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Flashcards in Oral Pathology Marathon Deck (168):
1

4 types of pathologies:

Developmental

Hereditary/Genetic

Familial

Congenital

2

Of the Genetic abnormalities, what % is unknown etiology?

% inherited ?

% known environmental causes?

85%

10%

5%

3

3 Characteristics of Developmental conditions:

Present at young age/congenital

Bilaterally symmetrical

Asymptomatic

4

Without jaw development (type of aplasia):

Small, underdeveloped jaw:

Large jaw:

Agnathia

Micrognathia

Macrognathia

5

Primary Macrognathia:

Secondary (acquired) Macrognathia:

Developmental

tumors, acromegaly, Paget's

6

A _______ is characterized by multiple different abnormalities

Syndrome

7

Teeth come from what germ layer?

Ectoderm

8

Micrognathia is a type of _____plasia

Hypo

9

Cleft lip/palate is a _______ anomaly occurring ______

developmental

1st trimester

10

Cleft lip occurs in 1/____ white births

1/1000

11

T/F
The etiology of cleft palate is unknown

True

12

Mutations in cleft lip/palate have been shown in how many genes involved in the development of the palat/lip?

6-12 genes

13

The lateral palatal shelves fuse anteriorly at the junction with the _______ and fuse posteriorly

Premaxilla

14

The upper lip (development) is a ______ epithelium

What penetrates/develops into CT and muscle in the upper lip adding bulk?

bilayered

Mesoderm

15

Where does the mesoderm (forms CT/muscle in upper lip) originate?

Globular portion of median nasal process and Maxillary processes bilaterally

16

When a cleft forms there is a lack of ______ penetration

Mesoderm

17

Cleft lip is on the upper lip, off the midline, ___% bilateral

20%

18

Cleft palate is _____ to the Premaxilla over the _____

Anterior

Alveolar Ridge

19

T/F
Bifid Uvula is related to Cleft Palate

False

20

Bifid Uvula is associated with what?

submucosal cleft of muscle

21

Most common cleft?

2nd most common?

Least common?

Cleft lip with cleft palate

cleft lip

cleft palate

22

There are over _____ syndromes that include clefting, making up about ____% of all clefting cases.

400

30%

23

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

1.5 years

24

An oft-missed congenital malformation that may be present with other anomalies:

Lip pits

25

T/F
Cleft lip is Familial but not Inherited

True

26

T/F
There isn't a single gene that gives you clefting, rather 10-12 genes that are involved with the development of your palat

True

27

T/F
Clefting is the result of abnormal genes plus environmental factors

True

28

The palatal shelves fuse anteriorly at the junction with the ________

Premaxilla

29

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

mesoderm

globular

30

T/F
Chelitis glandularis is developmental

False

*infection salivary glands lower lip

31

An infection of the salivary glands of the lower lip, often found in those that work outside (promotes retrograde infection):

Chelitis glandularis

32

T/F
Chelitis glandularis is a premalignant condition

False

*does NOT lead to lower lip cancer

33

Ectopic sebaceous glands that develop after puberty in 80% of the population

Fordyce granules

34

Asymptomatic, superficial yellow plaques that are bilaterally symmetric. (an increase of buccal mucosa)

Fordyce granules

35

T/F
Fordyce granules can be treated

False

no treatment, recognition only

36

Inherited, mostly Autosomal Dominant that genetically programs the over production of collagen:

Fibromatosis gingivae

37

Fibromatosis gingivae can be either ____ or found with ______ and is clinically found to be _______ generalized gingival hyperplasia

isolated

syndromes

asymptomatic

38

T/F
Tx of Fibromatosis gingivae can be surgical but tends to come back

True

39

No tongue development (an aplasia)

Small, underdeveloped tongue

Enlarged, overdeveloped tongue

Aglossia

Microglossia

Macroglossia

40

Macroglossia can either be developmental or acquired by what 2 means?

Tumor

Acromegaly

41

The fusion of the tongue to the floor of the mouth (tongue tied):

Ankyloglossia

42

Bifid or midline fissure of the anterior 2/3 of the tongue

Cleft Tongue

43

Deep grooves in the Tongue of unknown etiology (may be genetic) associated with familial pattern of heritability and Age:

Fissured tongue

*not associated with anything systemic

44

2 terms for Geographic Tongue:

Benign migratory glossitis

Erythema migrans

45

T/F
Geographic Tongue is developmental

False

46

Benign Migratory Glossitis (geo tongue) occurs __:__ females to males

On the ___/____ borders of the tongue

Borders color:

2:1

Dorsal/Lateral

Yellowish-Whitish

47

T/F
Benign Migratory Glossitis (geo tongue) is recommended for biopsy and is infectious

False to both

48

Benign Migratory Glossitis may burn or hurt (otherwise asymptomatic)

True

49

Hairy Tongue is hypertrophy of _______ papillae

Filiform

50

Hairy Tongue has unknown etiology, but name 3 predisposing factors:

Drugs (ABx, H2O2)

Smoking

Radiation Therapy

51

What is the Tx for Hairy Tongue?

Debridement

CHX

52

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 ______

Ventral Tongue

Esthetics

53

Using a Glass Slide to determine presence of Varix, blanch through the glass to see it better.

Diascopy

54

A Lingual Thyroid Nodule is b/c of a breakdown in the ______ Tract with is a ______ invagination starting ________

Thyroglossal Tract

Endodermal

Foramen Cecum

55

Lingual Thyroid Nodule appears where?

What images?

Tx surgical or ________

Posterior, mid dorsal tongue

Radioactive Iodine

Thyroid Replacement Therapy

56

2 Lymphoid Tissue oral pathologies:

Hyperplastic Lingual Tonsil

Lymphoepithelial Cyst

57

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

Salivary

Epithelium

Yellowish

58

Tx for Lymphoepithelial Cysts:

Excision

59

Lymphoepithelial Cysts are Asymptomatic

True

60

Developmental Lingual Mandibular Salivary Gland Depression:

Located:

Stafne's Bone Cavity

Below IA canal

61

In Stafne's Bone Cavity, the ______ salivary glands develop along the Lingual _____, which produces an indentation

Submandibular

Cortex

62

T/F
Stafne's Bone Cavity is inflammatory and changes with time

False

*to both - no swelling, doesn't change

63

Stafne's Bone Cavity is a ______ diagnosis

Radiographic

64

A group of inherited disorders which program the oral mucosa to abnormally keratinize and generally develop early in life

Genokeratoses

65

The most common Genokeratosis:

Genetically...

White sponge nevus

autosomal dominant

66

White sponge nevus

Hereditary benign intraepithelial dyskeratosis

Pachyonychia Congenita

Dyskeratosis congenital

Dariers Diseas - keratosis follicularis

Genokeratoses

67

The most common form of Developmental Cyst (non-odontogenic)

Incisive Canal Cyst

68

The Incisive Canal Cyst appears as a Radiolucency of over _____ mm between the roots of the ______

6 mm

Max CI's

69

Incisive Canal Cyst does what to the teeth?

Tx?

Tx complication?

Variant:

Moves CI's apart

Surgical

anesthesia lasts for months

Incisive papilla cyst (outside bone)

70

Most common radiolucency between Maxillary Lateral and Cuspid?

Globulomaxillary Cyst

71

The Globulomaxillary Cyst is a ___________ radiolucency btwn Mx LI's and Cuspids that probably _________

asymptomatic

doesn't really exist

*meaning they are really other cysts/tumors

72

A Cyst from entrapped epithelium during palatal closure producing a Radiolucency at MIDPALATE.

Tx surgical removal

Median Palatal Cyst

73

Cyst from the embryologic nasolacrimal duct producing upper lip cyst R or L of midline

Naso-alveolar cyst (nasolabial cyst)

74

The Naso-alveolar cyst (nasolabial cyst) is soft, fluctuant, and often elevates what?

3/4 occurs in _______

___% bilateral

Tx:

ala

Females

10%

Surgical

75

What cyst classicaly moves when a pt swallows?

Thyroglossal duct tract cyst

*goes through hyoid bone

76

The Thyroglossal Duct Cyst is a ______ cyst brom the base of tongue to the thyroid gland

Soft, fluctuant, more likely to occur in _____

Tx:

Midline

Females

Surgical

77

Cyst from entrapped salivary gland ducts in the paraparotid lymph nodes

Cervical Lymphoepithelial Cyst (Branchial Cleft Cyst)

78

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

salivary paraparotid

branchial

79

Epidermoid/Dermoid Cysts occur in the Midline and form from trapped _____ during surface closure

Common in what demographic?

Where?

Epithelium

young

FOM, ventral tongue

80

Epidermoid Cysts are lined by what?

Dermoid Cysts are lined by what?

Stratified Squamous Epithelium

Stratified Squamous w/ Dermal appendages (sebaceous, sweat, hair follicles)

81

Small teeth:

Large teeth:

Microdontia

Macrodontia

82

Attempted division of tooth germ with incomplete formation of 2 teeth, usually a single root

Gemination

83

Union of 2 teeth - often individual roots

Fusion

84

Fusion of teeth when joined by Cementum:

Concrescence

85

Bend or curve in a tooth or root, possibly due to trauma, causing problems with RCT/extraction:

Dilaceration

86

Dens Invaginatus

Dens in Dente

87

Dens in Dente results from the invagination of the enamel organ before ______

Most often found where?

Can be ______

Often a sequelae of _____ infection

calcification

Mx LI's

bilateral

periapical

88

A toothlike structure found in the Central Fossa:

Where does this happen more often?

Dens evaginatus

Mn Premolars

89

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

Taurodontism

phenotypic

90

Excess of enamel at a bi or trifurcation of Molars at the CEJ

Enamel Pearl

91

A few teeth, not enough:

No teeth (associated w/ systemic probs):

Oligodontia

Anodontia

92

Anodontia is most associated with what?

Heriditary Ectodermal Dysplasia

93

Supernumerary teeth usually occur where?

Called _____, and usually occurs between ______

Maxilla

Mesiodens, Mx CI's

94

What Syndrome associated with Supernumerary teeth?

What Dysplasia?

Garner's Syndrome

Cleidocranial Dysplasia

95

A Hereditary disturbance in Enamel Structure:

This is a defect in what cell?

Genetic pattern:

How many types?

Amelogenesis imperfecta

Ameloblasts

Autosomal dominant, recessive, sex linked

12-15 types

96

Amelogenesis Imperfecta presents clinically what 2 ways?

Hypoplasia

Hypocalcification

Hypomaturation

97

Amelogenesis Imperfecta - all teeth, both dentitions, Family Hx

some teeth, one dentition, no family Hx

Hereditary

Environmental

98

Rickets, Exanthematous diseases, Congenital Syphylis, Turner's tooth, Fluorosis, Tetracycline, - can all cause what?

Hypoplasia/hypocalcification

*enamel defects

99

Congenital Syphilis causes Hutchinsons...

Mulberry...

Incisors

Molars

100

What is a Local Infection or Trauma that can cause Enamel Defects?

Turner's Tooth

101

Dentinogenesis Imperfecta is inherited how?

Can be with or independent of what?

Affect what teeth?

Dominantly

Osteogenesis imperfecta

all teeth, both dentitions

102

Dentinogenesis Imperfecta affects type ___ Collagen

Teeth look...

Radiographic findings:

Tx:

I

grayish to yellowish brown

Obliteration of pulp chambers/canals (may have attrition and root fractures)

Crowns to prevent attrition

103

Autosomal dominant condition characterized by pulpal obliteration with abnormal dentin, defective root formation and tendency for periapical pathology

Dentinal Dysplasia

104

Dentinal dysplasia affects all teeth and both dentitions but differs from Dentinogenesis Imperfecta b/c the teeth look_______

Radiographic findings:

normal

Obliteration of pulp, short underdeveloped roots, periapical radiolucencies

105

In Dentinal Dysplasia, the teeth look normal, but there is abnormal....

Root Formation

106

Regional Odontodysplasia, aka...

Mostly affects ____ teeth

what teeth have increased chance of being unerupted?

Ghost teeth

Permanent

Mx

107

Radiographic findings of Regional Odontodysplasia:

Thin enamel/dentin anomalous teeth

108

Teeth that lack eruptive force:

*if generalize, think systemic (hypothyroidism)

Pseudoanodontia (embedded teeth)

109

Teeth that are unerupted b/c of mechanical block

Most often in the Mn:

Most often in the Mx:

Impacted

3M

Canine

110

Tooth roots fused to bone (often in Primary teeth with underlying succedaneous permanent tooth missing)

They have a distinctive _______

***no PDL, fused to bone

Ankylosed teeth

percussion

111

Loss of tooth structure occlusally and interproximally due to direct tooth to tooth contact:

If Pathological:

Attrition

Bruxism

112

Loss of tooth structure from mechanical force (cervical tooth brushing)

Abrasion

113

Loss of tooth structure from chemical process, most often non-bacterial acid dissolusion:

Erosion

114

Erosion due to exposure of Gastric Secretions:

Perimylosis

115

Loss of tooth structure due to repeated tooth flexure from occlusal stresses

Abfraction

116

The combined effect of attrition and abrasion (chewing tobaccos between opposing teeth):

Demastication

117

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):

Secondary Dentin

Reparative Dentin

118

Dentinal tubules devoid of cytoplasmic processes of odontoblasts:

Dead Tracts

119

3 types of Pulp Calcifications:

Denticles

Pulp Stones

Diffuse Linear Calcifications

120

Dentin dysplasia II, Pulpal dysplasia, Regional odontodysplasia, Tumoral calcinosis, Calcinosis universalis, and Ehlers-Danlos Syndrome are all associated with what?

Pulpal Calcifications

121

Abnormal thickening of cementum:

Hypercementosis

122

Hypercementosis can be localized (trauma/idiopathic) or Generalized, which is associated with what disease?

Paget's

123

Calcification is PDL with no clinical significance:

Cementicles

124

External Dental Root Resorption can be Physiologic or Pathologic

True

125

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

Pulp tissue

vital pulp

Mummery

126

Early vascular response to injury is ______ followed by _______

vasoconstriction, vasodilation

127

Vasodilation is caused by histamine, prostaglandins, etc

True

128

What transforms into fibroblasts during the Inflammatory Stage of Wound Repair?

Undifferentiated mesenchymal cells

129

in the migratory phase of Fibroplastic stage of wound repair, fibroblasts migrate into the wound following _______ strands

Fibrin

130

In the proliferative phase, collagen fibers are laid down in what manner?

Haphazardly

131

6 stages of Healing:

Early vascular response

Inflammatory stage

Migratory phase

Proliferative phase

Remodeling

Wound contraction

132

5 types of Biopsy:

Excisional

Incisional

Punch

Needle (FNA - fine needle aspiration)

Aspiration

133

T/F
A biopsy specimen goes into 10% buffered Formalin

True

134

4 biopsy artifacts

Crushing (hemostats)

Burning

Anesthetic injection

Fixation

135

Use incisional biopsy if larger than ______

or suspicion of _______

*diagnostic

1 cm

malignancy

136

T/F
Use Excisional biopsy if small and confident they are benign

True

137

T/F
Do not Excise if think something is malignant

True

138

Primary healing

Secondary healing

Tertiary healing

wound closes

wound is apart

graft

139

The removal of individual cells - usually does NOT provide definitive diagnosis

Cytology

140

3 Indications for Cytology:

premalignant/malignant lesions

HSV

Candidosis

141

Cytology for HSV - for what 2 things?

Cytopathic viral effect

Multinucleation

142

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

computer screening

Definitive

143

DIF

IIF

Both detect what?

Direct Immnofluorecencse

Indirect Immunofluorecense

Autoantibodies

144

T/F
Reserve Immunofluorescence testing for suspected autoimmune disorders like pemphigus vulgaris, mucous membrane pemphigoid

True

145

Most oral diseases are Positive on ______ immunofluorescence but Negative on ________ immunoflurescence

Direct

Indirect

146

DIF biopsies cannot be placed in what?

traditional fixative

*use transport media

147

Extraction, 1st week healing, blood clot organization begins

True

148

Extraction 2nd week healing, organization continues and what degrades?

What proliferates over wound surface?

PDL

Epithelium

149

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

Granulation tissue

Osteoid

Osteoclasts

Epithelium

150

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

4-6 months

151

Dry Socket, aka...

Caused by loss of what?

Localized Acute Alveolar Osteomyelitis

blood clot

152

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

Radiolucent

*may be mistaken for cyst/granuloma

153

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?

Pathologic

Extraction sockets

chronic anemia

Females (75%)

posterior Mn

154

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

155

Physiologic response of mucosa to chronic physical injury producing hyperkeratosis

This is reversible and presents as a white ______

Frictional keratosis

plaque

156

shredded keratinized tissue along linea alba

cheek chewing

*morsicatio buccarum

157

Loss of surface epithelium (trauma, more in kids, lateral tongue)

Traumatic ulcer

158

Self induced:

Factitional

159

Type of Traumatic Ulcer w/ injury to underlying muscle:

(increased prevalence on tongue, rolled borders)

This has the clinical features of what?

Traumatic Granuloma

Carcinoma

160

T/F
The silver compounds in an Amalgam Tattoo stain and sometimes a biopsy must be done to rule out melanoma

True

161

Extravascular bleeding into tissues, resolves:

Pinpoint bleeding from capillaries (thrombocytopenia vs Local cause):

Hematoma

Petechiae

162

1 acute complication to Radiation Therapy for H/N cancer:

When does it arise?

2 chronic complications:

Dermatitis Stomatitis

2nd week therapy

Xerostomia, Osteoradionecrosis

163

Chemical burn injuries to the Oral cavity may or may not rub off

true

164

3 Drugs causing Generalized Gingival Hyperplasia:

Phenytoin/dilantin (epilepsy)

Cyclosporine (immunosuppressant)

Calcium channel blockers (heart)

165

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?

50%

oral hygiene

166

Heavy metal ingestion presents how?

staining of marginal gingiva

167

Type I hypersensitivity is anaphylaxis by what immunoglobulin?

Type IV hypersensitivity is ____ mediated

Angioedema is swelling where?

IgE

cell

Lips

168

stomatitis medicamentosa (systemic) is what?

stmatitis venenata (topical) is what?

Cinnamon can cause...

icreased desquamative gingivitis

cheek + buccal mucosa on SAME side suggests

Allergy

Decks in Tim's Cards Class (140):