Developmental: Soft Tissue and Cysts Flashcards
Hereditary or Genetic
85% - unknown etiology
10% - inherited, any abnormality that is inherited is developmental
5% - known environmental cause (ETOH, thalidomide)
Familial
Runs in families
Congenital
Present at birth, doesn’t imply etiology
Developmental conditions often
A. Present at young age or congenitally
B. Bilaterally symmetrical
C. Asymptomatic
General considerations for developmental conditions
A. Sporadic vs Genetic
B. Isolated vs Generalized
Syndrome: A generalized condition characterized by multiple abnormalities
Agnathia
without jaw development (aplasia)
Micrognathia
Small underdeveloped jaw (hypoplasia)
Macrognathia
Large jaw
Agnathia, Micrognathia, Macrognathia Development
Primary - Developmental
Secondary or acquired - from another disease or condition, eg. tumors, acromegaly, Paget’s disease
Cleft lip and/or palate
Look at the Word Document
Lip pits
congential malformation often inherited and may be with other anomalies (eg. clefts)
Cheilitis glandularis
Not developmental, infection of minor salivary glands in lower lip, often outdoor workers which thins and drys lips promoting retrograde infection
Variable severity - from slight swelling with dilated, inflamed ductsto significant swelling, pain and deep abscesses ± sinus tracts
Premalignancy ??, shared etiology
Fordyce granules
“ectopic” sebaceous glands develop after puberty. > 80% of population. ↑↑buccal mucosa and often bilaterally symmetrical.
Asymptomatic, superficial yellowish “plaques”
No treatment, recognition only
Fibromatosis gingivae
Inherited, most autosomal dominant
Isolated or with syndromes
Clinically - Asymptomatic, generalized gingival hyperplasia
Treatment: Surgery ? recurrence
Aglossia
Microglossia
Macroglossia
Aglossia – Without tongue development (aplasia)
Microglossia - Small underdeveloped tongue (hypoplasia)
Macroglossia - Enlarged, overdeveloped tongue
Primary - Developmental
Secondary (Acquired) - Tumor, acromegaly etc.
Ankyloglossia
Fusion of tongue to FOM, “tongue tied”
Cleft tongue
bifid or midline fissure, failure of complete fusion of lateral halves of ant 2/3 tongue
Fissured tongue
unknown etiology but genetics may play role
Deep dorsal surface fissures, ↑ with age, ↑↑ xerostomia (dry mouth),
may retain plaque
Benign migratory glossitis
(Geographic tongue)
(Erythema migrans)
Not developmental
Common inflammatory condition (glossitis) of unknown etiology, 2:1 females,
dorsal and/or lateral borders of tongue, depapillated erythematous areas
surrounded by yellowish-white borders, single or multiple lesions, usually migrate,
asymptomatic (may burn or hurt) occasionally off tongue (erythema migrans)
Hairy tongue
Not developmental
Hypertrophy of filiform papillae
Unknown etiology, predisposing factors: drugs (antibiotics, H2O2),
smoking, radiation therapy
Extrinsic staining
Treatment: Physical debridement ± chlorhexidine
Varix
(varicose vein), varices
Superficial dilated veins
↑ calf, anus, orally - ventral tongue
color blanches with pressure (diascopy) - through glass
Treat only for esthetics
Varix - localized varicous vein
Lingual thyroid nodule
Thyroid gland develops from thyroglossal tract which is an endodermal invagination starting in base of tongue (foramen cecum)
A lesion that occurs back where the foramen cecum - r_emoval is a thyroid ecttomy_
Produces mass posterior, mid-dorsal tongue
May not have thyroid gland in neck
Radioactive I (Iodine) given to image gland
May treat surgically or with thyroid replacement therapy
Mass will shrink down and you can survive with therapy.
Lymphoid tissue
(lymphocytes, immune system)
- Lingual tonsil
- Lymphoepithelial cyst
Lingual tonsil - all lymphoid tissue in tongue, ↑↑ posterior-lateral and posterior dorsal surface
Normal (asymptomatic) or hyperplastic (often swollen and symptomatic, treat)
** Check for bilateral symmetry
Lymphoepithelial cyst - (true cyst) lymphoid tissue reacts and stimulates salivary ducts to proliferate producing a cyst or crypts around lymphoid tissue occlude
Common location: ↑↑ ventral tongue, FOM, soft palate
Asymptomatic, small yellowish nodules
Treatment: Excision
Developmental lingual mandibular salivary
gland depression
(Stafne’s bone cavity)
Submandibular salivary gland develops along lingual cortex producing an indentation
Asymptomatic radiolucency, often corticated, below inferior alveolar canal and from angle to midbody
No swelling
Unchanged with time
Is a clinical or radiographic diagnosis (sialography to confirm)
