chronic fatigue syndrome
Chronic headache
Fibromyalgia
Sleep disturbances
Irritable bowel syndrome

190
Q

What are the bones of the TMJ?

A

External acoustic meatus
Temporal bone
Articular disc
Zygomatic arch
Articular tubercle
Condyle of mandible

191
Q

What are the ligaments of the TMJ?

A

Joint capsule
Temporomandibular ligament
Stylomandibular ligament

192
Q

What is a normal TMJ opening?

A

3 fingers edge to edge (40mm)

193
Q

What are the TMD symptoms?

A

Pain
Popping, clicking, crepitus, grating sounds
Difficulty opening the mouth
Locking of the joint
Headache
Swelling on one or both sides of the face

194
Q

Causes of TMD

A

Bruxism
Arthritis
Trauma
Facial bone defects
Misalignment

195
Q

Phase 1: Non surgical treatment for TMD

A

Pharmacological therapy (drugs) - pain control, muscle relaxants, anti-inflammatory, anti-anxiety meds

Physiotherapy

Corrective dental tx (full mouth reconstruction with crowns)

Biteplate

Night guard

Botox

Chiropractic therapy

196
Q

Phase 2: ortho and adjustment treatments for TMD

A

Occlusal appliance
Anterior reposition appliance
Stabilizing appliance

197
Q

Phase 3: surgical treatment for TMD

A

Arthroscopy
Surgical reposition of the condyle
Open joint surgery for disc repositioning
Replacement or excision
Total joint reconstructions using prosthetics or autogenous grafts

198
Q

What is the role of the dental hygienist in TMD client management?

A

Advise client to eat soft diet, avoid opening wide, suggest relaxation training
Refer

Oral Pathology (2 decks)

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