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271 Cards in this Set
- Front
- Back
• What is the histological tell-tale sign of an ameloblastoma/Odontogenic tumors?
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o All exhibit reverse polarization of the nuclei (except plexiform ameloblastoma)
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• What has the highest incidence of true odontogenic tumors?
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o Ameloblastoma
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• What type of tissue is ameloblastoma arise from? Epithelial or Ectomesenchymal?
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o Epithelial
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• What is the average age and most common site affected by ameloblastoma?
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o Average age: 33
o Mostly in posterior mandible |
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• Will an ameloblastoma be radiolucent or radiopaque?
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o Radiolucent (ameloblasts never made enamel)
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• Does an ameloblastoma have to originate from an unerrupted tooth?
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o No, it can come from fragments of the dental lamina left behind from development
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• What is the most common form of ameloblastoma?
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o Solid and multicystic
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• Is an ameloblastoma associated with pain?
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o No
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• Can an ameloblastoma cross the midline? Diff dx.
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o Yes (diff dx: central giant cell granuloma, OKC, aneurismal bone cysts, odontogenic myxoma)
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• What is the radiographic appearance of a solid, multicystic ameloblastoma?
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o Most are well defined mulrilocular radiolucencies (soap bubble or honeycomb pattern)
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• True or false, an ameloblastoma will perforate through the cortical plate?
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o False
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• What is the common origin of unilocular (unicystic) type of ameloblastoma? What age group is most affected?
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o Usually arise from lining of dentigerous cyst
o In younger people (associated with impacted teeth) |
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• What is the diff dx for a unilocular ameloblastoma?
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o Dentigerous cyst, OKC
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• What histological pattern of ameloblastoma is characterized by islands and nests of tumor with peripheral columnar cells?
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o Follicular pattern
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• What is the treatment of a multicystic ameloblastoma?
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o Complete surgical removal (high chance of recurrence with only enucleation, so must be aggressive, especially with multicystic) **one shot treatment
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• What is the prognosis of an ameloblastoma?
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o Locally aggressive, infiltrative behavior, high recurrence, relentless, and potentially lethal
o **LIFELONG FOLLOWUP necessary |
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• What is the treatment and prognosis (reccurrence) of a unicystic ameloblastoma?
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o Conservative treatment (recurrence only 15%), treat through curettage with local bone removal, OR conservative en bloc resection
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• What defines a malignant ameloblastoma?
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o Metastatic ameloblastoma, whether or not the cells look atypical or malignant
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• What is the lesion called when, histologically the cells in an ameloblastoma exhibit very malignant features?
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o Ameloblastic Carcinoma
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• Does an ameloblastic Carcinoma metastasize?
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o No
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• What has a worse prognosis? Ameloblastic carcinoma or malignant ameloblastoma?
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o Ameloblastic carcinoma
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• What is the classic history of Adenomatoid Odontogenic Tumor?
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o Teenage girl with impaced canine, looks like dentigerous cyst. Not attached at CEJ but at root
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• What is the common gender and age for an Adenomatoid Odontogenic Tumor?
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o Female, teenager
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• What is the radiographic appearance of AOT?
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o Well circumscribed radiolucency with some speckled radiopacities, surrounds the crown and part of the root
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• What is the histopathology of AOT?
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o Glandular Duct like structures within a thick fibrous capsule
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• What is the treatment and recurrence of Adenomatoid Odontogenic Tumor?
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o Enucleation only (easily performed due to capsule)
o Virtually no reccurence since it is easy to remove completely |
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• What looks like an ameloblastoma but with opacities?
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o AOT or Calcifying Epithelial Odontogenic Tumor (Pindborg tumor)
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• What is the most common site of a Calcifying Epithelial Odontogenic Tumor (Pindborg tumor)
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o Mandible 2:1
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• What is the radiographic appearance of a Calcifying Epithelial Odontogenic Tumor (Pindborg tumor)?
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o A multilocular radiolucency with radiopacities within (driven snow calcifications)
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• What would you suspect with a multilocular radiolucency with radiopacities within with liesegang rings and amyloid deposition (stained with congo red)?
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o Calcifying Epithelial Odontogenic Tumor (Pindborg tumor)
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• What odontogenic tumor can mimic periodontal disease with severe focal alveolar bone loss?
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o Squamous Odontogenic Tumor
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• What odontogenic tumor DOES NOT have reverse polarization?
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o Squamous Odontogenic Tumor (comes from PDL)
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• What can a squamous odontogenic tumor be misdiagnosed as?
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o Acanthomatous ameloblastoma
o Squamous cell carcinoma o Metastatic carcinoma to the jaw |
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• What does squamous odontogenic tumor mimic radiographically?
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o Lateral periodontal cyst, OKC, perio
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• What is the common age and site for ameloblastic fibroma?
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o First two decages, posterior mandible
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• What lesion will have highly cellular FCT resembling dental papilla (primordial pulp)?
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o Ameloblastic Fibroma
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• What lesion will histologically show epithelial islands with intervening plain FCT in between?
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o Ameloblastoma
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• What is the treatment and prognosis of ameloblastic fibroma?
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o Conservative en bloc resection, can recur with inadequate treatment
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• What lesion, containing soft tissue identical to an ameloblastic fibroma, but has hard tissue composed of tooth components
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o Ameloblastic Fibro-odontoma
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• What is the treatment for an ameloblastic fibro-odontoma?
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o Conservative excision
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• What lesion, similar to an ameloblastic fibroma, has malignant mesenchymal tissue?
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o Ameloblastic fibrosarcoma
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• What is the treatment of an ameloblastic fibrosarcoma?
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o Radical resection with chemo
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• Is an odontoma a true neoplasm?
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o No, it is a hamartoma
|
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• What is the common age, site for odontoma?
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o First two decades of life, more common in maxilla
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• What are the two forms and respective appearances of odontomas?
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o Compound (tooth shapes) and complex (amorphous)
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• What is the likely diagnosis with a radiographically opaque lesion containing tooth components?
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o Odontoma
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• What is the likely diagnosis with a radiographically opaque lesion with a radiolucent component, containing tooth material?
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o Ameloblastic Fibro-odontoma
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• What is the age and site effected by odontogenic myxoma?
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o Age: 3rd and 4th decade, site: posterior mandible
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• What is the lesion if, radiographically, it is multilocular and radiolucent and, histologically, it contains loose, myxomatous connective tissue?
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o Odontogenic Myxoma
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• What is the reccurence rate of an odontogenic myxoma?
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o 25%
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• What is the first sign of hypohidrotic ectrodermal dysplasia?
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o Fever of unknown origin, happens when ambient temperature rises
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• What condition shows thin, sparse hair and sometimes oligodontia or microdontia?
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o Hypohidrotic Ectodermal Dysplasia
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• How do you tell the difference between white sponge nevus and leukoedema?
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o Leukoedema will go away upon stretching
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• What condition, looking very similar to white sponge nevus, appears on the oral AND conjunctival mucosa?
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o Hereditary Benign Intraepithelial Dyskeratosis (HBID)
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• Leukoplakia occurring on oral mucosa and ocular changes indicated what condition?
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o Hereditary Benign Intraepithelial Dyskeratosis
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• What syndrome exhibits hypermobility of joints, increased contusions, extremely elastic skin?
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o Ehlers-Danlos Syndrome
|
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• What syndrome exhibits Gorlin’s sign? (touching the tongue to the nose)
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o Ehlers-Danlos Syndrome
|
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• What condition, having defective collegen, can cause pregnancy complications and aortic aneurysms?
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o Ehlers-Danlos Syndrome
|
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• What condition exhibits multiple angiofibromas, shagreen patches and ash leaf spots?
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o Tuberous Sclerosis
|
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• What dermatological lesion can exhibit gingival angiofibromas and enamel pitting?
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o Tuberous Sclerosis
|
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• What is the category of conditions where the gums appear very red, and painful, and slough off?
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o Desquamative Gingivitis
|
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• What autoimmune condition exhibits blisters due to epithelial cells not bonding to eachother, defective desmosomes?
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o Pemphigus Vulgaris
|
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• What dermatological condition exhibits early, red oral lesions such as nikolski sign (gingival slough off)?
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o Pemphigus Vulgaris
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• What is likely condition that can cause “bloody crusted lips”?
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o Pemphigus Vulgaris
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• What condition exhibits acantholysis (intraepithelial separation) with Tzannk cells?
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o Pemphigus Vulgaris
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• What is the difference between direct and indirect immunofluorescence?
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o Direct uses tissue, indirect uses blood
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• What other conditiosn must be ruled out when pemphigus is diagnosed?
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o Malignant neoplasms such as leukemia and lymphoma
|
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• What is the main histological difference between pemphigus and pemphigoid in the location of cell abnormality?
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o Pemphigoid is subepithelial, epithelium separates from lamina dura), causes thicker blister, that heals with scaring.
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• Which condition, Pemphigoid or Pemphigus Volgaris exhibits the nikolski sign?
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o Both do
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• What condition that can cause blisters on fingers causing fingers to scar and fuse together with “mitten-like deformity)?
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o Epidermolysis Bullosis
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• What facial lesion is exhibited 50% of the time by people with SLE?
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o Butterfly rash
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• What condition exhibits Libman-Sacks endocarditis?
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o SLE
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• What is the most serious complication with SLE?
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o Renal Failure
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• What are the oral features of lupus erythmatosus?
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o Linear white striae radiating from central ulceration, Very similar to erosive lichen planus (ELP)
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• What are the lab findings with Lupus Erythematosus?
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o Positive ANA – 95%
o Anribodies against double stranded DNA – 70% |
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• What is the characteristic facies of Scleroderma?
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o Mask like facies, microstomia
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• What dermatological condition can cause diffuse widening of the PDL?
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o Scleroderma
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• What is the name for the localized variant of scleroderma?
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o Morphea (coup de sabre)
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• What does CREST stand for?
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o Calcifications of skin, Raynaud’s phenomenon, Esophageal dysfunction, Sclerodadtyly, Telangiectasia (not that important to remember)
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• What condition is kind of like scleroderma but with telangectasias?
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o CREST syndrome
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• What are the two oral manifestations of lichen planus?
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o Reticular form, erosive form
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• What is the appearance of reticular form of lichen planus?
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o Leukoplakia with Lace-like appearance, coalescing papules form Wickham’s striae,
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• What is the most common oral location for lichen planus?
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o Bilateral buccal musoca
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• What can lichen planus mimick in the mouth?
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o Hypersensitive reaction, perhaps to amalgam/tic tac/drug/ etc
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• What does lichen planus look like on the tongue?
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o White plaque
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• Erosive lichen planus, when occurring on the gums, is what class of conditions?
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o Desquamative Gingivitis
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• What is the treatment for oral lichen planus?
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o Typically only treat erosive type, treated with topical steroids or systemic steroids
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• What is unique about the onset of Erythema Multiforme?
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o Very acute, explosive onset
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• What condition, causing bloody crusted lips, are 50% of the time followed by viral infections or hypersensitivity to drugs?
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o Erythema multiforme
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• What condition exhibits “Target” lesions on the skin?
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o Erythema Multiforme
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• What is the name of severe form of erythema multiforme, that can have oral lesions?
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o Stevens Johnson syndrome
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• What condition exhibits single or multiple ‘bald’, red, flat areas on the tongue?
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o Geographic tongue
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• What is the histology of geographic tongue similar to?
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o Psoriasis
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• What condition exhibits a serpentine line of the tongue?
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o Geographic tongue
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• What is the common gender affected by Reiter’s Syndrome?
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o Young adult males (9:1)
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• What is the classic triad for Reiter’s Syndrome?
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o Non-gonococcal Urethritis, arthritis, conjunctivitis
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• What condition has characteristic penis lesions similar to geographic tongue lesions?
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o Reiter’s syndrome
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• Acanthosis Nigricans can be indicative of what underlying condition?
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o Internal undiagnosed malignancy
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• What are the oral S/S of mucopolysaccharidosis?
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o Macroglossia and gingival hyperplasia
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• What are three inherited lipid reticuloendotheliosis diseases?
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o Gaucher’s disease
o Niemann-Pick disease o Tay-Sachs |
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• What are the oral lesions associated with amyloidosis?
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o Gingival enlargement and macroglossia (<40% incidence), dry mouth
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• What neoplastic condition can cause a buildup of amyloid in the tongue secondarily?
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o Multiple myeloma
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• Pindborg tumors can cause a secondary buildup of what substance in the oral cavity?
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o Amyloid in the tongue
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• How is a diagnosis of amyloidosis made?
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o Bx of labial mucosa
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• What histologic stain affects amyloid?
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o Congo red
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• What does a deficiency in Vitamin B2 (riboflavin) cause in the oral cavity?
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o Bald burning tongue, angular cheilitis
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• What does a deficiency in Vitamin B3 (niacin) ‘pellagra’ cause?
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o 3 D’s: diarrhea, dermatitis, dementia
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• What does a deficiency in vitamin C ‘scurvy’ cause in the mouth?
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o Gingivitis, tooth mobility, severe periodontal loss
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• What are the oral signs of iron deficiency anemia?
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o Atrophic glossitis, burning tongue, mucosal pallor, angular cheilitis
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• Plummer-Vinson syndrome is an extreme form of what deficiency?
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o Iron
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• What are the general and oral S/S for Plummer-Vinson syndrome?
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o Dysphagia, esophageal webs
o Glossodynia (burning tongue) o Angular cheilitis o Atrophic glossitis |
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• Malignancy in the upper aerodigestive tract (5-50%) of the time can occur with which syndrome involved with severe iron deficiency anemia?
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o Plummer-Vinson syndrome
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• What is the deficiency involved with pernicious anemia?
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o An intrinsic factor that causes poor absorption of vitamin B12
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• What are the characteristics of the RBCs with pernicious anemia? With iron deficiency anemia?
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o Iron def: hypochromic, microcytic Pernicious anemia: Megaloblastic, normochromic
|
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• What condition has excess GH after closure of epiphyseal plates
|
o Acromegaly
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• What is usually the underlying cause of acromegaly? Which bones typically grow in acromegaly?
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o Usually secondary to pituitary adenoma. Membranous bones (skull and jaws) show renewed growth
|
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• What are the oral S/S of acromegaly?
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o Coarse facial features, hypertrophic soft palate, mandibular prognathism, teeth diastemas, macroglossia
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• What condition is associated with cretinism in infants and myxedema in adults?
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o Hypothyroidism
|
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• What condition has glycosaminoglycans depositing in tissues causing pitting edema?
|
o Hypothyroidism
|
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• What are the oral S/S with hypothyroidism?
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o Thickened lips (GAGs), marcoglossia, delayed eruption, impaction
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• What is the form of hyperthyroidism that is autoimmune in origin?
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o Grave’s disease
|
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• What is the etiology of Grave’s disease
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o Autoantibodies bind TSH receptor
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• What condition is associated with exopthalmos or proptosis and goiter?
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o Hyperthyroidism
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• What is the complication of hyperthyroidism that can be brought on by stress?
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o Thyroid Storm – excess release secondary to infection or stress, mortality 20-40%
|
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• What condition has heightened PTH and lowered serum calcium?
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o Hyperparathyroidism
|
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• What is a secondary cause of hyperparathyroidism?
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o Renal Failure
|
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• What condition is associated with melanin pigmentation in the oral cavity and bronzing of the skin?
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o Addison’s disease
|
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• What is the cause of increased melanin in Addison’s disease?
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o ACTH is being overexpressed
|
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• What is the name of the syndrome that is hyperadrenocorticalism?
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o Cushing’s
|
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• What are the complications of Diabetes Mellitus in the mouth?
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o Microangiopathy ischemia
o Impair neutrophil chemotaxis - infection o Perio disease, poor wound healing, replacement of salivary parenchyma by fat o Candidiasis (increased glucose substrate) |
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• What is the best time to have a diabetic patient appointement?
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o AM appointment, reduce medication
|
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• What condition that affects the GI can cause nodular swelling (cobblestone) with linear-shaped/apthous-like ulcers with granulomatous inflammation in the oral cavity?
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o Crohn’s disease
|
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• This is a rare manifestation of IBD in the oral cavity
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o Pyostomatitis Vegitans
|
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• What condition shows “Snail track” coalescing lesions in the oral cavity?
|
o Pyostomatitis Vegitans
|
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• What is the name for paralysis of muscles innervated by the 7th cranial nerve?
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o Bell’s Palsy
|
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• Is Bell’s Palsy usually acute or chronic? Unilateral or bilateral?
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o Acute, unilateral
|
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• What are the etiologies for Bell’s Palsy in children?
|
o Viral infection, lime disease, earache, associated with Melkersson-Rosenthal syndrome, Heerfordt’s syndrome
|
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• How long do Bells Palsy symptoms last?
|
o Usually regress slowly and spontaneously in 1-2 months OR longer in more severe cases/older patients
|
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• This is unexplained fifth cranial nerve pain
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o Trigeminal neuralgia
|
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• This is one of the most painful afflictions that can mimic dental pain with one of the highest suicide rates
|
o Trigeminal neuralgia
|
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• What are the two subsets of trigeminal neuralgia?
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o Classical (idiopathic)
o Symptomatic (secondary, often times 4% associated with MS) |
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• What are common triggers of trigeminal neuralgia?
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o Light touch on Nasolabial fold, lip vemillion, periorbital skin (oral sites rare)
o Noise, light, stress |
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• Which branch of the trigeminal is most often involved in trigem neuralgia? How often is it bilateral?
|
o Mandibular branch, bilateral 5%
|
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• What is the diagnostic criteria for trigeminal neuralgia?
|
o Onset of pain immediately follows trigger, pain is extreme and paroxysmal, each pain spasm lasts less than 60 seconds but can occur in waves of up to 30 minutes, initially, dramatic reduction in pain with use of carbamazepine, distribution of pain must be in trigeminal distribution
|
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• What condition, similar to trigeminal neuralgia, but much less common happens in 9th cranial nerve distribution?
|
o Glossopharyngeal neuralgia
|
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• Where are the trigger points for glossopharyngeal neuralgia? Where might pain be felt?
|
o Trigger points ‘internal’ with exception of ear canal
o Pain felt in: ear, intra-auricular, tonsil, base of tongue, posterial mandible, lateral pharynx |
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• What must be ruled out when suspecting a diagnosis of glossopharyngeal neuralgia causing pain in the lateral wall of pharynx? What about pain around ear?
|
o Lateral wall of pharynx (rule out eagles syndrome)
o Around ear (rule out TMJ problems) |
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• How is pain precipitated with glossopharyngeal neuralgia?
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o Talking, chewing, swallowing, yawning, touching tonsilar area
|
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• What diagnosis of exclusion is extremely difficult to diagnose, often has private practitioners “chasing” tooth pain by performing multiple root canals?
|
o Atypical facial pain
|
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• What headaches are extremely painful, around the eyes, often happen ar the same time of day?
|
o Cluster headaches
|
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• A patient experiencing cluster headaches feels the need to do what?
|
o Pace restlessly
|
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• What is the occurance pattern of cluster headaches?
|
o Occurs over a period of weeks then remission for months
|
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• What population is most often affected by cluster headaches?
|
o Blacks, 80% smokers
|
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• This is an autoimmune disease causing abnormal and progressive fatigue of skeletal muscle
|
o Myasthenia Gravis
|
|
• What is the pathophysiology of myasthenia gravis?
|
o Circulating antibodies to acetylcholine receptors (AChR) block ability of Ach to bind to receptors stimulus to contract muscle does not reach threshold (defective neuromuscular transmission) motor end plate normal
|
|
• What type of muscle is affected by myasthenia gravis?
|
o Superficial skeletal muscle, affected subtly and progressively grow weaker
|
|
• What muscle groups are the FIRST to be affected in myasthenia gravis?
|
o Head and neck muscles (ptosis, diplopia)
|
|
• What condition involving muscle weakening can exhibit jaws hanging open after a meal?
|
o Myasthenia gravis
|
|
• What is a very common etiology of myasthenia gravis?
|
o Thyoma (thymus tumor)
|
|
• What is the most often affected oral site for burning mouth syndrome?
|
o Tongue, but any other oral site can be affected, especially lips
|
|
• What gender is most commonly infected by burning mouth syndrome?
|
o Women (4-7x), 14% of post-menopausal women
|
|
• What are other extra-oral symptoms associated with burning mouth syndrome?
|
o Depression, anxiety, irritability
|
|
• What are the postulated local factors and postulated systemic factors of burning mouth syndrome?
|
o Local factors:
Chronic mouth breathing, chronic tongue thrust, candidiasis, allergies, xerostomia o Systemic factors: Vitamin A or B12 def., DM, chronic gastritis, hypothyroidism, estrogen def., psychosomatic disorders, depression, AIDS |
|
• What is dysgeusia?
|
o Sudden onset of persistent abnormal taste, most often metallic, foul, rancid
|
|
• What are the local factors and systemic factors that may cause dysgeusia or hypogeusia?
|
o Local factors: trichomiasis, oral galvanism, Periodontitis, gingivitis, chlorohexidine rinse
o Systemic factors: zinc, vit A and B12 deficiency, food sensitivities, sjogren’s, liver dysfunction, crohn’s, addisons, psychosis, pesticide ingestion, systemic medications |
|
• This is sweating, flushing brough on by chewing food and salivating
|
o Frey (auriculotemporal) syndrome
|
|
• What is the pathophysiology of Frey’s syndrome?
|
o Following parotid abscess, trauma, mandibular surgery or parotidectomy, parasympathetic fibers are misdirected and regenerate along sympathetic pathways
|
|
• What is the diagnostic test for frey’s syndrome?
|
o Minor’s starch-iodine test (turns sweat blue when patient eats)
|
|
• This is very common, degenerative, destructive alteration of joints
|
o Osteoarthritis
|
|
• When is osteoarthritis worse? Morning or night?
|
o Night
|
|
• About 10% of TMJ pain cases are associated with what joint condition?
|
o Osteoarthritis
|
|
• What are the radiographic signs of osteoarthritis?
|
o Irregularity and flattening of articular surface, sclerosis, osteolysis, bone spurs
|
|
• How is the pathogenesis of rheumatoid arthritis different from osteoarthritis?
|
o Synovitis occurs with rheumatoid arthritis, reactive macrophage laden fibroblastic proliferation from synovium releases collagenases that destroy cartilage and bone
|
|
• What join condition is symmetric and invalves small joints in hands and feet with nodules?
|
o Rheumatoid arthritis
|
|
• What lab values are significant in rheumatoid arthritis?
|
o 80% have elevated RF factor
o 50% have antinuclear antibody (ANA) |
|
• 75% of cases of this condition eventually involve the TMJ, bilaterally
|
o Rheumatoid arthritis
|
|
Ectopic sebaceous glands on oral mucosa
|
fordyce granules
|
|
This appears as multiple white yellow papules ---> plaques common on buccal and labial mucosa, also on retromolar area
|
fordyce granules
|
|
In what population is leukoedema common?
|
african americans
|
|
How do you tell the difference between leukoedema and white sponge nevus or hereditary benign intraepithelial dyskeratosis (HBID)?
|
Neither WSN or HBIN dissipate upon mucosal stretching.
|
|
Patient has diffuse white mucosal surface on buccal mucosa, does not disipate upon stretching, also shows eye involvment. Diagnosis?
|
HBID.
|
|
Multiple grooves and furrows in the dorsum of the tongue.
|
Fissured tongue
|
|
What 2 conditions is fissured tongue associated with?
|
geographic tongue and Melkersson-Rosenthal syndrome
|
|
This is from the accumulation of keratin on the filiform papilla
|
Hairy tongue
|
|
This is an abnormally dilated or tortuous vein
|
Varix
|
|
blue-purple asymptomatic vesicle sublingual on an older adult. what is this most likely to be?
|
Varix
|
|
This is a developmental concavity on the lingual aspect of the mandible around the location of the submandibular gland.
|
Stafne defect
|
|
Who is more likely to have a stafne defect, male or female? unilateral or bilateral?
|
Male predilection (90%) and mostly unilateral
|
|
What is the relationship between a stafne defect and the inferior alveolar canal?
|
it is always below the inferior alveolar canal
|
|
well circumscribed radiolucency with a corticated border seen below the inferior alveolar canal
|
stafne defect
|
|
What is the most common non-odontogenic cyst of the oral cavity?
|
nasopalatine duct cyst
|
|
This is an anterior palatal swelling with vital adjacent teeth that occurs more commonly in males
|
nasopalatine duct cyst
|
|
This is a central maxillary radiolucency greater than 6 mm in diameter, shaped round, oval, heart, or inverted pear shaped. Central incisors are vital.
|
Nasopalatine duct cyst
|
|
this is the term for excess cementum layered on the apical portion of premolar roots most commonly
|
hypercementosis
|
|
This is a round to oval lucency at site of previous extraction
|
residual cyst
|
|
This is a periapical radiolucency in which dense fibrous tissue has filled a bone defect due to both cortical plates being lost.
|
periapical scar
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early stage or periapical cemento-osseous dysplasia can mimmic what conditions?
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apical rarefying osteitis conditions such as PA granuloma, bone scar, cyst, langerhans cell disease and benign/malignant tumors
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What bone condition is associated with involcra or sequestra and appears radiographically as ill-defined, patchy, ragged, lucency with central opaque sequestrum
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osteomyelitis (both acute and chronic)
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This condition is a rare infectious process in the bone in which sclerosing centers around crestal portions of a tooth-bearing alveolar ridge
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diffuse sclerosing osteomyelitis
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this is a reactive bone condition that is initiated and exacerbated by chronic overuse of masticatory muscles
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chronic tendoperiostitis
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This is a localized area of bone sclerosis associated with the apices of non-vital teeth common in children and young adults
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condensing osteitis
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This is a form of inflammatory periosteal hyperplasia with an onion skin like reduplication of the cortical plate
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Osteomyelitis with proliferative periostitis or Garre's osteomyelitis
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Garre's osteomyelitis is most commonly seen in what age group? what is the most frequent cause/location
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mean age = 13
most freq cause - dental carries usually mandibular premolar or molar |
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This is a clinical term for chronic vesiculoerosive process in which the gingiva spontaneously sloughs or can be removed with minor manipulation
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desquamative gingivitis
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This set of conditions displays a positive nikolsky sign
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desquamative gingivitis
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What conditions fall under desquamative gingivitis?
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Lichen planus, mucous membrane pemphigoid, etc
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How do you treat desquamative gingivitis?
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perform perilesional incisional biopsy and us direct/indirect immunofluorescence to confirm clinical diagnosis.
use topical or systemic corticosteroids |
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What is the most common oral fungal infection in the US?
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Candida albicans
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This dimorphic condition depends on the immune status of the individual.
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candida
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What are the 5 clinical classifications of candidiasis?
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1. acute, pseudomembranous
2. erythematous (median rhomboid glossitis, angular cheilitis, denture stomatitis) 3. hyperplastic 4. mucocutaneous 5. endocrine syndrome-associated |
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This is a white plaque that wipes off leaving red mucosa
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acute, pseudomembranous candidiasis
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This is sometimes called acute atrophic antibiotic sore mouth
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erythematous type candidiasis
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Which form of candidiasis may be asymptomatic?
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chronic atrophic erythematous type associated with denture stomatitis, median rhomboid glossitis, angular cheilitis
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well-defined, asymptomatic, red, flat macule, symmetrical in shape and on the mid-dorsum posterior 1/2 of tongue
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median rhomboid glossitis (a form of erythematous candidiasis)
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What form of candidiasis appears clincally as a leukoplakia (Does not wipe off)
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chronic, hyperplastic form
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What are the treatments for candidiasis?
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nystatin, clotrimazole, or diflucan
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This condition histologically shows multinucleated Tzank cells
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herpes simplex virus
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This condition that can cause sore throat or dysphagia and red macules, vesicles, or small ulcers on the soft palate or tonsillar pillars is caused by multiple coxsackie A virus strains.
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Herpangina
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How many estimated new cases of oral cancer per year? How many deaths per year? what gender mainly affected?
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31,000, 7000
2:1 male |
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what types of HPV lead to cancer? which in the oropharynx?
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16,18,31,33
oral 16,18 |
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what is the name for the large, broad based, papillary leukoplakia that is highly associated with smokeless tobacco?
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verrucous carcinoma
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this encompasses 80% of all skin cancers?
this encompasses 95% of all oral cancers? |
basal cell carcinoma; squamous cell carcinoma
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which spreading pattern of melanoma is more common?
which has a worse prognosis? |
superficial spreading patter (70%);
nodular |
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where does oral melanoma usually occur? does it have a lower of higher chance of being a metastasis as compared to a primary lesion?
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usually on the maxillary gingiva or palate; less than 1% are primary lesion
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what is the diff dx for a mucocele?
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epidermoid cyst, dermoid cyst, mucous duct cyst
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plunging ranula dissects through what muscle?
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myelohyoid
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what is the most common salivary gland tumor?
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pleomorphic adenoma
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where does the pleomorphic adenoma most likely occur?
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parotid >palate
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where is warthin's tumor most likely to arise? who does it usually affect?
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parotid gland, usually men in 40s.
most frequent salivary gland tumor to be bilateral |
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what shows a histology of papillary, cystic, with lymphoid stroma in the walls?
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warthin's tumor
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what salivary gland tumor occurs most from MSG on palate and 25-33% of the time exhibits pain and parasthesia?
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adenoid cystic carcinoma
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which salivary gland tumor exhibits a cribiform "swiss cheese" pattern?
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adenoid "swisstic" carcinoma
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Conditions caused by EBV
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Hodgkin's lymphoma, Burkitt's lymphoma, mononucleosis, oral hairy leukoplakia
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what cell type does non-hodgkins lymphoma arise?
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B-lymphocytes
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this can occur on the buccal vestibule and exhibit a painless, diffuse swelling with a boggy consistency and purple/erythematous appearance
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non-hodgkins lymphoma
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which form of Burkitt's most commonly appears in the jaw?
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african; the american form is most often in the abdomen
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this condition exhibits a "Starry sky" pattern histology
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burkitts lymphoma
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this is a multicentric malignancy of the plasma cell origin
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multiple myeloma
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what condition can cause renal failure and exhibit Bence-Jones proteins in the urine?
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Multiple Myeloma
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this condition can cause amyloid deposition in the tongue and soft tissue sometimes, is diagnosed with monoclonal gammopathy with serum protein immunoelectrophoresis
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multiple myeloma
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this is exhibits multiple punched out radiolucencies on a skull film
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multple myeloma
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this is a fibrous hyperplasia, not a true neoplasm and is the most commonly biopsied lesion in the mouth
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fibroma
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what are the 3 p's?
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pyogenic granuloma, periferal ossifying fibroma, peripheral giant cell granuloma
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what liver colored lesion appears only on attached gingiva
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peripheral giant cell granuloma
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Which of the 3 Ps may exhibit 'saucerization' and cupping of bone?
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peripheral giant cell granuloma
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which of the 3 Ps can occur somewhere besides the gingiva?
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pyogenic granuloma
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which of the 3 Ps exhibits osteoid growth?
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peripheral ossifying fibroma
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this lesion is though to originate from swhann cells and occurs most frequently on the tongue
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granular cell tumor
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this benign vascular tumor blanches upon compression
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hemangioma
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is a lymphangioma a true neoplasm?
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no it is a hamartoma
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this is the most common cause of macroglossia
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lymphangioma
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what is the difference between a choristoma and a hamartoma? where is the most common location for a choristoma to occur?
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choristoma - normal tissue, abnormal location
hamartoma - normal tissue, normal location tongue most common |
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this condition that appears similar in radiographic appearance to a condensing osteitis occurs mostly in the mandibular 1st molar region
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idiopathic osteosclerosis
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what is the main difference between condensing osteitis and a dense bone island?
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condensing osteitis is associated with an inflammed or non-vital tooth
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this condition, occuring mostly in older caucasians, can cause foramina narrowing
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paget's bone disease
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the late radiographic appearance of this condition has a cotton wool appearance
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paget's bone disease
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what lab value will be elevated in paget's bone disease?
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serum alk phos
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what is the characteristic histology of paget's bone disease?
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jigsaw puzzle or mosaic pattern
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what are two main complications of paget's disease of bone?
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hypercementosis and osteosarcoma
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is a simple bone cyst a true cyst?
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no
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what is the common patient and location for a simple bone cyst?
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adolescent males, mandible
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what lesion exhibits scallop shapped margins extending between the roots of involved teeth without affecting them
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simple bone cyst
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what is the name for the diverse group of processes that replace normal bone with fibrous connective tissue and metaplastic bone? name 3 of these conditions
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benign fibro-osseous lesions:
1. fibrous dysplasia 2. cemento-osseous dysplasia 3. ossifying-cementifying fibroma |
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fibrous dysplasia is seen in what two polyostotic conditions?
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Jaffe and McCune-Albright
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are most fibrous dysplasias poly or monostotic?
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monostotic
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what is the classic radiographic pattern description of mature fibrous dysplasia?
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ground-glass
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what condition exhibits a histology of 'woven bone Chinese characters'
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fibrous dysplasia
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what treatment should be avoided in fibrous dysplasia?
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radiation (can cause transformation to osteosarcoma)
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what condition occurs most frequently in black females mandibular anterior teeth?
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periapical cemento-osseous dysplasia
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what condition occurs most frequently in black females mandibular posterior teeth?
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florid cemento-osseous dysplasia
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how does osteosarcoma appear radiographically? (4 things)
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1. ill defined radiolucenct or moth eaten radiopacity
2. codmans triangle - periosteum raises from bone 3. symmetrical widening of PDL space 4. 25% exhibit sunburst pattern |