Chapter 15: Disease of the Oral Cavity Flashcards
(114 cards)
1
Q
Characterized by a nodular or lobular bony growth in the midline of the hard palate
A
Torus palatinus
2
Q
Represented by single or multiple, unilateral or bilateral bony growths on the lingual aspect of the mandible in the region f the premolars
A
Torus mandibularis
3
Q
- Diminution in size of either jaw
- Failure at the growth center in the condyle
- Congenital or acquired
- Associated with plethora of syndromes (craniofacial dysostosis, acrocephalosyndactyly, trisomy 2)
A
Micrognathia
4
Q
Pierre Robin
A
- Micrognathia
- Glossoptosis (prevents adequate support of lingual of musculature, allowing the tongue to fall downward and backward
- Posterior cleft palate
Andy Gump facies
5
Q
Maxilla development
A
10th-12th week: maxilla grows rapidly
4th-5th month: disparity between the upper and lower jaws is quite apparent
6
Q
Treatment: Robin anomaly
A
- Keeping the infant in a prone position
2. Severe: tongue tip is sutured to the anterior mandible or lower lip
7
Q
Enlargement or anterior placement of the lower jaw
A
Prognathism
8
Q
Malocclusion
A
- Underdevelopment of the maxilla or mandible or overdevelopment of the mandible
- Incompatibility of tooth size and jaw size may result in spacing, crowding or irregularity of teeth
- Prolonged retention of primary teeth may result in delayed eruption of permanent teeth
- Neglected primary or permanent teeth may be lost prematurely
9
Q
Most congenital cases of macroglossia are due to..
A
- Lymphagioma
2. Hemagiolymphangioma
10
Q
Treatment of macroglossia
A
- Sclerosing agent
2. Corrective surgery
11
Q
- Caused by embryonal failure of the tuberculum impar to submerge, covered by the lateral lingual tubercles
- Characterized by a smooth to nodular, elevated or depressed area void of papillae, located just anterior to the circumvallate papillae on the dorsum of the tongue
- No treatment
A
Median rhomboid glossitis
12
Q
- Due to partial or complete embryologic failure of the thyroid gland to descend from the foramen cecum to its normal position in the neck
- Characterized by multiple nodules of thyroid tissue on the dorsum of the tongue in the area of the foramen cecum and within the body of the tongue
- No treatment is required for small lesion
- Larger lesion: surgery
No lingual thyroid tissue should be removed until the presence of thyroid tissue elsewhere is ascertained
A
Lingual thyroid
13
Q
Inability to elevate the tongue tip above a line extending through the commissures of a congenitally short lingual frenulum
A
Ankyloglossia
14
Q
Treatment for ankyloglossia
A
No treatment
Severe: frenulum should be clipped in infancy
Preferred treatment: Z-plasty
15
Q
- Occurs in about 1 per 1000 white births
- As a result of declining postnatal mortality, decreasing operative mortality, steadily improving operative results and attendant increases in marriage and childbearing
A
Cleft lip, with or without cleft palate
16
Q
- May be unilateral or bilateral
2. Unilateral: cleft is more common on the left side
A
Isolate cleft lip
17
Q
Cleft lip-cleft palate is more common in…
A
Males
18
Q
Complete clefts are more common in…
A
Females
19
Q
Can be a sign of a submucosal cleft of the palate
A
Cleft uvula
20
Q
Contraindicated in the presence of a submucosal cleft
A
Adenoidectomy
21
Q
- Caused by failure of penetration of ectomesenchyme between the embryonic maxillary and mandibular processes
- Cleft may be unilateral (left side) or bilateral, partial or complete (rare)
- Extending from the angle of the mouth toward the ear
- Many cases: cleft extends above or below the tragus
- More common in males
A
Lateral facial cleft
22
Q
May be found with 1st and 2nd branchial arch syndrome
- Hemifacial microsomia
- Oculoauriculovertebral dysplasia
- Mandibulofacial dysostosis
A
Lateral facial cleft
23
Q
Hypoplasia of the ascending ramus and condyle of the mandible, ear tags and microtia
A
Hemifacial microsomia
24
Q
Essential hemifacial microsomia with epibulbar dermoids and hemivertebra
A
Oculoauriculovertebral dysplasia
25
1. Associated with cleft lip and extends to the inner canthus of the eye
2. Some cases: cleft runs lateral to and does not involve the ala of the nose, passing near the outer canthus into the temporal region
3. Unilateral or bilateral
4. Associated with cleft lip, cleft palate or lateral facial cleft
Oblique facial cleft
26
Due to failure of ectomesenchymal penetrance between the maxillary, median nasal and lateral nasal processes or failure of coverage of the nasolacrimal groove
Oblique facial cleft
27
Acrocephalosyndactylu
Apert syndrome
28
1. Craniosyntosis leading to turribrachycephaly and syndactyly
2. Progressive synostoses of hands, feet, spine
3. Some mental retardation
4. Case reports of conductive deafness
Apert syndrome
29
1. Craniosynostosis
2. Hypoplasia of midface
3. Relative mandibular prognathism
4. Ocular proptosis
5. Hypertelorism
6. Conductive hearing loss
Craniofacial dysostosis (Crouzon syndrome)
30
1. Anomalies of the eye (antimongoloid obliquity of the lids and coloboma of the lower lids with lack of cilia)
2. Abnormalities of the external and middle ears
3. Hypoplasia of the mandible and malar bones
Mandibulofacial dysostosis (Treacher Collins syndrome)
31
Cavity lined by epithelium
True cyst
32
Derived form the proliferation and cystic degeneration
Odontogenic cyst
33
Derived from epithelial remnants of the tissue covering the embryonal processed that participate in the formation of the face and jaws
Nonodontogenic cysts
34
Odontogenic cyst
1. Dentigerous cyst
2. Eruption cyst
3. Gingival cyst of newborn infants
4. Radicular cyst
5. Keratocyst
35
1. Surrounds the crown of an unerupted tooth of either the regular or the supernumerary dentition
2. Arises though alteration of the reduced enamel epithelium after the crown has been completely formed
3. Teeth involved: mandibular 3rd molar, maxillary canine, maxillary 3rd molar and 2nd mandibular premolar
4. Solitary
Dentigerous cyst
36
1. Gingiva becomes swollen with associated salivation, fetor oris, dysphagia and painful lymphadenopathy
2. Sites of round to oval, sharply demarcated, disseminated vesicles or erosions: gingiva and tongue
3. Lesions are 2-4 mm, painful, covered by a yellowish pseudomembrane and surrounded by a red margin
4. After about 10-14 days, the primary infection subsides without scar formation
Primary herpes simplex
37
Unilateral vesicles appear on the palate, uvula, maxillary gingiva and upper buccal and labial mucosa
Second trigeminal nerve
38
Unilateral vesicles appear on the palate, uvula, maxillary gingiva and upper buccal and labial mucosa
Second trigeminal nerve
39
1. All human fetuses after their 4th month in utero and at least 80% of newborn infants have small nodules or cyst (Epstein's pearls, Bohn's nodules) at the junction of the hard and soft palates near the median raphe
2. White to yellowish white small epithelial inclusion cyst
3. Resulting from incorporation of epithelium during the embryonic process of palatal fusion
4. Becomes superficial and rupture, within the 1st few weeks of life
Gingival and palatal cysts of newborn infants
40
1. Uncommon type of dentigerous cyst
2. Associated with erupting deciduous or rarely permanent teeth
3. Represents the accumulation of tissue fluid or blood in a dilated follicular space about the crown of an erupting tooth
4. Unilateral or bilateral, single or multiple, present at birth
Eruption cyst
41
Extremely painful for months or even years especially in elderly persons
Postzoster neuralgia
42
1. Most common of oral cyst
2. Inflammatory in origin
3. Sequela of dental carries
4. Symptomless and is diagnosed on routine dental radiographs
5. Associated tooth is nonvital and usually manifests dental caries
6. Remain small and does not produce jaw expansion
Radicular (periapical) cyst
43
1. Basal cell carcinoma
2. Multiple keratocysts
3. Skeletal abnormalities
Nevoid basal cell carcinoma syndrome
44
1. Bifurcated and splayed ribs
2. Kyphoscoliosis
3. Fusion of vertebrae
4. Cervicothoracic spina bifida occulta
5. Lamellear calcification of the falx cerebri
6. Bilateral calcified fibromas of the ovary
7. Medulloblastoma
8. Meningioma
Nevoid basal cell carcinoma syndrome
45
1. Lined by simple to thinly keratinized strafified squamous
2. Appear as early as 7-8 years or as late as 30s
3. Tendency to recur, possibly from adjacent microcyst, in spite of thorpugh cuerettement
Nevoid basal cell carcinoma syndrome
46
1. Closed, epithelium-lined intrabony sac
2. Located below the incisive foramen (cyst of the palatine papilla)
3. Painless unless they become infected
Nasopalatine or incisive canal cyst
47
Klestadt's cyst
Nasoalveolar (nasolabial) cyst
48
1. Arises from the epithelial rests located at the junction of the globular, lateral nasal and maxillary processes
2. Situated at the attachment of the ala of the naris
3. Not located within the bone
4. May cause facial swelling to obliterate the nasolabial fold on the involved side
5. Swells into the floor of the nasal vestibule, projecting beneath the anterior end of the inferior turbinate
6. Patient experienced intermittent pain
Nasoalveolar cyst
49
1. Developmental cyst lined by epidermis and cutaneous appendages
2. Incorporation of ectoderm at the time of closure of embryonic fissures during the 3rd and 4th weeks in utero
Dermoid cyst
50
1. Arise in the floor of the mouth
2. Classified into median (midline) and lateral
3. Always originate above the mylohyoid muscle, they may penetrate through a developmental hiatus
4. Become evident between 12-25 years of age
Oral dermoid cyst
51
Causes elevation and displacement of the tongue, producing difficulty in speaking, eating and even breathing due to pressure exerted upon the epiglottis
Dermoid cyst located above the geniohyoid muscle
52
May bulge into submental area
Dermoid cyst located deeper (between the geniohyoid and mylohyoid muscles)
53
1. Slow painless swelling in the submental region
2. Extends from the mandible to the hyoid bone, giving the appearance of a double chin
3. As it enlarges, it may push the larynx down and by upward growth causes a bulge in the oral floor
Submental or geniohyoid region
54
Lining epithelium of dermoid cyst
Keratinized stratified squamous epithelium
55
Don not contain skin appendages
Epidermoid cyst
56
1. Result from rupture of a duct of a minor salivary gland, allowing the mucus to spill into the connective tissue
2. Occurs most often on the mucosal surface of the lower lip
3. Also appear on the buccal mucosa, oral floor or ventral surgace of the tip of the tongue (cyst of Blandin-Nuhn)
4. Large and involves the sublingual salivary gland it is called rannula
Retention cyst (mucocele)
57
Disease of the enamel, dentin and cementum that produces progressive demineralization of the calcified component and destruction of the organic component with the formation of a cavity in the tooth
Dental caries
58
1. Most frequent disease of civilized man
| 2. Once a carious cavity has formed, the defect is permanent
Tooth decay
59
1. Generalize enlargement of the gingiva
2. Gingiva seems to enlarge until the permanent teeth are covered by a hard, firm, painless gingiva that may displace the teeth
3. Tx: surgical removal of the hyperplastic tissues
Gingival fibromatosis
60
1. Painless hyperplasia of the gingiva
2. Degree of hyperplasia appears to be most closely related to oral hygiene: the poorer the hygiene, the more pronounced the enlargement
3. Tx: gingival surgery (severe hyperplasia)
4. Also occur with cyclosporine A and nifedipine therapy
Dilantin gingival enlargement
61
Yellow-gray, bright yellow, gray-brown or darker discoloration of teeth which may or may not accompanied by hypoplasia of the enamel
Tetracycline side effect
62
The most common disturbance in the eruption of teeth is caused by...
Premature loss or extraction of neglected permanent or primary teeth
63
Diseases associated with premature periodontal destruction
1. Trisomy 21
2. Papillon-Lefèvre syndrome
3. Histiocytosis X
4. Leukemia or agranulocyosis
64
1. Dorsum of the tongue shows characteristic smooth, shiny, erythematous areas that are slightly depressed below the surrounding normal papillae
2. No treatment, reassurance
Geographic tongue
65
1. Characterized by tongue papillae divided into groups and clumps by small fissures that may be apparent until the tongue is folded
2. May also be a part of the Melkersson-Rosenthal syndrome and frequently in trisomy 21
3. No treatment
Scrotal tongue
66
1. Characterized by elongation of the filiform papillae and concurrent growth of a black pigment-producing fungus
2. Associated with antibiotic therapy
3. Harmless and disappears spontaneously
Black hairy tongue
67
Treatment of black hairy tongue
1. 20% aqueous caprylate
2. 0.25% triamcinolone acetonide in an adhesive base
3. Brushing the dorsum of the tongue 2-3x
68
1. Gingiva becomes swollen with associated salivation, fetor oris, dysphagia and painful lymphadenopathy
2. Sites of round to oval, sharply demarcated, disseminated vesicles or erosions: gingiva and tongue
3. Lesions are 2-4 mm, painful, covered by a yellowish pseudomembrane and surrounded by a red margin
4. After about 10-14 days, the primary infection subsides without scar formation
Primary herpes simplex
69
Treatment of primary herpes simplex
1. Supportive
| 2. Topical anesthetic
70
1. Most common form of herpetic infection
2. Marked by a burning, itching or tingling sensation in the region of the forming lesion
3. Groups of small clear vesicles that soon become transformed into pustules or crusted confluent erosions located on the vermillion or mucocutaneous junction of the upper or lower lip
Secondary (recurrent) herpes simplex
71
Non-viral recurrent ulceration of the oral cavity and lips
Aphthous stomatitis
72
Caused by pleomorphic transitional L form of alpha-hemolytic streptococci
Recurrent aphthous stomatitis
73
1. Characterized by large (1-2cm) single or multiple necrotic ulcerations of the lips, cheeks, tongue, soft and hard palates and anterior tonsillar pillars
2. Pain and systemic manifestations are present during the acute state of the disease
Major aphthae
74
Recurrent neurotrophic manifestation of reactivated chickenpox virus
Herpes zoster
75
Several types of herpes zoster of the cranial nerves
1. Trigeminal type (attack of the gasserian ganglion with involvement of one or more branches
2. Zoster oticus (attack on the geniculate ganglion)
3. Zoster of the glossopharyngeal nerve
4. Zoster of the vagus nerve
76
Unilateral vesicles appear on the palate, uvula, maxillary gingiva and upper buccal and labial mucosa
Second trigeminal nerve
77
Involvement of the lower lip, mandibular gingiva and oral floor
3rd division zoster
78
Extremely painful for months or even years especially in elderly persons
Postzoster neuralgia
79
1. Bullous disease of autoimmune etiology
2. Autoantibodies to the intercellular cement substance of the stratified squamous epithelium of the oral mucosa and skin
Pemphigus
80
1. Most severe type
2. Rapid death prior to the use of corticosteroids
3. Middle aged and elderly person
4. No sex predilection
5. Oral involvement, pharynx, larynx, nasal, anal and vaginal mucosa
6. Nikolsky's sign
7. Suprabasilar and contains acantholytic cells as well as variable numbers of nonspecific inflammatory cells
Pemphigus vulgaris
81
Areas involved by pemphigus especially the larynx can heal with...
Cicatricial formation
82
Periadenitis mucosa necrotica recurrens
Major aphthae
83
Sutton's disease
Major aphthae
84
Cicatricial pemphigoid
Mucous membrane pemphigoid
85
1. Chronic vesiculobullous disease of autoimmune etiology
2. Involves primary oral and ocular mucous membranes
3. Bullae or erosions (ocular lesions tending to heal with scarring)
4. Oral lesions present as a desquamative gingivitis
5. No acantholysis, moderate, chronic inflammatory infiltrate in the subepithelial connective tissue
6. Linear deposition of complement and Ig in the BM zone
Mucous membrane pemphigoid
86
Treatment of mucous membrane pemphigoid
Immunosuppressive agent (prednisone,azathioprine)
87
1. Acute, recurrent, self-limited eruption of skin and mucous membranes
2. A hypersensitivity reaction
3. Various types of lesions: bullae, vesicles, papules, macules wheals
Erythema multiforme
88
When vesicles and bullae predominate
Erythema multiforme bullosum
89
1. Severe form of bullous erythema multiforme
2. Toxic, acute, febrile course
3. Precipitating factors: herpes simplex, Mycoplasma infections, long acting sulfonamides
4. Tx: systemic corticosteroids (initial dose 40-60 mg/day)
Steven-Johnson syndrome
90
1. Change in color of the normally reddish oral mucosa to white
2. White patch that does not rub away
Leukoplakia
91
1. Increased retention and production of keratin by mucosal stratified squamous epithelium
2. Associated with chronic mechanical irritation
3. Premalignant
Hyperkeratosis
92
Abnormal nuclear shapes and size and increased numbers of mitotic figures
Dyskeratosis
93
Typical buccal and labial lesion present as a fone lacework of white reticular hyperkeratotic papules (Wickham's striae) and gray plaque-like or annular lesions on the dorsum of the tongue
Lichen planus
94
Lichen planus on buccal mucosa
Lesions originate in the posterior area and spread anteriorly
95
1. Asymptomatic
| 2. Metallic taste or mild discomfort is common
Lichen planus
96
Becomes evident on the 5th to 6th postpartum day
Neonatal monilial stomatitis
97
Candidiasis must be promoted by...
1. Age (infants, elderly persons)
2. Hormonal status (pregnancy, diabetes)
3. Hereditary
4. Edentulousness
5. Ill-fitting dentures
6. Lowered body resistance (malabsorption, systemic malignancy, uremia)
98
Diffuse or localized as angular cheilosis, superficial monilial stomatitis, denture stomatitis and deep granulomatous candidiasis
Oral candidiasis
99
1. Mild erythema with fine, whitish deposits to diffuse, inflamed "white mouth"
2. 1st changes appear on the anterior dorsal third, edges and ventral surfaces of the tongue and latter in the oral vestibule
3. Snow-white, curdled milk can present as strips, plaques and diffuse pseudomembranes
4. Removed easily than a diphtheritic membrane
5. White spots are composed of a dense matting of Candida albicans together with cell detritus, residual food particles and bacteria
6. Surface of the lesion has a velvety appearance whereas the adjacent mucous membrane appears dark red and moderately swollen
Superficial monilial stomatitis
100
Patient complaints of swelling, sensitivity and pain of the oral mucous membrane at points of denture contract
Denture stomatitis
101
Treatment of oral candidal stomatitis
1. Improved oral hygiene and nutritional status (esp serum iron)
2. Correction of the irritating factor
3. Correction of the underlying disorder
4. Oral nystatin suspension, ointment or tablets
102
Origins of amenoblastoma
1. Epithelial lining of a dentigeous cyst
2. Remnants of the dental lamina of the enamel organ
3. Basal layer of the oral mucous membrane
103
1. 1% of the tumors and cysts of the jaws
2. Age group of 20-49 years
3. 90%: mandible
4. Insensitive to radiation therapy
5. Tx: surgical resection or hemisection
Amenoblastoma
104
1. Adenoamenoblastoma
2. Ameloblastic adenomatoid tumor
3. Odotogenic adenomatoid tumor
Adenomatoid odontogenic tumor
105
1. More common in females
2. 2nd decade of life
3. Arises frequently in the maxilla and predominantly in the anterior region of both jaws
4. Associated with an unerupted tooth, most often a canine
5. Xray: radiolucent, resembling a dentigerous cyst or lateral periodontal cyst
6. Expands the cortical plate but is not invasive and surgically shells out easily
Adenomatoid odontogenic tumor
106
1. Invasive and locally recurrent
2. Expands the surrounding bony structures and produces noticeable swelling
3. 75% arisen in the mandible with the majority in the premolar-molar area
4. Xray: radiolucency and radiopacity with numerous dense islands or various sizes scattered throughout
Calcifying epithelial odontogenic tumor
107
1. Ages 5 and 20 years
2. Painless, asymptomatic, slow expansion of the cortical plates of the premolar-molar area of the maxilla
3. Xray: smooth, outlined, cystlike lesion
Amenoblastic fibroma
108
1. Simultaneous occurrence of amenoblastoma and a complex or compound odontoma within the same tumor
2. Children, under age 15, more common in males, in maxilla
3. Growth is slow and often is associated with swelling of the alveolar process
4. Xray: Cystlike destruction
Ameloblastic odontoma
109
1. Virtual absence of amenoblastic tissue
2. 70% occurs in the 2nd and 3rd molar area, more common in the mandible
3. Asymptomatic and ate found on routine dental Xray
4. Xray: irregular radiopacities surrounded by a narrow radiolucent band
Complex odontoma
110
1. High degree of morphologic and histologic differentiation
2. Occur in the incisor-canine region of the upper jaw
3. Small and nonaggressive
4. Diagnosed on routine dental Xray
Compound odontoma
111
1. Locally aggressive, nonmetastazising rumor of odontogenic origin
2. Not well defined but tends to be honeycombed, perforating the cortex of the jaw only if it reaches great size
3. Mandible: involves the ramus and body with equal frequency
4. Tumors that arise in the maxilla may perforate and invade the antrum, filling it completely and producing exophthalmos
Myxoma (myxofibroma)
112
1. Most commonly involves the periapical regions of the mandibular anterior teeth
2. Teeth involved are nearly always mandibular
3. Lesions are often multiple, and some have as many as 8 mandibular teeth involved
Cementoma
113
Benign tumors seen in infancy
1. Melanotic neuroectodermal tumor of neural crest origin
| 2. Congenital epulis
114
1. Benign tumor present at birth
2. Pedunculated and located on the maxillary or mandibular gingiva (anterior region)
3. Female
4. Similar to granular cell myoblastoma (schwannoma)
5. Tx: simple surgical excision
Congenital epulis
