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Oral Pathology > Reactive Lesions Of Oral Mucosa > Flashcards

Reactive Lesions Of Oral Mucosa Flashcards

1
Q

Layers of Oral Mucosa

A
  • stratified squamous epithelium
  • lamina propria
  • gross types: lining, masticatory, gustatory
  • microscopic: keratinised and non- keratinised
  • Keratinised: orthokeratosis/ parakeratosis
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2
Q

What is orthokeratosis

A

thickening of the keratin layer with preserved keratinocyte maturation

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3
Q

What is parakeratosis

A

retained nuclei as a sign of delayed maturation of keratinocytes

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4
Q

Histology of cheek

A

non- keratinised

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5
Q

Histology of palate

A
  • keratinised
  • cells that produce large amounts of a protein called keratin, making them strong and better at forming barriers
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6
Q

Strata and Compartments

A

cell division in basal and suprabasal cells

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7
Q

Reactions of oral epithelium

A
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8
Q

What is acanthosis?

A
  • thickening of the epidermis and elongation of the rete ridges due to thickening of the spinous layer +/- enlargement of rete pegs
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9
Q

What is keratosis?

A
  • a growth of keratin on the skin or on mucous membranes stemming from keratinocytes, the prominent cell type in the epidermis
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10
Q

Epithelial reactions

A
  1. atrophy: reduction in viable layers
  2. erosion: partial thickness loss
  3. ulceration: full thickness loss with fibrin on surface
  4. oedema- intracellular and intercellular (spongiosis)
  5. blister - vesicle or bulla
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11
Q

Epithelial reactions on cheek

A
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12
Q

Dysplasia

A
  • disordered maturation/ growth in tissue

atypia: describes changes in cells

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13
Q

What causes dysplasia?

A
  • age: progressive atrophy
  • nutrition deficiency: Iron, Vit B12, Folate atrophy

** predisposes to infection

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14
Q

How does oral mucosa react to trauma?

A

Depends on:
- irritation
- time
- person

Reactions may be in form of
- inflammation
- keratosis
- ulceration
- fibrous tissue formation
- vesicles and bullae

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15
Q

What is fibrous lesions?

A
  • known as fibrous overgrowth
  • true benign fibroma rare in oral cavity
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16
Q

What is Epulides?

A
  • soft tissues swellings only on gingiva
  • reaction to chronic inflammation/ trauma
  • can reoccur after removal if stimulus persist
  • may have odontogenic tumours and cysts present
  • describe lesions as peripheral (meaning originates from gingiva not jaw bone)
  • benign tumours may present
17
Q

Fibrous overgrowths

A
  • localised gingival hyperplasia
  • fibrous epulis
  1. clinical presentation
  2. aetiology
  3. histology
  4. recurrence
18
Q

Histology of fibrous overgrowth

A
19
Q

Vascular epulis

A
  • also known as pyogenic granuloma
  • lobular capillary hemangioma is a form of epulide which is marked by an inflammatory infiltrate rich of blood vessels
20
Q

Pyogenic Granuloma

A
  • granulation tissue
  • any mucosal site
  • response to trauma

** on gingiva - vascular epulis (most frequent)
** on gingiva during pregnancy - pregnancy epulis

21
Q

Giant cell lesions

A
  • if on gingiva/ alveolus = epulis
    1. check clinical presentation
    2. histology
    3. recurrence

Peripheral giant cell granuloma
- central lesion in bone

22
Q

Giant cell epulis

A
23
Q

Why called Giant cell lesions?

A
  • encountered in the head and neck region, particularly within the jaw bones
  • fused macrophages
24
Q

Causes of Giant cell lesions?

A
  • unphagocytosable material
  • local chronic irritation
  • infective agents, ie: TB bacillus
  • hormonal stimulation of cells, ie: osteoclast
  • autoimmune sarcoidosis
25
Q

What to exclude for GCL?

A
  • any systemic disease
    1. raised parathyroid hormone
    2. low Vit D diet
    3. malabsorption
    4. renal disease
26
Q

Reactive hyperplastic lesions

A
  • traumatic fibroma
  • also known as fibroepithelial polyp
  • other sites are cheek, lip and tongue
27
Q

Photos of Fibroepithelial polyp

A
28
Q

Fibrous overgrowths and dentures

A
  • denture induced hyperplasia
  • “leaf fibroma”
  • papillary hyperplasia of palate
  • pseudo-epitheliomatous hyperplasia
  • candida infection
29
Q

Pseudo-epitheliomatous hyperplasia

A
30
Q

Papillary hyperplasia of palate

A
  • associated with upper denture use
  • candidal infection may be present
31
Q

Drug induced fibrous overgrowth

A
  1. anti-hypertensives - calcium channel blockers
  2. anti-epileptics - phenytoin
  3. immunosuppresants - cyclosporin

** may need repeated gingivectomy

32
Q

Pregnancy gingivitis

A
  • hormonal
  • due to increased progesterone levels
  • possible with OCP
  • not seen in HRT
  • poor oral hygiene with exagerrated plaque responses
33
Q

Vascular lesions

A
  • haemangioma present at brith
  • sturge weber syndrome
  • vascular malformation becomes evident in adult life

Microscopically 2 types
1. cavernous
2. capillary

34
Q

Carvenous vs Capillary vascular lesions

A

Oral Pathology (3 decks)

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