Soft tissue lesions Flashcards
(25 cards)
list developmental oral cyst of newborn
and management
(congenital)
Keratin: bohn nodules, epstein pearls, dental lamina cyst
blood: eruption cyst
management: clinical diagnosis and leave alone cept eruption cyst
location and origin of Bohn nodules
junction of hard and soft palate or on vestibular region (rare)
origin epithelial remnants of minor salivary glands
location and origin of epstein pearls
mid palate raphae
origin epithelium entrapment between palatal shelves
location and origin of dental lamina cysts
crest of alveolar ridge
odontogenic origin from cell rest of serres
appearance, location and origin of eruption cyst
soft, fluctuant sessile, dome shaped, translucent bluish colour
alveolar ridge
soft tissue variant of dentigerous cyst, from separation of reduced enamel epithelium from crown of tooth
treatment: naturally marsupializes as tooth erupts, symptomatic treatment of simple removal of roof of cyst (trauma and pressure causes discomfort)
what is ankyloglossia and effects
developmental: abnormally short anteriorly positioned lingual frenum that may result in restricted movement
effects: breast feeding difficulties, restriction of tongue movement
gingival recession in severe cases, speech and malocclusion
treatment for ankyloglossia
congenital
if breast feeding problems (<1month) frenotomy/frenolotomy (cut), frenectomy (tissue removed and more advanced surgical techniques)
internvene when: gingival stripping, recession, fremitus, tongue mobility with functional impairment (speech: sibilant sounds), diastema after perm canine eruption (mixed dentition)
poorly supported: malocclusion
vascular anomalities: tumours vs anomalities
congenital
tumours: endothelial proliferation (growth)
appears 1-3 months and high rate proliferates then involutes, F>M
malformations: structural problems, present at birth and only grows with child’s age, does not involute, (trauma, puberty, pregnancy can accelerate growth), no gender predilection
vascular tumour: infantile hemangioma
prevalence, characteristics and diagnosis and management
early infancy 1-3 months, F>M, predilection for head and neck region
clinical presentation: rapid growth and proliferation, benign, self limiting involution over time, may cause complications
management: depending on location
if in eyes/bone/tongue/brain/crucial areas will have compressive issues
different from congenital hemangioma clinically and histologically
vascular malformation classification and examples, syndromes
low flow: capillary, venous, lymphatic (lymphangioma)
high flow: ateriovenous malformation (arteries join to vein wo capillary, expansion of venous base)
combined
no gender predilection
sturge-weber (capillary)
lymphangioma
definition
prevalence
clinical presentation
def: bilated malformed lymphatic channels or cysts of varying size
prev: 50% at brith, 90% diagnosed by 2
pres: microcytic form, tongue most common, buccal mucosa second most, intraosseous (cystic hygromahard to take out)
congenital epulis definition prevalence clinical presentation histology (congenital)
congenital granular cell tumour
pre: 0.0006% of newborns, 8-10 more common in females
pres: single, firm, smooth, sessile or pedunculated round mucosal coloured mass <2cm around anterior maxillary alveolar ridge
management: diagnosis clinical and histological
granular cell tumour with no display of strong reactivity to S100 protein
surgical excision, recurrence unlikely
primary herpetic gingivostomatitis
presentation and management
majority subclinical incubation 5-7 days prodrome 1-2 days vesiculation and ulceration symptoms reduce from 6th day resolves in 10-14 days around
mxn: symptoomatic care, anti-pyretic analgesic, fluids, 0.2% chlorhex, acyclovir within 72hr of infection for immunocompromised
reactivation of HSV
appears on keratinised tissue only: attached gingiva, vermillion border of lips
HPV types and management
6/11 most common
16/18 cause scc/cervical cancer
orals: squamous papilloma, verruca vulgaris, condyloma acuminatum (assoc sexual abuse), heck’s disease (Focal Epithelial Hyperplasia, is an asymptomatic, benign, precancerous? neoplastic condition characterized by multiple white to pinkish papules)
mxn: excisional biopsy except for heck disease
squamous papilloma vs verruca vulgaris
sp more keratinised, whiter
superficial fungal inf in children and management
pseudomembranous candidiasis
angular cheilitis
median rhomboid glossitis
mxn: anti fungals: nystatin, clotrimazole
proper oral hygiene
wash utensils and store in antiseptic solution
identify underlying causes
linea alba
prev
pres
mxn
<20s, no gender predilection
white smooth to shaggy line, bilateral coincides with place of occlusion
mxn: remove irritation if possible
mucocele
<20s, no gender predilection
pres: lower labial mucosa, buccal mucosa, ventral tongue, localised, compressible, fluid filled nodule with smooth translucent to blue surface, fluctuate in size, may be tender, may be nodular if chronic
mxn: excisional biopsy
recurrent apthae ulceration prev etio pres mxn
<20
F>M
etio: immune mediated, stress, trauma, allergies, nutrition, genetic
pres:
minor- 1-5 lesions, fewest recurrences, shortest duration
major- 1-10 lesions, longest duration, larger and deeper onset after puberty
herpetiform- most frequent recurrence, ~100 ulcers, F>M, onset in adulthood
geographic tongue
benign chronic recurring inflammatory condition
many well demarcated areas of erythema red centre white border atrophic filiform papilla on dorsum of tongue
mxn: no treatment needed, avoid spicy food if its a trigger
erythema multiforme
etio
pres
mxn
type III hypersensitivity
etio: immune mediated triggered by preceding infection of HSV/mycoplasma pneumonia, drugs
pres: blistering ulcerative mucocutaneous condition, acute onset prodromal common 1 weeks before onset, 2-6 weeks self limiting, recurrent in 20% of patients, oral lesions start as erythematous patch, large shallow erosions and ulcerations with irregular borders
mxn: steroids + antiviral prophylaxis (if people get it multiple times a year)
4Ps of lumps and bumbs
pyogenic granuloma, peripheral giant cell fibroma, peripheral ossifying fibroma (calcification), peripheral fibroma
gingival enlargement
reactive
developmental
systemic
drugs: cyclosporin, calcium channel blocker, phenytoin
