Gih Week 1: Teeth And Oral Cavity Holliman

Front 1

Conditions that injure the ameloblasts during tooth development or interfere with calcification of the enamel matrix can lead to what tooth disorder?

What are some signs of this condition?

Back 1

Enamel hypoplasia

Signs:
1. Crown of tooth shows pitting
2. Tooth discoloration (yellow --> dark brown)
3. Dental caries

Front 2

An autosomal dominant disorder in which the odontoblasts produce a dentin matrix which does not calcify normally.

Back 2

Dentinogenesis imperfecta

Front 3

Which tooth disorder produces a characteristic translucent sheen to the teeth?

Back 3

Dentinogenesis Imperfecta
(Hereditary Opalescent Dentin)

Front 4

Why does Dentinogenesis imperfecta cause teeth to become stubby and flat?

Back 4

The dentin matrix does not calcify properly. It tends to obliterate the pulp chambers and does not adhere well to the overlying enamel.
The enamel chips off easily and the exposed dentin wears down readily--> stubby, flattened teeth

Front 5

These represent heterotropic sebaceous glands which appear as multiple, small, yellow-white nodules on oral mucosa.

Back 5

Fordyce granules/spots

(*Present in 80% population)

Front 6

Disorder characterized by a reddened, midline, rhomboid-shaped area on the dorsum of the tongue.

Back 6

Median Rhomboid Glossitis

Front 7

Today, Median rhomboid glossitis is thought to be caused by what?

Back 7

Chronic candidiasis of the tongue

(*Etiology is under debate)

Front 8

Disorder characterized by deep clefts of rissues on the dorsum of the tongue.

Back 8

Scrotal (Fissured) tongue

Front 9

How should you treat Fordyce granules/spots?

Back 9

Don't! They do not require treatment.
*Nonfunctional and asymptomatic

Front 10

What kind of problems can result from a Scrotal tongue?

Back 10

Food, candida, and bacteria may accumulate in the depths of the grooves.
Halitosis (bad breath) may be a problem

Front 11

Disorder characterized by the appearance of multiple patches of desquamation of the filiform papillae on the dorsum of the tongue in an irregular circinate pattern.

Back 11

Benign migratory glossitis
(Erythema migrans, Geographic tongue)

Front 12

Which type of tongue papillae are lost in benign migratory glossitis?

Back 12

Filiform papillae are lost
Fungiform papillae remain

*These areas heal quickly but may reappear in a different location

Front 13

What type of treatment is required for Benign migratory glossitis?

Back 13

No treatment is required
(generally asymptomatic)

Front 14

What condition results from hyperkeratinization of the filiform papillae?

Why does this usually occur?

Back 14

Hairy tongue

Usually develops after some type of alteration in the oral environment (too much mouthwash, xerostomia)

Front 15

Benign exostosis of the bone of the hard palate or mandible.

During what age do these generally appear?

Back 15

Torus

*usually appear in the late teenage years as a midline palatal lesion and/or on the lingual side of the mandibular alveolar ridge

Front 16

True cysts that derive from abnormal fusion of bones or from abnormal persistence of embryologic structures.

Back 16

Developmental cysts

Front 17

List 3 types of developmental cysts.

Back 17

1. Incisive canal cyst (nasopalatine duct cyst)
2. Median palatal cyst
3. Globulomaxillary cyst

Front 18

Cyst that originates from epithelial remnants of the nasopalatine duct and is a heart-shaped midline lesion of the maxilla between the roots of the central incisors.

Back 18

Incisive canal cyst
(Nasopalatine duct cyst)

Front 19

What type of epithelium may line an incisive canal cyst?

Back 19

1. Respiratory epithelium (cuboidal or pseudostratified columnar)
2. Oral epithelium (stratified squamous)

Front 20

Cyst that arises in the midline of the hard palate from epithelial rests trapped along the fusion line.

Back 20

Median palatal cyst

Front 21

Where do Globulomaxillary cysts develop?

Back 21

Lateral maxilla, usually b/w the roots of the lateral incisors and the canine teeth.

Front 22

What type of epithelium lines median palatal cysts?

Back 22

Squamous epithelium

Front 23

What type of epithelium lines globulomaxillary cysts?

Back 23

Squamous epithelium

Front 24

Cysts that develop from epithelium associated with the development of teeth.

Back 24

Odontogenic cysts

Front 25

List 2 types of odontogenic cysts.

Back 25

1. Dentigerous (follicular) cyst
2. Odontogenic keratocyst (OKC)

Front 26

What type of epithelium do dentigerous (follicular) cysts develop from?

Back 26

Enamel epithelium (after the crown of the tooth has formed)

Front 27

Cyst that is associated with the crown of a developed, but unerupted tooth.

Back 27

Dentigerous (follicular) cyst

Front 28

What type of developments may complicant dentigerous (follicular) cysts?

Back 28

1. Ameoblastoma
2. Squamous cell carcinoma

(may develop from the lining of the epithelium)

Front 29

Generic name for locally aggressive odontogenic cysts arising from prefunctional remnants of the dental lamina.

Back 29

Odontogenic keratocyst (OKC)

Front 30

Which cysts can be associated with the inherited nevoid basal cell carcinoma syndrome in which multiple basal cell carcinomas develop early in life?

Back 30

Odontogenic keratocyst (OKC)

Front 31

What type of oral cysts are especially noted for the high rate of recurrence?

Back 31

Odontogenic keratocysts

Front 32

At what age do odontogenic keratocysts generally occur?

Which oral surface is primarily involved?

Back 32

Teenage to early adult years

Posterior mandible primarily involved

Front 33

Cyst that results from failure of the proximal portion of the thyroglossal duct to degenerate.

Back 33

Thyroglossal duct cyst

Front 34

Cysts that lie in (or close to) the midline, contain mucinous fluid, and are lined by squamous or columnar/cuboidal epithelium overlying a lymphocytic infiltrate containing scattered thyroid follicles.

Back 34

Thyroglossal duct cyst

Front 35

What causes dental caries?

Back 35

Destruction of calcified tissue by acid-producing bacteria which colonize on tooth surface as dental plaque.

Front 36

What is an important defense mechanism against dental caries?

Back 36

Saliva production
(contains IgA and bacteriostatic factors like lysozyme)

Front 37

In appropriate concentrations, what compound strengthens tooth enamel?

Back 37

Fluoride

Front 38

When dental caries are formed, when does the characteristic pain begin?

Back 38

When pulp becomes inflamed and there is increased edema and exudate within the pulp chamber

(Once bacteria reach the dentin, they spread laterally and invade through the dentin tubules to reach the dental pulp)

Front 39

Medical emergency that can result from dental caries.

Back 39

Ludwig's angina

Front 40

What are the symptoms of Ludwig's angina?

Back 40

1. Painful board-like rigidity of the floor of the mouth
2. Airway obstruction caused by cellulitis of the anterior neck

Front 41

Result of a chronic inflammatory process initiated by the presence of dental plaque and tartar at the junction of the gingiva and the tooth in the gingival sulcus.

Back 41

Periodontal disease

Front 42

What is periodontal disease clinically characterized by?

Back 42

Receding gum line with reddened, inflamed gingiva

Front 43

What is the most common cause of tooth loss in adults over the age of 40?

Back 43

Periodonal disease

Front 44

Chronic periodontitis can result in the destruction of what anatomical structure?

Back 44

Periodontal ligament

*Results in subsequent loosening and loss of teeth.

Front 45

Painful, malodorous ulcerative disease of the interdental gingival papillae caused by the presence of a fusiform bacillus in combination with a spirochete--Borrelia vincentii.
(Usually occurs in an individual who has a decreased resistance to infection)

Back 45

Acute necrotizing ulcerative gingivitis (ANUG)

Front 46

What is almost always an underlying factor of acute necrotizing ulcerative gingivitis?

Back 46

Psychological stress
(occurs in immunocompromised individuals)

Front 47

A clinical mimic of oral candidiasis.

This lesion may herald the subsequent development of what disease?

Back 47

Oral hairy leukoplakia
(usually seen on lateral surface of tongue and consists of hyperkeratosis and acanthosis)

*AIDS

Front 48

What are the symptoms of a primary herpes simplex infection?

Back 48

Gingivostomatitis (multiple, painful ulcers on both the fixed and non-fixed mucosa)
Low-grade fever
Malaise
Lymphadenitis

Front 49

Canker sores are also known as...?

Back 49

Apthous stomatitis

Front 50

What is periadenitis mucosa necrotica recurrens?

Back 50

Variation of apthous stomatitis
*Large, painful, persistent canker sores that develop around salivary glands and produce scarring

Front 51

What is almost always an underlying factor of acute necrotizing ulcerative gingivitis?

Back 51

Psychological stress

Front 52

A clinical mimic of oral candidiasis.

This lesion may herald the subsequent development of what disease?

Back 52

Oral hairy leukoplakia
(usually seen on lateral surface of tongue and consists of hyperkeratosis and acanthosis)

*AIDS

Front 53

What are the symptoms of a primary herpes simplex infection?

Back 53

Gingivostomatitis (multiple, painful ulcers on both the fixed and non-fixed mucosa)
Low-grade fever
Malaise
Lymphadenitis

Front 54

Canker sores are also known as...?

Back 54

Aphthous stomatitis

Front 55

What is periadenitis mucosa necrotica recurrens?

Back 55

Variation of aphthous stomatitis
*Large, painful, persistent canker sores that develop around salivary glands and produce scarring

Front 56

Benign mucous membrane pemphigoid is seen most often in which patients?

Back 56

Post-menopausal women

Front 57

Autoimmune disease that results in supra-basilar bullae which rupture easily.

Back 57

Pemphigus vulgaris

*May be fatal

Front 58

A relatively uncommon disorder which produces asymptomatic lacy or net-like patterns of white striae on the mucosa.

Back 58

Lichen planus
(lace-like pattern = "Wickham's striae)

Front 59

Clinical term to describe white plaque-like lesions of the oral mucosa.

Back 59

Leukoplakia
(hyperkeratosis)

Front 60

What do odontomas microscopically consist of?

Back 60

Epithelial (enamel, enamel matrix) and mesenchymal (dentin, cementum, pulp) components.

Front 61

Where are compound odontomas generally found?

Where are complex odontomas found?

Back 61

Compound --> anterior mandible
(resembles a tooth-like structure)

Complex --> posterior mandible
(diffuse calcification often associated with impacted teeth)

Front 62

Ameoblastomas usually arise where?

Back 62

Ramus of mandible
(during early to mid-adulthood)

Front 63

Odontogenic myxomas are benign tumors derived from...?

Back 63

Mesodermal components of the the tooth-forming structures
(dentin, cementum, pulp, etc.)

Front 64

Which type of oral tumor is usually associated with a missing or unerupted tooth?

Back 64

Odontogenic myxoma

Front 65

Oral counterpart to HPV-induced cutaneous lesions and present as pedunculated cauliflower-like growth with a papillary surface.

Back 65

Papilloma

Front 66

Clinically, this lesion may present as a leukoplakia with a loss of normal demarcation b/w the skin and the vermillion border of the lip. There is also a loss of the vertical striations and redness of the lip.

Back 66

Actinic keratosis/ solar chelitis
(Result of chronic sun damage)

Front 67

Account for over 90% of all oral epithelial malignancies.

Back 67

Intra-oral squamous cell carcinoma

Front 68

Where do the majority of major salivary gland tumors arise?

Are these typically benign or malignant?

Back 68

Parotid gland (80%)

80% of these are BENIGN

Front 69

Tumors are most rare in which of the major salivary glands?

Back 69

Sublingual glands

Front 70

Where do most minor salivary gland tumors arise?

Are these generally benign or malignant?

Back 70

Posterior palate

50% are MALIGNANT

Front 71

Painless, slow-growing salivary gland tumor that is most frequently found in the superficial lobe of the parotid.

Back 71

Pleomarophic adenoma (mixed tumor)

Front 72

What is the most common of the salivary gland tumors?

Back 72

Pleomarophic adenoma

Front 73

Pleomorphic adenomas arise from what kind of cells?

Back 73

Myoepithelial cells and glandular epithelial cells

*Most common of the salivary gland tumors--frequently seen in superficial lobe of parotid gland

Front 74

Benign tumor that may arise from salivary gland tissue trapped in lymph nodes during embryogenesis.

Back 74

Papillary cystadenoma lymphomatosum
(Warthin tumor, "red, white, and blue tumor")

Front 75

Almost all papillary cystadenoma lymphomatosum tumors involve which gland?

Back 75

Parotid gland

Front 76

Describe the histological appearance of papillary cystadenoma lymphomatosum.

Back 76

"Red, white, and blue tumors"

Clefts and cystic spaces (white) are lined by a eosinophilic epithelium (red), with a lymphoid background (blue)

Front 77

Most common MALIGNANT tumor of the salivary glands.

Back 77

Mucoepidermoid carcinoma

Front 78

Explain how mucoepidermoid carcinomas typically present?

Back 78

Arise most frequently in the parotid as painless, slow growing, poorly encapsulated mass which contains a mixture of mucus-secreting cells and squamous cells.

Front 79

Mucoepidermoid carcinomas behave in a more aggressive fashion when a larger proportion of which cells are present?

Back 79

High proportion of squamous cells that are less well differentiated

Front 80

Most common minor salivary gland tumor.

Back 80

Adenoid cystic carcinoma (cylindroma)

Front 81

What is the characteristic, histological appearance of adenoid cystic carcinoma?

Back 81

"Cookie cutter" or cribriform histologic architecture

Front 82

Autoimmune syndrome that results in chronic lymphocytic/plasma cell infiltrates that ultimately produce atrophy and fibrosis of the salivary and lacrimal glands?

What are the characteristic symptoms of this disorder?

Back 82

Sjogren's syndrome

*Xerostomia, keratoconjunctivitis sicca

Front 83

Hemispheric, blue, functuant nodules that are the result of injury of a minor salivary gland duct, with the extravasation of mucus into the surrounding tissue.

Back 83

Mucocele

Front 84

What is a ranula?

What causes a ranula?

Back 84

It is similar to a mucocele, but it is larger and found on the floor of the mouth.

*It is usually due to obstruction of the submandibular or sublingual salivary gland ducts.

Front 85

Lesion that may involve vascular occlusion and infarction of salivary glands with squamous metaplasia of the acini and ducts.

Back 85

Necrotizing sialometaplasia