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485 Cards in this Set
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lymphoid hyperplasia may be a sign for HIV? T/F
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T
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enlarged, moveable, soft or rubbery/firm lymph nodes or tissue may indicate an acute or chronic infection called?
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lymphoid hyperplasia
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what may be a concern for metastatic lymphoid hyperplasia concering tonsils?
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tonsillar asymmetry
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Hyperplastic intraoral lymphoid aggregates present as discrete, non-tender, submucosal swellings (< 1 cm), may appear normal, dark pink or creamy yellow-orange
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lymphoid hyperplasia
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what portion of the tongue might lymphoid hyperplasia present, including buccal lymph nodes and rarely post. hard palate?
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lateral-posterior aspect of tongue
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Bleeding disorders associated with genetic deficiency of any of the clotting factors of the blood
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hemophilia
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-X-linked hereditary deficiency of factor VIII
females carry trait, expressed in males Severity depends on extent of clotting factor deficiency Deficiency is percentage of normal value in a patient |
Hemophilia A
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christmas disease
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Hemophilia B
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Genetic deficiency of factor IX (9)
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Hemophilia B
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Most common inherited bleeding disorder
Many cases mild, clinically insignificant |
Von Willenbrand's Disease
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lymphoid hyperplasia
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lymphoid hyperplasia
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lymphoid hyperplasia
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lymphoid hyperplasia
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lymphoid hyperplasia
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lymphoid hyperplasia
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lymphoid hyperplasia
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lymphoid hyperplasia
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tumor-like mass formed from tissue hemorrhage, may occur in oral regions
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pseudo-tumor of hemophilia
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Uncontrollable hemorrhage may result from any laceration, including surgical incisions, dental extractions, and periodontal curettage
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hemophilia
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what is mandatory prior to oral or perio surgery in the case of hemophilia patients?
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consult patient's physician
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rare
autoimmune disorder potentially fatal autoantibodies vs. factor VIII |
acquired hemophilia
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Decrease in the capacity to carry oxygen in the blood
A decrease in the volume of red blood cells or in the concentration of hemoglobin. |
anemia
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Symptoms:
tiredness headache lightheadedness pallor of mucous membranes |
anemia
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what genotype is required for sickle cell disease to manifest?
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2 alleles of HgS hemoglobin
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Sickle cell crisis – sickling of erythrocytes becomes severe; extreme pain from ischemia and infarction of affected tissue and affects which body features the most?
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long bones
lungs abdomen |
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pts. with sickle cell disease are especially susceptible to what bacteria?
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strep. pneumoniae
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reduced trabecular pattern of mandible, occasionally a “hair on end” appearance seen on skull radiograph
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sickle cell disease
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Group of disorders of hemoglobin synthesis characterized by reduced synthesis of either the alpha-globin or beta-globin chains of the hemoglobin molecule
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thalassemias
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Only one defective gene for beta-globin molecule inherited, no significant clinical manifestation
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thalassemia minor
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Two defective genes for beta-globin molecule inherited
-Cooley's anemia -Mediterranean fever |
thalassemia major
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Severe microcytic, hypochromic anemia develops during first year of life.
Rate of hematopoiesis greatly increased, results in massive bone marrow hyperplasia, hepatosplenomegaly and lymphadenopathy |
thalassemia major
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Bone marrow hyperplasia may produce marked, painless enlargement of mandible and maxilla
Skull radiograph shows “hair on end” |
thalassemia major
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sickle cell disease
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sickle cell disease
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sickle cell disease
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beta thalassemia
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why is alpha thalassemia a broade disease considered more broad spectrum?
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4 alpha-globin genes
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Alteration of one alpha globin gene =
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no disease
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Alteration of two genes alpha globin genes =
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produces mild anemia and microcytosis
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Alteration of three genes
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(Hb H disease)
produces hemolytic anemia splenomegaly |
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Alteration of four alpha globin genes
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(hydrops fetalis) is fatal within a few hours of birth.
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alpha-thalassemia trait
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alteration in 2 alpha globin genes
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Oral findings:
gingival hemorrhage oral mucosal petechiae purpura ecchymoses pale oral mucosa ulcerations |
aplastic anemia
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aplastic anemia
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agranulocytosis
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agranulocytosis
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agranulocytosis
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agranulocytosis
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Decreased number of circulating blood platelets
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thrombocytopenia
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how is thrombocytopenia often detected in the oral cavity?
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petechiae
ecchymosis hematoma |
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thrombocytopenia by decreased production or increased destruction?
1) immunological rxn 2) malignant cells in marrow 3) cancer chemo 4) abnormal clot formation |
decreased production:
1) immuno rxn 4) abnormal clot formation increased destruction 2) malignant cells in marrow 3) cancer chemo |
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Increase in mass of red blood cells; may include uncontrolled production of platelets and granulocytes
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Polycythemia Vera
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Ruddy complexion, generalized itching without rash
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Polycythemia Vera
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Erythromelalgia – painful burning sensation in hands and feet, accompanied by warmth. May lead to thrombotic occlusion of vessels, digital gangrene and necrosis is associated with ....?
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Polycythemia Vera
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Secondary polycythemia most often due to
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primary lung disease (COPD)
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Malignancies of hematopoietic stem cell derivation
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Leukemia
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Leukemia is classified according to histogenesis and clinical behavior
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histogenesis (myeloid/lymphocytic)
clinical behavior (acute/chronic) |
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Many of the clinical signs of _____ and symptoms are related to reduction in numbers of normal white and red blood cells due to crowding out of normal hematopoietic stem cells by malignant cells called ___
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leukemia
myelophthisic anemia |
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Polycythemia Vera
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Polycythemia Vera
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Petechial hemorrhages of posterior hard palate and soft palate may occur along with spontaneous gingival hemorrhage with low platelet count
in what condition? |
leukemia
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Ulceration of oral mucosa often present as result of
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impaired ability to combat normal microbial flora
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_____ is most severely affected with ulcers are deep, punched-out lesions with gray-white necrotic base
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gingival mucosa
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Oral candidiasis and herpetic infection are common complications of?
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leukemia
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diffuse, boggy, non-tender swelling of oral soft tissues caused by infiltration of leukemic cells
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Chloroma
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_____ treatment for leukemia serves to destroy as many atypical cells as possible in short time, thus inducing a remission
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Induction Chemo
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_____ treatment for leukemia serves to maintain a state of remission
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maintenance therapy
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leukemia
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leukemia
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leukemia
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chloroma arising from leukemia
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jaw lesions from leukemia
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infiltration and dissolute PDL of leukemia
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Monoclonal proliferation of dendritic mononuclear cells (in the epidermis, mucosa, lymph nodes and bone marrow)
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Langerhans Cell Histiocytosis
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what is the gender and age predilection for langerhans cell histio?
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Male
1/2 under 10yo |
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chronic disseminated histiocytosis is also know as ?
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Hand-Schuller-Christian disease
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acute disseminated histiocytosis is aslo referred to as ?
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Letterer -Siwe disease
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Monostotic/Polyostotic eosniophilic granuloma?
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1/3 Langherhans Cell Histio
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Jaws involved 10-20%; dull pain or tenderness
Punched-out or ill-defined radiolucency Jaw lesions may mimic radiographic features of periapical or periodontal diseases Teeth “floating-in-air”; premature exfoliation of deciduous teeth Oral ulceration, mucosal or gingival proliferation can occur |
Langerhans
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birbeck granules (rod -"racket" bodies)
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Langerhans
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Malignant lymphoproliferative disorder
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Hodgkin's Disease (Lymphoma)
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how common are oral presentations of Hodgkin's Lymphoma ?
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rare
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Usual presenting sign is persistently enlarging, non-tender, discrete mass(es) in one lymph node region. Masses movable in early stages, as condition progresses, nodes become more matted and fixed to surrounding tissue
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Hodgkin's Lymphoma
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langerhans
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langerhans
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langerhans: acute letterer siwe
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langerhans: acute letterer siwe
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langerhans eosinophilic granuloma
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langerhans: chronic hand schuller christian
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langerhans: chronic hand schuller christian
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reed sternberg cell
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hodgkins disease
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Complex group of malignancies of lymphoreticular histogenesis
Grouped into three categories by degree of aggressiveness: -low - intermediate - high grade |
Non Hodgkins disease
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Soft tissue lesions appear as non-tender, diffuse swellings most commonly affecting buccal vestibule, gingiva, or posterior hard palate
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Non Hodgkins disease
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Cutaneous T-Cell Lymphoma
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Mycosis Fungoides
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what are the 3 progressive stages of mycosis fungoides?
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1) Eczematous
2) Plaque stage 3) Tumor stage |
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what stage of mycosis fungoides is characterized by : slightly elevated red lesions
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Plaque
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histologically: Infiltration of lamina propria & epithelium by atypical T lymphocytes
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mycosis fungoides
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1)Usually affects children living in Central Africa
2)Growth of tumor may produce facial swelling and proptosis, tooth mobility |
African Burkitts Lymphoma
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what arch is most affected in Burkitts?
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Maxilla
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what segment of the jaw is most affected in Burkitts?
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posterior segment
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American Burkitts is usually detected as a :?
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abdominal mass
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Malignancy of B-lymphocyte origin, undifferentiated lymphoma
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Burkitts Lymphoma
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Hodgkins
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mycosis fungoides
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mycosis fungiodes
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what stage of mycosis fungoides?
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eczematous (erythromatous) stage
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what stage of mycosis fungoides
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plaque stage
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what stage of mycosis fungoides
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tumor stage
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nonhodgkins
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nonhodgkins
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nonhodgkins
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nonhodgkins
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nonhodgkins
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nonhodgkins
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Burkitt's Lymphoma
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Burkitt's Lymphoma
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Burkitt's Lymphoma
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starry sky appearance under microscope?
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Burkitts Lymphoma
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Malignancy of plasma cell origin that often appears to have multicentric origin within bone
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Multiple Myeloma
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what is the most common characteristic of multiple myeloma
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bone pain
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Multiple, well-defined “punched-out” radiolucencies or ragged radiolucent lesions , especially evident on skull film. Jaws involved in <30% of case
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multiple myeloma
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what is the prognosis for multiple myeloma
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poor 30-36 months
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signs and symptoms:
Pathologic fractures caused by tumor destruction of bone Fatigue (consequence of myelophthisic anemia) Petechial hemorrhages of skin and oral mucosa Fever Metastatic calcification involving soft tissues Renal failure Amyloid deposits to oral mucosa (tongue) or periorbital skin |
mutliple myeloma
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Process characterized by aggressive, non-relenting destruction of the midline structures of palate and nasal fossa. Rare condition; Tx with radiation/chemo 30-50% 5 yr survival
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Angiocentric Tcell Lymphoma
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another name for Angiocentric T cell Lymphoma
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Midline Lethal Granuloma
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Lesion may be localized to hard palatal region
Swelling of soft palate or posterior hard palate may precede formation of deep necrotic ulceration which can create an oronasal fistula. |
Angiocentric Tcell Lymphoma
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Unifocal, monoclonal, neoplastic proliferation of plasma cells usually arising within bone; most progress to multiple myeloma
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Plasmacytoma
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what is the most commonly involved site for Plasmacytoma?
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spine
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a plasmacytoma found in soft tissue is called _____ and may progress to multiple myeloma
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extramedullary plasmacytoma
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_______ appears as relatively nondescript, well-circumscribed, non-tender soft tissue mass, may be found in tonsillar region, maxillary sinus, and parotid gland
Radiographically, lesion may be seen as well-defined, unilocular radiolucency or as ragged radiolucency – no other lesions should be identifiable |
Extramedullary plasmacytoma
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angiocentric tcell lymphoma
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multiple myeloma
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multiple myeloma
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a cyst is a cavity (pathologic, often fluid-filled) that is line by epithelium
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odontogenic cyst
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what are the 2 subclassifications of odontogenic cysts?
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1) developmental
2) inflammatory |
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pericapical cyst
residual periapical cysts buccal bifurcation cysts are examples of what? |
inflammatory odontogenic cysts
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follicular cyst
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dentigerous cyst
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Cyst develops by separation of follicle from around the crown of an unerupted tooth.
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dentigerous cyst
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most common developmental odontogenic cyst
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dentigerous
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what are the 2 most common sites for dentigerous cysts to arise?
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mandibular 3rds
maxillary canines |
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Neville would suggest that the radiolucency of a dentigerous cyst be at least how large?
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3-4mm
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The 3 main complications of dentigerous cysts are:
1) 2) 3) a squamous cell carcinoma from the cystic epithelium. |
1) an ameloblastoma
2) a mucoepidermoid carcinoma |
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It develops as the result of a separation of the dental follicle from around the crown of an erupting tooth that is within the soft tissues overlying the alveolar bone.
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eruption cyst
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another name for eruption cyst?
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eruption hematoma
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what teeth are most involved in eruption cysts?
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First molars
Maxillary Incisors |
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eruption cysts are found in relatively :
young middle aged older |
young 10 yo
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originates from the cystic degeneration of the enamel organ before the development of the dental hard tissue
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primordial cyst
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preferred name of primordial cysts?
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Odontogenic Keratocyst
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All OKCs are primordial cysts or all primordial cysts are OKCs?
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all primordial cysts are OKCs
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OKCs arise from the _____ ____
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dental lamina
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most OKCs arise in the ____ region of which arch ___
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molar-ramus
mandibular |
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dentigerous cyst
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dentigerous cyst
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eruption cyst
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OKC
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OKCs or dentigerous cysts are most related to root resorption?
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dentigerous cysts
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____shows a thin, friable wall with little inflammatory infiltrate.
The epithelial lining consists of a uniform layer of stratified squamous epithelium usually 6.8 cells thick. The epithelial-connective tissue interface is usually flat |
OKCs
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luminal surfaces of OKCs show flattened ______ epithelial cells with wavy corrugated appearance
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parakeratotic
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OKCs:
The basal cell layer is composed of a ______layer of cuboidal to columnar cells, which are often Between 7-26 % of the OKCs have ______ cysts. |
palisaded
hyperchromatic satellite (daughter) |
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the relative distribution of OKCs tends to be greater in the ___ arch an in the _____ region
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mandibular
posterior |
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OKC recurrence is _____
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common and requires special surgical attention
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odontogenic cyst with orthokeratinized epithelial lining
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orthokeratinized odontogenic cyst
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-sometimes requires chemical cauterization of bony cavity with Carnoy's solution
-recurrence is more common up to 62% and can be in remission for up to 10 yrs |
OKCs
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which is most commonly associated with Nevoid Basal Cell Carcinoma Syndrome?
OKCs or Orthokeratinized Odontogenic cyst |
OKCs
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OKC
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orthokeratinized cyst
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Gorlin syndrom
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Nevoid Basal Cell Carcinoma Syndrome
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Nevoid BCCS has ___ penetrance and ------ expressivity
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high
variable |
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-multiple basal cell carcinomas of the skin
-jaw cysts -rib and vertebral anomalies -intracranial calcification |
Nevoid BCCS
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-Frontal and temporoparietal bossing
-40% patients present with hypertelorism. |
Nevoid BCCS
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Mild mandibular prognathism is common.
The skin tumors usually appear around puberty and are most common on the mid-face. Palmar and plantar pits are seen in 60 % of the patients. Over 50 % of the patients develop basal cell carcinomas |
Nevoid BCCS
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what is the most common skeletal abnormality?
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bifid rib
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reported:
kyphoscoliosis while others manifest spina bifida occulta, shortened metacarpals, calcification of the falx cerebri. Ovarian fibromas and medulloblastomas |
Nevoid BCCS
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most jaw cysts of Nevoid BCCS are diagnosed as ?
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OKC
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prognosis of Nevoid BCSS depend on behavior of _____
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skin tumors (basal cell lesions)
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These lesions appear as small, superficial, keratin-filled cysts on the alveolar mucosa
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gingival (alveolar) cyst
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gingival alveolar cysts arise from ____
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remnants of dental lamina
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what is the age predilection for gingival alveolar cysts?
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newborns
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which arch are gingival alveolar cysts most common to arise on?
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maxillary
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These uncommon lesions are derived from the rests of the dental lamina and are considered the soft tissue counterpart of the lateral periodontal cyst.
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gingival cyst of adult
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most common site for gingival cyst of adult?
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mandibular
K9/PM region facial gingiva/alveolar mucosa |
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NBCCS
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NBCCS
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NBCCS
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NBCCS
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NBCCS
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gingival alveolar cyst of newborn
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gingival alveolar cyst of newborn
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appear as painless, dome-shaped swellings have a blue-blue/gray coloration.
On occasion they may produce a superficial, “cupping-out” of the alveolar bone, which is not usually apparent on x-ray. |
gingival cyst of adult
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Botryoid Odontogenic Cyst
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Lateral Periodontal Cyst
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cyst occurring in the lateral periodontal region in which an inflammatory origin or an OKC has been excluded by clinical and histological means.
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Lateral Periodontal Cyst
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lateral perio cysts occur most of in _____ gender and after the age of ____
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males
30 |
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most of lateral perio cysts occur in the ___ region of the oral cavity
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mandibular
K9/PM |
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is the radiograph of a lateral perio cyst diagnostic?
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no
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multilocular lateral perio cysts are called
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botyroid odontogenic cysts
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what distinguishes a lateral perio cyst from a lateral radicular cyst
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lateral perio cyst occurs adjacent to VITAL teeth
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lateral periodontal cyst
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another name for :
Gorlin Cyst Dentinogenic Ghost Cell Tumor |
Calcifying Odontogenic Cyst (COC)
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another name for:
Calcifying Cystic Odontogenic Tumor Calcifying Ghost Cell Odontogenic Cyst |
Calcifying Odontogenic Cyst (COC)
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what is the mean age of COCs?
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33yo
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what is the gender predilection for COCs?
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women
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what is the most common region for COCs to appear?
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incisor/K9 region
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present as well-defined, unilocular radiolucency but the lesion may contain radiopaque foci (approximately 50 % of cases).
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COCs
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is root resorption a factor in the presence of COCs?
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yes
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About a third of the COCs are associated with an unerupted tooth, most often which tooth?
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K9
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From 13-21 % of the COCs are _________ and these lesions present as localized sessile or pedunculated gingival masses with no distinguishing feature.
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extraosseous
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most COCs are of neoplastic or NON-neoplastic nature?
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Non-neoplastic
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eosinophilic epithelial cells characterized by the loss of their nuclei
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ghost cells of COCs
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ghost cell nature is controversial between :
coagulative ______ vs. aberrant ____ |
necrosis vs. keratinization
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20% of COCs are associated with what tumor?
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odontoma
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Sialo-odontogenic Cyst
Mucoepidermoid Odontogenic Cyst? |
Glandular Odontogenic Cyst
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The Glandular Odontogenic Cysts are more common in what regions?
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Mandible
Anterior regions |
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are the glandular odontogenic cysts typically unilocular or multilocular in form?
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multilocular
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an uncommon inflammatory odontogenic cyst that characteristically develops on the buccal aspect of the mandibular first permanent molar.
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Buccal Bifurcation Cyst
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what is the typical age predilection for Buccal Bifurcation Cysts?
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5-11yo
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Clinical swelling and a foul-tasting discharge is usually noted by patient.
Radiographs typically show a well-demarcated unilocular radiolucency involving the buccal furcation and root area of the involved tooth. Occlusal radiographs may show lingual displacement of the roots. |
buccal bifurcation cyst
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proliferative periostitis may present with ______ cyst?
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buccal bifurcation cyst
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intraosseous jaw carcinomas are called?
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odontogenic carcinomas
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odontogenic carcinomas have a age predilection of ____ and gender of ____
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59 yo
male |
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COC
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COC
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buccal bifurcation cyst
|
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buccal bifurcation cyst
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Glandular Odontogenic cyst
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GOC
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White line,” usually bilateral, on buccal mucosa
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linea alba
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Associated with pressure, frictional irritation, or sucking
trauma from the facial surfaces of the teeth |
linea alba
|
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Chronic nibbling produces lesions that are white, shredded
|
morsicatio buccarum
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chronic cheek chewing
|
morsicatio buccarum
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morsicatio of the lateral border of the tonuge?
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morcatio linguarum
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Areas of erythema (red halo) that surrounds central yellow pseudomembrane (ulcer) or focal red ulcerated area without fibrin covering; smaller, uncomplicated lesions heal within days
|
traumatic ulcerations
|
|
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-Most often seen on tongue secondary to muscle damage
-Deep “pseudo-invasive” inflammatory reaction that is slow to resolve |
TUGSE (Traumatic Ulcerative Granuloma with Stromal Eosinophlia)
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Sublingual ulceration in infants, associated with nursing and natal/neonatal teeth
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Riga - Fede disease
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linea alba
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linea alba
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traumatic ulceractions
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traumatic ulcerations
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traumatic ulcerations
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TUGSE
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TUGSE
|
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riga-fede disease
|
|
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May be misdiagnosed as lymphoma.
Surface ulceration and underlying tumefaction. Treatment involves removal of irritating cause |
Atypical Histiocytic Granuloma
|
|
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|
which of the following is not considered to be a substance that can cause oral chemical injuries?
-aspirin -2% hydrogenperoxide -silver nitrate -phenol -copper -endo materials |
2% hydrogenperoxide (only 3%+)
copper |
|
|
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which type of exposure to caustic agents may lead to white wrinkling
|
brief exposure
|
|
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Mucositis - areas of ulceration; pain, burning, and discomfort
Dermatitis - varies according to intensity of therapy Intraoral hemorrhage, oral petechiae and ecchymosis Xerostomia are results of what type of tx? |
anticancer/neoplastic therapy
|
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Hypogeusia
|
loss of all 4 tastes
|
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dysgeusia
|
altered taste
|
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Result of non-healing, dead bone
Dead bone separates from residual vital areas Postradiation dental extractions are known risk factor |
Osteoradionecrosis
|
|
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trismus may be a complication of what non-infectous oral problem?
|
antineoplastic/cancer therapy
|
|
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|
what is the conductor in electrical mouth burns?
|
saliva
|
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Initial appearance is painless, charred yellow area with little bleeding; edema develops, then sloughing
Tetanus shot required Primary problem is contracture of mouth opening during healing (microstomia, prevents eating and hygiene) |
electrical burns
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factitious oral injury
|
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atypical histiocytic granuloma
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electric burns
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chemical injury
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chemical injury
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chemical injuries
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anticancer therapy
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anticancer therapy
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anticancer therapy
|
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anesthetic necrosis most commonly presents at which site?
|
hard palate
|
|
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Changes on vermilion border of lip caused by chronic lip licking, biting, picking, or sucking.
Mild cases feature chronic dryness, scaling, fissuring, cracking. |
Exfoliative Cheilitis
|
|
|
|
Vermilion can be covered with thick yellowish hyperkeratotic crust that may be hemorrhagic or fissured
Areas of papular and crusted erythema on perioral skin |
Exfoliative Cheilitis
|
|
|
|
secondary candidal infection in areas of low-grade trauma to vermilion border of lip
|
Cheilocandidiasis
|
|
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|
petechaie
purpura ecchymosis hematoma are all examples of ? |
submucosal hemorrhages
|
|
|
|
Hematoma – tumor-like swelling caused by an accumulation of blood trapped in the tissue (extravascular blood within tissue produces mass; often the result of blunt trauma
|
hematoma
|
|
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|
what is the most common lesion reported from sexual activity?
|
submucosal palatal hemorrhage secondary to fellatio
|
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Horizontal ulcerations of lingual frenum may be caused by ______ (frenum rubs across incisal edges of mandibular central incisors)
|
cunnilingus
|
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Implantation of dental amalgam resulting in clinically evident pigmentation = black, blue macules
|
amalgam tattoos
|
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|
-Ulcerative stomatitis
-Gingival line (bluish line along marginal gingiva) -Gray areas on buccal mucosa and tongue could be cause by? |
lead
|
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anesthetic necrosis
|
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anesthetic necrosis
|
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submucosal hemorrhage
|
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submucosal hemorrhage
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submucosal hemorrhage
|
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amalgam tattoo
|
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amalgam tattoo
|
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amalgam tattoo
|
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Metallic taste
Ulcerative stomatitis Inflammation and enlargement of salivary glands, gingiva, tongue Gingiva may become blue-gray to black Destruction of alveolar bone and exfoliation of teeth |
mercury intoxication
|
|
|
|
Acrodynia / pink disease or Swift disease with symptoms of:
-excessive salivation -ulcerative gingivitis -bruxism -premature tooth loss is all associated with? |
mercury intoxication
|
|
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|
argyria
|
systemic silver intoxication
|
|
|
|
what kind of metallic intoxication is associated with:
Blue-gray line along gingival margin Ptyalism, burning, stomatitis, ulceration |
bismuth
|
|
|
|
-Diffuse macular hyperpigmentation of the skin
-excessive salivation -necrotizing ulcerative stomatitis -metallic permalignant keratoses of skin |
arsenic
|
|
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Dermatitis
Severe oral mucositis metallic taste |
gold
|
|
|
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oral pigmentation due to heavy smoking?
|
smoker's melanosis
|
|
|
|
cigarette smokers will possess pigmentation in the _____ region whereas pipe smokers will exhibit this in the ______ region
|
anterior labial alveolar mucosa
commissural and buccal mucosae |
|
|
|
Which of the following drug groups does NOT lead to discolorations within the oral cavity.
Phenolphthalein Minocycline Antidepressants Antimalarials Tranquilizers Estrogen Chemotherapy agenst AIDS meds |
Anti-depressants
|
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|
|
Traumatic Osseous and Chondromatous Metaplasia is also referred to as the __ __
|
Cutright Lesion
|
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|
metallic pigmentation
|
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smoker's melanosis
|
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smokers melanosis
|
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drug related discoloration
|
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drug related discolorations
|
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-Alveolar atrophy with secondary fibrous hyperplasia of bone or cartlage overlying alveolar ridges occurs in anterior maxilla as result of pressure of dentures
-May present as raised, reddened, ulcerated areas or firm, movable polyp-like lesions |
traumatic osseous and chondromatous metaplasia (cutright lesion)
|
|
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|
Dome-shaped radiopaque lesions arising from floor of maxillary sinus
Inflammatory exudate accumulates under maxillary sinus mucosa causing sessile elevation |
antral pseudocysts
|
|
|
|
Arise from partial blockage of duct of seromucous glands or from invagination of respiratory epithelium
|
retention cysts
|
|
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Accumulations of mucin encased by epithelium
|
sinus mucoceles
|
|
|
|
the 2 types of sinus mucoceles?
|
1) surgical ciliated cyst
2) sinus obstruciton by osteum |
|
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|
Arises from air forced into subcutaneous or fascal spaces of face and neck
-Soft tissue enlargement from presence of air in deeper tissues, enlargement increases with secondary inflammation and edema |
Cervicofacial Emphysema
|
|
|
|
Crepitus synchronous with heartbeat is characteristic of ____ and is known as?
|
Cervicofacial Emphysema
Hamman's crunch |
|
|
|
Foreign body reaction resulting from placement of topical tetracycline, usually in a petroleum base, into surgical site
-Black, greasy, tar-like material found in lesion |
Myospherulosis
|
|
|
|
|
cervicofacial emphysema
|
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cervicofacial emphysema
|
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cervicofacial emphysema
|
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antral pseudocysts
|
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antral pseudocyst
|
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antral pseudocyst
|
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|
tumors of odontogenic epithelium derive from odontogenic epithelium an and odontogenic ectomesenchyme alike? T/F
|
F:
without participation of odontogenic mesenchyme |
|
|
|
what is the most clinically significant odontogenic tumor?
|
ameloblastoma
|
|
|
|
“usually unicentric, non-functional, intermittent in growth, anatomically benign and clinically persistent.”
|
amelosblastoma
|
|
|
|
what are the 3 presentations of an ameloblastoma?
(hint) |
1) Conventional solid/ Multicystic
2) Unicystic 3) Peripheral / Extraosseous |
CUP
|
|
|
of which of the 3 forms of ameloblastoma is most common?
|
conventional solid / multicystic
|
|
|
|
where are ameloblastomas most often found?
|
posterior - mandible
|
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|
|
soap bubble or honeycomb would describe what interpretation of an ameloblastoma?
|
radiographric appearance: multilocular, though can be unilocular just as often
|
|
|
|
what are the 6 types of ameloblastomas?
|
1) follicular
2) plexiform 3) acanthomatous 4) granular cell 5) desmoplastic 6) basaloid |
|
|
|
what are the most common types of ameloblastomas?
|
follicular
plexiform |
|
|
|
what is the least common type of ameloblastoma?
|
basaloid
|
|
|
|
type of ameloblastoma:
type is composed of islands of epithelium which resemble the enamel organ in a mature fibrous connective tissue stoma |
follicular
|
|
|
|
ameloblastoma type is composed of long, anastomosing cords or larger sheets of odontogenic epithelium. Its stroma tends to be loose and more vascular.
|
plexiform
|
|
|
|
ameloblastoma type shows evidence of extensive squamous metaplasia with keratin formation in the island of odontogenic epithelium.
|
acanthomatous
|
|
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|
ameloblastoma type there is transformation of groups of epithelial cells to granular cells; the nature of the granular change is unknown. This type is more common in young patients and has been shown to be clinically aggressive
|
granular cell
|
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|
|
ameloblastoma form is composed of islands/cords of odontogenic epithelium in a very dense collagenous stroma. It has a predilection for the anterior maxilla and because of the dense connective tissue may appear as a radiolucent-radiopaque lesion
|
desmoplastic
|
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|
ameloblastoma form composed of uniform basaloid cells with no stellate reticulum.
|
basaloid
|
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|
which of the following in untrue of ameloblastoma:
-may cause erosion of cortical plates -usually asymptomatic -more common in white males -may cause paresthesia |
more common in blacks
|
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|
marginal resection is usually used for ameloblastomas whereby usually ____ cm margin is resected beyond radiological limits
|
1.0
|
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|
|
typically unicystic ameloblastomas occur when the pt is (young/old?) and around what tooth?
|
young (1st 2nd decade)
mand. 3rd molar |
|
|
|
what are the 3 histopathological variants of a unicystic ameloblastoma?
|
1) luminal
2) Intraluminal/plexiform 3) mural |
|
|
|
ameloblastoma
|
|
|
|
ameloblastoma
|
|
|
|
ameloblastoma
|
|
|
|
ameloblastoma
|
|
|
|
ameloblastoma
|
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|
|
what type of histo variant of unicystic ameloblastomas infiltrate the fibrous cystic wall
|
mural
|
|
|
|
These tumors occupy the lamina propria underneath the surface epithelium but outside of the bone.
|
peripheral / extraosseous ameloblastoma
|
|
|
|
what is the predilection for peripheral ameloblastomas?
|
posterior gingival / alveolar mucosa
slight mandible |
|
|
|
the following describes which type of ameloblastoma:
Islands of ameloblastic epithelium are observed in the lamina propria; plexiform and follicular patterns are the most common; in 50 % of the cases the tumor connects with the basal cell layer of the surface epithelium. |
peripheral ameloblastoma
|
|
|
|
is a tumor that shows histologic features of the typical (benign) ameloblastoma in both the primary and secondary deposits and is metastatic
|
malignant ameloblastoma
|
|
|
|
is a tumor that shows cytologic features of malignancy in the primary tumor, in recurrence and any metastases
|
ameloblastic carcinoma
|
|
|
|
the metastatic types of ameloblastoma most often produce metastases where?
|
lungs
|
|
|
|
what type of metastatic ameloblastoma presents more aggressive with a ill-defined radiolucency with cortical destruction
|
ameloblastic carcinoma
|
|
|
|
prognosis for malignant ameloblastoma and ameloblastic metastases have what kind of prognosis?
|
poor
|
|
|
|
Several patterns have occurred with the predominant pattern consisting of nests of epithelial cells with a clear or faintly eosinophilic cytoplasm separated by strands of hyalinized connective tissue
|
clear cell odontogenic carcinoma
|
|
|
|
clear cells are filled with ____
|
glycogen
|
|
|
|
this odontogenic epithelial tumor has an inductive effect on the odontogenic ectomesenchyme with dentinoid frequently being produced.
|
Adenomatoid Odontogenic Tumor
|
|
|
|
the mean age of AOTs =
|
17yo
|
|
|
|
CCOC occur at the mean age of ?
|
50yo
|
|
|
|
is there a gender predilection for AOTs?
|
females
|
|
|
|
what is the most common location of AOTs?
|
K9 region of maxilla
|
|
|
|
"snow-flake calcification" radioopacities within lucencies?
|
AOTs
|
|
|
|
-The lesion is usually surrounded by a thick, fibrous capsule.
-The tumor is composed of spindle-shaped epithelial cells that form sheets, strands or whorled masses with little connective tissue. -The epithelial cells may form rosette-like structures, tubular or duct-like structures may be prominent or absent. -Calcifications may be observed in the tumor mass. |
Adenamatoid Odontogenic Tumors
|
|
|
|
do AOTs recur frequently?
|
seldom
|
|
|
|
-Pindborg tumor accounts for < 1 % of all odontogenic tumors.
-It is clearly of odontogenic origin but its histogenesis is uncertain. -The tumor cells are said to resemble cells of the stratum intermedium. |
Calcifying Epithelial Odontogenic Tumor (CEOT)
|
|
|
|
what is the mean age of CEOTs?
|
40yo
|
|
|
|
where is the most common location of CEOTs?
|
posterior mandible
|
|
|
|
are CEOTs associated with unerupted teeth or erupted teeth?
|
almost 50/50 with unerupted more likely
|
|
|
|
-This lesion is typically composed of islands, sheets or strands of polyhedral epithelial cells in a fibrous stroma.
-Areas of amorphous, eosinophilic, hyalinized extracellular material may be scattered throughout. |
CEOT
|
|
|
|
-Cells outlines are distinct and intercellular bridges may be seen.
-Nuclei show considerable variation with giant nuclei and pleomorphism observed. -Calcifications may be noted as well as amyloid-like material. |
CEOT
|
|
|
|
-Liesegang rings also may be present.
|
CEOT
|
|
|
|
are CEOTs typically more or less aggressive than ameloblastoma?
|
less
|
|
|
|
What is the mean age of the squamous odontogenic tumor?
|
SOT
|
|
|
|
what is the location for SOTs?
|
maxilla = mandible
anterior alveolar processes |
|
|
|
This group of tumors is composed of proliferating odontogenic epithelium in a cellular ectomesenchyme resembling the dental papilla.
|
Mixed Odontogenic Tumors
|
|
|
|
|
AOT
|
|
|
|
AOT
|
|
|
|
AOT
|
|
|
|
AOT
|
|
|
|
CEOT
|
|
|
|
CEOT
|
|
|
|
SOT
|
|
|
|
SOT
|
|
|
|
Ameloblastic Fibroma is a type of ___ tumor
|
mixed odontogenic tumors
|
|
|
|
what is the gender predilection for ameloblastic fibromas
|
males slightly
|
|
|
|
ameloblastic fibromas typically are (ill-defined or well-defined) and have a (epithelial or sclerotic border)?
|
well defined
sclerotic |
|
|
|
The tumor is composed of a cell-rich mesenchymal tissue resembling the primitive dental papilla admixed with proliferating odontogenic epithelium
|
ameloblastic fibromas
|
|
|
|
-The tumor is often encapsulated with small tumors usually being asymptomatic.
-Larger tumors produce swelling, which can expand the cortex and be quite pronounced. |
ameloblastic fibroma
|
|
|
|
This lesion is considered the malignant counterpart of the ameloblastic fibroma in which the mesenchymal portion shows features of malignancy
|
Ameloblastic Fibrosarcoma
|
|
|
|
what is the mean age for an ameloblastic fibrosarcoma?
|
26
|
|
|
|
what is the gender predilection for an ameloblastic fibrosarcoma?
|
males
|
|
|
|
what is the most common location of an ameloblastic fibrosarcoma?
|
mandible
|
|
|
|
-The epithelial component of this tumor appears histologically benign.
-The mesenchymal portion is highly cellular. The cells are hyperchromatic and quite pleomorphic. Mitoses are usually prominent. |
ameloblastic fibrosarcoma
|
|
|
|
what is the most common odontogenic tumor?
|
odontoma
|
|
|
|
an odontogenic tumor is not a true neoplasm but a ____
|
hamartoma
|
|
|
|
what are the 2 types of odontogenic tumors?
|
compound
complex |
|
|
|
this type of odontoma is composed of multiple small tooth-like structures.
|
compound
|
|
|
|
this lesion is composed of a conglomerate mass of enamel and dentin, which bears no anatomic resemblance to a tooth.
|
complex
|
|
|
|
what is the mean age for odontomas?
|
14yo
|
|
|
|
what is the most common location for odontomas?
|
maxilla
|
|
|
|
which type of odontoma resembles a uniform opaque mass with no apparent tooth shapes present?
|
complex
|
|
|
|
which type of odontoma is composed of enamel, dentin, and cementum and resembles tooth form?
|
compound
|
|
|
|
what is the prognosis of odontomas?
|
excellent
|
|
|
|
what is the mean age for odontogenic myxomas?
|
30
|
|
|
|
what is the most common location for odontogenic myxomas?
|
mandible
|
|
|
|
does the odontogenic myxoma appear as unilocular or multilocular radiolucent lesion
|
multilocular
|
|
|
|
The tumor is composed of loosely arranged stellate, spindle-shaped and round cells in an abundant, loose myxoid stroma with few collagen bundles.
|
odontogenic myxoma
|
|
|
|
are odontogenic tumors encapsulated?
|
no
|
|
|
|
what is the prognosis of odontogenic myxomas?
|
good
25% recurrence rate |
|
|
|
Radiographically, the lesion appears as an opaque lesion attached to and replacing the root of the involved tooth.
Opaque spicules radiate from the central mass. The lesion is composed of sheets or thick trabeculae of mineralized material with irregularly placed lacunae and prominent basophilic reversal lines. Multinucleated giant cells are often present. |
cementoblastoma
|
|
|
|
what is the most common location for cementoblastomas?
|
mandible
posterior roots |
|
|
|
ameloblastic fibroma
|
|
|
|
ameloblastic fibrosarcoma
|
|
|
|
ameloblastoma
|
|
|
|
ameloblastoma
|
|
|
|
ameloblastoma
|
|
|
|
ameloblastoma
|
|
|
|
ameloblastoma
|
|
|
|
unicystic ameloblastoma
|
|
|
|
unicystic ameloblastoma
|
|
|
|
cementoblastoma
|
|
|
|
cemenotblastoma
|
|
|
|
cementoblastoma
|
|
|
|
odontogenic myxoma
|
|
|
|
odontogenic myxoma
|
|
|
|
odontoma
|
|
|
|
odontoma
|
|
|
|
odontoma
|
|
|
|
odontoma
|
|
|
|
canker sores are referred to as ?
|
recurrent apthous stomatitis (ulcerations)
|
|
|
|
what are the 3 major causes Recurrent Apthous Stomatitis?
|
1) Primary immunodysregulation
2) Decrease of mucosal barrier 3) Increase in antigenic exposure |
|
|
|
what are the 3 variations of canker sores?
|
1) minor
2) major 3) herpetiform |
|
|
|
what is the most common clinical variation of recurrent apthous ulcerations?
|
minor = 80%
|
|
|
|
Sutton's disease =
|
minor variation canker sore
|
|
|
|
where do minor apthous ulcerations appear?
|
non-keratinized mucosa
|
|
|
|
associated with canker sore: macule develops an ulceration covered by a yellowish-white membrane and encircled by erythematous halo
|
erythromatous macule
|
|
|
|
Ulcerations deeper than minor variant, measure 1-3 cm in diameter, take from 2-6 weeks to heal, may cause scarring
Labial mucosa, soft palate, tonsillar fauces are most commonly affected |
major canker sore
|
|
|
|
canker ulcerations with greatest number of lesions and highest recurrence rate?
|
herpetiform apthous ulcers
|
|
|
|
Multisystem disorder – ocular, mucocutaneous (oral/genital), joints (arthritis), CNS (paralysis & dementia)
Strong association with HLA-B51 type |
Behcets Syndrome
|
|
|
|
Oral lesions similar to aphthous ulcerations, but involve ____ and ___
|
soft palate and oropharynx.
|
|
|
|
btween 70-85% of Behcets Syndrom pts. present with lesions of the ___ and _____ involvement
|
genitals
ocular |
|
|
|
Multisystem granulomatous disorder of unknown cause:
Lungs, lymph nodes, skin, eyes, salivary glands are predominant sites Lymphoid tissue involved in almost all cases |
sarcoidosis
|
|
|
|
symptosm:
Chronic, indurated lesions on nose, ears, lips, face Symmetric, elevated, indurated, purplish plaques on limbs, back, buttocks |
sarcoidosis
|
|
|
|
a characteristic of sarcoidosis consisting of :
scattered, nonspecific, tender, erythematous nodules on lower legs =? |
erythema nodosom
|
|
|
|
_____ syndrome is associated with sarcoidosis and presents with:
erythema nodosum bilateral hilar lymphadenopathy arthralgia |
Lofgren's syndrome
|
|
|
|
____ syndrome is associated with sarcoidosis and presents with:
-also called "uveoparotid fever" – parotid enlargement anterior uveitis of the eye facial paralysis fever |
Heerfordt's Syndrome
|
|
|
|
Non-tender, persistent swelling of lips; edema, ulcers, papules of intraoral sites; fissured tongue, swollen gingiva, edematous buccal mucosa characterizes what pathology?
|
Orofacial Granulomatosis
|
|
|
|
orofacial granulomatosis characterized by :
Superficial amber vesicles, facial paralysis, fissured tongue, swollen lips |
Melkersson-Rosenthal Syndrome
|
|
|
|
orofacial granulomatosis characterized by: lips alone?
|
Cheilitis granulomatosa (of Miescher)
|
|
|
|
Necrotizing granulomatous lesions of respiratory tract, glomerulonephritis, systemic vasculitis of small arteries and veins
|
Wegener’s Granulomatosis
|
|
|
|
"strawberry gingivitis"
|
Wegener’s Granulomatosis
|
|
|
|
--Present before renal involvement
--Florid and granular hyperplasia --Short hemorrhagic, friable, bulbous projections --Most frequently affects buccal mucosa all characterize what presentation of Wegener's Granulomatosis? |
strawberry gingivitis
|
|
|
|
minor apthous
|
|
|
|
minor apthous lesion
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minor apthous ulcer
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major apthous ulcer
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major apthous ulcer
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herpetiform ulcers
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herpetiform ulcers
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herpetiform ulcers
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herpetiform ulcers
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behcets syndrome
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behcets syndrome
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sarcoidosis
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sarcoidosis
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sardoidosis
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sarcoidosis
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sarcoidosis
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melkersson - rosenthal syndrome
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cheilitis granulomatosa of Miescher
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wegener's granulomatosis
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wegeners granulomatosis
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An allergic reaction of oral mucosa to systemic administration of medication
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stomatitis medicamentosa
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stomatitis venenata
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allergic contact stomatitis
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what is the most frequent symptom of allergic contact stomatitis?
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burning sensation
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erythematous or white and hyperkeratotic mucosa, erosion charaterizes what form of allergic contact stomatitis
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chronic
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what artificial ingredient may cause pain and burning as a form of contact stomatitis
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cinnamon
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cinnamon induced contact stomatitis when using toothpaste most often affects what feature of oral cavity?
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gingiva
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reactions from cinnamon chewing gum and candy affect what oral features most readily? (2)
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buccal mucosa
lateral borders of tongue |
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What may lead to the following symptoms:
Erythematous base, hyperkeratosis of surface epithelium, ulceration Lingual involvement may spread to dorsal surface Thickening of surface epithelium can occur (resembles hairy leukoplakia or carcinoma) |
cinnamon induced contact stomatitis
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what element in amalgam may cause an allergic rxn within the mouth?
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mercury
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Lesions that do not migrate. Involve only mucosa directly in contact with dental amalgams, and resolve after removal of adjacent amalgams
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contact lichenoid reaction
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Quincke's Disease?
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Angioedema
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Diffuse edematous swelling of soft tissues related to alteration in vascular permeability
Mast cell degranulation is most frequent cause (hypersensitivity reaction to drugs, foods, plants, dust, inhalants). May occur in those using ACE inhibitors or deficiency of C1-INH. |
angioedema
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where does angioedema most often present itself?
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subcutaneous and submucosal CT
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stomatitis medicamentosa
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stomatitis medicamentosa
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stomatitis medicamentosa
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stomatitis medicamentosa
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allergic contact stomatitis
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cinnamon induced contact stomatitis
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cinnamon induced contact stomatitis
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cinnamon induced contact stomatitis
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allergic rxn to dental amalgam
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angioedema
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angioedema
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angioedema
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