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89 Cards in this Set
- Front
- Back
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Fordyce Granules
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ectopic sebaceous glands
could be nornal - 80% of population yellow, fine papules, buccal mucosa, upper lip |
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Leukoedema
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non-wipable, white often macular change, bilateral, buccal mucosa, disappears when stretched
90% blacks adults - 50% black children |
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Macroglossia
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enlarged tongue
congenital (Down's, MENIII, Neurofibro) acquired (angioedema, edentulous) |
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ankyloglossia
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short lingual frenum
developmental - common to rare (severity) if presents problem - frenectomy |
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fissured tongue
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grooves on dorsal tongue
geographic distri. asymptomatic |
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hairy tongue
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long filliform papillae on dorsal tongue
uncommon keratin, hygiene, systemic tongue scrape, id cause |
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varicosities
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tortuous dilated veins
common in older px developmental, no systemic |
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exostoses
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bony protuberances in specific locations - hamartomas
uncommon, buccal, palatal, sunpontine no treatment, rare surgical removal |
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torus palatinus
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common exostoses
midline hard palate, females 2:1 no treatment |
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torus mandibularis
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common exostoses
lingual aspect of mandible no treatment |
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stafne defect
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lingual cortial mandibilar defect
concavity of bone on lingual surface of mandible, male 9:1, common x |
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lip pits
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commissural:
common, preauricular pits paramedian: rare, VDWS, genetoc counseling |
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lingual thyorid
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ectopic thyroid tissue in the posterior dorsal toungue
rare, female 4:1, often only thyroid tissue hormone supplementation |
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eagle syndrome
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mineralization of the stylohyoid ligament.
uncommon to have symptoms, if severe surgical excision |
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nasopalatine duct cyst
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cyst in ant maxilla, incisive canal
most common non-odonto cyst teeth uninvolved surgery |
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Other cysts
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palatal of newborn, epstiens pearls, bohns nodules,
nasolabial cyst - soft tissue only |
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dermoid cyst
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rare devel cyst in young adults, mass above geniohyoid
source of epi lining, skin and structures surgery |
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thyroglossal duct cyst
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uncommon, swelling midline of neck, below hyoid
surgery, low risk of carcinoma |
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oral lyhphoepithelial cyst
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uncommon, small submuc mass, lumen fills with white cheesy matter
asymp surgery |
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cervical lymphoepithelial cyst
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uncommon, lateral upper neck mass,
paotid glands trapped in lymph nodes? epi lining. branchial clefts? surgery |
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Periapical Granuloma
characterists |
does not have granulomatous inflammation
Granulation tissue at apex of non-vitaltooth •May arise in setting of periapical abscess •May transform into periapical cyst or may demonstrate acute exacerbation •Most found on radiographic examination radiolucent, loss lamina dura, granulation tissue surrounded by fibrous connective tissue, lymph infiltrate, eosin. globules (russel bodies), malassez rests |
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Periapical Granuloma
treatment |
RCT
extraction and curettage if non-restorable |
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Periapical cyst
characterists |
pathologic cavity lined by epithelium
most common odontogenic cyst epi at apex of non vital may form cyst lining rests of malassez, giant cells can rise residual periapical cyst |
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Periapical cyst
clinical and radio |
asymp. maybe swelling
non-vital tooth radio. identical to PA granuloma lumen cell debris or fluid rushton bodies - Calcification |
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PA cyst treatment
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RCT or extract
untreated can give rise to carcinoma |
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PA abscess
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acute inflammatory cells at apex of non-vital
initial pathosis or acute exacerbation of chronic inflam lesion (phoenix abscess) |
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PA abscess
clinical features |
headache, chills, malaise,
tenderness on tooth can spread through to soft tissue |
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PA abscess
treatment |
drain
elim infection antibiotics if compromised |
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cellulitis
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Acute and edematous spread of acute inflammatory process through fascial planes of soft tissues
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ludwig angina
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submandibular cellulitis
infection from mandibular molar bilateral swelling of sublingual, submaxillary, and submental immunocompromised |
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Amelogenesis Imperfecta
characteristics |
enamel defect without systemic disorder
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Amelogenesis Imperfecta
Types |
I) hypoplastic - inadequate enamel deposition
III) hypocalcified - inadequate mineraliztion II) hypomaturation - mineralized matrix but does not form crystal IV) hypo-calc/matur- combo |
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Hypoplastic AI
inherit pattern and clinical patterns |
inheritence: AD/AR/x-linked
patterns: pitted - buccal pits local - horizontal rows pits smooth- tapered, open contact, white-yellow rough - tapered, open contact, rough enamel agenesis - lack of enamel normal pulp chamber |
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hypocalcified AI
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enamel easily lost
AD/AR (more severe) enamel yellow-brown then brown-black calculus, irregular occlusal surfaces, open bite normal pulp chambers/enamel similar in density to dentin |
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hypomaturation AI
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enamel softer, tends to chip off
AR/x-linked patterns: pigmented- mottled brown surface, can pierce with explorer x-linked - opaque white w/ mottling snow-capped - denture dipped in white paint on insical/occlusal all normally shaped, normal pulp |
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Hypomaturation/plastic AI
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AD
combo |
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Amelogenesis Imperfecta
treatment |
variable, depends on severity
full coverage, crowns and veneers if possible over dentures if not |
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Dentinogenesis imperfecta
characteristics/classifications |
developmental defect affects dentin collagen
shields type I - dentin defect plus OI shields type II - dentin defect w/o OI shields type III - shell teeth, variation of type II DSPP gene accounts for DI |
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osteogenesis imperfecta
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inherited connective tissue disorder
bone fragility, blue sclera, long bone and spine deform, hearing loss 4 types, I common, II fatal |
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DI
radio/clinical features |
blue-brown hue
enamel chips off, defect at DEJ bulbous crowns, short roots, no chambers or canals |
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DI shell teeth
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thin layer of dentin
root resorption thin layer of dentin in roots only PA radiolucency deciduous teeth more common |
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DI
Treatment |
protect remaining structure
over denture endo challenging |
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dentin dysplasia
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defect in dentin w/o systemic disease
ectopic dentin formation AD |
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dentin dysplasia type I
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radicular type
crowns appear normal, mobility and exfoliation no chamber, short roots perm teeth: no roots, pulp stones |
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dentin dysplasia type I
treatment |
prevention, higher risk with perio
challenging endo |
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dentin dysplasia type II
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coronal:
deciduous teeth blue/yellow perm teeth no clinical color radio: decidious bulbous crowns, normal roots, cervical constriction perm: thistle shaped chambers, large pulp stone |
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dentin dysplasia type II
treatment |
prevention, over dentures over deciduous
less complex endo, increased PA lesion risk |
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regional odontodysplasia
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non heriditary? developmental abnormality
affects enamel,dentin,pulp "ghost teeth" malformed or hypoplastic teeth localized, one or two quadrants, max more common some teeth fail to errupt, eruppted teeth abnormal conserve teeth, endo, crowns (metal), composite |
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Segmental Odontomaxillary Dysplasia
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devel disorder - painless expansion of max - soft tissue hyperplasia - posterior most affected
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OPC
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candida albicans
often part of normal flora |
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OPC carrier rates
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hiv/aids
hospitalized pxs denture users diabetic and cancer px |
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Factors promoting symptomatic OPC
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inhaled steroids, radiation, dentures, xerostomia,
antibiotics, cancer theraphy, hiv/aids, cancer DM, hypothyroid infants/elderly malnutrition |
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acute atrophic candidiasis
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red dorsal tongue "bald"
loss of filliform papillae follows antibiotic course burning |
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median rhombois glossitis
central papillary atrophy |
devel defect?
well demarcated erythematous area on midline post dorsal tongue asymptomatic |
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angular chelitis
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erythema, fissuring, scaling
waxes and wanes predisposing: loss of VDO co-infection with staph. aureus |
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chronic multifocal cand.
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Erythematous cand. in various locations
dorsal tongue papillae atrophy junction of hard and soft palate angular cheilitis |
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denture stomatitis
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Erythema in denture bearing mucosa
outlines denture asymptomatic improper design? allergy? inadequate curing? |
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pseudomembranous cand.
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thrush
most widely recognized creamy white plaque, can be wiped off w/o bleeding predispose: antibio, immunosupp, infants symptoms: asymp, bitter taste?, roughness? |
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hyperplastic cand.
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least common
non-wipeable plaques location: ant buccal muc. lateral tongue preexisiting leukoplakia? antifungal tx or else biopsy |
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mucocutaneous cand.
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cand in assoc. with immunologic dysfunction
sporadic or AR cand. in oral, nails, skin, non-wipable |
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endocrine-cand. syndroms
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hypo- thyroid, parathyroid, adrenocor., DM
non-wipable, rough, foul smelling plaques |
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Cand. diagnosis and treatment
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cytology - PAS stain culture
KOH method in office biopsy treatment - topical - nystatin/clotrimazole systemic - fluconazole/ampho B |
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nystatin
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antifungal used in dent.
polyene increase perm of fungal membrane |
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clotrimazole
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imidazole antifungal
inc. perm. fungal membrane |
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alcortin A
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cream
anti-fung, bac, inflam. iodoquinol and hydrocortisone |
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ketoconazole
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imidazole
first systemic antifungal not reccomended, liver toxic contraindic, interactions |
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fluconazole
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triazole
inhibits syn ergosterol may induce liver tox. interactions |
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itraconazole
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similar to fluconazole
do not give with food, liver metab. |
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amphotericin B
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polyene
inc. fungal membrane slow iv infusion in hospital typically used in life threatening situations |
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histoplasmosis
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endemic in ohio and mississippi
80-90% mold grows in humid envi w/ bat or bird feces inhalation most common systemic fungal infection mild symptoms unless immunocompromised - extrapulmonary/oral lesions |
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histoplasmosis
oral lessions |
disseminated histoplas.
solitary, painful rolled margins chronis resemble SSC cancer |
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histoplasmosis
diagnosis/treatment |
cultue, serology, biopsy
acute- no tx chronic TB like - itraconazole, amphotericin B disseminated - ketoconazole, ampho, itraconazole small yeasts |
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blastomycosis
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uncommon
males 9:1 eastern US/miss. ohio |
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blastomycosis
oral lessions |
Extrapulmonary dissemination orLocal inoculation (“Kentucky field candy”)
irreg ulceration w/ rolled borders nodules, painful resemble SCC large yeasts |
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blastomycosis
treatment |
can be self limiting
amphotercirin B, itraconazole, ketoconazole |
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cryptococcosis
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endemic worldwide
pigeon excrement inhalation no probs in immunocompetent strongly associated with immunosupressed AIDS (most common killer AIDS px) meninges. skin papules, |
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cryptococcosis
diag. / treatment |
biopsy, serology, culture
amphotericin B, flucytosine, triazoles |
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zygomycosis
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inhalation, worldwide
hyphae on decaying organic matter opportunistic infection uncontrolled diabetes I, immunocompromised rhinocerebral |
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RHINOCEREBRAL ZYGOMYCOSIS
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nasal obstruction, facial pain, swelling
sinus involvement - opacification poor prognosis |
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aspergillosis
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A. flavus, fumigatus
inhalation world wide decomposing organic matter, opportunistic infection |
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aspergillosis non-invasive/allergic
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Aspergilloma-cluster of organisms in sinus , can calcify or can get nonspecific allergic rhinitis symptoms
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aspergillosis local invasive
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Infection after endo TX or exodontia, soft tissues and especially sinuses infected , healthy pts, tissue necrosis
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aspergillosis disemenated invasive
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immosupp and diabetic
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aspergillosis treatment
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allergic - debride and antifungal
local invasive - triazole w/o debride disseminated - ampho B |
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cavernous sinus thrombosis
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may result from infection of max post teeth
edamatous periORBITal enlargement drain,antibio,extract offending tooth 30% mortality |
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osteomyelitis
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acute or chronic bone infection
acute: fever, leukocytosis... involucrum: necrotic bone encased in healthy bone acute: antibio and drain chronicL surgical removal, iv antibio |
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condensing osteitis
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localized area of bone sclerosis
often adjacent to teeth with caries children/young adults post mandible endo/exxtraction may leave scar |
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proliferative periostitis
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subperiostal bone formation
onion peel like appearance assoc. with caires and PA disease young px endo or extrction |
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pulpal calcifications
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denticles - form during root devel
adjacent to furcation area |
