Butterfly rash on face
Systemic Lupus Erythematosous (SLE)
Maxillary sinus infection, valveless veins
Cavernous sinus infection
Sub-mandibular infection
Ludwig’s angina
External ear changes
Treacher Collins
Strawberry tongue
Scarlet Fever
Yellow papules (sebaceous glands under mucosa)
Fordyce granules
Malformation of tooth structure due to trauma during tooth formation
Turner Tooth
Intrinsic staining of tooth can be caused by…
Tetracycline use
Ulceration on movable mucosa, white w/ red ring
Recurrent Aphthous Ulcer
deep epithelial, desmisomes, basal membrane separation, + Nikolsky sign, fluorescence
Pemphigoid (BMMP)
Super-epithelial, + Nikolsky sign, IgG, fluoresence
Pemphigus Vulgaris
Veneral wart, HPV
Condyloma Acuminatum
White, wipeable, red underneath
Candidiasis (pseudo-membranous), thrush
median rhomboid glossitis, attrophy of filiform papilli, dorsum of tongue, under dentures
Candidiasis (chronic)
Trigeminal ganglion, lip, skin, vesicles, non-moveble hard palate /gingiva, cluster, trigger event
Recurrent Herpes Simplex
Chronic trauma, nerve with scar tissue, firm lump
Traumatic Neuroma
Like pyogenic, Mand 1st molar, multi-nucleated giant cells
Peripheral Giant Cell Granuloma (PGCG)
Anterior Mandible. Intra-bony, multi-nucleated giant cells. Soap-bubble expansion. Root destruction common.
Central Giant Cell Granuloma (CGCG)
White, epithelium, *CAULIFLOWER, elevated, gingiva, palate and tongue
Squamous papilloma
Reactive hyperplasia from trauma, connective tissue
Fibroma
Granular cytoplasm, dorsum of tongue, like SCC
Granular cell tomor
White patch, non-wipeable, pre-malignant
Leukoplakia
Red or red/white patch, non-wipeable, pre-malignant
Erythroplakia
Actinic cheilitis precedes, border of tongue, floor of mouth is much worse
Squamous cell carcinoma
Posterior mandible, poorly defined w/ sclerotic border
Metastatic disease of the jaw
upper lip nodule, not a mucocele, aka cananlicular
Monomorphic adenoma
Cell edema, African, bi-lateral buccal mucosa, disappears when tugged
Leukoedema
Red, swollen, hyperplastic gingiva; bleeds, purpura, LOW Neutrophils
Leukemia
Most Common salivary gland tumor, palate, pre-neoplasm
Pleomorphic Adenoma
Perineural invasion of the parotid gland
Adenoid Cystic Carcinoma
Located between roots of mandibular pre-molars, epithelial lining
Lateral Periodontal cyst
Posterior mandible most common location, odontogenic, multilocular (soap bubble), columnar cell rev. polarized. Age 20-40.
Ameloblastoma
Posterior Mandible, < 20 y/o, non-odontoma, pure lucency, not aggressive
Ameloblastic fibroma
Benign tumor of odontogenic origin, composed of normal dental tissue that has grown in an irregular way.
Compound: toothless in anterior maxilla.
Complex: large unidentifiable mass in posterior mandible
Odontoma
Anterior maxilla, *SNOWFLAKE calcifications around crown
Adenomatoid Odontogenic Tumor (AOT)
Lacks enamel, discolored, mottled
Picket fence appearance
Amelogenesis Imperfecta
*OPALESCENT DENTIN (blue-gray) Blue scera NO PULP Cervical constriction (golf ball on a T) bone fractures
Dentinogenisis Imperfecta
Bi-lateral jaw expansion, puffy cheeks and radiolucencies
Cherubism
*GROUND GLASS , early onset and stops growing by 20 y/o. Painless, unilateral
CAFE AU LAIT (McCune Albright)
Fibrous dysplasia
Chronic inflammation of a non-vital tooth, separate from root
Condensing Osteitis
Radiopacity in lucent rim of vital tooth
Idiopathic Osteosclerosis
Radiolucency w/ scalloping around and between roots
Traumatic bone cyst
*Cotton Wool appearance, 40+ males, generalized hypercementosis, enlargement of jaw ridges. #high risk of osteosarcoma
Paget’s Disease of Bone
Triad: DM, Exopthalmos, bone lesion; *FLOATING TOOTH
Langerhans Cell Disease
Enlargement of canal/formina
Schwannoma/Neurofibroma
Maxillary anterior radiolucency, adjacent to lateral, soft tissue
Nasolabial Cyst
Ventral tongue, pale/yellow
Lymphoepithelial Cyst
*HIGH Recurrence, multilocular, basal cell nevus, similar to ameloblastoma
Odontogenic Keratocyst (OKC)
OKC’s, Gorlin complex, bifid rib, BCC, falx cerebri calcification
Nevoid Basal Cell Carcinoma
Linea alba, rough-white
Morsicatio Buccarum (cheek bite)
Multiple osteomas, hyperdontia, colon polyps
Gardner Syndrome
CN VII, unilateral facial paralysis
Bell’s palsy
*TARGET/bulls-eye lesion, drug/viral
Erythema Multiforme
Red lesions everywhere (eye, mouth, genitalia)
Steven Johnson Syndrome (EM-severe)
Skin tightening, PDL widening
Progressive Systemic Sclerosis or Scleroderma
Red-flat depapillated areas on tongue w/ with borders, moves around
Migratory glossitis or Geographic tongue
White lesion, coagulative surface necrosis, somewhat wipeable
Aspirin burn
Upper lip, non-metastasizing, raised margins
Basal Cell Carcinoma
Trauma to salivary ducts, swelling
Mucocele
*Frog’s belly, recurrence, large mucocele in floor of the mouth filled w/ mucin
Ranula
Slight radiopacity, dome shape in maxillary sinus
Antral pseudocyst
Posterior mandible, 3rd molars, can become
ameloblastoma, radiolucency attached to CEJ of unerrupted tooth
Dentigerous cyst
Abnormally dilated vessel with a tortuous course, if calcified = phlebolith
Varix or varices
Draining fistula (sinus tract)
Parulis (gum boil)
elongation of the stylohyoid ligament, causes pain on yawning
Eagle syndrome
Unilateral crop of vesicles
Shingles (Herpes Zoster)
Multiple ulcerations, inflammation of gingiva, vesicles
Acute Gingivostomatitis (Primary herpes)
Granulomatous gingiva, intestinal “skip” lesions
Crohn’s Disease
Well-circumscribed,*Doughy soft tissue, often in floor of the mouth, sub-mandibular and sublingual areas, mid-line distribution
Dermoid/Epidermoid Cysts
*Heart shaped radiolucency between maxillary central incisors
Incisive Canal Cyst
Bilateral white rough surface, thickening of buccal mucosa, Mutation of Keratin 4 and 13 genes
White Sponge Nevus
Severe facial and neck pain, Trigger point pain
Trigeminal Neuralgia, or Tic douloureux
Intense pain for 1 week, unilateral, forehead/eye area
Neuritis
Crusty lesion found on vermilion border, corner of the mouth and lower lip, pre-SCC
Actinic Cheilitis
Hypertrophy of filiform papilla, Smokers, HIV and Epstein-Barr virus
Hairy Leukoplakia
Multi focal radiolucency of vital teeth, *Middle-aged, Black women, anterior mandible. Turn opaque with time
Periapical Cemento-osseous Dysplasia (PCOD)
Black women, Multi-quad, fibro-osseos lesions, secondary osteomylitits
Florid Cemento-osseous Dysplasia (FCOD)
*Wickam striae, noon-wipeable, white papules, can be errosive
Lichen planus
Exclusively on gingiva, Nodular mass that protrudes from inter-dental papilla, maxillary anterior
Peripheral Ossifying Fibroma
Unerrupted supernumerary teeth, retained primary, no clavicles, slow erupt
Cleidocranial Dysplasia
Multiple nodules (esp on tongue) cafe au lait pigment
Neurofibromatosis, or Von-Reckinghausen
*Ghost cells (no neucleus)
Calcifying Odontogenic Cyst (Gorlin’s)
Minor salivary glands are red, hard palate, pipe smokers
Nicotine Stomatitis
After parotid surgery, sweating of face prior to eating
Frey Syndrome or Auriculotemporal Syndrome
Extra-oral tissue swelling w/ fistula, *woody consistency, *sulfur granules
Actinomycosis
Patchy, ragged, ill-defined radiolucencies w/ surrounding radiodensity
Chronic Osteomyelitis
Elongated condyle, chin deviation away from this side
Condylar Hyperplasia
PARL from inflammatory disease, non-vital tooth
Perapical Cyst or Granuloma
Type I = rootless/pulp-less, apical radiolucency
Dentin Dysplasia
Hypodontia (anodontia), skin/hair issues, heat intolerance
Ectodermal dysplasia
Hyperplastic tissue from an ill-fitting denture
Epulis Fissuratum
Blue line (lead line) along gingiva
Heavy metal intoxification
red/blue nodule that blanches with pressure
Hemangioma
Lymph-filled, cause of macroglossia
Lypmphangioma
Seen in Paget’s Disease and Acromegaly, attached to root surface w/ intact PDL, often a result of occlusal trauma
Hypercementosis
Cervical swelling, palatal petechiae, Epstein-Barr, sore throat
Infectious Mononucleosis
Malignant soft tissue tumor, Blue/purple lesions on skin and mucosa, associated with immunocompromised patients such as HIV/AIDS and HHV 8
Kaposi’s sarcoma
Sun-exposure, Raise lesion w/ keratin plug in center, forms over weeks to months then spontaneously resolves in 4-6 months
Keratocanthoma
Well demarcated radiolucency near angle of mandible, BELOW IA Canal
Staphne Defect
Parotid swelling, xerostomia, associated w/ SLE and RA
Sjogren’s Syndrome
Parotid swelling tumor
Oncocytoma
Bilateral hilar lymphadenopathy (chest x-ray) skin lesions
Sarcoidosis
*Onion skin, posterior mandible
Proliferative Periostitis
Also *onion skin, white males 5-25 y/o
Ewing’s Sarcoma
Multiple pigmented (melanotic) macules (lips, tongue, buccal mucosa), intestinal polyps
Peutz-Jeghers Syndrome
2nd most common malignant neoplasm of bone, *Sunburst appearance, painful swelling, loose teeth, parasthesia, aggressive expansion
Osteosarcoma
Multiple radiographic *PUNCHED OUT lesions, elderly, Bence-Jones, bone pain
Multiple Myeloma
Deep ulcerations on palate, self resolving
Necrotizing Sialometaplasia
*SOAP BUBBLE radiolucency, multi-loculated, honeycomb-like. <30 y/o
Odontogenic myxoma
Smooth swelling next to maxillary lateral incisors. Soft tissue only, no bone involvement
Nasolabial cyst
*Ground glass bone, loss of laminate dura, brown tumor of bone. Painful bones Abdominal groans Renal stones Psychotic moans
Hyperparathyroidism
Deformed ears and hearing loss Fissure of lower eyelid Downward sloping palpebral fissures Hypoplasia of Mandible “Bird face”
Treachery Collins Syndrome
Type I: radicular, rootless teeth, pulpal obliteration, tooth mobility
Type II: enlarged thistle-tube shaped pulp chambers
Dentin Dysplasia
