PBDE Oral Pathology
Terms
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DEVELOPMENTAL VARIATIONS OF NORMAL ORAL STRUCTURES
Epstein's Pearls (2) -
Epithelial inclusion cyst
Palatal midline -
DEVELOPMENTAL VARIATIONS OF NORMAL ORAL STRUCTURES
Bohn's Nodules (2) -
Buccal and lingual aspect of alveolus
Ectopic mucous glands -
DEVELOPMENTAL VARIATIONS OF NORMAL ORAL STRUCTURES
Dental Lamina Cysts (2) -
Crest of the alveolus
Remnants of dental lamina -
DEVELOPMENTAL VARIATIONS OF NORMAL ORAL STRUCTURES
Hyperplastic Foliate Papillae (3) -
Lateral border of tongue
Easily traumatized
Normal lymphoid tissue -
DEVELOPMENTAL VARIATIONS OF NORMAL ORAL STRUCTURES
Fordyce Granules (5) -
30% of children
Ectopic sebaceous glands in oral mucosa
Elevated yellowish nodules
Maybe discrete or confluent
Common sites: buccal mucosa, upper lip -
DEVELOPMENTAL VARIATIONS OF NORMAL ORAL STRUCTURES
Median Rhomboid Glossitis (5) -
? Result of anomalous vascularity vs. persistence of tuberculum impar
Usually asymptomatic, but may cause soreness/burning
Surface flat or slightly raised
Color varies from pale pink or whitish to bright red
Candidial infection present (~40%) -
DEVELOPMENTAL VARIATIONS OF NORMAL ORAL STRUCTURES
Fissured Tongue (4) -
Rarely seen before age 4 years
? Genetic (A.D.) Autosomal Dominant
3-5% frequency, but higher in mentally retarded population
May be associated with Melkersson-Rosenthal syndrome -
DEVELOPMENTAL VARIATIONS OF NORMAL ORAL STRUCTURES
Melkersson-Rosenthal syndrome (8) -
Rare
Facial palsy (40%)
Facial swelling
Labial swelling in >80%
Maybe recurrent
Becomes persistent with progressive fibrosis
Fissured tongue (50%)
Etiology unknown -
DEVELOPMENTAL VARIATIONS OF NORMAL ORAL STRUCTURES
Leukoedema (5) -
If you stretch cheek, it disappears
Most commonly seen in African Americans
Grayish-white thickening of buccal mucosa
Usually bilateral
Extensive intracellular edema of epithelium -
DEVELOPMENTAL VARIATIONS OF NORMAL ORAL STRUCTURES
Idiopathic Osteosclerosis (5) -
Well-defined radiopacity in the tooth-bearing area of jaw
No surrounding radiolucent space
Not typical of any other condition
Mandibular premolar/molar area most common
Maybe related to root apex, but normal PDL -
DEVELOPMENTAL VARIATIONS OF NORMAL ORAL STRUCTURES
Stafne Bone Defect (3) -
Males with square jaws
Cyst-like radiolucent area near angle of mandible
Indentation of bone containing extension of submandibular gland -
DEVELOPMENTAL VARIATIONS OF NORMAL ORAL STRUCTURES
Bifid Tongue (3) -
Developmental malformation
May coexist with orofaciodigital syndrome
Complete form requires surgical reconstruction -
DEVELOPMENTAL VARIATIONS OF NORMAL ORAL STRUCTURES
Bifid Uvula (3) -
Minor expression of cleft palate
Must rule out submucous cleft
May require surgical correction -
MACROGLOSSIA
Discrete swellings or lumps/bumps (5) -
Congenital
Inflammatory
Traumatic
Neoplastic
Others -
MACROGLOSSIA
Lingual thyroid (3) -
Redundant thyroid tissue in tongue
Hypothyroidism (~20%)
~70% lack normal thyroid tissue in neck - VASCULAR MALFORMATIONS OF THE TONGUE (4)
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Present at birth
Become clinically evident in late infancy/early childhood
May increase in size following trauma, infection, or endocrine changes
~35% associated with skeletal changes -
VASCULAR MALFORMATIONS OF THE TONGUE
Lymphangioma (4) -
Diffuse vs. discrete
Tongue most common site
Surface often papillary or vesicular
Tx: Surgical excision -
VASCULAR MALFORMATIONS OF THE TONGUE
Hemangioma (5) -
Common vascular tumor of infancy
Usually appear early in infancy, grow rapidly until age 6 to 8 months, then slowly involutes
Blanch on pressure
Generally do not involve adjacent skeletal tissue
Tx: Watch and Wait -
VASCULAR MALFORMATIONS OF THE TONGUE
Infection/Abscess (3) -
Uncommon, but may follow traumatic injury
May represent secondary infection of neoplasm/cyst
Tx: Antibiotics -
VASCULAR MALFORMATIONS OF THE TONGUE
Tongue pyogenic granuloma (5) -
Looks similar to hemangioma
Common reactive lesion
Painless, nodule, red lesion
Typically pedunculated with ulcerated surface
Tx: Surgical Excision -
VASCULAR MALFORMATIONS OF THE TONGUE
Riga-Fede disease (3) -
Chronic trauma from primary lesion
Typically ulcerated lesion on tip of tongue
Tx: Smooth incisal edges -
VASCULAR MALFORMATIONS OF THE TONGUE
Fibroma (4) -
Most common tumor of oral mucosa
Often the result of chronic trauma
Typically painless, firm, sessile or pedunculated
Tx: Surgical Excision -
VASCULAR MALFORMATIONS OF THE TONGUE
What are the two reasons isolated lesions look white in the mouth? -
Keratin
Necrosis -
VASCULAR MALFORMATIONS OF THE TONGUE
Papilloma (6) -
70% will appear white due to keratin
Human papilloma virus
Exophytic, well circumscribed
Usually pedunculated with either finger-like projections or cauliflower surface
Rule out condyloma acuminatum
Tx: Surgical removal