Disorganized overgrowth of normal tissue in its normal location
Growth of normal tissue in an abnormal location
Growth of abnormal tissue, may be either benign or malignant
What are some characteristics of a Benign lesion?
-Bilateral -Rapid onset (ulceration, soft tissue swelling) -Pain -Growth around native structures - Slow expansion (osseous) - Smooth root resorption
What are some characteristics of malignant lesion?
- Unilateral - Chronic, persistent (ulceration) - Absence of pain/presence of paresthesia - Invasion/destruction of native structures - Cortex destruction - Spiking root resorption
Usually a benign neoplasm: Pleomorphic adenoma, oncocytoma
- Malignant neoplasm derived from epithelial cells - Surface (skin, mucosal): Basal cell carcinoma - Glandular: Adenocarcinoma
Malignant neoplasm derived from cells of mesodermal origin: Liposarcoma, fibrosarcoma
- Spread of disease from one part of the body to another - Tumor implants are discontinuous with the primary tumor
What are the 4 differentials for the gum bump differential?
1. Fibroma 2. Pyogenic Granuloma (Lobular Capillary Hemangioma) 3. Peripheral Ossifying Fibroma 4. Peripheral Giant Cell Granuloma POF AND PGCG OCCUR ONLY ON THE GINGIVA!
What are the 4 Human Papilloma Virus Differential?
1. Squamous Papilloma 2. Verruca Vulgaris 3. Condyloma Acuminata (High risk types 16 & 18) 4. Heck's Disease (Multifocal Epithlial Hyperplasia)
What is the differential list for Multilocular Radiolucent Lesions?
MACHO! M: Myxoma A: Ameloblastoma C: Central Giant Cell Lesion H: Hemangioma (Vascular Malformation) O: Odontogenic Keratocyst Also may be included: - Dentigerous Cyst - Glandular Odontogenic Cyst
What is the differential for Mixed Radiolucent/Radiopaque Differential Diagnosis?
- Adenomatoid Odontogenic Tumor - Calcifying Odontogenic Cyst - Ameloblastic Fibro-Odontoma - Calcifying Epithelial Odontogenic Tumor - Ossifying Fibroma - Fibrous Dysplasia - Desmoplastic Ameloblastoma
Define Odontogenic Cyst...
Cysts lined by odontogenic epithlium
Which odontogenic cysts are inflammatory? Can you name 3?
1. Periapical (radicular) cyst 2. Residual periapical (radicular) cyst 3. Buccal bifurcation cyst
Which odontogenic cysts are developmental...there's a lot!
1. Dentigerous Cyst 2. Eruption Cyst 3. Odontogenic Keratocyst 4. Orthokeratinized Odontogenic Cyst 5. Gingival (alveolar) cyst of the newborn 6. Gingival Cyst of the Adult 7. Lateral Periodontal Cyst 8. Calcifying Odontogenic Cyst 9. Glandular Odontogenic Cyst
What are the 4 tumors of Odontogenic Epithelium?
1. Ameloblastoma 2. Adenomatoid Odontogenic Tumor 3. Calcifying Epithelial Odontogenic Tumor 4. Squamous Odontogenic Tumor
What are some Mesenchymal Odontogenic Tumors? Can you name 3?
1. Odontogenic Myxoma 2. Central Odontogenic Fibroma 3. Cementoblastoma
What are some mixed epithelial/mesenchymal odontogenic tumors?
1. Ameloblastic Fibroma 2. Fibroodontoma 3. Odontoma (considered a hamartoma)
White patch that cannot be wiped off, clinical descriptions, not a diagnosis
- Red patch or plaque-like lesion that cannot be clinically or pathologically diagnosed as any other condition - Often represents malignant change: Up to 90% of erythroplakic lesions represent severe epithelial dysplasia, carcinoma in situ, or SCCa
- AKA speckled leukoplakia - Frequently dysplasia or carcinoma in situ on biopsy
Sharply demarcated leukoplakia is concerning for...
What percentage of erythropakic lesions represent severe epithelial dysplasia, carcinoma in situ, or squamous cell carcinoma?
What is the evolution of Proliferative Verrucous Leukoplakia look like?
- Characterized by multiple, persistent, keratotic plaques that over time progress to SCC - Verrucous hyperplasia leads to... - Verrucous Carcinoma that leads to... - Invasive squamous cell carcinoma - Lesions rarely regress dispite therapy
- Abnormal tissue development - Rapid cell turn over - Immature epithelial cells, lack of maturation - Can be mild, moderate, or severe (thirds of epithelium)
What is Squamous Cell Carcinoma in situ...
- Dysplastic change involving the full-thickness of epithelium - Latin (in site) - Not extending beyond the focus or level of origin - No invasion by definition
Oral Squamous Cell Carcinoma is most commonly found in these 2 locations...
1. Tongue: posterior lateral most common 2. Floor of mouth (midline near frenum) Most likely location intraorally (versus oropharynx) to demonstrate early metastasis to cervical lymph nodes. Leukoplakia in this area also has a higher chance of containing dysplasia/carcinoma
What is the vitality of teeth associated with buccal bifurcation cysts?
What is the tx for buccal bifurcation cyst
curettage, do not ext