Lec 6: Reactive Epithelial Cysts

Question 1

Fissured tongue: cause and clinical findings?

Answer 1

Cause:
Hereditary is strong contributor
Incidence increases with age
Clinical Findings:
Sometimes associated with geographic tongue

Question 2

Fissured tongue–Significance and Management?

Answer 2

Variation of normal
Usually asymptomatic and no treatment needed
Encourage patient to brush tongue to remove debris

Question 3

AKNYLOGLOSSIA is characterized by?

Answer 3

short lingual frenum

Question 4

LINGUAL THYROID–cause?

Answer 4

Failure of thyroid gland to descend properly

Question 5

GINGIVAL FIBROMATOSIS is?

Answer 5

Slowly progressive gingival enlargement

Caused by collagenous overgrowth of gingival tissue

Question 6

Gingival Fibromatosis treatment?

Answer 6

Treatment: gingivectomy and rigorous oral hygiene

Question 7

2 categories of soft tissue enlargements

Answer 7

Reactive

Tumors

Question 8

“Tumor” means enlargement and is based on clinical features of being ____ and ____ and not on microscopic criteria

Answer 8

persistent and progressive

Question 9

Reactive lesions examples (2)

Answer 9

Necrotizing silometaplasia (covered in SG lecture)

Mucocele (covered in SG lecture)

Question 10

PARULIS/SINUS TRACK aka

Answer 10

“gum boil”, periodontal abscess

Question 11

PARULIS/SINUS TRACK is a?

Answer 11

A gingival abscess secondary to periapical pathosis

Focus of pus in the gingiva

Question 12

PARULIS/SINUS TRACK treatment?

Answer 12

Treating the underlying condition (periodontal pocket or nonvital tooth) achieves resolution of gingival abscess

Question 13

IRRITATION FIBROMA(FIBROUS HYPERPLASIA)–caused by?

Answer 13

chronic irritation or trauma

Question 14

IRRITATION FIBROMA(FIBROUS HYPERPLASIA)–clinical features?

Answer 14

Well-circumscribed, slowly growing
Smooth-surfaced, sessile, pink nodule
Typically firm
May be ulcerated or inflamed

Question 15

IRRITATION FIBROMA(FIBROUS HYPERPLASIA)–treatment?

Answer 15

surgical excision

Question 16

Denture-Leaf Fibroma:

Answer 16

Occurs on hard palate under a denture

Question 17

INFLAMMATORY PAPILLARY HYPERPLASIA represents both?

Answer 17

Represents both fibrous and epithelial hyperplasia

Question 18

INFLAMMATORY PAPILLARY HYPERPLASIA cause reactive process to?

Answer 18

Poorly fitting Dentures

Wearing dentures 24h/day

Question 19

INFLAMMATORY PAPILLARY HYPERPLASIA clinical features?

Answer 19

Numerous red, edematous papillary projections

Associated with denture

Question 20

INFLAMMATORY PAPILLARY HYPERPLASIA–therapeutic management?

Answer 20

Discontinue wearing denture 24h/day
Antifungal medication if candidosis is present
Excise large lesions
Construct new denture or reline/rebase existing denture

Question 21

DRUG-RELATED GINGIVAL HYPERPLASIA–what drugs for this affect collagen remodeling and degradation?

Answer 21

Anticonvulsants: Phenytoin (dilantin); young
Calcium channel blockers: Nifedipine; middle-aged
Cyclosporine: broad age range

Question 22

Soft Tissue EnlargementsBenign Tumors–usually grows slow or fast?

Answer 22

Usually slowly growing (months to years)

Question 23

Soft Tissue EnlargementsMalignant Tumors–usually grows slow or fast?

Answer 23

Rapidly growing (weeks to months)

Question 24

Categories of Benign Tumors

Answer 24

Epithelial
Mesenchymal
Salivary gland
Soft tissue cysts

Question 25

Soft tissue cysts:

Answer 25

historical and clinical features are similar to those of benign tumors. Cysts are typically compressible

Question 26

Papilloma

Answer 26

Pedunculated | Multiple finger-like projections with a pedunculated base

Question 27

VERRUCA VULGARIS clinical features?

Answer 27

Similar to papilloma but verruca has a sessile base | More common on skin

Question 28

CONDYLOMA ACUMINATUM--clinical features?

Answer 28

Usually multiple lesions Most common in anogenital area Typically sexually transmitted

Question 29

CONDYLOMA ACUMINATUM--high risk HPV strands?

Answer 29

HPV 16,18, 31

Question 30

Seborrheic keratosis is benign proliferation of

Answer 30

epidermal basal cells

Question 31

Does seborrheic keratosis occur in the mouth?

Answer 31

NO

Question 32

The ______ of soft tissue cysts can be a clue to diagnosis then determine what the lesion is reacting to:

Answer 32

location

Question 33

A cyst consists of what 3 layers?

Answer 33

1. Connective tissue wall 2. Epithelial layer (lining) 3. Lumen--often are fluid-filled, but not always

Question 34

Cyst clinically, they are often ______

Answer 34

compressible

Question 35

A SPACE-OCCUPYING LESION WITH an outer wall of fibrous connective tissue that surrounds a central cavity called the?

Answer 35

cyst

Question 36

Epidermoid Cyst is a?

Answer 36

Keratin-filled cyst derived from hair follicle

Question 37

Epidermoid (dermoid) cyst is most commonly found in the?

Answer 37

floor of the mouth (intraorally)

Question 38

Gingival Cyst of the Adult occurs on?

Answer 38

attached gingiva anterior to first molars

Question 39

Lymphoepithelial Cyst are what color?

Answer 39

yellow or white in color

Question 40

Lymphoepithelial Cyst are almost always located:

Answer 40

Lateral and ventral tongue | Floor of the mouth

Question 41

Thyroglossal Tract Cyst 60-80% of cases are?

Answer 41

below hyoid bone

Question 42

Thyroglossal tract cyst occurs in?

Answer 42

the midline of the neck

Question 43

Thyroglossal tract cyst characterized by?

Answer 43

Painless, fluctuant, movable swelling

Question 44

All cysts are treated by?

Answer 44

excision

Question 45

Reactive vs. Tumor

Answer 45

Reactive if take away the cause will regress but tumor will progress and persist unless removed.

Question 46

Benign warty tumors of the Squamous Epithelium

Answer 46

Papilloma Verruca vulgaris Condyloma

Question 47

HPV's that has higher risk for cancer and associated with Condyloma?

Answer 47

16, 18, 31

Question 48

What grows slowly and mimic benign tumors?

Answer 48

Soft tissue cysts

Question 49

What cyst is at the floor of the mouth?

Answer 49

Epidermoid cyst