oral pic exam 2 Flashcards by Angela Marulanda

how would you describe this

desquamative gingivits

it is a clinical term, not a ds

ONLY for erosive lichen planus not reticular

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lichen planus - reticular

White striae or leukoplakia appearance

Bilateral!

Can be on other mucosal surfaces BUT buccal is the most common

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lichen planus

White striae or leukoplakia appearance

Bilateral!

Can be on other mucosal surfaces BUT buccal is the most common

Commonly seen on areas that flex, like wrists, elbows etc.

They are SUPER itchy, and have a small lace like appearance to them too.

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lichen planus

White striae or leukoplakia appearance

Bilateral!

Can be on other mucosal surfaces BUT buccal is the most common

Commonly seen on areas that flex, like wrists, elbows etc.

They are SUPER itchy, and have a small lace like appearance to them too.

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reticular lichen planus

“classic appearance”

Bilateral asymptomatic white lesions of the buccal mucosa

Wickman striae lace-like appearance.

Plaque-like areas.

Normally not painful.

Can be in different surfaces like the alveolar mucosa and then onto the vestibular appearance involved.

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Erosive form of lichen planus

Bilateral symptomatic erythematous areas with fine white radiating striae

Central ulceration

Desquamative gingivitis → ONLY ON EROSIVE LICHEN PLANUS NOT THE RETICULAR ONE

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Reticular lichen planus

Bilateral asymptomatic white lesions of the buccal mucosa

Wickman striae lace-like appearance.

Plaque-like areas.

Normally not painful.

Can be in different surfaces like the alveolar mucosa and then onto the vestibular appearance involved.

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Reticular lichen planus

Bilateral asymptomatic white lesions of the buccal mucosa

Wickman striae lace-like appearance.

Plaque-like areas.

Normally not painful.

Can be in different surfaces like the alveolar mucosa and then onto the vestibular appearance involved.

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Reticular lichen planus

Bilateral asymptomatic white lesions of the buccal mucosa

Wickman striae lace-like appearance.

Plaque-like areas.

Normally not painful.

Can be in different surfaces like the alveolar mucosa and then onto the vestibular appearance involved.

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Reticular lichen planus

Bilateral asymptomatic white lesions of the buccal mucosa

Wickman striae lace-like appearance.

Plaque-like areas.

Normally not painful.

Can be in different surfaces like the alveolar mucosa and then onto the vestibular appearance involved.

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Reticular lichen planus

fine lace like apperance with some red in the background.

Bilateral asymptomatic white lesions of the buccal mucosa

Wickman striae lace-like appearance.

Plaque-like areas.

Normally not painful.

Can be in different surfaces like the alveolar mucosa and then onto the vestibular appearance involved.

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Reticular lichen planus

Here it is a plaque-like presentation of lichen planus

This is not a classic presentation.

Would still get a biopsy to confirm.

Bilateral asymptomatic white lesions of the buccal mucosa

Wickman striae lace-like appearance.

Plaque-like areas.

Normally not painful.

Can be in different surfaces like the alveolar mucosa and then onto the vestibular appearance involved.

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Erosive form of lichen planus

Bilateral symptomatic erythematous areas with fine white radiating striae

Central ulceration

Desquamative gingivitis → ONLY ON EROSIVE LICHEN PLANUS NOT THE RETICULAR ONE

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Erosive form of lichen planus

Bilateral symptomatic erythematous areas with fine white radiating striae

Central ulceration

Desquamative gingivitis → ONLY ON EROSIVE LICHEN PLANUS NOT THE RETICULAR ONE

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Erosive form of lichen planus

Bilateral symptomatic erythematous areas with fine white radiating striae

Central ulceration

Desquamative gingivitis → ONLY ON EROSIVE LICHEN PLANUS NOT THE RETICULAR ONE

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Erosive form of lichen planus

Bilateral symptomatic erythematous areas with fine white radiating striae

Central ulceration

Desquamative gingivitis → ONLY ON EROSIVE LICHEN PLANUS NOT THE RETICULAR ONE

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Pemphigus vulgaris

autoantibodies to desmoglein-3

Glycoprotein component of desmosomes

Tzank cells = free floating epithelial cells

Intra-epithelial split because the epithelial cells are not attached by desmosomes.

Can affect skin and mucosal surfaces

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Pemphigus vulgaris

autoantibodies to desmoglein-3

Glycoprotein component of desmosomes

Tzank cells = free floating epithelial cells

Intra-epithelial split because the epithelial cells are not attached by desmosomes.

Can affect skin and mucosal surfaces

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Pemphigus vulgaris

autoantibodies to desmoglein-3

Glycoprotein component of desmosomes

Tzank cells = free floating epithelial cells

Intra-epithelial split because the epithelial cells are not attached by desmosomes.

Can affect skin and mucosal surfaces

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Pemphigus vulgaris

autoantibodies to desmoglein-3

Glycoprotein component of desmosomes

Tzank cells = free floating epithelial cells

Intra-epithelial split because the epithelial cells are not attached by desmosomes.

Can affect skin and mucosal surfaces

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Pemphigus vulgaris

autoantibodies to desmoglein-3

Glycoprotein component of desmosomes

Tzank cells = free floating epithelial cells

Intra-epithelial split because the epithelial cells are not attached by desmosomes.

Can affect skin and mucosal surfaces

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Pemphigus vulgaris

autoantibodies to desmoglein-3

Glycoprotein component of desmosomes

Tzank cells = free floating epithelial cells

Intra-epithelial split because the epithelial cells are not attached by desmosomes.

Can affect skin and mucosal surfaces

Oral lesions come FIRST then SKIN lesions

Think second = skin

Prognosis improved it tx early

May be fatal without tx.

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Pemphigus vulgaris

autoantibodies to desmoglein-3

Glycoprotein component of desmosomes

Tzank cells = free floating epithelial cells

Intra-epithelial split because the epithelial cells are not attached by desmosomes.

Can affect skin and mucosal surfaces

Oral lesions come FIRST then SKIN lesions

Think second = skin

Prognosis improved it tx early

May be fatal without tx.

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Pemphigus vulgaris

autoantibodies to desmoglein-3

Glycoprotein component of desmosomes

Tzank cells = free floating epithelial cells

Intra-epithelial split because the epithelial cells are not attached by desmosomes.

Can affect skin and mucosal surfaces

Oral lesions come FIRST then SKIN lesions

Think second = skin

Prognosis improved it tx early

May be fatal without tx.

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**Pemphigus vulgaris** autoantibodies to desmoglein-3 Glycoprotein component of desmosomes Tzank cells = free floating epithelial cells Intra-epithelial split because the epithelial cells are not attached by desmosomes. Can affect skin and mucosal surfaces Oral lesions come FIRST then SKIN lesions *Think second = skin* Prognosis improved it tx early May be fatal without tx.

**Pemphigus vulgaris** *mutliple areas of ulceration because cells arent atttached really.* autoantibodies to desmoglein-3 Glycoprotein component of desmosomes Tzank cells = free floating epithelial cells. Intra-epithelial split because the epithelial cells are not attached by desmosomes. **Can affect skin and mucosal surfaces** Oral lesions come FIRST then SKIN lesions *Think second = skin* Prognosis improved it tx early May be fatal without tx.

**Pemphigus vulgaris** autoantibodies to desmoglein-3 Glycoprotein component of desmosomes Tzank cells = free floating epithelial cells. Intra-epithelial split because the epithelial cells are not attached by desmosomes. Can affect skin and mucosal surfaces Oral lesions come FIRST then SKIN lesions *Think second = skin* Prognosis improved it tx early May be fatal without tx.

**Pemphigus vulgaris** *this is painful.* autoantibodies to desmoglein-3 Glycoprotein component of desmosomes Tzank cells = free floating epithelial cells Intra-epithelial split because the epithelial cells are not attached by desmosomes. Can affect skin and mucosal surfaces Oral lesions come FIRST then SKIN lesions *Think second = skin* Prognosis improved it tx early May be fatal without tx.

paraneoplatic pemphigus which is associated with malignancy: lymphoma and leukemia.

**Mucous membrane pemphigoid** This is a chronic, autoimmune blistering mucocutaneous ds Autoantibodies to basement membrane antigens: Laminin 5 (epiligrin) & BP180 Subepithelial split involved. Oral lesions of mucous membrane pemphigoid: has **Vesicles, bullae, and ulcerations**, desquamative gingivitis and nikolsky sign They do not respond to steroids but do respond to Cellcept

**Mucous membrane pemphigoid** This is a chronic, autoimmune blistering mucocutaneous ds Autoantibodies to basement membrane antigens: Laminin 5 (epiligrin) & BP180 Subepithelial split involved. Oral lesions of mucous membrane pemphigoid: has Vesicles, bullae, and ulcerations, **desquamative gingivitis** and nikolsky sign They do not respond to steroids but do respond to Cellcept

**Mucous membrane pemphigoid** This is a chronic, autoimmune **blistering** mucocutaneous ds Autoantibodies to basement membrane antigens: Laminin 5 (epiligrin) & BP180 Subepithelial split involved. Oral lesions of mucous membrane pemphigoid: has Vesicles, bullae, and ulcerations, desquamative gingivitis an**d nikolsky sign** They do not respond to steroids but do respond to Cellcept

this shows

positive nikolsky sign in mucous membrane pemphigoid

**Mucous membrane pemphigoid** This is a chronic, autoimmune **blistering** mucocutaneous ds Autoantibodies to basement membrane antigens: Laminin 5 (epiligrin) & BP180 Subepithelial split involved. Oral lesions of mucous membrane pemphigoid: has **Vesicles, bullae, and ulcerations,** desquamative gingivitis and nikolsky sign They do not respond to steroids but do respond to Cellcept

**Mucous membrane pemphigoid** This is a chronic, autoimmune blistering mucocutaneous ds Autoantibodies to basement membrane antigens: Laminin 5 (epiligrin) & BP180 Subepithelial split involved. Oral lesions of mucous membrane pemphigoid: has **Vesicles, bullae, and ulcerations,** desquamative gingivitis and nikolsky sign They do not respond to steroids but do respond to Cellcept

**Mucous membrane pemphigoid** This is a chronic, autoimmune blistering mucocutaneous ds Autoantibodies to basement membrane antigens: Laminin 5 (epiligrin) & BP180 Subepithelial split involved. Oral lesions of mucous membrane pemphigoid: has Vesicles, bullae, and ulcerations, **desquamative gingivitis** and nikolsky sign They do not respond to steroids but do respond to Cellcept

**Mucous membrane pemphigoid** **This is a chronic, autoimmune blistering mucocutaneous ds** Autoantibodies to basement membrane antigens: Laminin 5 (epiligrin) & BP180 Subepithelial split involved. Oral lesions of mucous membrane pemphigoid: has **Vesicles, bullae, and ulcerations,** desquamative gingivitis and nikolsky sign They do not respond to steroids but do respond to Cellcept

**Mucous membrane pemphigoid** ***nasal involvement*** This is a chronic, autoimmune blistering mucocutaneous ds Autoantibodies to basement membrane antigens: Laminin 5 (epiligrin) & BP180 Subepithelial split involved. Oral lesions of mucous membrane pemphigoid: has Vesicles, bullae, and ulcerations, desquamative gingivitis and nikolsky sign They do not respond to steroids but do respond to Cellcept

**Mucous membrane pemphigoid** ***ocular involvement*** This is a chronic, autoimmune blistering mucocutaneous ds Autoantibodies to basement membrane antigens: Laminin 5 (epiligrin) & BP180 Subepithelial split involved. Oral lesions of mucous membrane pemphigoid: has Vesicles, bullae, and ulcerations, desquamative gingivitis and nikolsky sign They do not respond to steroids but do respond to Cellcept

**Mucous membrane pemphigoid** This is a chronic, autoimmune blistering mucocutaneous ds Autoantibodies to basement membrane antigens: Laminin 5 (epiligrin) & BP180 Subepithelial split involved. Oral lesions of mucous membrane pemphigoid: has Vesicles, bullae, and ulcerations, desquamative gingivitis and nikolsky sign **They do not respond to steroids but do respond to Cellcept**

**Erythema multiforme** is an immunologically mediated self limited mucocutaneous ds Seen in young adults Sudden onset of widespread painful superficial mucosal ulcers and target lesion soft skin. **Will see “target” “bullseye” lesion** Crusted ulcers on lips. Lesions might be limited to the oral mucosa. May be recurrent. Prodromal symptoms (fever, mailase) This ds is self-limiting can last up to 2-6 weeks Want to avoid dehydration

**Erythema multiforme** is an immunologically mediated self limited mucocutaneous ds Seen in young adults Sudden onset of widespread painful superficial mucosal ulcers and target lesion soft skin. Will see “target” “bullseye” lesion **Crusted ulcers on lips**. Lesions might be limited to the oral mucosa. May be recurrent. Prodromal symptoms (fever, mailase) This ds is self-limiting can last up to 2-6 weeks Want to avoid dehydration

**Erythema multiforme** is an immunologically mediated self limited mucocutaneous ds Seen in young adults Sudden onset of widespread painful superficial mucosal ulcers and target lesion soft skin. Will see “target” “bullseye” lesion Crusted ulcers on lips. Lesions might be limited to the oral mucosa. May be recurrent. Prodromal symptoms (fever, mailase) This ds is self-limiting can last up to 2-6 weeks Want to avoid dehydration

**Erythema multiform**e is an immunologically mediated self limited mucocutaneous ds Seen in young adults Sudden onset of widespread painful superficial mucosal ulcers and target lesion soft skin. Will see “target” “bullseye” lesion Crusted ulcers on lips. Lesions might be limited to the oral mucosa. May be recurrent. Prodromal symptoms (fever, mailase) This ds is self-limiting can last up to 2-6 weeks Want to avoid dehydration

**Erythema multiforme** is an immunologically mediated self limited mucocutaneous ds Seen in young adults Sudden onset of widespread painful superficial mucosal ulcers and target lesion soft skin. Will see “target” “bullseye” lesion Crusted ulcers on lips. Lesions might be limited to the oral mucosa. May be recurrent. Prodromal symptoms (fever, mailase) This ds is self-limiting can last up to 2-6 weeks Want to avoid dehydration

seen on a young adult with some prodromal symptoms

**Erythema multiforme** is an immunologically mediated self limited mucocutaneous ds Seen in young adults Sudden onset of widespread painful superficial mucosal ulcers and target lesion soft skin. Will see “target” “bullseye” lesion Crusted ulcers on lips. Lesions might be limited to the oral mucosa. May be recurrent. Prodromal symptoms (fever, mailase) This ds is self-limiting can last up to 2-6 weeks Want to avoid dehydration

**Erythema multiforme** is an immunologically mediated self limited mucocutaneous ds **Seen in young adults** Sudden onset of widespread painful superficial mucosal ulcers and target lesion soft skin. Will see “target” “bullseye” lesion **Crusted ulcers on lips. Lesions might be limited to the oral mucosa.** May be recurrent. Prodromal symptoms (fever, mailase) This ds is self-limiting can last up to 2-6 weeks Want to avoid dehydration

**Erythema multiforme is an immunologically mediated self limited mucocutaneous ds** **Seen in young adults** Sudden onset of widespread painful superficial mucosal ulcers and target lesion soft skin. Will see “target” “bullseye” lesion Crusted ulcers on lips. Lesions might be limited to the oral mucosa. May be recurrent. Prodromal symptoms (fever, mailase) This ds is self-limiting can last up to 2-6 weeks Want to avoid dehydration

## Footnote **Erythema multiforme** is an immunologically mediated self limited mucocutaneous ds Seen in young adults Sudden onset of widespread painful superficial mucosal ulcers and target lesion soft skin. Will see “target” “bullseye” lesion Crusted ulcers on lips. Lesions might be limited to the oral mucosa. May be recurrent. Prodromal symptoms (fever, mailase) This ds is self-limiting can last up to 2-6 weeks Want to avoid dehydration

24 yo pt. Has noticed difference on the palate for about 3 weeks. Had some fever.

**Erythema multiforme** is an immunologically mediated self limited mucocutaneous ds **Seen in young adults** Sudden onset of widespread painful superficial mucosal ulcers and target lesion soft skin. Will see “target” “bullseye” lesion Crusted ulcers on lips. Lesions might be limited to the oral mucosa. May be recurrent. **Prodromal symptoms (fever, mailase)** **This ds is self-limiting can last up to 2-6 weeks** Want to avoid dehydration

Erythema multiforme is an immunologically mediated self limited mucocutaneous ds Seen in young adults Sudden onset of widespread painful superficial mucosal ulcers and target lesion soft skin. Will see “target” “bullseye” lesion Crusted ulcers on lips. Lesions might be limited to the oral mucosa. May be recurrent. Prodromal symptoms (fever, mailase) This ds is self-limiting can last up to 2-6 weeks Want to avoid dehydration

**Erythema multiforme** is an immunologically mediated self limited mucocutaneous ds Seen in young adults Sudden onset of widespread painful superficial mucosal ulcers and target lesion soft skin. Will see “target” “bullseye” lesion Crusted ulcers on lips. Lesions might be limited to the oral mucosa. May be recurrent. Prodromal symptoms (fever, mailase) This ds is self-limiting can last up to 2-6 weeks Want to avoid dehydration

**Erythema multiforme Major** Stevens-Johnson Syndrome is the severe form of EM Triggered by a drug not an infection.

**Toxic Epidermal Necrolysis (Lyell ds)** The most severe form of EM Seen in older individuals Triggered by a drug exposure There is diffuse sloughing of epidermis leading to a scalded appearance, fluid loss and infection Treated as a sever burn pt in the hospital.

**Lupus is a multisystem autoimmune ds** Most common in **adult woman** in child-bearing years Autoantibodies - antinuclear antibodies (ANA) Immune complexes are deposited throughout the body, especially kidney and blood vessels

Discoid LE Chronic, limited to skin and mucosa Sun-exposed skin Scaly, erythematous patches Cosmetic problems: cutaneous atrophy, scarring and pigmentation (hypopigmentation)

**Discoid LE** Chronic, limited to skin and mucosa Sun-exposed skin Scaly, erythematous patches Cosmetic problems: cutaneous atrophy, scarring and pigmentation (hypopigmentation)

Oral mucosal lesions in LE Seen in ANY form of LE Red and white lesions that may be clinically identical to erosive lichen planus Dependent on blood work to tell the difference

Oral mucosal lesions in **LE** Seen in ANY form of LE Red and white lesions that may be clinically identical to erosive lichen planus Dependent on blood work to tell the difference

**Systemic LE** The most common form of lupus Has the highest morbidity Kidney involvement - glomerulonephritis- renal failure 50% have a butterfly rash Malar area and nose, aggravated by sunlight. Libman-sacks endocarditis Other clinical involvement: arthritis, arthralgia, heart and lung involvement, anemia, bone marrow depression, vasculitis, skin rashes Tx and prognosis: - Systemic corticosteroids - Antimalarial drugs – plaquenil. Causes hyperpigmentation of mucsa. - Avoid excessive exposure to sunlight - Prognosis depends on organs affected and ds activity - Renal failure is most frequent cause of death

**Systemic LE** The most common form of lupus Has the highest morbidity Kidney involvement - glomerulonephritis- renal failure 50% have a butterfly rash Malar area and nose, aggravated by sunlight. Libman-sacks endocarditis Other clinical involvement: arthritis, arthralgia, heart and lung involvement, anemia, bone marrow depression, vasculitis, skin rashes Tx and prognosis: Systemic corticosteroids **Antimalarial drugs – plaquenil. Causes hyperpigmentation of mucosa.** Avoid excessive exposure to sunlight Prognosis depends on organs affected and ds activity Renal failure is most frequent cause of death

**SYSTEMIC SCLEROSIS** = an autoimmune ds of adults, predom females Characterized with excessive fibrosis May be limited to the skin or be widespread affecting various organ systems Clinically see: Microstomia, xerostomia, generalized widening of PDL space, and mandibular resorption. Mask-like face. Telangiectasia - dilated small vessels on the skin, face, mucosa. Raynaud phenomenon (=Arterial spasm in response to cold or emotional stress) Hands and fingers can show fibrosis, stiffness, deformity Limited hand dexterity can be reason for poor oral hygiene.

SYSTEMIC SCLEROSIS = an autoimmune ds of adults, predom females Characterized with excessive fibrosis May be limited to the skin or be widespread affecting various organ systems Clinically see: Microstomia, xerostomia, generalized widening of PDL space, and mandibular resorption. Mask-like face. Telangiectasia - dilated small vessels on the skin, face, mucosa. Raynaud phenomenon (=Arterial spasm in response to cold or emotional stress) Hands and fingers can show fibrosis, stiffness, deformity Limited hand dexterity can be reason for poor oral hygiene.

this is a sign for

a sign for

this is associated with:

Morphea - a localized form of **scleroderma** “coup de sabre” Limited skin involvement, no systemic involvement **Progressive hemifacial atrophy** (Pierre Romberg syndrome may be a form of scleroderma)

**Hereditary epidermolysis bullosa** Primarily a severe and debilitating skin ds in which blisters form at sites of minor trauma and may heal with scarring → nikolsky positive. NOT an autoimmune ds. Has defective structural proteins. Orally: Normal diet produces bullae that heals with scarring leading to obliteration of vestibule. Can cause: ankyloglossia, microstomia, and esophageal stricture Skin: "mitten", ulceration on hands and fingers, dystrophic

Hereditary epidermolysis bullosa Primarily a severe and debilitating skin ds in which blisters form at sites of minor trauma and may heal with scarring → nikolsky positive. NOT an autoimmune ds. Has defective structural proteins. Orally: Normal diet produces bullae that heals with scarring leading to obliteration of vestibule. Can cause: ankyloglossia, microstomia, and esophageal stricture Skin: "mitten", ulceration on hands and fingers, dystrophic

Hereditary epidermolysis bullosa Primarily a severe and debilitating skin ds in which blisters form at sites of minor trauma and may heal with scarring → nikolsky positive. NOT an autoimmune ds. Has defective structural proteins. Orally: Normal diet produces bullae that heals with scarring leading to obliteration of vestibule. Can cause: ankyloglossia, microstomia, and esophageal stricture Skin: **"mitten",** ulceration on hands and fingers, dystrophic

PSORIASIS = A common, chronic, genetically-determined inflammatory and hyperproliferative skin ds Associated with certain HLA types. Immunoregulatory disorder - T cells trigger inflammation Defect in control of keratinocyte proliferation- turnover rate 8x normal. Clinically: well-demarcated, red plaques covered by silvery scales. Auspitz Sign - removal of scale leaves pinpoint bleeding area. Koebner phenomenon - lesions develop following trauma to normal-appearing skin. Nail involvement. Psoriatic arthritis- 15% polyarthritis, TMJ involvement rare

PSORIASIS = A common, chronic, genetically-determined inflammatory and hyperproliferative skin ds Associated with certain HLA types. Immunoregulatory disorder - T cells trigger inflammation Defect in control of keratinocyte proliferation- turnover rate 8x normal. Clinically: **well-demarcated, red plaques covered by silvery scales.** Auspitz Sign - removal of scale leaves pinpoint bleeding area. Koebner phenomenon - lesions develop following trauma to normal-appearing skin. Nail involvement. Psoriatic arthritis- 15% polyarthritis, TMJ involvement rare

This is a sign of what

PSORIASIS = A common, chronic, genetically-determined inflammatory and hyperproliferative skin ds Associated with certain HLA types. Immunoregulatory disorder - T cells trigger inflammation Defect in control of keratinocyte proliferation- turnover rate 8x normal. Clinically: well-demarcated, red plaques covered by silvery scales. **Auspitz Sign - removal of scale leaves pinpoint bleeding area.** Koebner phenomenon - lesions develop following trauma to normal-appearing skin. Nail involvement. Psoriatic arthritis- 15% polyarthritis, TMJ involvement rare

PSORIASIS = A common, chronic, genetically-determined inflammatory and hyperproliferative skin ds Associated with certain HLA types. Immunoregulatory disorder - T cells trigger inflammation Defect in control of keratinocyte proliferation- turnover rate 8x normal. Clinically: well-demarcated, red plaques covered by silvery scales. Auspitz Sign - removal of scale leaves pinpoint bleeding area. **Koebner phenomenon - lesions develop following trauma to normal-appearing skin.** Nail involvement. Psoriatic arthritis- 15% polyarthritis, TMJ involvement rare

sign of what

PSORIASIS = A common, chronic, genetically-determined inflammatory and hyperproliferative skin ds Associated with certain HLA types. Immunoregulatory disorder - T cells trigger inflammation Defect in control of keratinocyte proliferation- turnover rate 8x normal. Clinically: well-demarcated, red plaques covered by silvery scales. Auspitz Sign - removal of scale leaves pinpoint bleeding area. Koebner phenomenon - lesions develop following trauma to normal-appearing skin. **Nail involvement.** Psoriatic arthritis- 15% polyarthritis, TMJ involvement rare

WHITE SPONGE NEVUS = hereditary, autosomal dominant mutation of keratin genes that requires NO tx. Clinically: asymptomatic, bilateral white lesions with a thick, folded, consistency “spongy” appear before puberty Primarily involves buccal mucosa, but may affect other mucosal surfaces- anogenital, esophageal. Histopath: perinuclear keratin condensation

NASOPALATINE DUCT CYSTAka incisive cyst canal The most common odontogenic cyst of oral cavity A developmental cyst that arises from epithelial remnants of nasopalatine duct ONLY place you will EVER see is at the midline of the maxilla between 8 and 9. Can cause roots to resorb. Teeth are vital!!!!!! Seen in adults 4th to 6th decade. Symptoms: RL ~0.6cm in the upper limit of normal for the incisive foramen. Swelling of the anterior palate. Drainage and pain, if it is inflamed.

Median palatine cyst Well-circumscribed palatal lucency Epithelium entrapped during fusion of palatal shelves Stratified squamous or pseudostratified columnar May be difficult to distinguish from nasopalatine duct cyst *On XR nasopalatine is more anterior and median palatine is more post. The location is how you can tell them apart.*

Periapical cyst **A inflammatory odontogenic cysts: RL at the apex of a non-vital tooth** Arises from the rests of malassez If you have multiple periapical cysts, then you would also need multiple non vital teeth

Periapical cyst A inflammatory odontogenic cysts: RL at the apex of a non-vital tooth Arises from the rests of malassez If you have multiple periapical cysts, then you would also need multiple non vital teeth

Buccal bifurcation cyst An inflammatory odontogenic cyst. Paradental cyst Buccal bifurcation of vital md molar teeth with cervical enamel projection Most commonly seen on the md M.

Dentigerous cyst Most common type of developmental odontogenic cyst but you must have an impacted tooth Arises from dental follicle - attached to the cervix, enclosing the crown of an unerupted tooth Enlarged follicular space \>4mm A possibility that a dentigerous cyst can transform into a unicystic ameloblastoma (an odontogenic tumor, XR large pericoronal radiolucencies looks just like a dentigerous cyst)

unicystic ameloblastoma ## Footnote **A possibility that a dentigerous cyst can transform into a unicystic ameloblastoma (an odontogenic tumor, XR large pericoronal radiolucencies looks just like a dentigerous cyst)**

Eruption cyst The soft tissue variant of dentigerous cyst. It is associated with the crown of an erupting tooth Clinically: will have a blue-ish color. Tooth will erupt through it.

where is this

Globulomaxillary cyst - A developmental “globulomaxillary cyst” dn exist Located at the junction of maxilla with premaxilla and between MX LI and C No developmental fissural cyst in this position. More of a position than a ds.

Lateral periodontal cyst Arises from dental lamina rests (rests of Serres) VITAL teeth of adult males (3:1) Md pm area Mx I-C area

Botryoid odontogenic cyst Polycystic variant of the lateral periodontal cyst A developmental odontogenic cyst that presents as a multilocular lucency associated with the vital md PM of adults Difference between botryoid vs lateral is that botryoid is multicystic and lateral is unicystic.

Gingiva cyst of adult Soft tissue variant of lateral periodontal cyst NO XR PRESENTATION Arises from dental lamina Vital teeth M 3:1 F Seen @ md PM and mx I-C area Clinically sometimes has a blue-ish swelling. Can never be mucocele or a mucoepidermoid carcinoma bc not in salivary gland area, it is in the mucosa

oral pic exam 2 Flashcards

(112 cards)