Pathology

Question 1

Induced by stress, involves the dorsal and lateral borders of tongue; loss of filiform papilla (filiform papilla are atrophic), burning sensation, erythematous patches surrounded by white or yellow perimeter.

Answer 1

Geographic Tongue (benign migratory glossitis)

Question 2

Associated with tobacco use, chemical rinses, alcohol or certain foods, dorsal surface, asymptomatic, filiform papilla become elongated, result from antibiotic, corticosteroid or radiation therapies, poor OH, TX is brushing tongue.

Answer 2

Hairy Tongue

Question 3

Dorsal surface, variant of normal, TX is brushing tongue with a soft tooth brush.

Answer 3

Fissured Tongue

Question 4

Ventral surface, red to purple enlarged vessels, observed in patient >60 years old.

Answer 4

Lingual Varicosities

Question 5

Associated w/fungal infections from candida albicans, erythematoous area at the midline of the dorsal surface of the tongue anterior to the circumvallate papilla, seen in immuno-compromised individuals, no specific TX.

Answer 5

Median Rhomboid Glossitis

Question 6

Enlarged tongue, described in patients with acromegaly.

Answer 6

Macroglossia

Question 7

Trisomy 21; incidence increases with increased maternal age, fissured tongue, macroglossia, mouth breathing, decreased dental caries possibly due to hyper salivation, taurodontism, gingival and periodontal disease, crowding of teeth.

Answer 7

Down Syndrome

Question 8

Tongue-tied, caused by a short lingual frenum.

Answer 8

Ankyloglossia

Question 9

Benign lesion on hard palate of heavy smokers, the raised red dots represent the duct openings of minor salivary glands, coarse, white, wrinkled appearance.

Answer 9

Nicotine Stomatitis

Question 10

Most common oral fungal infection from candida albicans, can occur in patient’s who are diabetics, HIV infection, Xerostomia, denture wearers, chemotherapy, and antibiotic therapy.

Answer 10

Candidiasis

Question 11

What systemic administrated meds are used for candidiasis?

Answer 11

Ketoconazole and fluconazole (Diflucan)

Question 12

White plaques that wipe off w/underlying red mucosa, burning or metallic taste, “thrush”, effects infants and elderly.

Answer 12

Pseudomembranous Candidiasis

Question 13

2nd most common candidiasis and also known as acute atrophic candidiaisis, red mucosa

Answer 13

Erythematous

Question 14

Erythematous mucosa, mucosa covered by the partial or denture, asymptomatic, usually women, denture stomatitis.

Answer 14

Chronic Atrophic Candidiasis

Question 15

Redness or fissuring at the labial commissures, nutritional deficiencies such as insufficient riboflavin-Vitamin B2, persons who frequently lick their lips.

Answer 15

Angular Cheilitis

Question 16

Erythematous area at the midline of dorsal of tongue, asymptomatic, immune-compromised patients.

Answer 16

Median Rhomboid Glossitis

Question 17

Benign anomaly, gray to white film on buccal mucosa, stretching the mucosa makes the opalescence less noticeable, common in african americans.

Answer 17

Leuukoedema

Question 18

“White Line”, hyperkeratotic, antero-posteriorly on the buccal mucosa along the occlusal plane, may be bilateral, may be prominent in patient with bruising or clenching habit (type A personalities?)

Answer 18

Linea Alba

Question 19

White patch or plaque of oral mucosa that cannot be wiped off, related to use of tobacco, can range from hyperkeratosis to squamous cell carcinoma.

Answer 19

Leukoplakia

Question 20

Etiologic agent appears to be Epstein-Barr virus in association with HIV, associated with patients with low CD4 counts, white patch seen on the lateral border of the tongue (may be the first oral manifestation of HIV disease), benign lesion

Answer 20

Hairy Leukoplakia

Question 21

Flat, brown lesion. “oral freckle”, seen on lower lip also intraoral, monitor size and changes.

Answer 21

Melanotic Macule

Question 22

Most common pigmented lesion, amalgam particles in soft tissues, refer to radiographic images.

Answer 22

Amalgam Tattoo

Question 23

intraoral sebacceous (oil) glands, small yellow nodules on buccal mucosa and vermilion, seen after puberty.

Answer 23

Fordyce granules

Question 24

Dilated superficial veins

Answer 24

Varicosities

Question 25

Insufficient production of adrenal steroids due to destruction of the adrenal gland, diffuse pigmentation of the skin, melanotic macules on buccal mucosa, gingiva may extend to the tongue and lips, also petechiae are seen on the palate, bronzing, tinted skin.

Answer 25

Addison's Disease

Question 26

Most common tumor of the oral cavity, painless, result of chronic trauma such as cheek biting, smooth, pink, firm elevated nodule (a small node, cluster of cells), TX includes surgical excision.

Answer 26

Irritation/Traumatic Fibroma (New Growth)

Question 27

Caused by human papilloma virus (HPV), pedunculate (stalk-like), warty, soft lesion, cauliflower-like appearance, TX is surgical excision, usually do not recur, on soft palate and uvula/

Answer 27

Papilloma

Question 28

Can cause cutaneous or skin warts (Verruca)

Answer 28

HPV

Question 29

White, papillary exophytic lesion.

Answer 29

Verruca Vulgaris

Question 30

Common vascular lesion, considered developmental due to limited growth potential, tongue is the most common intramural location, when they occur on the tongue macroglossia can result, Girls>Boys.

Answer 30

Hemangioma

Question 31

due to Ill-fitting denture in vestibule along the denture border, dense, fibrous CT, surface is often ulcerated, TX is surgical removal of excess tissue and construction of new denture.

Answer 31

Epulis Fissuratum

Question 32

Form of denture stomatitis, always associated with removable appliance, palatal mucosa is covered w/red papillary projections; granular appearance, no fungal infection.

Answer 32

Papillary Hyperplasia of the palate.

Question 33

commonly occurring intraoral lesion seen as result of injury, usually ulcerated, soft to the touch, bleeds easily, vascular appearance, common on gingiva where plaque or calculus forms. "pregnancy tumor", TX is surgical excision, and may rear if the agent remains.

Answer 33

Pyogenic Granuloma

Question 34

Seen on gingiva or alveolar process (usually anterior to the molars), dark red in color due to numerous blood vessels, more frequently <30 years, Women>men, TX by surgical excision and generally do not recur.

Answer 34

Peripheral Giant Cell GRanuloma

Question 35

Rounded gingival margin, begins in the interdental papilla, increase bulk of attached and free gingiva, may be generalized or localized, caused by local irritants, hormonal changes, certain meds, or hereditary causes.

Answer 35

Gingival Hyperplasia

Question 36

What meds cause Gingival Hyperplasia?

Answer 36

Phenytoin (Dilantin), Calcium Channel Blockers (procardia, nifedipine) for HTN, and cyclosporine for transplant meds.

Question 37

"Pulp Polyp", occurs in teeth w/large, open carious lesions, red or pink nodule of tissue is seen protruding from the pulp chamber, asymptomatic, TX includes endodontic therapy or extraction of the foot.

Answer 37

Chronic Hyperplastic Pulpitis

Question 38

Characteristic skin lesion is the bull's eye (target) lesion that demonstrates circles of erythema and normal skin tones. Oral lesions commonly present as ulcers on the lateral borders of the tongue, or crusted and bleeding lips, hemorrhagic crusting.

Answer 38

Erythema Multiforme

Question 39

Most severe from of erythema multiform, two mucosal surfaces involved (genital mucosa and mucosa of the eyes may be involved).

Answer 39

Stevens-Johnson Syndrome

Question 40

Benign, chronic disease that affects the skin and oral mucosa, lace-like white lines, commonly seen on the buccal mucosa, The slender fine lines are termed Wickham's strain, cause is unknown, erosive lesions increase with stress.

Answer 40

Lichen Planus

Question 41

Chronic, progressive w/periods of remission in between, most common lesion is the "butterfly" rash over the nose, diagnosis is based on multi-organ involvement, TX include ASA and NSAIDs.

Answer 41

Lupus

Question 42

Ulcerated lesion due to trauma and healing usually lasts 7-14 days unless the trauma persists.

Answer 42

Traumatic Ulcer

Question 43

Painful, recurring ulcers, only on movable mucosa o0f the oral cavity (the mucosa not covering bone), minor, major, or herpetiform (Clusters), caused by trauma, emotional stress, or certain foods, non-keratinized mucosa includes the tongue, soft palate, floor of mouth, buccal and lingual mucosa.

Answer 43

Aphthous Ulcer

Question 44

What does HSV Type 1 cause?

Answer 44

Oral Infections

Question 45

What does HSV Type 2 Cause?

Answer 45

Genital infections

Question 46

Initial infection, characterized by painful, erythematous, swollen gingiva and multiple tiny vesicles that progress into ulcers, commonly seen in children under age 6, lesions heal in 1-2 weeks.

Answer 46

Primary Herpetic Gingivostomatitis

Question 47

What's the typical route of HSV?

Answer 47

Physical contact with an infected person.

Question 48

Why does HSV recur?

Answer 48

It persists in a latent stage, found in the trigeminal ganglion.

Question 49

What is the most common type of recurrent oral herpes?

Answer 49

Herpes Labials that occurs on the vermilion border of the lips, often referred to as a "cold sore" or "fever blister". Also seen intraorally on keratinized mucosa fixed to bone such as the hard palate or gingiva; "bound-down mucosa".

Question 50

How is recurrent HSV treated?

Answer 50

Antiviral drugs such as acyclovir

Question 51

Painful infection of the fingers, primary or recurrent infection, may last 4-6 weeks.

Answer 51

Herpetic Whitlow

Question 52

Caused by the coxsackie virus, seen on the soft palate, usually accompanied by fever, malaise, and flu-like symptoms, resolves w/o treatment

Answer 52

Herpangina

Question 53

Caused by the coxsackie virus, seen in young children, ulcerative vesicles, merciless typically appear on feet, toes, hands and fingers as well, TX not required.

Answer 53

Hands-Foot-Mouth Disease

Question 54

Infectious Mononucleosis

Answer 54

Caused by Epstein-Barr Virus, palatal petechiae is a oral manifestation, transmitted by kissing and contact with saliva. Clinical symptoms include sore throat, fever, lymphadenopathy, and fatigue.

Question 55

Varicella-Zoster Infections

Answer 55

Caused by varicella zoster virus, transmission is via inhalation of contaminated droplets, very contagious virus.

Question 56

What are the primary and secondary Varicella Zoster Infections?

Answer 56

Primary is varicella or chickenpox | Secondary is herpes zoster or shingles

Question 57

Torus (Tori)

Answer 57

Bony RO mass seen on the lingual surface of mandible and in the midline of the hard palate.

Question 58

Exostoses

Answer 58

Bony protuberance on facial and buccal surfaces of the jaw.

Question 59

Odontoma

Answer 59

Most common odontogenic tumor, TX is excision

Question 60

Periapical Cemental Dysplasia (Cementoma)

Answer 60

Middle age, african american females, seen at apex of vital teeth, usually mandibular anterior, No TX required.

Question 61

Common in middle age, african american females, dense sclerotic masses of bone or cementum can be seen in all four quadrants

Answer 61

Florid Osseous Dysplasia (Florid cemento-osseous dysplasia)

Question 62

Common in men older than 50, enlargement of the bone and spaces between the teeth are seen, cotton-wool radiopacities.

Answer 62

Paget's Disease (Osteitis deformans)

Question 63

Common in men older than 60, originates in bone marrow, fatal, symptoms are anemia, painful bone lesions, "punched out" radiolucencies in the jaw.

Answer 63

Multiple Myeloma

Question 64

Cyst

Answer 64

Epithelial-lined cavity or sac often filled with straw-colored fluid.

Question 65

Odontogenic Cyst

Answer 65

Cyst in which the lining of the lumen is derived from epithelium produced during tooth development.

Question 66

Seen at apex of a necrotic tooth, well-defined funicular radiolucency, asymptomatic, most common cysts of the jaws, tooth needs extracted or endodontic TX

Answer 66

Radicular Cyst (Periapical cyst)

Question 67

Residual Cyst

Answer 67

Radicular cyst that was "left behind" and TX is removal of cyst.

Question 68

Intraosseous

Answer 68

Within bone, central

Question 69

Extraosseous

Answer 69

In soft tissue, peripheral

Question 70

Primordial Cyst

Answer 70

Occurs in place of a tooth.

Question 71

Dentigerous Cyst (Follicular cyst)

Answer 71

Around the crown of an impacted or unerupted tooth, commonly seen w/mandibular 3rd molars and max. canines, 2nd to 3rd decade of life, halo appearance around tooth radiographically, TX is removal of tooth and enucleation.

Question 72

Odontogenic Keratocyst (OKC)

Answer 72

Uniocular OR multiocular radiolucency, high recurrence rate, benign but aggressive behavior, can move teeth and cause resorption, and 3rd molars.

Question 73

Common location is between the roots of mandibular premolars, cannot probe this area, males>females.

Answer 73

Lateral periodontal cyst

Question 74

Seen between maxillary lateral incisor and canine, causing divergence of the roots, inverted pear shape radiographically.

Answer 74

Globulomaxillary cyst

Question 75

Oval radiolucency in the midline of the anterior maxilla, "heart-shaped" due to presence of anterior nasal spine, asymptomatic, TX is surgical enucleation

Answer 75

Nasopalatine duct cyst (incisive canal cyst)

Question 76

Nasolacrimal Cyst (Nasolabial Cyst)

Answer 76

Often lifts the ala of the nose, see swelling over the maxillary canine region.

Question 77

Calcifying Odontogenic Cyst (Gorlin Cyst)

Answer 77

Goblet Cells

Question 78

Mucocele

Answer 78

Lower lip most common site, bluish-pink fluid-filled nodule, common in adolescents and children, TX is excision.

Question 79

Ranula

Answer 79

"Mucocele of the floor of the mouth", caused by obstruction of Wharton's duct, bluish appearance compared to a frog's belly.

Question 80

Sialolithiasis

Answer 80

Salivary stones, wharton's duct is the most common site.

Question 81

Benign Mixed Tumor (Pleomorphic Adenoma)

Answer 81

Most common tumor of the salivary glands, Parotid gland most common location, Most common intramural site is the posterior hard palate, TX surgical excision.

Question 82

Submandibular salivary gland depression (Stafne's Bone Cyst, Static Bone Cyst)

Answer 82

Seen below the inferior alveolar canal toward the mandibular angle, ovoid radiolucency, no TX.

Question 83

Autoimmune disorder in which the immune cells attack the exocrine system, dry mouth, dry eyes, halitosis, so of tongue papillae, increased caries, periodontal disease, and calculus.

Answer 83

Sjogren's Syndrome

Question 84

Etiology is meds, radiation TX, aging and the peak age is 50 and 90% of cases are women.

Answer 84

Xerostomia

Question 85

Actinic Keratosis

Answer 85

Pre-malignant skin lesion that may transform into squamous cell carcinoma, commonly seen on sun-exposed skin, scaly plaques.

Question 86

Actinic Cheilitis

Answer 86

Pre-malignant lesion of the lower lip, crusted, red, white, ulcerated, glossy, pale, hard to differentiate lip border.

Question 87

Squamous cell carcinoma

Answer 87

Most common form of oral cancer, malignant tumor of squamous epithelium, white plaque (leukoplakia) then become an exophytic ulcerative mass-be suspicious of a red and white lesion; indurated lesion (hardened), seen on lateral border of the tongue and floor of the mouth. Do not recommend an alcohol mouth wash for patient's with oral cancer.

Question 88

Gemination

Answer 88

Two teeth or two crowns within a single root, tooth count is normal.

Question 89

Fusion

Answer 89

Joining of 2 developing tooth germs resulting in a single, large tooth. Tooth count is one tooth less than normal.

Question 90

Concrescence

Answer 90

Teeth joined by cementum only, common in maxillary second and third molars.

Question 91

Dilaceration

Answer 91

Bend in a tooth (root or crown)

Question 92

Dens in Dente (dens invaginatus)

Answer 92

"tooth within a tooth", most common in maxillary lateral incisor, accentuation of the lingual pit, may be bilateral.

Question 93

Large pulp chamber, furcation more apical, elongated crown, people with down's syndrome, and "bulls tooth"

Answer 93

Taurodontism

Question 94

Seen on the bifurcation or trifurcation areas, problem in cases of periodontal disease.

Answer 94

Enamel Pearls (Ectopic enamel)

Question 95

Physiologic wearing of teeth, tooth-to-toothcontact, bruxism is a pathologic form of attrition.

Answer 95

Attrition

Question 96

Pathologic wearing of teeth, examples; pipe smokers or aggressive tooth brushing.

Answer 96

Abrasion

Question 97

Seen in adults, wedge-shaped lesions at cervical areas of teeth.

Answer 97

Abfraction

Question 98

Loss of tooth structure from a chemical process, shiny, glossy look results from vomiting, bulimia, acidic foods, and patients w/GERD

Answer 98

Erosion

Question 99

Small teeth, maxillary lateral incisor is most common "peg lateral"

Answer 99

Microdontia

Question 100

large teeth

Answer 100

Macrodontia

Question 101

Space between two adjacent teeth, due to high frenum attachment and muscle pull

Answer 101

Diastema

Question 102

Complete absence of teeth

Answer 102

Anodontia

Question 103

A syndrome where complete anodontia may be seen, partial anodontia is more typical w/conical-shaped teeth.

Answer 103

Ectodermal Dysplasia

Question 104

Extra teeth in the dentition; hyperdontia, mesiodens is most common followed by maxillary molar area.

Answer 104

Supernumerary Teeth

Question 105

Endogenous stain, instead during tooth development, can be fluorescent to yellow, gray or brown.

Answer 105

Tetracycline Staining

Question 106

Amelogenesis Imperfecta

Answer 106

Hereditary disorder of enamel formation, see enamel hypoplasia, pits, grooves, soft enamel, teeth can darken or be discolored.

Question 107

Dentinogenesis Imperfecta

Answer 107

Heriditary disorder of dentin, discoloration of teeth gives the name opalescent dentin, enamel is structurally normal but fractures easily due to poor dentinal support, radiographically see obliterated pulp chambers and crowns.

Question 108

Internal Resorption

Answer 108

Result of pulpal injury, or no apparent cause. Teeth may appear pink due to proximity of the pulp to the surface and the pulp becomes enlarged, TX is endodontic therapy.

Question 109

Systemic hypoplasia of teeth.

Answer 109

Syphilis infection affects the permanent incisors and first molars: Hutchinson's incisors (Screw Driver) and Mulberry molars (Many cusps). Levels of fluoride > 1 ppm during crown formation may result in fluorosis.

Question 110

Local hypoplasia of teeth.

Answer 110

Resulting hypoplastic or hypocalcified permanent tooth is Turner's tooth. The absence of ameloblasts during development.