08 Physical & Chemical injuries

Question 1

linea alba

Answer 1

-pressure -friction irritation -sucking trauma -13% population -no treatment/biopsy

Question 2

morsicatio buccarum

Answer 2

-cheek chewing -females>males -ragged hyperkeratosis histologically

Question 3

electrical burns

Answer 3

-common, 5% burn admissions -extreme heat -usually small children on lips -charred, little bleeding, significant edema

Question 4

ulceration treatment

Answer 4

-remove injury source -treat symptoms -biopsy if no healing

Question 5

common chemical injuries

Answer 5

-aspirin -OTC meds -gasoline -dental chemicals -listerine

Question 6

chemotherapy changes

Answer 6

-mucositis (mucosal necrosis) of nonkeratinized surfaces -hemorrhage -increased infection susceptibility -oral ulceration -impaired healing

Question 7

radiation changes

Answer 7

-acute mucositis (mucosal necrosis) of mucosal surfaces -dermatitis -hemorrhage secondary to thrombocytopenia -xerostomia -loss of taste (hypogeusia, dyseusia) -osteoradionecrosis, risk increases with surgery -trismus of TMJ capsule and muscles -developmental abnormalities

Question 8

BRONJ

Answer 8

-bisphosphonate-related osteonecrosis of the jaw -bisphosphonates used to slow bone involvement of cancer -IV use most often contributes

Question 9

meth mouth

Answer 9

-methamphetamine abuse -xerostomia, parasitosis, rampant caries -users appear emaciated, agitated, nervous, multiple class V lesions

Question 10

anesthetic necrosis

Answer 10

-ulceration/necreosis several days after LA from tissue ischemia

Question 11

exfoliative cheilitis

Answer 11

-from habitual lip licking, biting, picking, sucking -may have secondary bacterial or fungal infection

Question 12

submucosal hemorrhage

Answer 12

-petechiae - minute hemorrhage of skin, mucosa, serosa -purpura - slightly larger than petechiae -ecchymosis - over 2cm -hematoma - swelling or mass -traumatic/non-traumatic -non-traumatic - thrombocytopenia, disseminated intravascular coagulopathy (DIC), viral infections (mono, measles)

Question 13

oral sexual practices

Answer 13

-palatal erythema, petechiae, purpura -lingual frenum tears, tongue ulcerations

Question 14

amalgam tattoo

Answer 14

-incorporation of amalgam into tissues -can be seen on radiograph if large enough

Question 15

oral piercings

Answer 15

-acute complicatoins - bleeding, infection, nerve damage -chronic complications - speech impediment, allergy, chipped teeth, aspiration

Question 16

systemic metal intoxication

Answer 16

-lead - ulcerative stomatitis, burton’s line, metalic taste, tongue tremor -mercury (acrodynia) - hypersalivation, ulcerative gingivitis -silver (argyria) - slate blue gingival margins, gray skin discoloration

Question 17

smoker’s melanosis

Answer 17

-increased oral pigmentations in 21% of smokers -polycyclic amines stimulate melanin -mostly in anterior facial gingiva

Question 18

discoloration of oral mucosa (drug related)

Answer 18

-deposits of drug metabolites: phenolphthalein tranquilizers estrogen AIDS meds minocycline antimalarials chemotherapeutics

Question 19

reactive osseous metaplasia

Answer 19

-bone within soft tissues specimens of oral cavity (nasopalatine duct, mechanical denture irritation)

Question 20

reactive chondromatous metaplasia

Answer 20

-cartilage within soft tissue specimens of oral cavity

Question 21

spontaneous sequestration

Answer 21

-rise along lingual mandible surface -ulcerative bone associated with loss of overlying mucosa -possible from: trauma, occlusion, vascular disruption, mucosal denudation, genetics

Question 22

antral pseudocyst

Answer 22

-common finding on pan radiograph -dome-shaped radiopacity -floor of maxillary sinus -inflammatory serum exudate -odontogenic infection?

Question 23

sinus mucocele

Answer 23

-mucin accumulation encased in epithelium -surgical ciliated cysts: mucocele due to blocked sinus ostium -retention cysts: partial blockage of duct of sero-mucus glands or invagination of respiratory epithelium -true sine mucoceles enlarge and expand bone making sinus cloudy

Question 24

cervicofacial emphysema

Answer 24

-introduction of air into subcutaneous or fascial spaces of face and neck -can be from sneeze following extraction or from compressed air blown into wound with air syringe -treat with antibiotic/warm compress

Question 25

myospherulosis

Answer 25

-topical antibiotic in petrolatum base placed in extraction socket -asymptomatic circumscribed radiolucency similar to residual cyst