Oral Pathology

Front 1

Layers of Teeth (3)

Back 1

Enamel - mineralized outer layer
Dentin - living tissue
Dental Pulp - vascular, innervated

Front 2

Dental Caries

Back 2

Bacteria form plaque/biofilm -> produce acid by fermenting sugars which destroy tooth

often S. Mutans, Lactobacillis

Front 3

Periapical Abscess

treatment?

complications?

Back 3

dental caries progresses to pulp -> abscess formation at root apex

treatment: root canal, fillings

complicaitons: abcess can drain into other cavities and spaces in the face -> cellulitis, ludwig's angina (medical emergencies)

Front 4

Ludwig's Angina

Back 4

Periapical abcess drains to below the myloid hyoid m. to floor of mouth -> infection -> swelling -> block airway

Front 5

Periapical Granuloma

Back 5

ignored periapical abcess can become chronic inflammation

Front 6

Periapical Cyst

complication?

Back 6

chronic inflammation from periapical abcess stimulates epithelial rests (embryonic dental tissue) to form cyst

can cause pathologic fracture of mandible

Front 7

Gingivitis

Back 7

plaque accumulates on tooth -> becomes calcified to tartar -> inflammation of gingiva

erythema, edema, hemorrhage, tenderness of gingiva, gingival recession

Front 8

Periodontitis

Back 8

Biofilm transition to facultative bacteria to g- anaerobic bacteria

bone resorption and loss of gingival attachment - increase bone pocket depth

Front 9

Periodontitis

complications?

Back 9

complications: bacterial endocarditis, lower resp infection

Front 10

Dentigerous Cyst

what is it?
complications?

Back 10

Cyst around unerupted/impacted tooth often 3rd molar

forms from ameloblast

complication: pathologic fracture

Front 11

Odontogenic Keratocyst

what is it?
likely location?

Back 11

parakeratinizing epithelial lining without rete peg formation

aggresive, resorbes bone, hard to ressect

likely location: posterior mandible

Front 12

Ameloblastoma

Back 12

most common benign true tumor of odontogenic tissue

causes bone destruction, very agressive, poorly encapsulated -> recurrance

multioccular, intraosseous

Front 13

Histology of Ameloblastoma

Back 13

Pallasading columnar cells with nucleus away from the basement

Front 14

Odontoma

Compound vs Complex

Back 14

not a true tumor - harmatoma - disorganized mature of dental tissue

Compound resemble teeth
Complex don't resemble teeth

Front 15

aphthous stomatitis

Back 15

canker sore, oral ulcer of unknown cause likely multifactorial

can be small (minor) or large (major)

painful

Front 16

acute herpetic gingivostomatitis

Back 16

HSV1 usually, sometimes HSV2

painful, vesicular eruption -> ulcers

becomes latent - hides in trigeminal gangilion -> erupts as secondary (recurrent) form on lips or hard pallet

Front 17

Herpes Labialis

Back 17

secondary outbreak of cold sores from HSV1 or 2 often on vermillion zone

Front 18

Oral candidiasis (Thrush)

Erythematous Candidiasis

Chronic Atrophic Candidiasis

Back 18

most common oral fungal infection

usually candida albicans

infection usually results from immunocompromized state (system or local)

forms white deposit that you can scrape off

Erythematous Candidiasis - no deposit - just red

Chronic Atrophic Candidiasis - due to denture

Front 19

Oral hairy Leukoplakia

etiology?
which patients? significance?
morphology?

Back 19

etiology: EBV

immunocompromised pateints

raised, white, verrucous plaques on lateral tongue

early marker for worsening of HIV

Front 20

irritation fibroma

Back 20

REACTIVE, localized aggregation of fibrous tissue forms a nodule

due to irritation or trauma

Front 21

pyogenic granuloma

which patients are more susceptible?

histology?

Back 21

REACTIVE - not pyogenic or a real granuloma

associated with pregnancy (hormonal changes)

histology: capilary vascular spaces - hemangioma - ulcerates and bleeds easily

due to irritation or trauma

Front 22

peripheral ossifying fibroma

what is it?
location?

Back 22

exclusive to gingiva

REACTIVE aggregation of fibrous tissue with foci of bone or cementum

Front 23

peripheral giant cell granuloma

what is it?
location?

Back 23

REACTIVE - multinucleated giant cells in vascular stroma

purple nodule

exclusive to gingiva

Front 24

leukoplakia

what is it?
location?

Back 24

white patch on floor of mouth, ventral or lateral tongue

clinical diagnosis - must rule out other disease and lesion cannot be scraped off

most are hyperkeratosis but some (25%) turn out to be dysplasia/carcinoma

should be biopsy and removed

Front 25

erythroplakia

Back 25

red patch on oral mucosa - cannot be determined to be anything else

90% show dysplasia/carcinoma

should remove/biopsy

Front 26

squamous cell carcinoma

gross morphology?
histology?

Back 26

94% of all oral cancers

etiology - tobacco, UV light on lip, HPV, betal chewing, ethanol

gross: nonhealing ulcer with indurated, elevated, rolled boarders, PAINLESS

histology:
-sheets, chords, nests of malignant cells which invade submucosa
-keratin perals

Front 27

erythroleukplakia

Back 27

mix of leukoplakia and erythroplakia - just as dangerous as erythroplakia

Front 28

Verrucous carcinoma

Back 28

papillary form of SCC that invades with borad, pushing margins rather than nests of cells

etiology: chewing tabacco

good prognosis - metastasis rare

Front 29

Melanoma

Back 29

intraoral worse prognosis than extraoral. if you cant determine it to be an amalgum tatoo, then must remove immediately

Front 30

mucocele

Back 30

traumatic severance of duct - muscin pools in lamina propria

most common salivary gland lesion

mucin filled pseudocyst in submucosa

Front 31

ranula

treatment?

Back 31

blockage in wharton (submandibular) duct - swelling

remove entire gland

Front 32

sialadenitis

Back 32

bacterial infection of salivary gland

usually S. aureus or viridan ...often due to dehydration or medication that causes stasis

Front 33

sialolith

Back 33

salivary gland stone - blocks flow causing stasis -> bacterial infection

Front 34

pleomorphic adenoma

Back 34

most common salivary gland neoplasm

pleomorphic - mixture of cells, pseudocapsule, intraloral salivary gland

benign, but can become malrignant

Front 35

warthin tumor - papillary cystadenoma lymphomastosum

Back 35

2nd most common salivary gland tumor

benign

males

perotid only

etiology: smoking

morphology - papillary projections into cystic spaces, bilayer of cells on papillary

Front 36

mucoepidermoid carcinoma

Back 36

most common primary salivary gland MALIGNANCY

sheets of squamous cells - epidermoid
+
mucoid secerting cells

Front 37

adenoid cystic carcinoma

Back 37

malignant

grows along nerves and sheaths

histology: ductal cells and myoepithelial cells in caribriform, tubular, solid patterns

painful, slow, persistant (recurrent)