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Oral Path Review

Oral Path Review. Name this oral lesion:. Varix (Varices, pl.). Sometimes called caviar tongue Distended vein (like a hemorrhoid) No treatment usually required Diff. diagnosis: mucocele and hemangioma. Name this oral lesion:. Mucocele. Collection of saliva in the oral mucosa

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Oral Path Review

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  1. Oral Path Review

  2. Name this oral lesion:

  3. Varix (Varices, pl.) • Sometimes called caviar tongue • Distended vein (like a hemorrhoid) • No treatment usually required • Diff. diagnosis: mucocele and hemangioma

  4. Name this oral lesion:

  5. Mucocele • Collection of saliva in the oral mucosa • Common symptom: gets bigger, then smaller, bigger, etc. • Traumatic severance of salivary ducts • Treated by surgical excision of the entire gland that feeds the duct • Could be confused with salivary gland neoplasm, varix, and hemangioma

  6. Name this oral lesion: • You should know this by now…

  7. Torus palatinus and Torus mandibularis • Bony bumps in the mouth…midline if on the hard palate…single or bilateral for mandibular • Could be inherited…developmental overgrowths • Won’t grow past their “programmed size” • May require removal if they interfere with prosthetics

  8. Name this oral lesion:

  9. Leukoedema • Filmy, white/grey discoloration of oral mucosa (mostly buccal) • Variation of normal caused by intracellular edema of the superficial epithelial cells • Seen primarily in blacks (90%) and smokers • No treatment required • Could only be confused for a bunch of really rare conditions.

  10. Name this oral lesion:

  11. Papillary hyperplasia (PH) and/or Denture sore mouth (DSM) • PH and DSM may be the same thing, thought to be caused by Candida albicans • Can be small red spots. When it worsens, it turns bright red and produces the red, pebbly look of papillary hyperplasia. • Treatment with antifungals, but recurrence is common • Good oral/denture hygiene may help • Benign and unmistakable See the book for other pictures and more detailed information. This can be highly variable in appearance.

  12. Name this oral lesion:

  13. Geographic tongue (AKA: benign migratory glossitis) • Usually asymptomatic • Hard to misdiagnose this “maplike” nastiness on the dorsal tongue • Affects all ages • Cause is unknown • Chronic: lasts months to years with periods of remission and exacerbation.

  14. Name this oral lesion:

  15. Nicotine Stomatitis • Caused by smoking (particularly pipe) • Asymptomatic and usually disappears after quitting smoking

  16. Name this oral lesion:

  17. Periapical dental granuloma • Periapical radiolucency found at the apex of a tooth with chronic inflammation • Usually round or oval with a distinct border • If there is a sinus tract, may be asymptomatic • Endo therapy or extraction necessary • Could be confused with radicular cyst or periapical abscess

  18. Name this oral lesion:

  19. Periapical cyst (Radicular cyst) • Looks a lot like the last one, eh? • ONLY difference is the presence of an epithelium lined central cavity in the cyst.

  20. Name this oral lesion:

  21. Angular cheilosis • Dry corners of the mouth • May be caused by slobber accumulating in the corners of the mouth in patients with a deep bite. Candida likes to hang out in the drool. • May be a riboflavin defficiency???

  22. Name these oral lesions:(Hint: they’re different!)

  23. Top: Periferal FibromaBottom: Pyogenic Granuloma • Usually in children & young adults • Histologically, this is mostly connective tissue • Can be excised, but may recur • Histologic examination may be the only way to distinguish this from Periferal Fibroma • Vascular and sometimes painful • Common in pregnancy

  24. Name this oral lesion:

  25. Peripheral giant cell granuloma • Much the same as peripheral fibroma and pyogenic granuloma, but these are histologically different (contain fibroblasts and multinucleated giant cells) • Surgical excision • May recur

  26. Name this oral lesion:

  27. Amalgam tattoo • Blue-grey and permanent • Caused by accidental implantation amalgam into soft oral tissues • No treatment required, but didn’t your Mama warn you against getting tattoos?

  28. Name this oral lesion:

  29. Condensing Osteitis • Sclerotic reaction to infection commonly seen in young patients • Caused by infection of periapical tissues of low virulence • Treat only cases where the infection is symptomatic or carious in the associated tooth. Follow up with regular x-rays.

  30. Name this oral lesion:

  31. Nasopalatine duct cyst • Heart-shaped radiolucency at theincisive canal • Developmental from epithelial remnants of the nasopalatine duct • Can be confused with other types of cysts (remember the radicular cysts?) • Surgical removal is treatment

  32. Name this oral lesion:

  33. Dentigerous Cyst • Very common & found around an unerupted tooth • Most commonly around 3rd molars, but any tooth could be affected (rarely on deciduous teeth) • Large cysts can cause parasthesia and/or pain • Surgical enucleation should be followed up with histological examination

  34. Name this oral lesion:

  35. Lichen planus • Lacy, white lines are characteristic of reticular type. Erosive type and plaque type are variations. • Only erosive type requires treatment • May predispose patient to oral cancer

  36. Name this oral lesion:

  37. Dilantin gingival hyperplasia • Can also be caused by cyclosporin and nephedapine (sp?) • Fibrous overgrowth of the gingiva, particularly the anterior (as opposed to the posterior and lingual areas) • Scrupulous dental hygiene recommended • Overgrowth requires surgical removal. Or ceasing to take the anticonvulsant may cause gradual recession within one year.

  38. Name this oral lesion:

  39. Papilloma • Sessile or pedunculated & look like cauliflower • Usually on palate-uvula area, or on tongue or lips • Lasts weeks to years, but usually months • Could be viral origin • Surgical removal • No evidence that they are premalignant

  40. Name this oral lesion (be specific):

  41. Herpes Labialis • Recurrent oral infection caused by herpesvirus • Recurrences vary from person to person and are thought to be triggered by exposure to sunlight, fever, trauma, and other irritants. • Virus “hides” in the nearest ganglion and lies dormant • Acyclovir ointment shortens healing time …systemic acyclovir doesn’t work for oral herpes

  42. Name this oral lesion:

  43. Primary herpetic stomatitis • Generalized involvement of the oral cavity infected with herpesvirus • Usually seen in children • Blisters break easily and are VERY painful (can’t eat or drink) • Accompanied by fever OUCH!!!

  44. Name this oral lesion:

  45. Fordyce granules • Ectopic sebaceous glands caused by a developmental anomaly • Seen in greatest numbers during puberty • Most common on buccal mucosa • No treatment required

  46. Name this oral lesion:

  47. Ideopathic osteosclerosis • Area of dense but normal bone found anywhere in the jaw, but usually in mandibular molar-premolar area • Shape varies and may be associated with a tooth, but does not require treatment

  48. Name this oral lesion:

  49. Candidosis (Candidiasis, Moniliasis, Thrush) • Infection with Candida albicans • Involved mucus membrane develops a white, necrotic slough. • White lesions can be wiped off, leaving a bleeding, white surface • Occurs in the very young, very old, those with reduced resistance and those on long-term antibiotic therapy or immunosuppression (AIDS victim shown here)

  50. Name this oral lesion:

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