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146 Cards in this Set
- Front
- Back
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cysts of vestigial ducts
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nasopalatine duct cyst and nasolabial duct cyst
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nasopalatine duct cyst
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Incisive canal cyst - intraosseous developmental cyst of the mid line of the ant. palate, derived from the islands of epithelium remaining after clusre of the embryonic nasopalatine duct
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nasolabial cyst
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developmental cyst of teh soft tissue of the ant. muco buccal fold beneath the ala of the nose, most likely derived from the remnants of the inf. portion of the nasolacrimal duct.
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lymphoepithelial cyst
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- cyst with a lumen lined by keratanizing stratified squamous epithelium and a capsule containing multiple normal lymphoid follicles and a dense accumulation of normal lymphocytes.
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lymphoepithelial cyst
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oral lymphoepithelial cyst
cervical lymphoepithelial cyst |
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oral lymphoepithelial cysts
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- a lymphoepithelial cyst commonly located intraorally on the posterior lateral tongue and the ant. floor of the mouth.
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cervical lymphoepithelial cyst (branchial cleft cyst)
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- large lymphoepithelial cyst located on the lateral aspect of the neck.
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cysts of vestigial tracts
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- thyroglossal tract cyst
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thyroglossal duct cyst
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- a cyst located above the thyroid gland and beneath the base of the tongue, with a lumen lined by a mixture of epithelial cell types derived from remnants of the embryonic thyroglossal tract, and often containing thyroid tissue in the capsule.
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cysts of embryonic skin
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dermoid cysts
epidermoid cysts |
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dermoid cyst
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- cyst of midline of upper neck or ant. floor of the mouth of young patients derived from remnants of embryonic skin, consisting of a lumen lined by keratinizing stratified squamous epithelium and containing one or more skin appendages such as har, swear or sebacious glands.
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epidermoid cyst
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- cyst of skin with a lumen lined by keratinizing SSE usually filled with keratin and without skin appendages in the capsule wall.
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cysts of mucosal epithelium
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- surgical ciliated cyst of maxilla
- heterotropic oral gi cyst. |
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surgical ciliated cyst of maxilla
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intrabony cyst located near the floor of th maxillary sinus lined by pseudostratifiefd ciliated columnar epithelium, caused by implantation of normal mucus secreting sinus epithelium during previous surgery.
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heterotopic oral GI cyst
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- rare developmental cyst commonly found in tongue or floor of the mouth in infants or young children.
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infection of teeth and bone
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starts here
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young patients are more prone to ...
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pit and fissure caries with 2nd molars followed by 2nd bicuspids as the most likely
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clinical types of dental caries
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- pit and fissure
- smooth surface - cemental - recurrent |
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pit and fissure
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most common type at early cage
- most destructive |
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smooth surface caries
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- less common
- interproximal of teeth and occasionally on cervical regions of buccl and lingual surfaces - common caries in infants sleeping with juice or milk bottle in their mouth. common in patients under radiation therapy or dry mouth patients. |
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cemental caries
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- found in older patients
in teeth with gingival recesson rapid progression into the pulp. |
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acute (rampant) caries
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- in young patients with large pulpal chambers and wide short dentinal tubules
- patients with high sugar diet and poor oral hygeine caries progress rapidly and penetrate into the pulp. |
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chronic caries
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- older patients with smaller pulps
- pulps with deposits of denser and less tubular dentin on pulpal walls called tertiary or secondary dentin - the pain is not as severe as in acute caries. |
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pulpitis
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- an inflammaion of the pulpal tissue that may be acute or chronic with or without symptom, and reversible or irreversible.
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pulpitis
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- reversible/ irreversible
- pulpal necrosis - common diag. techniques - histopathology of pulpal diseases |
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reversible pulpitis
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- pain is sharp and lasts less than 20 mins.
- pain is elicited not spontaneous - pain is unaffected by body position - pain is easily localized |
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common diagnostic techniques of pulpistis
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- history and nature of pain
- reaction to thermal changes - to electric stimulation - to percussion of the tooth - radiographic examination - visual examination - palpation of surrounding area. |
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acute pulpitis
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- pt. are younger
- pulp chamber is closed - pain is spontaneous and affected by body position - often difficult to localize the pain dull or sharp and more intense pain lasting longer than 20 min. with themal change - responds with higher voltage to electrical stimulation or no response. |
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chronic pulpitis
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- older tooth
- is caused by low grade irritant - smaller pulp chamber with fibrotic pulp, pulp stones or dystrophic calcification with sclerotic dentinal tubules. - dull and low intensity pain or no pain. |
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pulp polyp (chronic hyperplastic pulpitis)
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- mostly in molars of children
- result in rampant caries - it is an open pulpitis - pulpal tissues proliferate and produce granulation tissue - asymptomatic |
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pulpal necrosis
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- pulp tisse that is no longer living
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PA lesions
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- chronic apical periodontitis
- periapical granuloma - PA cyst |
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nature and behavior of the apical lesions depends on teh following factors
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- presence of an open or closed pulpitis
- virulence of the involved MO's - extent of the sclerosis of the dentinal tubules - competency of the host immune response |
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chronic apical periodontitis
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- the earliest radiographic evidence of extension of the infl. process of the pulpal chamber into adjacent period. membrane around the apical foramen.
- faint evidence of vitality - positive reaction to percussion - transitory phase between pulpitis and more distinct PA lesions. |
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PA granuloma
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- pulpitis progresses into a pa lesion; most common lesion that occurs after pulpal necrosis.
- usually painless - pregress slowly - may be ass. with draining exudate - if open pulp chamber is blocked and drainage is inhibited the PA lesion will transform to an apical abscess with pain. - the most common transformatino is PA cyst |
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acute pa conditions
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- pa abscess -
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pa abscess
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- the initial lesion that develops when circumstances are adverse.
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PA cyst
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- common development of long standing untreated PA granuloma.
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osteomyelitis
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- acute or chronic inflammatory process of the bone and its structures secondary to infection with pyogenic organisms.
- infl. process within medullary bone that involves the marrow spaces - acute, chronic and garre types |
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acute osteomyelitis
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- rapidly destructive infl. process within bone that consists of granulaiton tissue, purulent exudate and islands of NONVITAL bone (sequestra)
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chronic osteomyelitis
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- suppurative infections of the medulla of the bone which follows a chronic course with intermittent acute or sub acute exacerbations.
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various lesions ass. with apical infection
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- cellulitis
- sinus tract - parulis - fistula |
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cellulitis
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- a painful swelling of the soft tissue of the mouth and face resulting from a diffuse spreading of purulent exudate along the fascial planes that seperate the muscle bundles.
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bone lesions
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benign fibro ossesous lesions
metabolic conditions benign tumors malignant tumors |
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benign fibro osseous lesions
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- cemento ossesous lesions
- fibrous dysplasia - cherubism |
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cemento ossesous lesions
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- benign fibro ossesous lesions of the jaws closely ass. with the apices of the teeth and containing amorphous spherical calcifications thought to resemble aberrant form of cementum; lesions are usually without signs or symptoms.
- types - pa cemental dysplasia - florid cemento osseous dysplasia |
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pa cemental dysplasia
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- diffuse pa radiolucent and radiopaque areas primarily of the ant. mand. in which cemento osseous tissue replaces normal oarchitecture of the bone.
3 distinct appearances - osteolytic (radiolucent - conn. tissue replaces normal pa trabecular bone - cementoblastic - mixed RL and RO - spherical calcifications fuse together and replace conn. tissue - mature - mostly radiopaque - sclerotic mineralized bone with some conn. tissue interspersed within the mass. - more common in women NO TX. required |
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florid cemento osseous dysplasia
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- diffuse asymptomatic radiopaque and radiolucent intraosseos areas of cemento osseous tissue that involve one or BOTH arches.
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fibrous dysplasia
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- asymptomatic regiojnal alteration of bone in which the normal architecture is replaced by fibrous tissue and non functional trabeculae like osseous structures; lesions may be monostotic or polyostotic, with or without ass. endocrine disturbances.
- types - juvenile fibrous dysplasia - adult monostotic fibrous dysplasia - polyostotic fibrous dysplasia - albright and jaffe type |
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juvenile fibrous dysplasia
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- the most common monostotic type of FD of head and neck
- slow growing regional distortion that enlarges proportionately with the affected bone - an aggressive type of juvenile FD has a faster growth rate causing more funcitonal problems. |
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polyostotic FD
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- fibrous dysplasia without any other findings is JAFFE TYpe
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Polyostotic FD with hormonal disorders and brownish skin lesions
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albright syndrome
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adult monostotic FD
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- rare form of FD occuring in adults
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cherubism
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- autosomal dominant fibro osseous lesion of the jaw involving more than one quadrant that stabilizes after the growth period, usually leaving some facial deformity and malocclusion
male to female is 2 to 1 mor in mandible than maxilla |
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metabolic conditions
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- pagets disease
- hyperparathyroidism - osteoporosis - osteogenesis imperfecta |
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pagets disease
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- osteitis deformans
- uncoordinated increase in osteoclastic and osteoblastic activity in the bone - etiology unknown, in older adults - producing larger but weaker bones - extensive pain - high levels of serum alkaline phosphatase and urinary hydroxyproline an in creased tendency to develop malignant bone neoplasms |
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summary of the clinical features in pagets disease
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- bone pain, enlargement
- deformity - increases risk of bone fracture - deafness - fatigue - hd - men more than women - 3% of over 40 population - increased risk of osteosarcoma - hypercalcemia and inc. risk of kidney stone - increased serum alkaline phosphatase |
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tx. of pagets disease of bone
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- bisphosphanates
- calcitonin - palliative for the management of fracture, pain and infection. |
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hyperparathyroidism
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- loss of bone mineralizatino because of increased PTH secretion or increased demand for serum calcium, resulting in multiple systemic complications loss of alveolar bone architecture and occasionally giant cell tumor.
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tx. in hyperparathyroidism
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- surgery on pth gland with hyperplasia or neoplastic tumors
- vitamin D - bisphosphanates and hormone replacement. |
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osteopetrosis
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- generalized hereditary condition
- excessive bone mineralization, resulting in altered stature - frequent fractures - lack of bone marrow hematopoietic function - tendency for severe osteomyelitis of the jaws. |
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types of osteopetrosis
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- congenita - infants - poor prog.
- marble bone disease - childhood - poor prognosis - tarda - adult onset with good prognosis |
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albers schoenberg syndrome with marble bone disease
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- very dense bone, fragile bone. stunted growth, no proper medullary space and bone marrow with short life span
- hydrocephalus with abnormal dental development - anemia, neutropenia, inc. rate of infection and inc. rate of bleeding with hepatosplenomegaly - pain, deafness, blindness, stroke and cardiac disease |
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tx. of osteopetrosis
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- allogenic bone marrow transplantation in some form of disease.
- oral calcitriol combined with calcium deficient diet - hyperbaric oxygen in tx. of osteomyelitis in jaws. |
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osteogenesis imperfecta
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- faulty bone matrix mineralization
- tendency for multiple broken bones - blue sclera of the eyes - ass. dentinogenesis imperfecta - deafness |
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tx. of oseogenesis imperfecta
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- maximize function minimize deformity main comfort and surgery may be required for repeated fractures.
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benign tumors and tumor like lesions of bone
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- torus/ exostosus/ osteoma
- osteoid osteoma/ osteoblastoma - cemento ossifying fibroma - giant cell lesions - traumatic bone cyst - langerhaans cell histiocytosis |
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torus palatinus
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- 20% of adult pop. with familial tendency more in femals starts to appear in puberty
is a form of exostosis more in native americans. |
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exostosis
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- exophytic nodular growth of dense cortical bone commonly located on max. or mand. buccal alveolar bone usually in the bicuspid/ molar area
- late teen and early adult years - more common in females than in males - slowly growing and asymptomatic - multiple rounded or oval mass of dense bone - broad based - smooth surfaced |
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osteoma
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- exophytic nodular growth of dense cortical bone on or within the mandible or maxilla
- in locations other than those occupied by tori or exostosis - the periosteal layer is more active in osteomas than tori and exostosis |
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gardnersy syndrome
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- autosomal dominant diesease
- polyposis of the colon - multiple osteomas of the jaws - soft tissue tumors |
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osteoid osteoma/ osteoblastoma
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- benign intraosseous lesions
- similar clinical, radiographic and histopatholigic features - well demarcated rounded intraosseous swellings - each with an active cellular central nidus surrounded by a wide zone of osteoid - pain upon palpation - before age 25 mostly more in males too - dull or aching pain due to intralesional prostaglandin releae - swelling, 1-2 cm radiolucency centrally with peripheral radiopacity - more in long bone, infrequent in jaws treated surgically. |
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cemento ossifying fibroma
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- a well demarcated encapsulated expansile intraosseous lesion.
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cemento ossifying fibroma cont.
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- cellular fibrous tissue containing spherical calcificaitons and irregular, randomly oriented bony structures.
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central ossifying fibroma
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- slow growing neoplastic lesion
- more in mandible - well defined radiolucency, mixed radiolucent radiopaque. |
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peripheral ossifying fibroma
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- soft tissue swelling mostly found in gingiva
- a reactive and hyperplastic lesion (non neoplastic) metaplastic ossification - mistaken with fibroma, pyogenic granuloma - should be removed surgically, with elimination of irritant. |
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giant cell lesions
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- peripheral giant cell granuloma
- central giant cell lesion |
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peripheral giant cell granuloma
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- most common of giant cell lesions in the jaw.
- arising from the periosteum membrane - purplish red soft tissue nodule - multinucleated giant cells in a background of mononuclear cells and red blood cells. |
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central giant cell granuloma
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- intraosseous destructive lesion
- mostly found in the ant. mandible and maxilla, always radiolucent - larger lesions expand the cortical plates, cause movement of teeth - produce root resorption - composed of multinucleated giant cells in a background of mononuclear fibrohistiocytic cells and RBC's |
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tx. of giant cell granuloma
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- most tx. by curettage
- occasionally block resection may be needed - lesion may recur and require tx. |
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aneurysmal bone cyst
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- uncommon
- located primarily in post. mand. and maxilla - clinical features similar to central giant cell lesions - contains many large blood filled spaces separated by conn. tissues septa containing giant cell tissue. |
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abc cont.
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- 70% are primary
- 30% are secondary - unilocular or multilocular expansile painful pathological fracture in long bone. - congenital acquired - ass. with trauma tx. is surgical. |
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bony lesions showing multinucleated giant cells microscopically
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- cherubism
- hyperparathyroidism (brown tumor) - peripheral and central giant cell granulomas - aneurysmal bone cyst |
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traumatic bone cyst
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asymptomatic intraosseous empty cavity or filled with fluid
- young pt. before 20 - primarily witing the mandible - lined by a thin loose conn. tissue membrane - well demarcated radiolucency with scalloping - slight if any bone expansion - no displaced teeth - surgical expoloration and curetage is the tx. |
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langerhans cell histiocytosis (histiocytosis x)
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- a probable neoplastic proliferatino of langerhans type of histiocytic cells
- wide spectrum of biological behavior rangion from a single leasion of the mandible to diffusely distributed bone lesions in combo with organ an other soft tissue lesions. - consists of s-100 positive histiocytes containgin birbeck granules and accumulations of eosinophils. - acute disseminated disease(letterer siwe disease) - chronic disseminated disease - hand schuller - christian - focal chronic disease eosinophilic granuloma |
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letterer siwe disease
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- aggressive in infants or young children
- wide spread disease; skin and mucosal lesions, visceral and bone involvement - rapidly fatal despite chemotherapy and radiation therapy. - radiolucencies are seen all over the body |
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hand schuller christian disease
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- exophthalmosis, diabetes insipidus, lytic skull lesions (characteristic triad)
- hepatosplenomegaly and skin and mucosal lesions - chemotherapeutic tx. |
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eosinophilic granuloma
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- solitary localized bone destruction
- swelling, pain - clinically looking like periodontal or apical lesions - typical floating in air apical radiolucency - conservative tx. good prognosiss |
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malignant tumors of bone
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- osteogenic sarcoma
- chondrosarcoma - ewing sarcoma |
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osteogenic sarcoma
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- most common cancer from bone cells
- in jaws may exhibit widening of pdl - histologically all contain atypical osteoblasts and abnormal bone or osteoid formation. |
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osteosarcoma of the jaw
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- between ages 30 and 40
- usually affects mandible - firm rapidly growing swelling - pain and mibility of teeth - loss of sensation and parasthesia - irregular radiolucency with areas of opacity "sun ray appearance at margin - early metastasis to the lung - poor prognosis but better than long bone - treated surgically and with chemotherapy. |
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chondrosarcoma
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- uncommon malignant cartilaginous neoplasm in the jaws
- usually of the ant. maxilla - consisting of a proliferation of plump chondroblasts or spindle shaped mesenchymal cells and abnormal cartilage - no osteoid or bone. |
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chondrosarcoma
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- avg. age of 45
- most are in ant. maxilla - aggressive tumor with high rate of recurrence after excision 10% metastasize - poorly defined radiolucency with areas of opacity wide excision, no response to radiaition. |
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ewing sarcoma
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- rare malignant neoplasm
- young patients - composed of anaplastic small, dark, round cells containing glycogen granules and intermediate filaments. - swelling of bone with pain - loosened teeth with ulcerated overlying mucosa, irregular RL - fever, leukocytosis raised ESR and anemia - poor prognosis - wide excision, chemotherapy and radiation therapy. |
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microdontia types
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- true generalized microdontia
- generalized relative microdontia - microdontia involving a single tooth |
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macrodontia
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- true generalized macrodontia
- relative generalized macrodontia - macrodontia involving a single tooth - facial hemi hypertrophy |
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dental anomalies ass. with shape and form of teeth evident clinically
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- gemination
- fusion - dens invaginatus - dens evaginatus - microdontia and macrodontia |
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anomolies evident radiographically
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- dilaceration
- taurodontism - concrescence - hypercementosis - enamel pearl - supernumerary roots |
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gemination
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extra wide crown due to the dev. of two crowns from one tooth germ
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fusion
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- abnormally shaped crown that may appear as extra wide crown, a normal crown wit an extra root, or other combinations resulting from the union of two adjacent tooth germs by dentin during dev.
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dilaceration
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sharp bend or angulation of the root or portion of both obviously you can't see this clinically so its RG confirmed.
- caused by trauma during tooth development |
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taurodontism
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- molar with an elongated crown and apically placed furcation of the roots, resulting in an enlarged rectangular coronal pulpal chamber.
- possible causes include - amelogenesis imperfecta - down syndrome complicates RCT |
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concrescence
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- 2 or more roots unite by cementum after formation UNLIKE FUSION
- cause would be crowding or trauma and possible max. molars are more susceptible. |
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hypercementosis
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- excessive deposit of cementum on root surface
- cause - increased or decreased forces - pagets disease - hyperpituitarism - chronic infection of adjacent area. |
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premature eruption
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- natal teeth at birth
- neonatal during first 30 days - prematureeruption of permenant teeth - premature loss - hyperthyroidism |
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causes of delayed eruption
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- systemic - hyperthyroidism (cretinism)
- heredity - cleidocranial dysplasia and gingival fibromatosis - idiopathic- |
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most common impacted teeth
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mand. and max. 3rd molars and maxillary cuspids followed by mand. 2nd premolars and supernumerary teeth.
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eruption sequestrum
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- a small spicule of calcified tissue that is extruded through the alveolar mucosa that overlies the erupting molar.
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enamel hypoplasia
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- localized and generalized
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causes of enamel hypoplasia
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- heredity (amelogenesis imperfecta)
- trauma and local injury (turners tooth) - congenital infection - excessive ingestion of flouride febrile systemic infection - nutritional and vitamin deficiency - traumatic birth. |
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1-2 teeth turner tooth
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- as a result of inflammation or trauma during tooth development.
- if deciduous caries lead to abscess cna damage the developing successor. |
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flouride mottling (flouride)
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- chemical induction
- increased level of lfouride >1.0 ppm - disturbance of ameloblast function affects enamel matrix formation and enamel matrix calcification |
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hereditary disturbances
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- amelogenesis imperfecta
- dentinogenesis imperfecta - dentin dysplasia |
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amelogenesis imperfecta
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- spectrum of hereditary defects in the function of emeloblasts and the mineralization of enamel matrix that results in teeth with multiple generalized abnormalities affecting the enamel layer only.
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amelogenesis imperfecta
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- type 1 hypoplastic amelogenesis imperfecta
- type 2 hypocalcified amelogenesis imperfecta - type 3 hypomaturation amelogenesis imperfecta |
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dentinogenesis imperfecta
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- hereditary defect consisting of opalescent teeth composed of irregularly formed and undermineralized dentin that obliterates the coronal and root pulpal chambers.
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3 types of dentinogenesis
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type 1 - afflicted with osteogenesis imperfecta ( blue sclera)
- type 2 - most common, incidince is 1:8000 - type 3 - brandywine type - racial isolated area (maryland) multiple pulpal exposures in deciduous dentition. |
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dentinogenesis imperfecta
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- radiographically present as buld shaped crowns with constricted CEJ and thin roots.
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dentin dysplasia
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- hereditary defect in which the coronal dentin and tooth color is normal; the root dentin is abnormal witha gnarled pattern and ass. shortened and tapered roots.
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dentin dysplasia rootless tooth
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type 1 - radicular - normal shape and color but SHORT ROOT
tyupe 2 - coronal - abnormal color inprimary teeth and normal in secondary color, obliterated pulp chamber and canals, normal root length. |
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dentin dysplasia
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- abnormal root dentin
- shortened and tapered roots - abnormal pulpal morphology - pulp stone - normal eruption pattern - bulish in cervical region - radiographs - W shaped roots or radiolucencies of the root tips. |
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regional odontodysplasia
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- a developmental disturbance of several adjacent teeth
- enamel and dentin are thin and irregular - not adequately mineralized - much less radiodensity |
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GHOST TEETH
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- ass. with regional odontodysplasia
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discoloration
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- intrinsic tetracycline staining falls in this category.
- extrinsic - tobacco or coffee |
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congential lip pits
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- defects involving the paramedial portion of the vermillion of the lower and upper lip of the labial commissure area.
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double lip
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- horizontal fold of redundant mucosal tissue located on the inner aspect of the upper lip.
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frenal tag
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- redundant piece of mucosal tissue that projects from the maxillary labial frenum.
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ankyloglossia
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- extensive adhesion of the tongue of the floor of the mouth or the lingual aspect of the ant. portion of the mandible caused by a short lingual frenum.
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macroglossia
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- tongue is larger than normal due to an increase in the amount of tissue.
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fordyce granules
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- cluster of ectopic sebaceous glands on the lips or buccal mucosa variant of normal.
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leukoedema
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- benign anomaly; generalized opalescence on the buccal mucosa.
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white sponge nevus
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- autosomal hereditary condition in which the oral mucosa is white thickened and folded
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lingual thyroid nodule
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- sessile nodule in the midline of the dorsal surface of the tongue; thyroid tissue remnant ass. wtih a developmental anomaly.
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oral tonsil (ectopic lymphoid tissue)
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- islands of extrapharyngeal tonsillar tissue; lymphoid aggregates that exhibit geminal centers surfaced by nonkeratinized squamous epithelium.
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retrocuspid papilla
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- a sessile nodule on the gingival margin of the lingual aspect of the mand. cuspids.
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dev. anomolies affecting bone
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- hemifacial hypertrophy
- hemifacial atrophy - cleft lip and cleft palate - osteoporotic bone |
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hemifacial hypertrophy
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- condition which involves the enlargement of half of the head with enlarged teeth on the involved side.
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hemifacial atrophy
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- loss in the soft tissue below the skin on one side of face in some cases the underlying bone is affected.
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possible causes of hemifacial hypertrophy
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- peripheral nerve dysfunction
- trauma - infection - heredity - regional unilateral progressive systemic sclerosis |
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etiology of cleft lip or palate
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- heredity and environmental factors
- about 40% of CL with or without CP are hereditary - 20% of isolated CP are hereditary 5% are ass. with syndromes. |
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environmental factors
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- nutritional, physiologic, emotional or traumatic stress, ischemia mechanical obstruction like a large tongue. alchohol, drugs and toxins and infections.
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osteoporotic bone bone marrow defect
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- abnormal anatomic variation of bone marrow; asymptomatic radiolucent lesion that contains either hematopoeitic or fibrofatty marrow.
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lingual mandibular salivary gland depression (stafne cyst, static bone cyst, latent bone cyst)
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dev. concavity of the lingual cortex of teh mandible usually in the third molar area, caused by overextension of an acc. lateral lobe of the submand. gland, and has the radiographic appearance of a well circumscribed cystic lesion within the bone, usually below the inf. alveolar canal.
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cleidocranial dysplasia
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- rare condition inherited and characterised by partial or complete absence of the clavicles, defective ossification of the skull, and faulty occlusion due to missing, misplaced or supernumerary teeth.
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papillon lefevre syndrome
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- manifests with palmoplantar keratoderma and early, destructive periodontitis.
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treacher collins syndrome
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- mandibulofacial dysostosis
- facial features including downward slanting palpebral fissures, sunken cheekbones, receding chin and malformed ears. |
