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Paediatrics > OM And OP > Flashcards

OM And OP Flashcards

0
Q

What percentage of lesions were benign and what percentage were malignant?

A

Majority of lesions were benign

Less the 1% malignant

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1
Q

According to Jones and Franklin, what percentage of specimens from oral and max pathology were for children under 16?

A

10%

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2
Q

Which lesions predominate?

A

AOT

Ameoloblastic fibroma

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3
Q

Which lesions were rare?

A

Odontogenic tumours

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4
Q

What were the most frequently diagnosed mucosa lesions?

A

Mucous extravasion cyst 16%

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5
Q

How frequent were tooth pathology, salivary gland disease and mucosal path?

A

Tooth: 22%
Salivary gland: 19%
Mucosal: 12%

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6
Q

What percentage of Periapical path was seen and what type of lesions were they?nand how frequent were they?

A

Radicular cyst
Residual cyst
Chronic apical gran

13% of cases

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7
Q

Now can you classify lesions?

A 
Newborn 
Infective/ulcerative
Pigmented, vascular and red lesions
Exophytic
Gingival enlargement
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8
Q

Which newborn pathology is there?

A

Gingival cysts of infancy which include:

  1. Bohns nodules
  2. Gingival cyst of newborn
  3. Epstein pearl

Rare:
congenital epulis of newborn
Melanotic nueroectoderma, tumour of infancy

Other
Partial ankyloglossa

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9
Q

How do gingival cysts appear?

A

Small
White
Grey lesions on mucosa, alveolar ridge and hard palate

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10
Q

How common are gingival cysts of newborn?

A

75% of new borns

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11
Q

Why may parents not know their babies have gingival cysts?

A

Asymmptomic and rupture witching first three months of life

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12
Q

What is the name of the gingival cyst that occurs on the alveolar ridge?

A

Bohns nodules

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13
Q

Where do Bohns nodules arise from?

A

They arise from the remanants of the dental lamina

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14
Q

What is the dental lamina?

A

It is the earliest epithelium to grow into ectomesenchyme

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15
Q

What are the remnants of dental lamina called?

A

Epithelial cell rests of serres

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16
Q

Where are the epithelial cell rests of serres located?

A

In the CT between the developing tooth crowns and oral mucosa

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17
Q

What can happen to the Bohns nodules?

A

Can undergo cystic degen

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18
Q

What are the midline raphe cysts called?

A

Epstein pearls

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19
Q

How do Epstein pearls develop?

A

Small lesions located along the Palatal midline and they develop from trapped epithelium in the Palatal raphe which then undergo cystic change

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20
Q

What are Epstein pearls lined by?

A

Keratinising stratified squamous epithelium

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21
Q

Wheee do you find a congenital epulis?

A

Rare lesion seen in neonates

Usually in the anterior maxilla along the alveolar ridge

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22
Q

What is the clinical appearance of a congenital epulis?

A

Soft round exophytic swelling

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23
Q

In which gender a congenital epulis err common amongst?

A

Females

80% seen in females

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24
Q

What is inside congenital epulis?

A

Granular cells which are covered by epithelium

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25
Q

How do you manage congenital epulis?

A

Benign

Excise

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26
Q

When does a melanocytic tumour develop??

A

This develops withing the first few mths of life.

60% are found in those less than 6 months

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27
Q

Where are the majority of the MNT?

A

70% anterior maxilla

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28
Q

What is the composition of a MNE?

A

Epithelial cells containing melanin with a fibrous stroma

Neoplasm of neuroblsstic pigmented epithelial cells of neural crest origin

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29
Q

T/F MNE are rapidly growing?

A

T

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30
Q

How do you manage MNT?

A

Excision

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31
Q

What is partial ankyloglossa?

A

Lingual frenum has a short attachment to the FOM

May be seen in up newborn but may resolve with tongue use

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32
Q

Which infective lesions are there?

A

Infective
Bacterial: odontogenicninfection
Fungal: thrush
Viral: primary herpetic gingivostomatitis, hero angina, HFM, VZV,

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33
Q

What causes thrush?

A

Candida

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34
Q

What is the clinical appearance of thrush?

A

White plaques on labial,buccal and gingival mucosa and tongue

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35
Q

What happens when the white plaques are removed?

A

Raw, bleeding mucosa

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36
Q

How does an acute odontogenicn infection present?

A

Pyrexia
Red swollen face
Anxious child

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37
Q

How would you manage an acute odontogenic infection?

A

Antibiotics are indicted for oyredia and spreading infection

The cause of infection does also need to be eliminated

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38
Q

How does a chronic odontogenic infection present?

A

Sinus
Mobile tooth
Halitosis
Discoluree tooth

39
Q

How would you manage a chronic infection?

A

Xla tooth

40
Q

How does primary herpetic gingivostomatitis present?

A 
This presents as inflamed gingiva
Small vesicles throughout mouth oral mucosa, tongue, lips, and gingiva 
Vesicles can then coalesce forming a highly infectious exudate 
Painful 
Bleeding and crusting lips 
Lymphadenopathy 
Temperature 
Headache malaise
41
Q

What. Age is primary herpetic usually seen in?

A

2-5

Maternal antibodies in young children protect young

42
Q

What is the incubation period for primary herpetic gingival?

A

6-7 days

43
Q

How long does it take for primary herpetic to go resolve?

A

14 days

44
Q

What are rare complications of primary herpetic?

A

Aseptic meningitis and encephalitis

45
Q

How do you manage primary herpetic?

A 
Paracetamol for pyrexia
0.2% CHX
Acilovir: 2+ 200mg 5 times a day , 5 days (half dose for less then 2 yrs and double dose for immunology risked) 
Fluids
Bed rest 
Soft diet

Review in 7 days to check healing

46
Q

How does herpangina present?

A

Small vesicles on soft palate and fauces
Febrile , irritatble, cervical lymphadenopathy , young children
NOT ON GINGIVAE

47
Q

What causes herpangina?

A

Coxsackie

Usually A4 or A10 but can be 1-6,8,12,22

48
Q

How does HFM present?

A

Vesicles on tongue and oral mucosa

Macula papillary rash on hand and feet

49
Q

Hat causes HFM?

A

Coxsackie usually a16 but occasionally 5,7,9,10 or B9

50
Q

How is HFM caused?

A

Faeco oral transmission

51
Q

What causes herpes zoster?

A

VZV virus

52
Q

How does Herpes zoster present in the mouth?

A

Vesicles on palate which rupture and produce ovoid ulcers with halos

53
Q

What else is associated with intra oral ulceration in herpes zoster?

A

Skin lesions following dermatome

54
Q

What causes EM?

A

It is a VB disorder with unknown aetiology but is predicated by infections, drugs and various other things

55
Q

What intra oral lesions are seen in EM?

A

Subepithekual blisters
Crusting or the lips
Affects anterior region

56
Q

What extra oral lesions are seen in EM?

A

Target lesions of squamous epithelium

57
Q

What infective lesions can have similar appearances as primary herpetic?

A 
Herpangina 
HFM
herpes zoster
EM
Thrush
58
Q

What ulcerative lesions are there?

A

Those caused by infection
Others: self induced post anaesthetic, Riga fede ulceration, RAS (seen in EM, SJS, Bechets, Epidermilysis bullosa, Lupus, neutropenia)

59
Q

What is Riga fede ulceration?

A

Traumatic ulcer on ventral of tongue caused by rubbing of the tongue on newly erupted mandib teeth

60
Q

How do you mange Riga fede ?

A

Smooth incisa edge

61
Q

In which children is Riga fede more common amongst?

A

Indifference to pain
Familial dysautonomia
Cerebral palsy

62
Q

What are examples of pigmented and vascular lesions?

A

Eruption cyst
Eruption heamatoma

Haemangioma

Petechia and purpura

63
Q

What is an eruption cyst and how does this become a heamatoma?

A

Asymptomatic and resolve once tooth has erupted
Cyst: Fluctuations fluid filled cyst that may appear 2-3 weeks prior to tooth eruption

Heamatoma: as tooth emerges the cyst may become blood filled and appear bile or purple in colour

64
Q

How do you manage eruption cysts?

A

Do not excise as risk of infection

65
Q

What are haemaginomas?

A

This are typically present at birth and may grow with the infant and may then regress with time and even disappear

66
Q

How do you manage haemajngiomas?

A

Monitor

67
Q

Which syndrome can you see haemajngiomas in?

A

Sturge weber

68
Q

What are the feature of Sturge weber?

A

Haemajngiomas of face and oral mucosa
Ipsilateral haemangiomas and calcification of the meninges
Contralateral focal epileptiform fits and transient or permanent paralysis
Mental retardation

69
Q

Which exophytic lesions are there?

A 
Congenital epulis of newborn
Squamous papilloma
Epulis
Eruption cyst haemaoma
Mucocele
Ranula
70
Q

What is a mucocele?

A

There are three types

  1. Retention
  2. Extravasion: arises due to damage of the salivary duct of a minor gland
  3. Superficial
71
Q

What is a common cause of mucocele in children?

A

Cheek biting

72
Q

What causes the mucosa to swell up in mucous extravasion cysts?

A

Mucous builds up in the connective tissue and appears as a blue swelling which may have a keratinised surface

73
Q

What is the management for mucoceles?

A

Monitor
Some heal spontaneously
Others need surgical excision

74
Q

What are the causes of gingival enlargements?

A

Drug induced : phenytoin, cyclosporin
Hereditary: gingivofibromatosis
Vascular: Sturge weber
Syndromes: gorlon goltz

75
Q

What other pathology is seen in the young ?

A

Odontogenic tumours

76
Q

What are the three common type of odontogenic tumours in children?

A

AOT
Ameloblastic fibroma
Odontoma

77
Q

How common are Ameloblastic fibromas?

A

Rare

78
Q

Which age group do Ameloblastic fibromas affect?

A

Patients below 20

79
Q

Which site is most commonly affected by Ameloblastic fibromas?

A

Mandib molar premolars site

80
Q

How do Ameloblastic fibromas appear radiographically?

A

Well defined

Usually unilocular radiolucency

81
Q

T/F radiopacities are found in Ameloblastic fibromas?

A

F

They are seem in Ameloblastic fibro odontomas

82
Q

Where do Ameloblastic fibromas develop from?

A

Mixed tumour: Odontogenic epithelium and mesenchymal tissue

83
Q

What effect do Ameloblastic fibromas have in eruption?

A

May affect normal eruption of teeth in that area

84
Q

What can an Ameloblastic fibroma be mistaken for occasionally?

A

Dentigerous

85
Q

How do you manage Ameloblastic fibromas?

A

Excise or curettage

86
Q

What is the microscopy of Ameloblastic fibromas?

A

Proliferating strands and cords of epithelium
Cellular fibroblastic stroma
May have inductive changes

87
Q

How do adenomatoid odeontgenic tumours present?

A

Asymmptomatic slow growing associated with an unerupted tooth
More common in maxilla than mandible

88
Q

How does an AOT appear radiographically?

A

Radiolucency with well defined margins

89
Q

How do you mange AOT?

A

Enucleation

90
Q

What is the microscopy behind AOt?

A

Whirls of epithelium
Duct like microsysts lined by columnar cells
Convoluted eosinophilia bands and sometimes calcification

91
Q

What do complex odontomes appear as?

A

Disorganised mass of dentine, enamel and pulp

More commonly seen in posterior mandibl e

92
Q

How do compound odontomes appear?

A

Denticles

Anterior maxilla

93
Q

What is the effect of odontomes?

A

Prevent eruption of teeth

94
Q

Which type of odontome is more common?

A

Compound 4x more common than complex

Paediatrics (31 decks)

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