8 Red Lesions Flashcards by Love Dog

also known as red lesions

REACTIVE HYPERPLASIAS

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a group of fibrous connective tissue that commonly occur in oral mucosa secondary to injury

REACTIVE HYPERPLASIAS

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→ usually a chronic process
→ usually painless because the nerve does not proliferate with the hyperplastic tissue

REACTIVE HYPERPLASIAS

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during mastication, these lesions may become secondarily
ulcerated

REACTIVE HYPERPLASIAS

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True or false

REACTIVE HYPERPLASIAS has no known etiology

True

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overexuberant repair; a stimulus causes the tissues repair
itself excessively

REACTIVE HYPERPLASIAS

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What does it mean if the REACTIVE HYPERPLASIAS has a color Lighter than surrounding tissues?

high collagen

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What does it mean if the REACTIVE HYPERPLASIAS has a color Red?

increased granulation tissue

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Treatment of REACTIVE HYPERPLASIAS

treatment:

o removal or modification of the irritating factor

o surgical excision

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usually caused by a minor trauma to the tissues providing a pathway for the invasion of non-specific types of microorganisms

PYOGENIC GRANULOMA

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usually caused by calculus or any foreign material within the gingival crevice

PYOGENIC GRANULOMA

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tissues respond to low virulence organisms by overzealous proliferation of vascular type of connective tissues

PYOGENIC GRANULOMA

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hormonal changes of puberty and pregnancy also modify reparative response to injury

PYOGENIC GRANULOMA

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HISTOLOGIC FEATURES
→ lobular mass of granulation tissues
→ neutrophils

PYOGENIC GRANULOMA

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CLINICAL FEATURES
→ not pus-producing
→ reddish
o indicates that it is made of hyperplastic granulation tissue

→ usually found in the gingiva
→ prominent capillaries

PYOGENIC GRANULOMA

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Txt of PYOGENIC GRANULOMA

→ removal of any local etiologic factors
o if calculus, perform oral prophylaxis

→ surgical excision

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seen exclusively in the gingiva between the 1st permanent molars and the incisors

PERIPHERAL GIANT CELL GRANULOMA

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→ presumed to arise in the PDL or from the periosteum

PERIPHERAL GIANT CELL GRANULOMA

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→ occasionally cause resorption of the alveolar bone because of
the presence of the giant cells → more in females than in males
→ size is usually 1 cm in diameter

PERIPHERAL GIANT CELL GRANULOMA

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HISTOLOGIC FEATURES
→ hyperplastic granulation tissues
→ chronic inflammatory cells

PERIPHERAL GIANT CELL GRANULOMA

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HISTOLOGIC FEATURES

→ neutrophils
→ abundant multinucleated giant cells

PERIPHERAL GIANT CELL GRANULOMA

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RADIOGRAPHIC FEATURES
→ cup-shaped radiolucency if on edentulous ridges

PERIPHERAL GIANT CELL GRANULOMA

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Txt. Of PERIPHERAL GIANT CELL GRANULOMA

→ removal of local factors or irritants
→ surgical excision

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→ also called:

Focal Fibrous Hyperplasia

Hyperplastic Scar

PERIPHERAL FIBROMA

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increase in fiber tissues

Focal Fibrous Hyperplasia

highly collagenous, relatively avascular

Hyperplastic Scar

CLINICAL FEATURES → found in gingiva, anterior to permanent molars → can either be: o pedunculated with a stem o sessile mass

PERIPHERAL FIBROMA

→ color is similar to surrounding tissue → rarely causes erosion of the alveolar bone

PERIPHERAL FIBROMA

Txt of PERIPHERAL FIBROMA

→ removal of etiologic agent → surgical excision (including PDL, if involved)

TYPES of PERIPHERAL FIBROMA

→ has (3) types: o Peripheral Ossifying Fibroma o Peripheral Odontogenic Fibroma o Giant Cell Fibroma

→ calcified islands seen are presumed to be bone

PERIPHERAL OSSIFYING FIBROMA

→ a gingival mass

PERIPHERAL OSSIFYING FIBROMA

bone is found in an encapsulated proliferation of plumped benign fibroblasts and chronic inflammatory cells typical location

PERIPHERAL OSSIFYING FIBROMA

composed of well-vascularized, non-encapsulated fibrous connective tissue

PERIPHERAL ODONTOGENIC FIBROMA

→ usually non-ulcerated → distinguishing feature: o presence of strands of odontogenic epithelium from PDL

PERIPHERAL ODONTOGENIC FIBROMA

→ the color is lighter than the surrounding tissues, signifying high collagen content, high fibrous connective tissues

IRRITATION FIBROMA

a very common reactive hyperplasia found in the buccal mucosa, tongue, or lower lip → usually painless, broad base swelling

IRRITATION FIBROMA

IRRITATION FIBROMA may be part of an autosomal dominant syndrome which is either

o multiple hamartoma syndrome o Cowden syndrome

HISTOLOGIC FEATURES → collagen overproduction → fibroblasts in collagen matrix

IRRITATION FIBROMA

Txt of IRRITATION FIBROMA

TREATMENT → surgical excision → recurs if area is traumatized nodule at commissure

most cases are non-specific

GENERALIZED GINGIVAL HYPERPLASIA

an unusual tissue response to chronic inflammation associated with local factors such as plaque, calculus, or bacteria

GENERALIZED GINGIVAL HYPERPLASIA

→ hormonal changes and drugs can also potentiate effects on local factors through gingival tissues o hormonal changes include: pregnancy, puberty, and menopause o drugs appear to have a regulating effect on fibroblast metabolism or growth rate

GENERALIZED GINGIVAL HYPERPLASIA

an anticonvulsant drug used to control seizure disorders

Dilantin (Phenytoin)

irreversible damage; surgical procedure must be done to treat the condition

Dilantin (Phenytoin)

→ immunosuppressive drug used for transplant patients and treatment of alopecia → reversible damage; if medication is stopped, changes will reverse

Cyclosporine

→ calcium channel blocker used for treatment of angina and arrhythmias → reversible damage

Nifedipine

also known to occur in patients with leukemia o there is spontaneous pooling of blood in the mouth is expected

GENERALIZED GINGIVAL HYPERPLASIA

→ other forms include: o idiopathic hyperplasia o hereditary gingival fibromatosis

GENERALIZED GINGIVAL HYPERPLASIA

CLINICAL FEATURES → increase in bulk of free and attached gingiva, especially the interdental papilla → lost stippling or gingival margins become rolled and blunted

GENERALIZED GINGIVAL HYPERPLASIA

consistency of GENERALIZED GINGIVAL HYPERPLASIA either:

Soft & Spongy Firm & Dense

typical generalized gingival hyperplasia A. Soft & Spongy B. Firm & Dense

idiopathic hyperplasia & hereditary gingival fibromatosis A. Soft & Spongy B. Firm & Dense

HISTOLOGIC FEATURES → abundant collagen deposition → fibroblasts increase in number

GENERALIZED GINGIVAL HYPERPLASIA

HISTOLOGIC FEATURES → capillaries may increase and are prominent → in leukemic enlargements, atypical and immature white blood cells (malignant infiltrate)

GENERALIZED GINGIVAL HYPERPLASIA

Txt of GENERALIZED GINGIVAL HYPERPLASIA

→ good oral hygiene necessary to minimize effects of inflammation on fibrous proliferation → gingivoplasty or gingivectomy, in combination with prophylaxis + oral hygiene instructions especially for dilantin hyperplasia

also known as epulis fissuratum

DENTURE-INDUCED FIBROUS HYPERPLASIA

→ a very common lesion → a form of chronic trauma produced by an ill-fitting denture

DENTURE-INDUCED FIBROUS HYPERPLASIA

CAUSE bony ridges of mandible and maxilla resorb with long-term denture use ↓ flanges extend farther into vestibule ↓ chronic irritation + trauma ↓ incite over exuberant fibrous connective tissue reparative response ↓ result into appearance of painless fold of fibrous tissues surrounding overextended dentures flanges

DENTURE-INDUCED FIBROUS HYPERPLASIA

CLINICAL FEATURES → usually occurs in the vestibular mucosa where the dentures flange contacts the tissues

DENTURE-INDUCED FIBROUS HYPERPLASIA

Txt of DENTURE-INDUCED FIBROUS HYPERPLASIA

TREATMENT → construction of a new denture → relining of the old denture → decreasing the flanges → surgical excision usually required → reduction in size of lesion may follow prolonged removal of denture

also known as palatal papillomatosis

PAPILLARY HYPERPLASIA

CAUSE → exact cause appears exclusively on the hard palate and is often related with ill-fitting RPD, which somehow potentiates the growth of candida albicans organisms beneath interface of denture base material and mucosa

PAPILLARY HYPERPLASIA

CAUSE → related to the process of fungal organisms in a setting of a low-grade form of trauma

PAPILLARY HYPERPLASIA

CLINICAL FEATURES → involves most frequently the palatal vault and less affects the alveolar ridge

PAPILLARY HYPERPLASIA

multiple, erythematous papillary projections that are tightly aggregated, producing an overall verrucous granular or “cobblestone appearance”

PAPILLARY HYPERPLASIA

HISTOLOGIC FEATURES → appears as numerous small papillary projections covered with intact parakeratotic stratified squamous epithelium

PAPILLARY HYPERPLASIA

HISTOLOGIC FEATURES → projections may be slender or almost villous

PAPILLARY HYPERPLASIA

Txt of PAPILLARY HYPERPLASIA

→ surgical removal → electrosurgery → laser ablation → curettage → cryosurgery → mucoabrasion → reconstruction of denture → antifungal therapy (can reduce but cannot cure alone) → in mild cases, utilize soft tissue conditioning agents and liners with frequent changing of lining material → removal of appliance at bedtime → maintenance of good oral hygiene

also known as oral verruca vulgaris

ORAL SQUAMOUS PAPILLOMA

→ most common papillary lesion of oral mucosa → will include papillary and veruccal growths composed of benign epithelium and connective tissues

ORAL SQUAMOUS PAPILLOMA

CAUSE → human papillomavirus o a DNA virus with 1 molecule of a double-stranded DNA

ORAL SQUAMOUS PAPILLOMA

CLINICAL FEATURES → usually found in the vermillion border of the lips → predilection for hard and soft palate and uvula

ORAL SQUAMOUS PAPILLOMA

CLINICAL FEATURES appear as exophytic granular to cauliflower-like surface alteration

ORAL SQUAMOUS PAPILLOMA

CLINICAL FEATURES many, long, thin, finger-like projections extending above the mucosal surface

ORAL SQUAMOUS PAPILLOMA

CLINICAL FEATURES each projection is made up of a continuous layer of stratified squamous epithelium

ORAL SQUAMOUS PAPILLOMA

HISTOLOGIC FEATURES → represent an exaggerated growth of squamous epithelium → many cases demonstrate slight cellular atypia (rapid cellular turnover)

ORAL SQUAMOUS PAPILLOMA

Txt of ORAL SQUAMOUS PAPILLOMA

surgical removal by routine excision or laser ablation

also referred to as ‘gumboil’

PARULIS

represents a focus of pus in gingival connective tissues

PARULIS

→ derived from an acute infection o if the path of least resistance leads to gingival submucosa, soft tissue abscess/parulis is formed → usually associated with non-vital tooth

PARULIS

CLINICAL FEATURES → “yellow-white gingival tumescence” with variable amounts of erythema → induces pain

PARULIS

HISTOLOGIC FEATURES → central cavity filled with pus

PARULIS

TREATMENT of PARULIS

→ treat the acute infection to achieve resolution of gingival abscess → root canal treatment or extraction → periodontal surgery to reduce pocket depth

8 Red Lesions Flashcards

(84 cards)