Variant of Normal Flashcards
Palatine Torus/Torus Palatinus
- Tori are incredibly common, a normal of variant
- Part of physical exam is to visualize as well as running index finger over the hard palate every time
- Sometimes, torus palatinus is quite small and unnoticeable until you touch it (feel a hard bump and it’s just a bony growth)
- Sometimes, they are pedunculated; Sometimes, they get so large they become traumatized; vascular supply on surface can sometimes form ulcerations and even get a little bone exposure.
- If patient with history of use of bisphosphonates (bone modifying agents given to women who have osteoporosis or osteopenia and to prevent metastesis for certain cancers), he will remove that dead bone, and it will slowly heal. That’s one of the perils of having an enlarged palatine torus
What is this clinical finding?
Palatine Torus/Torus Palatinus
What is this clinical finding?
Palatine Torus/Torus Palatinus
Mandibular Torus: Torus Mandibularis
- Sometimes pt’s tori are so large that the sublingual frenum gets stuck underneath
- repeated irritation/trauma can create a little white rim on the tori
- these tori are rock hard and may grow overtime, but we don’t really understand why people get them
What is this clinical finding?
Mandibular Torus:
Torus Mandibularis
What is this clinical finding?
Mandibular Torus:
Torus Mandibularis
Buccal Exostoses
- Sometimes patient develops exostoses (another word for torus).
- Can get buccal exostoses, all just bone. Can pick these up on radiograph, the bone is a lot denser.
Why does it happen?
- Maybe it’s related to parafunctional habits – but don’t really understand the
- basis for the exostosis.
- They’re going to be bilateral. If it’s unilateral, we start thinking about other bony diseases
a variant of normal
What is this clinical finding?
Buccal Exostoses
Unencapsulated Lymphoid Aggregates
- the lymphoid aggregates are part of the foliate papillae (they contain some taste buds as well).
- This is lymphoid tissue -- when you get a cold or upper respiratory tract infection, sometimes these areas can become hyperplastic in response to infection – can become a little enlarged.
- These are usually bilateral.
- a variant of normal
What is this clinical finding?
Unencapsulated Lymphoid Aggregates
What is Lymphoepithelial
cyst?
a cystic structure.develops in that area where there are already unencapsulated lymphoid tissue.
This is not normal – Pathologic
Sometimes when you get a cyst in this area – because of lymphoid tissue, you can develop lymphoepithelial cyst – a tiny yellowish cyst. we see the blood vessels on the surface; this is quite characteristic.
What is this clinical finding?
Lymphoepithelial
cyst
we see a tiny yellowish cyst. we see the blood vessels on the surface; this is quite characteristic.
What is this clinical finding?
Unencapsulated
Lymphoid
Aggregates
Post-tonsillectomy
Can even develop these on area of tonsils.
(left pic) Red/salmon is a lymphoid aggregate (unencapsulated lymphoid tissue). This is someone
who had a tonsillectomy , and you can see these
lymphoid aggregates on posterior pharyngeal wall (salmon color).They move around the area.
(right pic) It grew back even in post-tonsillectomy patients.
Fordyce Granules
- Occurs on the buccal labial mucosa, retro molar pad and tonsillar area and lips
- They are white or yellow ectopic sebaceous glands
- They can be present in small or large quantity
- Why do we have sebaceous glands in mouth? we dont know, evolutionary advantage? we don’t really understand.
- a variant of normal
What is this clinical finding?
Fordyce Granules
What is this clinical finding?
Fordyce Granules
Fimbriated
fold/Plica
semiluminaris
- Some patients have more obvious fimbriated folds or plica semilunaris in their mouths than others
- When you look at the ventral surface of the tongue, you’ll sometimes be able to pick these up.
- These are duct opening from a series of salivary glands, minor glands, but they’re a little bit different than other minor glands in the mouth.
- They produce more of a viscous type of saliva, and they are the glands of the Blandin and Nuhn
- a variant of normal
What is this clinical finding?
Fimbriated
fold/Plica
semiluminaris
What is a Frenal tag?
- Frenal attachments are thin folds of mucous membrane with enclosed muscle fibers that attach the lips to the alveolar mucosa and underlying periosteum.
- Most often, during the oral examination of the patient the dentist gives very little importance to the frenum, for assessing its morpholology and attachment.
- Sometimes occur; essentially normal of varient
What is this clinical finding?
Frenal tag
Sublingual Varices
- Tortuous dilated vessels (enlarged engourged veins) on the ventral surface of the tongue, and sometimes stretch onto lateral border
- Appears bluish purple in color
- More prominent with increasing age; we don’t see it in younger pts.
- Nothing to be concerned about, a variant of normal
What is this clinical finding?
Sublingual Varices
What is this clinical finding?
Sublingual Varices
What is this clinical finding?
Sublingual Varices
Circumvallate papillae
- Located in the posterior region of the tongue; dividing the body from the base
- They are mushroom shaped and arranged in V-shape formation
- Although they are usually not apparent in most patients, you may be able to visualize them in some
- a variant of normal
What is this clinical finding?
Circumvallate papillae
Parotid Papillia (Stenson duct)
- Located in right and left buccal mucosa at the level of the occlusal plane close to the maxillary first and second molar.
- This structure may appear as a small dot or have a prominent pink to red papillae presence.
- This is the parotid papilla, and It is the opening of the parotid duct which drains saliva from the parotid gland.
A normal of variant
What is this clinical finding?
Parotid Papillia (Stenson duct)
What is this clinical finding?
Parotid Papillia (Stenson duct)
Linea Alba
•a white line or keratotic area that present along occlusal plane in some patients
- due to some friction In that area. (the buccal mucosa)
- It varies in thickness and opacity
- Can be seen in some patients who have bruxism
- a variant of normal
What is this clinical finding?
Linea Alba
Leukoedema
- A bluish and white filmy opalescence of the mucosa is observed
- In order to differentiate it from other white lesions à gently stretch the patient’s cheek forward and the leukoedema will disappear or partly fade and appears less apparent
- It is commonly found in people of color and some smokers.
- a variant of normal
What is this clinical finding?
Leukoedema
Palatal Rugae
- Raised ridges or folds
- Located in the anterior palate on either side of the mid-palatine raphe behind the incisive papilla
- They vary in number and size
- May increase with age
- a variant of normal
What is this clinical finding?
Palatal Rugae
