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BDS5 > Oral Pathology > Flashcards

Oral Pathology Flashcards

1
Q

What are the types of epithelial cysts

A

-Odontogenic
-Non-odontogenic

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2
Q

What are the types of odontogenic cysts

A

-Inflammatory
-Developmental

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3
Q

What are the types of inflammatory cysts

A

-Radicular
-Residual

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4
Q

What are the types of developmental cysts

A

-Odontogenic keratocyst
-Dentigerous cyst

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5
Q

What are the phases of cyst formation

A

-Source of epithelium
-Mechanism for epithelial proliferation
-Mechanism for continued growth

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6
Q

What are the sources of epithelium and which cysts use which source

A

-Hertwig’s root sheath (radicular and residual cysts)
-Reduced enamel epithelium (dentigerous cyst)
-Remnants of dental lamina (odontogenic keratocyst)

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7
Q

What are the mechanisms of continued cyst growth

A

-Internal hydraulic pressure (radicular, residual and developmental cysts)
-Bone resorption by cytokines (odontogenic keratocyst)
-Epithelial cell proliferation

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8
Q

What are the general clinical features of a cyst

A

-Swelling
-Pain if infection
-Displacement or loosening of teeth
-Eggshell crackling
-Signs of fluctuant

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9
Q

What are the features and treatment of a radicular cyst

A

-Associated with apex of non-vital tooth
-Unilocular, well defined, well corticated
-No resorption
-Treated with endo or surgical extraction

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10
Q

What are the features of a residual cyst

A

-Forms in an edentulous area
-Well-defined, oval radiolucency

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11
Q

What are the features and treatment of a dentigerous cyst

A

-Also called eruption cyst
-Found at the CEJ of unerupted teeth (8s and 3s)
-Unilocular, well corticated
-Treated with surgical excision or uncover tooth

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12
Q

What are the features and treatment of an odontogenic keratocyst?

A

-Found at the angle of the mandible
-Multilocular
-Associated with unerupted tooth

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13
Q

What is gorlin goltz syndrome

A

-Genetic disorder characterised by basal cell carcinoma
-Odontogenic keratocyst
-Pitting of palms, defects in spine and rib

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14
Q

What is a lateral periodontal cyst

A

-Associated with lateral roots of vital teeth
-Very small, round, well corticated
-Unilocular

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15
Q

What is a solitary bone cyst

A

-Associated with children and adolescents
-Occurs in the body of the mandible
-Monolocular, irregular outline

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16
Q

List non-neoplastic bone lesions

A

-Tori
-Bony exostosis

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17
Q

Describe tori

A

-Found in midline of hard palate or mandible
-Bony outgrowth
-Clear radiopacity on radiograph

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18
Q

List benign bone neoplasms

A

-Osteoma
-Gardener’s syndrome
-Chondroma
-Haemangioma (intraosseous)

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19
Q

List malignant bone neoplasms

A

-Myeloma (increased Bence-Jones protein)
-Lymphoma
-Metastases (from breast or lung)

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20
Q

Describe osteoma and gardener’s syndrome

A

-Osteoma is a slow growing benign tumour
-Common in mandible
-Gardener’s syndrome is when there are several osteomas of the jaw
-Gardener’s syndrome is genetic

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21
Q

What is a chondroma

A

-Benign neoplasm of cartilage
-Affects maxilla, mandible, palate

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22
Q

What is an intraosseous haemangioma

A

-Benign lesion of blood vessels
-More common in mandible than maxilla
-Causes mobility of teeth

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23
Q

What is a chondrosarcoma

A

-Formation of malignant cartilage
-Causes exfoliation of teeth
-Evidence of calcification representing cartilage formation
-Irregular bone destruction

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24
Q

What is an osteosarcoma

A

-Malignant tumour of the bone
-More common in mandible
-Rapid growth
-Parasthesia
-Loosening of teeth

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25
Q

What is a myeloma

A

-Most common malignant tumour
-Increased bence-jones protein in blood and urine
-Pain, anaemia, infection
-Punched out defects with radiolucent lesions

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26
Q

What is a lymphoma

A

-Pain and pathological fractures
-Malignant neoplasm

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27
Q

What is alveolar osteitis

A

-Inflammation of the bone following failure of blood clot to form or premature loss of blood clot

28
Q

What are the predisposing factors for alveolar osteitis

A

-Mandibular extractions
-Traumatic extractions
-Females
-Oral contraceptive pills
-Periodontitis
-Smoking
-Poor OH
-Previous history of dry socket

29
Q

Clinical affects of alveolar osteitis

A

-Pain
-Halitosis
-Granulation tissue forming from adjacent vital bone

30
Q

Management of alveolar osteitis

A

-Irrigate socket with saline
-Pack with Alvogyl
-Analgesics
-Review
-Consider radiograph if concern of remaining tooth fragments in socket

31
Q

How does alvogyl work

A

-Oxidised celloluse
-Non-irritant antiseptic
-Prevents bacterial and fungal infections
-Contains medicament for pain-relief

32
Q

What is osteomyelitis

A

-Infection of the medullary spaces
-Can be due to bacterial infection of dental origin or extraction sites

33
Q

What are the local predisposing factors for osteomyelitis

A

-Radiation to the jaw
-Reduced blood flow and reduced healing
-Paget’s disease
-Osteoporosis
-Bisphosphonate medication

34
Q

What are the systemic predisposing factors for osteomyelitis

A

-Immunosuppression
-Diabetes
-Leukaemia
-Elderly
-Corticosteroids
-Chemotherapy

35
Q

Symptoms of osteomyelitis

A

-Pain
-Fever, malaise
-Trismus (oedema of muscles of mastication)
-Parasthesia
-Pus

36
Q

Complications of osteomyelitis

A

-Bacterial sepsis
-Pathological fractures

37
Q

Management of osteomyelitis

A

-Antibiotics
-Pus sample to identify bacteria present
-Surgery to remove necrotic bone

38
Q

What is osteoradionecrosis

A

-Exposed radiated bone
-More than 3 months
-Without evidence of recurring tumour

39
Q

How does radiation cause non-vital bone

A

-Thrombosis of the blood vessels suppling the bone
-Causes loss of vitality
-Aseptic necrosis

40
Q

What are the symptoms of osteoradionecrosis

A

-Painful necrosis of the bone
-If becomes infected, then spreads quickly
-Sloughing of the soft tissues

41
Q

What is the management of osteoradionecrosis

A

-Antibiotics (tocopherol or pentoxifylline)
-Hyperbaric oxygen therapy
-Surgical removal of the bone and reconstruction

42
Q

What is MRONJ

A

-Medication related osteonecrosis of the jaw
-Exposed bone for more than 8 weeks, probable through a fistula
-Absence of radiation
-Use of anti-resorptive or anti-angiogenic drugs
-No metastases

43
Q

Symptoms of MRONJ

A

-Pain
-Discharge
-Swelling

44
Q

Aims of treatment in MRONJ

A

-Relieve pain
-Control infection of bone and soft tissue
-Minimise progression of bone necrosis

45
Q

What is fibrous dysplasia

A

-Replacement of normal bone with poorly organised, immature bone and fibrous tissue

46
Q

Clinical presentation of fibrous dysplasia

A

-Facial asymmetry
-Associated with McCune Albright syndrome

47
Q

What is paget’s disease

A

-Abnormal bone remodelling
-Caused by genetic and environmental factors

48
Q

Dental relevance of Paget’s disease

A

-Wider alveolar ridge
-Poor fitting dentures
-Derangement of the occlusion
-Late stages can cause decreased vascularity and increased risk of osteomyelitis

49
Q

What is cherubism

A

-Benign genetic condition affecting children
-Bilateral enlargement of the maxilla and mandible

50
Q

What is the treatment for cherubism

A

-Good OH
-Extraction of unerupted teeth
-Wait for growth cessation before surgical correction of facial deformities

51
Q

What is ameloblastoma

A

-Benign neoplasm
-Common in the mandible
-Resorption of the soft tissues, painless, egg shell cracking

52
Q

What is the treatment of ameloblastoma

A

Surgical excision with a high reoccurrence rate

53
Q

What is the radiological appearance of ameloblastoma

A

-Soap bubble appearance
-Borders are well defined and well corticated
-Multilocular

54
Q

What is the high risk area for oral SSC

A

-Floor of the mouth
-Retromolar pad
-Ventral surface of the tongue
-Mandibular alveolus

55
Q

How do oral cancers present

A

-Sore mouth ulcers non-healing
-Indurated (firm)
-Necrotic centre
-Rolled borders
-Red/white speckled
-Non-homogenous
-Bleeding/numbness in the mouth

56
Q

Systemic manifestations of cancer

A

-Unexplained weight loss
-Shortness of breath
-Coughing up blood

57
Q

Treatment options for oral cancers

A

-Surgery +/- radiotherapy
-Chemoradiotherapy
-Palliative care

58
Q

List the major salivary glands and their salivary composition

A

Parotid - serous
Submandibular - serous and mucous
Sublingual - mucous

59
Q

What is bacterial siladenitis

A

-Acute or chronic infection of salivary gland
-Predisposing factor is reduced salivary flow
-Staph. aureus infection

60
Q

What are the risk factors for bacterial siladenitis

A

-Salivary gland stones/calculi
-Diabetes
-Sjorgrens syndrome
-Hypothyroidism
-Chronic renal failure
-Medications

61
Q

What are the clinical features of bacterial siladenitis

A

-Pus
-Erythema and redness of the overlying soft tissue
-Fever, malaise
-Lymphadenopathy
-Trismus

62
Q

What is the management of bacterial siladenitis

A

-Antimicrobial therapy
-Reverse predisposing factors
-Good hydration
-Good OH

63
Q

What imaging options are used for bacterial siladenitis

A

-US
-Sialography
-MRI
-CT Scan

64
Q

What are the causes of viral siladenitis

A

-Mumps (paramyxovirus)
-HIV
-Cytomegalovirus

65
Q

What is the clinical appearance of necrotising silometaplasia

A

-Occurs in hard palate
-Crater-like ulceration
-Indurated swelling
-Surrounding erythema

BDS5 (4 decks)

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