Flashcards in Oral Pathology Marathon Deck (168):
4 types of pathologies:
Of the Genetic abnormalities, what % is unknown etiology?
% inherited ?
% known environmental causes?
3 Characteristics of Developmental conditions:
Present at young age/congenital
Without jaw development (type of aplasia):
Small, underdeveloped jaw:
Secondary (acquired) Macrognathia:
tumors, acromegaly, Paget's
A _______ is characterized by multiple different abnormalities
Teeth come from what germ layer?
Micrognathia is a type of _____plasia
Cleft lip/palate is a _______ anomaly occurring ______
Cleft lip occurs in 1/____ white births
The etiology of cleft palate is unknown
Mutations in cleft lip/palate have been shown in how many genes involved in the development of the palat/lip?
The lateral palatal shelves fuse anteriorly at the junction with the _______ and fuse posteriorly
The upper lip (development) is a ______ epithelium
What penetrates/develops into CT and muscle in the upper lip adding bulk?
Where does the mesoderm (forms CT/muscle in upper lip) originate?
Globular portion of median nasal process and Maxillary processes bilaterally
When a cleft forms there is a lack of ______ penetration
Cleft lip is on the upper lip, off the midline, ___% bilateral
Cleft palate is _____ to the Premaxilla over the _____
Bifid Uvula is related to Cleft Palate
Bifid Uvula is associated with what?
submucosal cleft of muscle
Most common cleft?
2nd most common?
Cleft lip with cleft palate
There are over _____ syndromes that include clefting, making up about ____% of all clefting cases.
What is the Rule of 10's in treating cleft lip?
When do you treat cleft Palate?
10 weeks old / 10 lbs / 10 gm% Hb
An oft-missed congenital malformation that may be present with other anomalies:
Cleft lip is Familial but not Inherited
There isn't a single gene that gives you clefting, rather 10-12 genes that are involved with the development of your palat
Clefting is the result of abnormal genes plus environmental factors
The palatal shelves fuse anteriorly at the junction with the ________
In Utero, there is nothing in between the bilayered epithelium of the upper lip, but is filled with _______ from the ______ portion of the median nasal process and maxillary process bilaterally
Chelitis glandularis is developmental
*infection salivary glands lower lip
An infection of the salivary glands of the lower lip, often found in those that work outside (promotes retrograde infection):
Chelitis glandularis is a premalignant condition
*does NOT lead to lower lip cancer
Ectopic sebaceous glands that develop after puberty in 80% of the population
Asymptomatic, superficial yellow plaques that are bilaterally symmetric. (an increase of buccal mucosa)
Fordyce granules can be treated
no treatment, recognition only
Inherited, mostly Autosomal Dominant that genetically programs the over production of collagen:
Fibromatosis gingivae can be either ____ or found with ______ and is clinically found to be _______ generalized gingival hyperplasia
Tx of Fibromatosis gingivae can be surgical but tends to come back
No tongue development (an aplasia)
Small, underdeveloped tongue
Enlarged, overdeveloped tongue
Macroglossia can either be developmental or acquired by what 2 means?
The fusion of the tongue to the floor of the mouth (tongue tied):
Bifid or midline fissure of the anterior 2/3 of the tongue
Deep grooves in the Tongue of unknown etiology (may be genetic) associated with familial pattern of heritability and Age:
*not associated with anything systemic
2 terms for Geographic Tongue:
Benign migratory glossitis
Geographic Tongue is developmental
Benign Migratory Glossitis (geo tongue) occurs __:__ females to males
On the ___/____ borders of the tongue
Benign Migratory Glossitis (geo tongue) is recommended for biopsy and is infectious
False to both
Benign Migratory Glossitis may burn or hurt (otherwise asymptomatic)
Hairy Tongue is hypertrophy of _______ papillae
Hairy Tongue has unknown etiology, but name 3 predisposing factors:
Drugs (ABx, H2O2)
What is the Tx for Hairy Tongue?
The aging phenomenon of Varix (varicose veins) usually happens where in the mouth?
Also occurs on mouth/lips where color blanches with pressure, but only treated for ______
Using a Glass Slide to determine presence of Varix, blanch through the glass to see it better.
A Lingual Thyroid Nodule is b/c of a breakdown in the ______ Tract with is a ______ invagination starting ________
Lingual Thyroid Nodule appears where?
Tx surgical or ________
Posterior, mid dorsal tongue
Thyroid Replacement Therapy
2 Lymphoid Tissue oral pathologies:
Hyperplastic Lingual Tonsil
Lymphoepithelial Cysts come from _____ ducts
Are a true cyst, meaning they are lined with what?
Present as superficial ______ bumps
***are common in floor of mouth, ventral lateral tongue
Tx for Lymphoepithelial Cysts:
Lymphoepithelial Cysts are Asymptomatic
Developmental Lingual Mandibular Salivary Gland Depression:
Stafne's Bone Cavity
Below IA canal
In Stafne's Bone Cavity, the ______ salivary glands develop along the Lingual _____, which produces an indentation
Stafne's Bone Cavity is inflammatory and changes with time
*to both - no swelling, doesn't change
Stafne's Bone Cavity is a ______ diagnosis
A group of inherited disorders which program the oral mucosa to abnormally keratinize and generally develop early in life
The most common Genokeratosis:
White sponge nevus
White sponge nevus
Hereditary benign intraepithelial dyskeratosis
Dariers Diseas - keratosis follicularis
The most common form of Developmental Cyst (non-odontogenic)
Incisive Canal Cyst
The Incisive Canal Cyst appears as a Radiolucency of over _____ mm between the roots of the ______
Incisive Canal Cyst does what to the teeth?
Moves CI's apart
anesthesia lasts for months
Incisive papilla cyst (outside bone)
Most common radiolucency between Maxillary Lateral and Cuspid?
The Globulomaxillary Cyst is a ___________ radiolucency btwn Mx LI's and Cuspids that probably _________
doesn't really exist
*meaning they are really other cysts/tumors
A Cyst from entrapped epithelium during palatal closure producing a Radiolucency at MIDPALATE.
Tx surgical removal
Median Palatal Cyst
Cyst from the embryologic nasolacrimal duct producing upper lip cyst R or L of midline
Naso-alveolar cyst (nasolabial cyst)
The Naso-alveolar cyst (nasolabial cyst) is soft, fluctuant, and often elevates what?
3/4 occurs in _______
What cyst classicaly moves when a pt swallows?
Thyroglossal duct tract cyst
*goes through hyoid bone
The Thyroglossal Duct Cyst is a ______ cyst brom the base of tongue to the thyroid gland
Soft, fluctuant, more likely to occur in _____
Cyst from entrapped salivary gland ducts in the paraparotid lymph nodes
Cervical Lymphoepithelial Cyst (Branchial Cleft Cyst)
Cervical Lymphoepithelial Cyst, aka...
it is a cyst from entrapped ____ glands in the ______ lymph nodes
OR a cyst from _______ arch and pouch development
Branchial Cleft Cyst
Epidermoid/Dermoid Cysts occur in the Midline and form from trapped _____ during surface closure
Common in what demographic?
FOM, ventral tongue
Epidermoid Cysts are lined by what?
Dermoid Cysts are lined by what?
Stratified Squamous Epithelium
Stratified Squamous w/ Dermal appendages (sebaceous, sweat, hair follicles)
Attempted division of tooth germ with incomplete formation of 2 teeth, usually a single root
Union of 2 teeth - often individual roots
Fusion of teeth when joined by Cementum:
Bend or curve in a tooth or root, possibly due to trauma, causing problems with RCT/extraction:
Dens in Dente
Dens in Dente results from the invagination of the enamel organ before ______
Most often found where?
Can be ______
Often a sequelae of _____ infection
A toothlike structure found in the Central Fossa:
Where does this happen more often?
Block like teeth with large pulps, associated with Klinefelter's Syndrome:
This can be one or multiple teeth, isolated or w/ syndromes, or a _____ expression of a gene pool
Excess of enamel at a bi or trifurcation of Molars at the CEJ
A few teeth, not enough:
No teeth (associated w/ systemic probs):
Anodontia is most associated with what?
Heriditary Ectodermal Dysplasia
Supernumerary teeth usually occur where?
Called _____, and usually occurs between ______
Mesiodens, Mx CI's
What Syndrome associated with Supernumerary teeth?
A Hereditary disturbance in Enamel Structure:
This is a defect in what cell?
How many types?
Autosomal dominant, recessive, sex linked
Amelogenesis Imperfecta presents clinically what 2 ways?
Amelogenesis Imperfecta - all teeth, both dentitions, Family Hx
some teeth, one dentition, no family Hx
Rickets, Exanthematous diseases, Congenital Syphylis, Turner's tooth, Fluorosis, Tetracycline, - can all cause what?
Congenital Syphilis causes Hutchinsons...
What is a Local Infection or Trauma that can cause Enamel Defects?
Dentinogenesis Imperfecta is inherited how?
Can be with or independent of what?
Affect what teeth?
all teeth, both dentitions
Dentinogenesis Imperfecta affects type ___ Collagen
grayish to yellowish brown
Obliteration of pulp chambers/canals (may have attrition and root fractures)
Crowns to prevent attrition
Autosomal dominant condition characterized by pulpal obliteration with abnormal dentin, defective root formation and tendency for periapical pathology
Dentinal dysplasia affects all teeth and both dentitions but differs from Dentinogenesis Imperfecta b/c the teeth look_______
Obliteration of pulp, short underdeveloped roots, periapical radiolucencies
In Dentinal Dysplasia, the teeth look normal, but there is abnormal....
Regional Odontodysplasia, aka...
Mostly affects ____ teeth
what teeth have increased chance of being unerupted?
Radiographic findings of Regional Odontodysplasia:
Thin enamel/dentin anomalous teeth
Teeth that lack eruptive force:
*if generalize, think systemic (hypothyroidism)
Pseudoanodontia (embedded teeth)
Teeth that are unerupted b/c of mechanical block
Most often in the Mn:
Most often in the Mx:
Tooth roots fused to bone (often in Primary teeth with underlying succedaneous permanent tooth missing)
They have a distinctive _______
***no PDL, fused to bone
Loss of tooth structure occlusally and interproximally due to direct tooth to tooth contact:
Loss of tooth structure from mechanical force (cervical tooth brushing)
Loss of tooth structure from chemical process, most often non-bacterial acid dissolusion:
Erosion due to exposure of Gastric Secretions:
Loss of tooth structure due to repeated tooth flexure from occlusal stresses
The combined effect of attrition and abrasion (chewing tobaccos between opposing teeth):
Physiologic deposition of dentin throughout life:
Localized formation of dentin on pulp-dentin border (protective response of pulp to seal itself off from external stimuli):
Dentinal tubules devoid of cytoplasmic processes of odontoblasts:
3 types of Pulp Calcifications:
Diffuse Linear Calcifications
Dentin dysplasia II, Pulpal dysplasia, Regional odontodysplasia, Tumoral calcinosis, Calcinosis universalis, and Ehlers-Danlos Syndrome are all associated with what?
Abnormal thickening of cementum:
Hypercementosis can be localized (trauma/idiopathic) or Generalized, which is associated with what disease?
Calcification is PDL with no clinical significance:
External Dental Root Resorption can be Physiologic or Pathologic
Internal Dental Root Resorption presents as what?
Most often occurs following injury to _______
Process continues as long as there is _______
Pathologic, asymptomatic, Pink tooth of _______
Radiolucent enlargement of Root Canal/Chamber
Early vascular response to injury is ______ followed by _______
Vasodilation is caused by histamine, prostaglandins, etc
What transforms into fibroblasts during the Inflammatory Stage of Wound Repair?
Undifferentiated mesenchymal cells
in the migratory phase of Fibroplastic stage of wound repair, fibroblasts migrate into the wound following _______ strands
In the proliferative phase, collagen fibers are laid down in what manner?
6 stages of Healing:
Early vascular response
5 types of Biopsy:
Needle (FNA - fine needle aspiration)
A biopsy specimen goes into 10% buffered Formalin
4 biopsy artifacts
Use incisional biopsy if larger than ______
or suspicion of _______
Use Excisional biopsy if small and confident they are benign
Do not Excise if think something is malignant
wound is apart
The removal of individual cells - usually does NOT provide definitive diagnosis
3 Indications for Cytology:
Cytology for HSV - for what 2 things?
Cytopathic viral effect
Oral CDX brush "biopsy" has improved what due to the brush?
improved diagnostic accuracy due to...
is NOT a _______ diagnosis
cell harvesting - all cell layers
Both detect what?
Reserve Immunofluorescence testing for suspected autoimmune disorders like pemphigus vulgaris, mucous membrane pemphigoid
Most oral diseases are Positive on ______ immunofluorescence but Negative on ________ immunoflurescence
DIF biopsies cannot be placed in what?
*use transport media
Extraction, 1st week healing, blood clot organization begins
Extraction 2nd week healing, organization continues and what degrades?
What proliferates over wound surface?
Extraction 3rd week healing, clot is organized into what?
What is formed arising in PDL and adjacent bone?
Alveolar crest rounded off by what?
_____ covers entire surface
Extraction 4th week healing, is bone evident on radiographs?
When does it appear?
New bone in alveolar socket will persist for how long?
No - not fully calcified
6-8 weeks can see on radiographs
Dry Socket, aka...
Caused by loss of what?
Localized Acute Alveolar Osteomyelitis
If a difficult extraction removes Lingual and Buccal bone along with Periosteum, what might occur?
How does this appear on a Radiograph?
Fibrous Healing of Extraction Wound
*may be mistaken for cyst/granuloma
Focal Osteoporotic Bone Marrow defect is from marrow expansion and may not be _______
Many are in ______
Might occur in response to what?
Occurs in what sex more frequently?
Where in mouth most frequently?
Fragment of bone in a healing socket after extraction can cause what?
Tissue growing from socket can also be what?
Localized Tissue overgrowth
malignancy along path of least resistance
Physiologic response of mucosa to chronic physical injury producing hyperkeratosis
This is reversible and presents as a white ______
shredded keratinized tissue along linea alba
Loss of surface epithelium (trauma, more in kids, lateral tongue)
Type of Traumatic Ulcer w/ injury to underlying muscle:
(increased prevalence on tongue, rolled borders)
This has the clinical features of what?
The silver compounds in an Amalgam Tattoo stain and sometimes a biopsy must be done to rule out melanoma
Extravascular bleeding into tissues, resolves:
Pinpoint bleeding from capillaries (thrombocytopenia vs Local cause):
1 acute complication to Radiation Therapy for H/N cancer:
When does it arise?
2 chronic complications:
2nd week therapy
Chemical burn injuries to the Oral cavity may or may not rub off
3 Drugs causing Generalized Gingival Hyperplasia:
Calcium channel blockers (heart)
If someone is on Phenytoin/dilantin for epilepsy, what is the chance of developing gingival hyperplasia?
The severity of which is related mostly to what?
Heavy metal ingestion presents how?
staining of marginal gingiva
Type I hypersensitivity is anaphylaxis by what immunoglobulin?
Type IV hypersensitivity is ____ mediated
Angioedema is swelling where?