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23 Cards in this Set
- Front
- Back
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Commissural Lip Pits
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- Occur in 12-20% of adults
- Unilateral or bilateral - 1-4 mm deep - Asymptomatic and innocuous - No Tx necessary |
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Double Lip
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- Rare anomaly
- Redundant fold of tissue on the mucosal side of the lip - Congenital vs acquired - Usually unnoticed when lips at rest, but becomes visible upon smiling - Tx: excise for esthetics |
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Fordyce Granules
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- Ectopic sebaceous glands that occur on the oral mucosa
- More than 80% of pop - Multiple yellow or white-yellow papules, often clustered together - Buccal mucosa, upper lip vermilion; less common on retromolar pad and tonsillar pillars - Adults >kids - No Tx needed |
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Leukoedema
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- Diffuse grayish or bluish-white, milky appearance to oral mucosa
- Bilateral buccal mucosa, often w/ folds or wrinkles - Common, esp. in smokers - Probably a variation of normal - Confirm Diagnosis: whitish appearance disappears when the mucosa is stretched/distended! - No Tx necessary |
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Histology: fluid accumulation w/in the epithelial cells of spinous layer
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Leukoedema
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Microglossia
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- Uncommon
- Abnormally small tongue - May be a part of several syndromes - Ortho care to manage collapsed dental arch |
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Ankyloglossia
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- "Tongue-tied"
- Abbreviated or absent lingual frenum - 2-4% neonates - Speech problems are probably exaggerated - Frenectomy may be necessary if mucogingival stress is evident |
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Lingual Thyroid
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- Rare developmental problem due to failure of thyroid anlage
- Mass develops in foramen cecum area - Striking female predilection - Variable symptoms - Diagnosed by radioactive iodine - Biopsy may not be necessary; but consider excision in males older than 30 |
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Fissured Tongue
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- Common variation of normal
- Seen almost exclusively in adults - Varies in severity, from midline fissure to extensive arborized pattern - No Tx necessary - Some burning sensations normal |
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Hairy Tongue
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- Elongation of the filiform papillae in the dorsal tongue (accumulation of keratin)
- Inc production/dec removal of keratin - Often assoc. w/ smoking - Papillae become discolored - No Tx except to scrape the tongue |
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Varix
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- Abnormally dilated and tortuous veins
- Often seen in older adults -Thought to be secondary to age-related degeneration or laxity in elastic support of vessel walls - Common sites: ventral and lateral tongue, buccal mucosa, labial mucosa, lip vermilion - May become secondarily thrombosed - Tx: may undergo surgical excision to confirm diagnosis or for esthetic purposes |
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What is a "diascopy" and what does it diagnose?
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- Diascopy: performed by applying pressure and observing color changes (vascular lesion will blanch)
- Diagnose varices |
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Caliber-Persistent Artery
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- Common vascular anomaly
- Main arterial branch extends superficially, w/o reduction in its diameter - Older adults - Almost exclusively on lip mucosa (upper>lower) - Linear, arcuate, or papular lesion ("seagull in flight") - Normal to bluish color w/ pulsations - No Tx necessary |
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Exostoses
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- Benign bony protruberances
- Debated pathogenesis; genetic vs environmental - Asymptomatic, unless secondarily traumatized - Common sites: buccal, torus palatines, torus mandibularis - No Tx generally necessary |
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Stafne Defect
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- AKA Stafne cyst and "lingual mandibular salivary gland defect"
- Asymptomatic, discovered on routine pan radiographs - Adult males; well-demarcated readiolucency below the mandibular canal, post mandible - CT scan helps confirm the diagnosis - Usually explored surgically and not suspected clinically - Occasionally examples in the anterior mandible |
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Nasiolabial Cyst
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- Rare soft tissue cyst
- Upper lip, lateral midline; along nasiolabial groove - The ala of the nose may be elevated - 3:1 ratio (F:M); 10% bilateral - No radiographic changes - Pseudostratified ciliate columnar epi lining, cuboidal epi and squamous metaplasia not uncommon - Tx: biopsy, surgical removal |
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Incisive Canal Cyst
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- AKA nasopalatine duct cyst
- Most common non-odontogenic developmental cyst of the jaws - Develops from epithelial remnants of the nasopalatine duct - Occurs at the apices of (usually vital) maxillary central incisors |
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Epidermoid Cyst/ Milia
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- Common; characterized by production of orthokeratin by a cystic lining that resembles the epidermis
- Milia are simply very small epidermoid cysts; resolve spontaneously by self- marsupialization - Usually affect the skin- face or back - Tx: simple excision |
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Dermoid Cyst
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- Uncommon: lined by epidermis-like epithelium
- Cyst wall contains adnexal elements (hair follicles, sebaceous glands) - Benign cystic form of teratoma - Most common location in floor of the mouth (above geniohyoid=hard to swallow; below geniohyoid=looks like a double chin) - Tx: surgical excision - Rare malignant transformation |
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Thyroglossal Duct Cyst
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- Rare; midline of the neck
- Arises from remnants of thyroglossal tract - 50% develop before 20 yrs of age - 2-10 cm (most <3cm) - High recurrence rate unless treated by a Sistrunk Procedure - 1% malignant transformation |
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Sistrunk Procedure
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Surgical excision w/ portion of the hyoid bone
- for thyroglossal duct cyst |
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Brachial Cleft Cyst
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- Cervical variant of lymphoepithelial cysts
- Presumably arises from remnants of the brachial clefts - Fluctuant swelling of lateral neck - Usually anterior to the sternocleidomastoid; most on the left - 1/3 cases develop fistula tract - Lymphoid tissue in wall; lined by stratified squamous epi - Tx: surgical removal; minimal recurrence |
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Oral Lymphoepithelial Cyst
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- Arises from epithelial rests trapped in oral lymphoid tissue
- Waldyer's ring or accessory lymphoid aggregates - Floor of the mouth (50%), ventro-lateral tongue, tonsillar pillar - Soft to firm, white-yellow nodule - Usually < 1 cm and asymptomatic - Tx: surgical excision |
