Related Essays

  • Primary Sjögren's Syndrome

    Primary Sjögren's syndrome (SS) is an autoimmune disorder affecting 0.2–3% of the general population (1). Its hallmark is chronic inflammation of the salivar...

  • Sjogren's Syndrome: Chronic Autoimmune Disease

    Sjogren’s syndrome is a chronic autoimmune disease that is characterized by many in the medical field as an inflammatory disease that effects the exocrine gl...

  • Parotitis Research Paper

    Sialodenitis (Parotitis) Parotitis, or sialadenitis, is an inflammatory reaction of the parotid gland caused by bacterial, viral, fungal, or mycobacterial p...

  • The Digestive System: A Case Study

    The function of the oral cavity is the ingestion of liquids, solids and the chewing of solids to break them down ready for the stomach. Salivary glands in th...

  • Erdheim-Chester Disease: A Case Study

    Sjögren syndrome is also associated with rheumatic disorders such as rheumatoid arthritis or systemic lupus erythematosus. The hallmark symptoms of the diso...

  • Primary Central Mec Case Studies

    Primary central MEC has been reported in the first to seventh decade; however, cases occurring in the: fourth and fifth decades are most widespread. [6] In ...

  • Oral Submucous Fibrosis Research Paper

    The oral submucous fibrosis is defined as a premalignant condition, a generalized state of oral mucosa associated with a significantly increase risk of oral ...

  • Erythematous Pamela Case Study

    No anterior or posterior cervical lymphadenopathy. Skin Examination around the mouth does show a small, erythematous papule just to the left side of the u...

  • A Case Summary: Sjögren Syndrome

    Primary SS occurs as an isolated disorder, while secondary SS occurs in connection with another autoimmune disease. Of these, rheumatoid arthritis is the mos...

  • Two Most Common Causes Of Oral Ulcers

    ORAL ULCERS Description Oral ulcers are single or multiple 1-15mm size painful ulcers surrounded by erythematous mucosa occurring repeatedly anywhere in the ...

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/321

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

321 Cards in this Set

  • Front
  • Back
What are the major salivary glands, what do they secrete?
o Parotid – 100% serous
o Submandibular – mostly serous, some mucos
o Sublingual – mostly mucus glands, some serous
• What are the minor salivary glands, what do they secrete?
o Palate, 100% mucous
o Buccal mycosa, floor of mouth, labial mucosa: mucous and serous
o Etiology of a mucocele?
 Accidental trauma (bite lower lip)  severance of MSG duct  leakage of mucin into surrounding tissue  walling off by granulation tissue
o What is the morphology/color of a mucocele?
 Vesicle/bulla (> 5 mm) – fluctuant
 Blue translucent, though may appear pink if mucin located deep
o How can you tell the difference between a fibroma and a mucocele?
 If it is able to be condensed upon touch, it is a mucocele
o What is the most common site for a mucocele?
 Lower lip (due to the fact that most people have class I or II occlusion), especially halfway between midline and commissure
o What is the most common population to have mucocele?
 Adolescents
 Other common sites: buccal musoca, ventral tongue, floor of mouth
o Is a mucocele a cyst?
 Not a true cyst (no epithelial lining)
o Will a mucocele go away after local excision of mucus?
 No, must also remove severed duct and gland
o Why do mucoceles fluctuate?
 Because macrophages uptake a significant amount of the extravasated mucus
 Because macrophages uptake a significant amount of the extravasated mucus
 Ranula
o What causes a ranula most commonly?
 The severance of a sublingual gland duct
o What are differential diagnoses for a ranula?
 Dermoid cyst (will feel doughy)
 Mucus duct cyst
 Epidermoid cyst
o This is a blue fluctuant vesicle/bulla on the floor of mouth that may elevate the tongue.
 Ranula
o This extravasation of mucin dissects through the mylohyoid muscle into the neck (lateral or midline)
 Plunging ranula
o Etiology of mucus duct cyst?
 Due to obstruction of salivary gland (minor or major) such as sialolith, bacterial plug
o Is a mucus duct cyst a true cyst?
 Yes, epi-lined.
o This is the formation of a calcified structure within the salivary duct system
 Sialolithiasis
o When does pain occur with sialolithiasis?
 Classically upon salivation (just prior to meal)
o Where is the most common site of a sialolith?
 80% - submandibular duct (Wharton’s duct) due to tortuous path and viscous mucus content
o This is the term for inflammation of the salivary glands
 Sialadenitis
o This lip lesion involving the minor salivary glands can undergo malignant transformation
 Cheilitis Glandularis
o Which type of Cheilitis Glandularis causes the lower lip to be everted, extremely swollen and pus filled?
 Deep, suppurative type
o What is the treatment of Cheilitis Glandularis?
 Vermillionectomy
o Chronic, systemic, autoimmune disorder that affects the salivary and lacrimal glands
 Sjogren’s Syndrome
o This is a subjective criteria, describing feeling a dry mouth.
 Xerostomia
o This is an objective criteria, describing a declined salivary flow
 Salivary gland hypofunction
o What differentiates Sjogren’s syndrome and Sicca syndrome?
 Sicca syndrome is a general term for dry eyes, mouth. Sjogren’s is an autoimmune disease with these symptoms.
o What are the two types of Sjogren’s? What differentiates them?
 Primary: no other autoimmune disease
 Secondary: Autoimmune disorder present, usually (rheumaroid arthritis, SLE)
o Which sex is more affected by sjogren’s?
 Female 80-90%, elderly
o What are the intraoral findings of sjorgren’s?
 Xerostomia, dysphagia, predisposition to cervical caries, fissured tongue with atrophy of papillae, secondary candidiasis
o What is a common extraoral finding of sjogren’s?
 Bilateral parotid swelling (33-50%)
o What condition predisposes to a 40x higher risk of developing lymphoma?
 Sjogren’s
o What diagnostic lab values indicate Sjogren’s?
 Positive rheumatoid factor (RF), Antinuclear antibodies (ANA)
o What diagnostic test is used to measure tear secretion in Sjogren’s? What are the + and – values?
 Schirmer test. < 5 mm (suggests +), <2 mm (confirms +)
o What condition will show a sialogram with a “fruit-laden, branchless tree” pattern?
 Sjogren’s syndrome
o What sites are common for a biopsy to be performed for Sjogren’s?
 Labial mucosa biopsy or major gland (Parotid)
o Pilocarpine hydrochloride (Sialogen) or another drug, Evoxac, is the most common treatment for what condition?
 Sjogren’s
o How should you treat a patient with dry mouth?
 With sialologues, daily fluoride applications
o This condition is an unusual non-inflammatory disorder causing salivary gland (parotid) enlargement
 Sialadenosis
o This condition is when minor salivary glands on the palate shut down (possibly from ischemia), causing painful swelling, then forms a deep ulcer with sharply defined borders, will self-resolve.
 Necrotizing Sialometaplasia
o This ulcerative condition on the palate may be misdiagnosed as malignancy and overtreated.
 Necrotizing Sialometaplasia
o What helps to differentiate between Necrotizing Sialometaplasia and malignancy?
 Necrotizing Sialometaplasia will happen very immediately (24-48 hours)
o The most common site for salivary neoplasia?
 On the palate, off the midline
o *Firm palatal swelling off the midline in an otherwise healthy mouth. What do you think?
 Salivary gland tumor
o How do you distinguish between benign vs malignant salivary gland neoplasia?
 Perform biopsy
o A rapid increase in growth of a palatal firm swelling after initial slow growth indicates what?
 Possibly malignant salivary neoplasm
o What are 3 signs of possible malignancy for salivary neoplasms?
 Paresthesia, Fixation, Rapidly increased growth rate
o What is the most common salivary gland neoplasm?
 Pleomorphic adenoma
o Most common sites for salivary neoplasms?
 minor salivary gland site: palate
 major salivary gland site: parotid
o Most common parotid gland tumor?
 Pleomorphic adenoma
o Most common benign salivary gland tumor?
 Pleomorphic adenoma
o Most common malignant salivary gland tumor?
 Mucoepidermoid carcinoma
o What are the two types of monomorphic adenomas?
 Canalicular adenoma
 Basal cell adenoma
o What is the most common site for a canalicular adenoma?
 Upper lip
o What is the most common site for a basal cell adenoma?
 Parotid gland
o What is the most likely site for Warthin’s tumor?
 The parotid (95%)
o What is the most likely salivary gland tumor to be bilateral?
 Warthin’s tumor
o What population is most commonly affected by Warthin’s tumor?
 Male > 40 yrs
o What is the characteristic histology of Warthin’s tumor?
 Papillary, cystic, with lymphoid stroma in wall
o What is the most common location for oncocytoma
 Parotid gland
o What is characteristic of oncocytes?
 Cytoplasm has massive amounts of degenerating swollen mitochondria
o What is the most common salivary gland malignancy?
 Mucoepidermoid cyst
o What ages are affected by mucoepidermoid cysts?
 People in the 3rd and 6th decade of life (bimodal)
o What is the most common childhood salivary gland malignancy?
 Mucoepidermoid Carcinoma
o What malignant tumor is found more often in the submandibular gland than the parotid?
 Adenoid cystic carcinoma
o What is the most common malignant salivary tumor IN the mouth?
 Adenoid Cystic Carcinoma
o 50% of adenoid cystic carcinomas develop where?
 In the minor salivary glands (23% on the palate)
o Most common malignancy on the palate?
 Adenoid cystic carcinoma
o 25-33% of adenoid cystic carcinoma patients experience what symptoms?
 Pain and paresthesia
o A radiographic finding of apical radiolucency with root resorption in a pointed “pencil tip” like root apearence indicated what salivary gland tumor?
 Adenoid Cystic Carcinoma
o A biopsy report showing areas of swiss cheese pattern or cribiform pattern is indicative of what condition?
 Adenoid cystic carcinoma
o Neurotropism is involved in 25-33% of occurrences of what salivary gland tumor?
 Adenoid cystic carcinoma
o What are the most common sites of metastasis of adenoid carcinoma?
 Lung and bone
o Is the prognosis more favorable with a parotid as opposed to a MSG adenoid cystic carcinoma?
 Parotid is more favorable
o This salivary tumor is a slow growing and painless mass, more common in females, African americans, and occurs in the 6th and 8th decade.
 Polymorphous Low-grade Adenoma
o This salivary gland tumor shows a histological pattern of ‘indian filing’ and neurotropism
 Polymorphous Low-grade Adenoma
o Which malignant salivary gland tumor has the best prognosis?
 Polymorphous Low-Grade Adenoma
• What does NOS mean?
o Not otherwise Specified, can’t be identified exactly but is malignant
• Which malignant salivary gland tumor has the worst prognosis?
o Adenoid cystic carcinoma
• Should you treat a benign salivary gland tumor with radiation therapy?
o No, can create a malignant chance
• What is the order of locations for prognoses, most to least favorable, for malignant salivary gland tumors?
o MSG > palate > submandibular
o What is the main difference between chronic and acute lymphoid hyperplasia?
 Chronic is non-tender
o What is the name of the scattered aggregates of lymphoid tissue in the mouth?
 Waldeyer’s Ring
o Hyperplastic Lymphoid tissue can appear what color?
 Pink, or yellow-orange
o Bi-lateral pink papules on the posterior lateral border of the tongue, history of pneumonia.
 Lingual tonsils
• Excessive bleeding upon primary tooth extraction might suggest what condition?
o Hemophilia A
• Most common inherited bleeding disorder
o Von Wilderbrand’s disease
• What lab tests should be abnormal in vWD?
o Abnormal von willebrand’s factor
o Abnormal platelets
o Abnormal BT and prolonged PTT
• A slick, depapillated tongue that is light pink in coloration could be due to what condition?
o Anemia
• What condition is precipitated by hypoxia, infection, hypothermia, and dehydration?
o Sickle-cell anemia
• What is the most common cause of death in children affected by sickle-cell anemia?
o Strep pneumonia
• A radiographic pattern of a “step ladder” for the jaw bone, and “hair on end” skull, or reduced trebecular pattern appearance is indicative of what condition?
o Sickle-cell anemia
• What is causing the unique radiographic patterns shown in sickle-cell anemia?
o Marrow areas are being recruited to make more red-blood cells
• This a class of disorders affects hemoglobin
o Thalassemia
• What is Hydrops Fetalis?
o A genetic disorder of alpha hemoglobins, (a thalassemic condition)
• What condition experiences anemia, deficiency of WBC, and thrombocytopenia?
o Aplastic Anemia
• What are the oral symptoms of aplastic anemia?
o Gingival hemorrhage (sometimes hyperplasia), petechiae, ecchymoses, ulcerations associated with infection.
• What constitutes Neutropenia?
o <1500 ANC count
• Are infections associated with neutropenia likely to be bacterial, viral, or fungal?
o Bacterial
• Rare idiopathic hematologic disorder characterized by regular periodic reuctions in neutrophils
o Cyclic neutropenia
• How long is the usual cycle for cyclic neutropenia?
o 21 days
• What hematologic condition can cause severe periodontal bone loss and gingival recession?
o Cyclic Neutropenia
• How is Cyclic Neutropenia diagnosed?
o 2-3 blood tests a week for 8 weeks (3 cycles)
o What is the etiology of agranulocytosis?
 Usually induced by exposure to drugs (chemotherapeutic drugs)
o The gingival appearance in agranulocytosis mimicks what condition?
 ANUG
• Term for decreased number of circulatory blood platelets
o Thrombocytopenia
• What is Polycythemia Vera?
o Too many red blood cells
• What are the common clinical signs of polycythemia vera?
o Ruddy complexion
o Pruritus with no rash
o Epistaxis, ecchymoses, gingival hemorrhage
• What are the oral signs of leukemia?
o Oral ulcers (deep punched out lesions with a gray white necrotic base)
o Oral herpetic infections
o Oral candidiasis
o Diffuse gingival enlargement
o Gingival tumor like growth
• What type of leukemia most often has gingival enlargement?
o Myelomonocytic type
• What is Myelophthisic anemia? What conditions is it associated with?
o Crowding out of normal hematopoietic stem cells by malignant proliferation
o Associated with leukemia and multiple myeloma
o What are the forms of langerhans cell disease?
 Acute Disseminated Form
 Chronic, localized form
 Chromic, disseminated form
o Which form of langerhans cell disease shows an eosinophilic granuloma of bone?
 Chronic, localized form
o Hand-Schuller-Christian disease exhibits what triad? Is another name for what disease?
 Triad: bone lesions, exophthalmos, diabetes insipidus. AKA chronic, disseminated form of langerhans cell disease
o What is another name for the acute disseminated form of langerhans cell disease?
 Letterer-Siwe disease
o What age distribution is often affected by Letterer-Siwe (acute disseminated langerhans)?
 Infants
o In general, what are the most commonly affected sights of langerhans cell disease?
 Skull, ribs, vertebrae and mandible common
o What is the radiographic appearance of langerhans cell disease?
 ‘Tooth floating in air’ or severe periodontitis
o Birbeck bodies will be seen in the cytoplasm of cells in what condition?
 Langerhans cell disease
o What is the treatment for chronic localized langerhans cell disease?
 Solitary jaw lesions, curettage
o Etiology of Hodgkin’s lymphoma?
 It is thought to be from E-B virus
o What is the classic cell seen in hodgkin’s lymphoma?
 Reed-Sternberg cells (neoplastic, exhibit owl-eye nuclei) ***going to be on the exam
o What is the age distribution for hodgkins lymphoma?
 Bimodal (15-35 and >50)
o What are the clinical signs and symptoms of hodgkin’s lymphoma?
 Weight loss, fver, night sweats, generalized pruritus, enlarged lymphnodes
o What two conditions (that are covered on the exam) have bimodal age distribution?
 Mucoepidermoid cysts and hodgkin’s lymphoma
o Which has a better prognosis, Hodgkin’s or Non-Hodgkin’s lymphoma?
Hodgkin's
o How does Hodgkin’s lymphoma affect nodes?
 Mess with their architecture
o What virus is thought to play a role in Burkitt’s lymphoma (a type of non-hodgkin’s lymphoma)?
 Epstein Barr virus
o What cell type does non-hodgkins lymphoma originate from most commonly?
 Most commonly originate from B-lymphocyte (~80%)
o Which type of lymphoma more commonly occurs in the mouth?
 Non-hodgkins
o What is the number of oral cavity and oropharyngeal cancer diagnoses a year?
 35,000/yr (at least 7000 is in the oropharynx)
o What autoimmune disease would predispose someone 40x to nonhodgkins lymphoma?
 Sjorgrens
o Which has a more organized classification scheme, non-hodgkins or hodgkins?
 Hodgkins lymphoma
o What are the oral soft tissue lesion characteristics of non-hodgkins lymphoma?
 Nontender, diffuse swelling, buccal vestibule, gingival, or posterior hard palate, boggy consistency, erythmatous or purplish, some ulcerated
o What is the worst of the non-hodgkins lymphomas?
 Burkitt’s
o What percent of African form Burkitt’s lymphomas form in the jaw?
 50-70% form in the jaw (more in the posterior maxilla, common in young)
o Where does Burkitt’s lymphoma most commonly occur in America?
 Usually in the abdominal region, only some in jaw
o What are radiographic signs of Burkitt’s lymphoma in the jaw?
 Radiolucent bone, will ragged, ill defined margins,
 Patchy loss of lamina dura is an early sign
o What is the histological pattern of Burkitt’s lymphoma?
 Starry sky pattern
• This condition is rare, aggressive, nonrelenting, destruction of palate and nasal fossa
o Extranodal NK/T-lymphoma
• Where does Extranodal NK/T-lymphoma arise? In what age population?
o Intranasal in adults
• This lymphoma can cause midline ulceration leading to palatal perforation
o Extranodal NK/T-lymphoma
• What are the complications of Extranodal NK/T-lymphoma?
o Secondary infection, hemorrhage
• What lymphoma begins with signs of epistaxis and nasal stuffiness/pain?
o Extranodal NK/T-lymphoma
• This is a malignancy of plasma cell origin; multicentric origin in bone
o Multiple myeloma
• This is the number one primary bone malignancy in the US
o Multiple myeloma
• What population, age and race, is most commonly affected by multiple myeloma?
o Ages 60-70, 2x more likely in Blacks vs whites
• What types of antibodies are usually formed by the malignant clone plasma cells in multiple myeloma?
o Most commonly IgG and IgM
• What is the number one sign or symptom of multiple myeloma?
o Bone pain
• What is the etiology of petechiae of skin and oral mucosa in multiple myeloma?
o Lack of platelets due to myelophthisic anemia
• What is the significance of Bence-Jones proteinuria?
o Seen in renal failure caused by multiple myeloma
• What lab exam finding in multiple myeloma?
o Monoclonal gammopathy with serum protein immunoelectrophoresis (which means the antibody produced by the malignant plasma cell will be the only one present)
• What condition can lead to amyloid deposits in various soft tissue (ex. tongue) in some patients?
o Multiple myeloma
• What condition will have a radiographic appearance of multiple well defined “punched out” radiolucencies common on skull films?
o Multiple myeloma
• What is the name for a solitary focal form of multiple myeloma?
o Plasmacytoma
• This is the most commonly biopsied oral pathology lesion
o Fibroma
• This is a reactive fibrous hyperplasia, not a true neoplasm
o Fibroma
• Most common locations of fibroma?
o Commonly bitten areas (buccal mucosa, lip, tongue)
• What form of fibrous hyperplasia can occur in denture wearing patients?
o Epulis fissuratum
• Raised areas or ridges of tissue on or near edentulous ridge caused from tissue trauma?
o Epulis Fissuratum
• What is the name for a pedunculated, pressed down fibrous hyperplasia under palatal part of removable denture?
o Fibroepithelial polyp
• What is the treatment for epulis fissuratum?
o Local excision, reline denture or fabricate new, advise patient to remove denture at night
• What is the common patient to present with inflammatory papillary hyperplasia?
o Patients who wear dentures 24/7, ill-fitting dentures, poor denture hygiene
• Where are the common sites for inflammatory papillary hyperplasia?
o Palatal vault and alveolar ridge
• What is possible etiology of inflammatory papillary hyperplasia?
o Candidiasis
• What benign condition, common in denture wearers, mimics the epithelial islands seen in squamous cell carcinoma? (psuedoepitheliomatous hyperplasia)
o Inflammatory papillary hyperplasia
• Which condition can occur in NON-denture wearers, epulis fissuratum or inflammatory papillary hyperplasia?
o Inflammatory papillary hyperplasia
• What are the 3 conditions that start in the interpapillary gingival?
o PG – pyogenic granuloma
o PGCG – peripheral giant cell granuloma
o POF – peripheral ossifying fibroma
• This lesions have a female predilection, and can be due to hormonal changes
o Pyogenic granuloma
• What is the most common location from pyogenic granuloma?
o Gingival
• What is the classic appearance of pyogenic granuloma
o Red, rapid growth, bleeds easily, frequently secondarily ulcerated
• What is the treatment of a pyogenic granuloma?
o Conservative excision
o Eliminate the triggering factor or recurrence is likely
• This is a gingival reactive lesion in response to local irritant histologically shows multinucleated giant cells
o Peripheral giant cell granuloma
• Which of the 3 P’s ONLY occurs on the gingival?
o Peripheral giant cell granuloma AND peripheral ossifying fibroma
• Which of the 3 P’s are true granulomatous inflammation?
o None of them
• What gingival condition may show radiographic bone resorption creating cupping or saucerization or resorption?
o Peripheral giant cell granuloma
• What is the most common mesenchymal tumor of the skin?
o Lipoma
• This is a smooth yellow nodule that happens 50% of the time on the buccal mucosa.
o Lipoma
• What must be ruled out with a possible lipoma on the buccal mucosa?
o Herniation of buccal fat pad
• True or false, lipoma is a reactive growth.
o False, it is a true benign neoplasm
• This is a tender nodule that has the appearance of a fibroma.
o Traumatic neuroma
• Is a traumatic neuroma a reactive or a true neoplastic lesion?
o Reactive
• What is the typical histology of a schwannoma?
o Antoni A with verocay bodies
o Antoni B tissue no associated verocay bodies
• This neoplasm composed of neural tissue can present as a solitary or multiple lesions, and does not contain verocay bodies.
o Neurofibroma
• What are the stigmata with neurofibromatosis type 1 (von recklinghaus)?
o Crowe’s sign (axillary freckling)
o Café Au lait
o Multiple neurofibromas
o Lisch nodules (macules on the iris)
• What is a major complication of neurofibromatosis?
o Neurosarcoma
• Neuromas of the oral mucosa are the first sign of what disease?
o MEN
• This condition often also presents with pheochromocytoma of the adrenal medulla
o MEN
• Medullary thyroid carcinoma is an VERY common complication (90%) of what condition?
o MEN
• What body type is often associated with MEN?
o Marfanoid
• Multiple NON-tender neuromas on the tongue or lips, are indicative of what condition?
o MEN
• What condition would be suspected with a teenager showing signs of hypertension from an over-secretion of catecholamines and nodules on the tongue?
o MEN
• What is the origin of neuroectodermal tumor of infancy?
o Neural crest cells
• This condition presents in infants as a melanotic lesion on the anterior maxillary alveolar ridge
o Neuroectodermal Tumor of Infancy
• This condition can cause bone destruction in the maxilla of an infant
o Neuroectodermal tumor of infancy
• This is a deep-seated nodule commonly on the tongue that is thought to originate from Schwann cells
o Granular cell tumor
• What nodular lesion commonly on the dorsum of the tongue commonly presents with a histology of pseudoepitheliomatous hyperplasia?
o Granular cell tumor
• What is the most common site in the body for a granular cell tumor?
o Tongue
• Is a granular cell tumor considered cancer?
o No, though it histologically appears very similar
• What is the gender and common site commonly affected by congenital epulis of the newborn?
o Maxillary alveolar ridge, 90% female
• What condition common in infants has a histology that appears similar to granular cell tumors but without neural tissue?
o Congenital Epulis of the Newborn
• This is the MOST common tumor of humans and infants
o Hemangioma
• This vesicle or bulla is compressible and blanches upon pressure
o Hemangioma
• What is the difference between vascular malformations and hemangiomas?
o A hemangioma arises within the 1st year of life and should resolve
o A vascular malformation is present at birth and will persist throughout life
• What condition presents with a “port wine” stain and often follows the distribution of a branch of the trigeminal?
o Vascular malformation
• Most intrabony vascular malformations in the mandible are fed by what vessel?
o Carotid artery
• What vascular condition can appear as a radiographic radiolucency with trebeculi?
o Intrabony Vascular malformation
• What are the major components of sturge-weber syndrome?
o Vascular malformations involving face and brain and angiomatosis of leptomeninges
o Seizure disorders, mental retardation
• This is a hamartoma growth rather than true neoplasm
o Lymphangioma
• What type of lymphangioma is very large, seen in newborns and often involves the neck?
o Cystic Hygroma
• This is the MOST common cause of macroglossia
o Lymphangioma
• What is the most common site for lymphangioma?
o On the tongue
• This is the term for a benign smooth muscle tumor
o Leiomyoma
• Leiomyomas are very common in what part of the body?
o Uterus
• What is the origin of a leiomyoma in the mouth?
o Smooth muscle cells around blood vessels (vascular leiomyoma)
• This benign tumor of skeletal muscle is most commonly seen on the tongue:
o Rhabdomyoma
• Which is more common, Rhabdomyoma or Rhabdomyosarcoma?
o Rhabdomyosarcoma
• What are the definitions of choristoma and hamartoma?
o Hamartoma= tumor in normal tissue in a normal location
o Choristoma = tumor in normal tissue in an abnormal location
• What is the most common site for Choristoma?
o Tongue
• What are the most common components in Choristoma?
o Bone or cartilage
• What is the most common soft tissue sarcoma seen in the mouth?
o Rhabdomyosarcoma
• What is the most common soft tissue sarcoma in childhood (60%)?
o Rhabdomyosarcoma
• What is the tissue origin of rhabdomyosarcoma?
o Skeletal muscle
• What are the common head and neck sites of rhabdomyosarcoma
o Orbit, nasopharynx, palate
• What is the most common type of inherited bone disease?
o Osteogenesis imperfecta
• What is a systemic manifestation of dentinogenesis imperfect?
o Osteogenesis imperfecta
• This is a rare hereditary disease with increased bone density
o Osteopetrosis
• What are the two forms of osteopetrosis?
o Infantile and adult
• Which form of osteopetrosis is most deadly?
o Infantile
• In what disease is osteomyelitis common following tooth extraction?
o Osteopetrosis
• True or false, Osteopetrosis patients exhibit a deficiency in the numbers of osteoclasts
o False, normal number of osteoclasts but functionally defective
• What condition presents with globular amorphous bone deposited in marrow spaces?
o Osteopetrosis
• What sex and body site is most commonly affected by focal osteoporotic marrow defect?
o 75% female and 70% posterior mandible
• What is the condition that is non-pathologic and appears radiographically as a radiolucency with thin fine radiopaque trebeculae?
o Focal osteoporotic marrow defect
• This condition could be confused with condensing osteitis
o Idiopathic osteosclerosis
• Where is the most common location for idiopathic osteosclerosis?
o 90% in mandible near 1st molar region
• What is the radiographic appearance of idiopathic osteosclerosis?
o Well-defined radiopaque mass
• What is the required treatment for idiopathic osteosclerosis?
o None!
• This radiopaque bone lesion is associated with pulpitis or pulpal necrosis
o Condensing Osteitis
• This radiopaque bone lesion commonly occurs in children and young adults and exhibits no bony swelling
o Condensing osteitis
• What is the radiographic appearance of condensing osteitis?
o Localized radiopacity at or adjacent to apex of tooth with inflammation, no radiolucent border (distinguishes it from focal cemento-osseous dysplasia)
• What is the treatment for condensing osteitis?
o No specific treatment for affected bone, associated tooth should be extracted or RCT
• This abnormal resorption and deposition of bone affects older, generally Caucasian patients, who experience thickened distortion and weakening of bones
o Paget’s disease of bone
• What condition exhibits narrowing of foramina leading to vertigo, deafness, and visual disturbances?
o Paget’s disease of bone
• How often is the jaw affected in Paget’s disease of bone?
o 17% of cases, bilaterally
• What is the LATE radiographic appearance of paget’s bone disease?
o “cotton wool” radiopacities similar to cement-osseous dysplasias
• Elevation of what lab value is associated with paget’s disease of bone?
o Serum alkaline phosphatase
• What is the characteristic histology of paget’s disease of bone?
o Jigsaw puzzle or mosaic pattern
• What are two common complications of paget’s disease of bone?
o Hypercementosis 50% (difficult extractions) and Osteosarcoma (mostly in pelvis and long bones)
• This bone disease that affects the anterior jaw and often crosses the midline is histologically indistinguishable from hyperparathyroidism, cherubism, and peripheral giant cell granuloma
o Central Giant Cell Granuloma
• This bone condition that often affects children has an early appearance of bilateral mandibular swelling
o Cherubism
• What condition has maxillary involvement stretching skin to expose more sclera of the eye?
o Cherubism
• What is the radiographic appearance of cherubism?
o Multiple, multilocular radiolucencies
• Is a simple bone cyst a true cyst?
o No, no epi lining, therefore a pseudocyst
• What is the presumed etiology of simple bone cyst?
o Trauma, however >50% of cases report no history of trauma
• What gender, body site, age group is mostly affected by simple bone cysts
o Males 2:1, mandible most often, adolescents and young adults
• This bone condition is usually asymptomatic and exhibits a radiographic appearance of scallop shape margins extending between roots of involved teeth without affecting them
o Simple bone cyst
• What does the surgeon usually encounter upon exploratory surgery of simple bone cyst?
o An empty cavity, or more rarely one filled with seroanginous fluid
• What are the clinical features (common age of pts, common location, symptoms) of aneurismal bone cysts?
o Young adults, mandible molar region, and rapid facial swelling (pain)
• What is the radiographic appearance of an aneurismal bone cyst?
o Uni or multilocular radiolucency with a “blow-out” distension of bone contours
• This is a diverse group of processes that replace normal bone with fibrous connective tissue and metaplastic bone
o Benign Fibro-osseous lesions
• What are three benign fibro-osseous lesions?
o Fibrous dysplasia, cemento-osseous dysplasia, ossyfing cemetifying fibroma
• What is the most common site for fibrous dysplasia?
o The jaw
• Does fibrous dysplasia more commonly affect one bone or multiple?
o 80% of cases are monostotic
• What are two syndromes that are characterized by polyostotic fibrous dysplasia?
o Jaffe’s syndrome and McCune-Albright syndrome
• When is the typical onset of fibrous dysplasia?
o In children and teenagers typically before puberty
• This is a painless, slow enlargement of the maxilla or mandible that commonly affects children before puberty.
o Fibrous dysplasia
• What are the radiographic appearances of immature and mature fibrous dysplasia lesions?
o Early: mottled radiolucency
o Late: ground glass radiopaque bone with poorly defined margins
• This polyostotic disease presents with café au lait macules with irregular borders and precocious puberty
o Albright’s syndrome
• What is the characteristic histology of fibrous dysplasia?
o Irregular trabeculae of immature (woven) bone shaped like Chinese writing characters
• What is the treatment of large, diffuse maxillary fibrous dysplasia? What treatment should be avoided?
o Delay treatment until growth ceases and hope the disease will stabilize
o Avoid radiation therapy since osteosarcomatous transformation has been seen
• What is the common population affected by periapical cemento-osseous dysplasia? (age, sex, race)
o 30-50 yrs old
o Black predilection
o Female predominance 14:1
• What is the most commonly affected site with periapical cement-osseous dysplasia?
o Mandibular anterior teeth (happens with vital teeth)
• What is the radiographic appearance of periapical cemento-osseous dysplasia?
o Asymptomatic periapical radiolucencies which transform into radiopacities
• What is the treatment for periapical cemento-osseous dysplasia?
o None
• What is the most common benign fibro-osseous lesion?
o Focal cemento-osseous dysplasia
• What population is most often affected by focal cemento-osseous dysplasia?
o 30-50 yrs old, whites, 90% women
• Where is the most common site for focal cemento-osseous dysplasia?
o Most often in posterious mandible and usually asymptomatic and solitary
• Treatment of focal cemento-osseous dysplasia?
o Observe after diagnosis (hemorrhagic, fragmented gritty tissue that is much more difficult to remove than ossifying fibroma)
• What is the most commonly affected population for Florid Cemento-Osseous Dysplasia?
o Middle aged, female, 90% black
• What fibrous bone condition exhibits bilateral, symmetrical posterior jaw involvement that is multiquadrant and not tooth related?
o Florid Cemento-osseous Dysplasia
• What bone condition may become secondarily infected and mimic diffuse, chronic sclerosing osteomyelitis?
o Florid Cemento-Osseous Dysplasia
• What is the characteristic histology of Florid Cemento-Osseous Dysplasia?
o Sequestrum/involcrum in advanced cases with secondary infection
• What is the treatment of asymptomatic and symptomatic Florid Cemento-Osseous Dysplasia?
o Asymptomatic: prevent or control Periodontitis, avoid biopsy or tooth extraction
o Symptomatic: antibiotics, sequestrectomy, chronic mgmt
• What is the age range, sex, and location most affected by Cementifying-Ossifying Fibroma?
o 20-40yrs old, females 5:1, Mandible 90% molar region
• What lesion is radiographically a well-defined unilocular radiolucent to radiopaque lesion with centripetal expansion of the inferior border of the mandible?
o Cementifying-Ossifying Fibroma
• What is the treatment of Cementifying-Ossifying Fibroma?
o Curettage – shell out from surrounding bone
• This is a benign tumor of mature compact bone
o Osteoma
• What is the most common location for an osteoma to occur?
o Mandibular angle is a frequent location
• What condition presents with multiple osteomas of the jaw and other cranial bones at puberty?
o Gardner Syndrome
• What are 4 stigmata of Gardner Syndrome?
o Multiple osteomas of jaw and cranium, supernumerary teeth/impacted teeth/odontomas, multiple epidermoid cysts of skin, multiple colon or rectal polyp
• Colorectal polyps associated with Gardner syndrome increase the likely hood of the patient developing what?
o Malignant transformation to invasive colorectal carcinoma (50% by age 30, chance increases to almost 100% with increasing age)
• What prophylactic treatment is typically done after the discovery of oral lesions assoicaited with Gardner Syndrome?
o Colonectomy due to the high risk of malignant transformation of polyps
• The is a true neoplasm that is frequently classified as a bone lesion, although it is a tumor of the cementum
o Cementoblastoma
• A cementoblastoma most often occurs in what age group? What region of the mouth?
o Young adults, mandibular first molar region
• True or false, a tooth involved with a cementoblastoma must be non-vital.
o False, involved tooth is vital
• Is a cementoblastoma associated with pain and swelling?
o 2/3rds of the time, yes
• What is the radiographic appearance of a cementoblastoma?
o Root anatomy and PDL obscured by dense radiopaque tumor with thin radiolucent border
• What lesion presents as a jaw swelling with tooth mobility “pumping action” with pulsation or bruit present?
o Central (Intrabony) Hemangioma
• What gender and location is most commonly affected with central (intrabony) hemangioma?
o Females, mandible
• What are the 3 types of primary malignant tumors of the jaw?
o Osteosarcoma
o Chrondrosarcoma
o Ewing’s sarcoma
• This bone malignancy will occur on average 10-15 years later in the jaw than in the long bones
o Osteosarcoma
• What is the clinical presentation of osteosarcoma?
o Bone pain, swelling, tooth mobility
• What is the radiographic appearance of Osteosarcoma?
o Ill-defined radiolucency or moth-eaten radiopacity, Codman’s triangle (tumor raises periosteum away from the bone)
o Symmetrical widening of PDL space
o 25% have sunburst pattern
• What lesion presents radiographically with Codman’s triangle?
o Osteosarcoma (tumor raises periosteum away from bone)
• What is the prognosis of osteosarcoma with and without metastasis?
o 30-70% without metastasis. 1 in 3 metastasize within 2 years (ave survival = 6 mo)
o maxilla, older age have worse prognosis
• To what locations is metastasis of osteosarcoma common?
o Lung and brain
• What is the average age for jaw osteosarcoma and chonrosarcoma?
o 35 yrs
• Does a chonrosarcoma occur more often in the maxilla or mandible?
o Maxilla 4:1
• What lesion looks similar radiographically to chondrosarcoma?
o Osteosarcoma
• This malignant bone lesion that can occur in the jaw most commonly affects white males, age 5-25 and presents most frequently in the mandible.
o Ewing’s sarcoma
• This malignant lesion, when occurring in the jaw, presents with pain, rapid jaw swelling, tooth mobility and parasthesia and can be misdiagnosed as a dental infection
o Ewing’s sarcoma
• This malignant lesion radiographically mimics Garre’s osteomyelitis in the onion skin periosteal appearance.
o Ewing’s sarcoma
• This bone malignancy is considered a small ‘blue dot’ tumor
o Ewing’s sarcoma
• Are most malignancies found in the jaw primary or secondary?
o Secondary (eg. Multiple myeloma, osteosarcoma)
• What are 6 common origin sites for metastatic tumors found in the jaw?
o Lung, brest, kidney, colon, prostate, thyroid glands
• What is the hypothesized route of metastasis for tumors from distant sites to the head and neck?
o Paravertebral venous plexus of Batson (Batson’s plexus)
• Where do metastatic tumors going to the jaw usually appear? Max or mandible?
o Mandible 4:1
• Bone swelling, pain or parasthesia, tooth mobility and post extraction extrusion from the socket in 50+ yr old adult might indicate what?
o Metastatic jaw tumor
• What are common radiographic appearances of metastatic tumors in the jaw?
o Most are ill defined radiolucencies but some may be radiopaque since they produce calcifications