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199 Cards in this Set
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Most common odontogenic cyst Most common cyst of oral cavity at apex of NON VITAL tooth |
Periapical (Radicular) Cyst |
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Types of Odontogenic cysts |
inflammatory developmental neoplastic |
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Types of inflammatory odontogenic cysts |
periapical residual periapical buccal bifurcation |
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Types of developmental odontogenic cysts |
dentigerous/eruption cyst primordial lateral periodontal gingival |
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types of neoplastic odontogenic cysts |
odontogenic keratocyst (keratocytstic odontogenic tumor calcifying odontogenic tumor |
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periapical cyst = inflammatory |
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How do you treat a periapical cyst? |
root canal therapy extraction for non restorable teeth |
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periapical granuloma |
radiographically can't tell diff from cyst histologically = chronically inflamed granulation tissue of non vital tooth |
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Inflammatory |
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buccal bifurcation cyst |
cyst in furcation of most commonly: Mandibular 1st M INFLAMMATORY response |
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Dentigerous cyst MC DEVELOPMENTAL encloses crown of unerrupted tooth MC 3M and C |
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primordial cyst enamel organ becomes cyst most cases are OKC in place of tooth Developmental |
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Lateral from rest of dental lamina between 2 roots of vital teeth Developmental around transition point mand from ant to post |
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gingival developmental from rests of dental lamina (Serres) mand C and PM |
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Calcifying Odontogenic Cyst |
GORLIN CYST NEOPLASM |
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Odontogenic Keratocyst (OKC) |
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Odontogenic Keratocyst |
histopath feat= most important parakeratotic surface epith cells (Wavy)- horizontal Plaisaded basal cells(fence )- on the bottom borders lighter pink, vertical standing NEOPLASTIC |
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Gorlin Syndrome |
multiple basil cell carcinomas of the skin multiple OKC |
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multiple bcc associated with Gorlin syndrome |
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basil cell carcinoma ( usually multiple and associated with gorlin syndrome) |
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intracranial calcification associated with Gorlin syndrome |
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What are the 2 odontogenic cysts that may act as a tumor? |
OKC can become keratinizing cystic odontogenic turmor (KCOT) calcifying odont cyst (COC) can become Calcifying cystic odonto tumor (CCOT) |
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Tumors of odonto epith without odonto ectomesenchyme |
ameloblastoma calcifying epith odonto tumor squamous odonto tumor |
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Tumors of odonto epith with ectomesenchyme, with or without dental hard tissue formation |
adenomatoid odonto tumor ameloblastic fibroma ameloblastic fibro-odontoma odontoma |
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Tumors of odonto ectomesenchyme with or without epith |
odonto myxoma cementoblastoma |
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Ameloblastoma features |
multilocular radiolucency pericoronal radiolucency extra- osseous (peripheral) |
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multilocular radiolucency |
can be ameloblastoma (tumor of epith) |
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pericoronal radiolucency |
can be ameloblastoma (tumor of epith) |
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extra osseous peripheral |
can be ameloblastoma (tumor of epith) |
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Histo features of Ameloblastoma |
Resembles the enamel organ |
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Calcifying epithelial odontogenic tumor |
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Calcifying epithelial odonto tumor can also look same as ameloblastoma in age location and treatment |
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Calcifying epithelial odontogenic tumor |
histo: cells look like stratum intermedium of enamel organ has uni and multilocular radiolucency Tumor of epithelium |
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Squamous Odontogenic Tumor |
from rest of Malassez in PDL space local radiolucency loss of alveolar bone and lamina dura tumor of epithelium |
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squamous odonto tumor loss of alveolar bone and lamina dura |
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adenomatoid odontogenic tumor tumor of epith and ectomesenchyme involve crown of unerupt tooth younger pt's ( 10-19) Females Maxilla canine snowflake calcification |
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The malignant counter part of ameloblastic fibroma ? |
ameloblastic fibrosarcoma |
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ameloblastic fibroma tumor of epith and ectomesenchyme in young pt's |
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ameloblastic fibro-odontoma tumor of epith and ectomesenchyme ameloblastic fibroma of forming tooth tissue |
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What is the most common type of odontogenic tumor ? |
Odontoma : considered developmental anomaly tumor of epith and ectomesenchyme pt age avg: 14 yrs maxilla |
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compound odontoma (odontogenic tumor) usually in anterior maxilla tooth-like structures |
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complex odontoma posterior jaws irregular calcified mass, radiolucent rim |
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odontogenic myxoma tumor of ectomesenchyme soap bubble local aggressive |
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cementoblastoma tumor of ectomesenchyme benign radio opaque mass around apex of tooth |
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What is oral squamous papilloma caused by ? |
HPV (6 and 11) |
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oral squamous papilloma usually solitary |
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verruca vulgaris aka common wart |
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verruca vulgaris orally often indistinguishable from oral squamous papilloma white |
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condyloma acuminatum venereal warts - pic in oral cavity multiples, cauliflower like caused by HPV 6 and 11 |
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seborrheic keratosis exclusively skin lesion stuck on look associated with sun exposure |
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actinic lentigo no intraoral counterpart from sun exposure topical retinoic acid reduces color may be lip lesions |
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oral melantotic macule <7mm usually on lower lip can occur on soft palate |
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acquired melanocytic nevus mole intraorally- palate and gingiva may never be pigmented |
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actinic keratosis old people sandpaper feel from sun exposure Topical 5-fluorouracil |
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actinic cheilitis scaly look may have ulceration vermillionectomy can become cancerous |
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Tobacco pouch keratosis grey/ grey-white in area of placement textured |
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nicotine stomatitis grey-white mucosa, multiple papules (red spots in it ) and cracked look |
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Leukoplakia Definition |
a white patch or plaque which can't be characterized clinically or path as any other disease |
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what is the most common precancerous oral lesion? |
leukoplakie= considered premalignant |
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Leukoplakia homogenous and speckled white worry = tongue, floor of mouth, soft palate tobacco and alcohol contribute |
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For which epithelial lesion is a biopsy mandatory? |
Leukoplakia |
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erythroplakia red may be adjacent to leukoplakia most show sever dysplasia tobacco and alcohol etiology |
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Oral squamous cell carcinoma |
sites: tongue, floor of mouth, soft palate minimal pain |
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Oral squamous cell carcinoma |
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squamous cell carcinoma of lip from chronic sun exposure slow growing |
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Squamous cell carcinoma |
spread by lymphs firm nodes move or fixed spreads to lungs, liver, bones use TMN staging |
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TNM staging |
used with squamous cell carcinoma stage at diagnosis = most important prognostic indicator T=tumor size, N= local node involvement, M= distant metastasis |
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Field cancerization |
people with a carcinoma in one place are at increased risk of developing a second mucosal tumor |
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basil cell carcinoma |
low grade malignancy from chronic sun exposure in middle 1/3 of face nodulouclerative = MC form |
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Melanoma |
acute solar damage = really bad sun burn ABCD's asymmetry, irreg borders, color variation, diameter >6mm (eraser), evolution |
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melanoma |
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oral melanoma |
rare maxillary gingiva, palate |
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oral melanoma |
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Osteoma benign tumor of compact bone MC site: in posterior mandible |
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What is the most serious feature of Gardner Syndrome? |
Intestinal Polyps serious because has ability of malignant transformation |
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intestinal polyps associated with Gardner syndrome |
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Gardner syndrome: intestinal polyps with malignant potential multiple osteomas multiple odontomas supernumerary teeth |
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Idiopathic Osteosclerosis |
increased bone density not attributed to any specific cause Mandible PreM and 1st M area adjacent teeth=vital NOT condensing osteitis |
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idiopathic osteosclerosis |
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Idiopathic osteosclerosis vs condensing osteitis |
CO= non-vital tooth widened pdl sclerosis of bone around root from chronic inflam IO=increase bone density adjacent teeth are vital radioopaque mass |
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condensing osteitis |
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traumatic bone cyst |
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Traumatic bone cyst |
asymptomatic empty cavity assoc with trauma pseudocyst |
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Aneurysmal bone cyst pseudocyst Blood soaked sponge=surgical finding uni/multilocular radiolucency from rupture of local vascular network in a pre existing bone lesion |
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Central giant cell granuloma: non- neoplastic can be either central or peripheral Females Mandible Anterior uni/ multi locular radiolucency assoc with jaw expansion and divergence of tooth roots |
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peripheral giant cell granuloma |
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Post- surgical hyperostosis |
tumor-like reactive growth of bone at surgical site in periosteum after perio surgery ex: gingival graft |
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3 types of benign Fibro-osseous Lesions of the jaws |
Fibrous dysplasia- unknown central ossifying / cementifying fibroma-neoplasm cemento-osseous dysplasia - reactive lesion |
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Fibro-osseous lesions of the jaw |
diseases characterized by the replacement of bone with abnormal fibrous CT interspersed with varying amounts of calcification |
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Fibrous Dysplasia: monostotic =affect only 1 bone- MC type maxilla benign and chronic radiograph- ground glass appearance |
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polyostotic fibrous dysplasia |
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Histology of fibrous dysplasia |
chinese letters appearance |
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central ossifying fibroma: true benign neoplasm female mandible well defined unilocular radiolucency with varying radiopacity |
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Periapical cemento-osseous dysplasia: Reactive lesion= not neoplasm Female Black Anterior Mandible Involved teeth= vital |
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focal cemento-osseous dysplasia: Female White posterior mandible |
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florid cemento-osseous dysplasia: Multiple quads Black women Osteomyelitis=complication in edentuolous |
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Paget's disease: enlargement and deformity of affected bone spacing of teeth headache dizziness deafness |
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paget's disease |
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cotton wool appearance associated with paget's disease hypercementosis in radiographs as well |
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Histologically, what does paget disease of bone look like? |
mosaic pattern bc prominent reversal lines |
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What are there significantly high levels of in lab serum in paget's disease? |
alkaline phosphatase |
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Osteoblastoma |
benign tumor cells show osteoblastic differentiation bone forming mixed radiolucency |
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Osteosarcoma Malignant tumor bone forming *sunray or sunburst * widening PDL |
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Where is the most frequent intraoral site for metastatic tumors of the jaw? |
Mandible these tumors have begun because of cancers that began in other areas ex:breast, prostate, kidney |
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Metastatic tumor of jaw radioopaque |
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Frictional keratosis chronic mechanical irritation calloused mucosa linea alba= specific type |
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Endentulous alveolar ridge keratosis |
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frictional keratosis of tongue |
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chronic cheek biting frictional keratosis irregular thick can also occur on tongue |
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Snuff dippers keratosis |
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amalgam tatoo |
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graphite tatoo from pencil in kids usually |
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Smoker's melanosis in facial anterior usually femal type of hypermelanosis |
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Lichen Planus type of post inflam hypermalanosis (hyperpigmentation) from inc in melanin synthesis from prostaglandins and other inflam products |
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Oral melantotic macule post- inflam hypermelanosis MC = lower lip |
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Melanoacanthosis in African descent pt after trauma ***need biopsy differ to from melanoma increased in melanocytes |
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Where do drug induced pigmentations usually occur? |
hard palate and gingiva |
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Minocycline pigmentation drug induced |
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Lead line /poisoning drug induced pig |
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Traumatic ulcer MC cause ulcer in OC = trauma physical thermal or chemical |
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Nicotine stomatitis in heavy smokers thermal and chemical injury |
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Cocaine osteonecrosis cocaine abuse manifest: palatal perforations perforated nasal septum cocaine keratosis cocaine dehiscence |
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What drug can cause a chemical burn? |
aspirin = necrotic epithelium |
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Geographic tongue looks like bald spots elevated borders |
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Hematoma submucosal hemorrhage red dark elevated mass trauma related anticoag disorder = predispose |
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Keloid abnorm prolif of scar tissue |
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What is a mucosal alteration that can cause recession of the gingiva ? |
lip barbell |
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What are 2 complications in the oral cavity from chemo? |
mucositis hemorrhage |
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What are 3 complications that arise in the oral cavity in radiation ? |
mucositis xerostomia osteoradionecrosis |
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Chemo related mucositis moveable tissue = affected most |
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Chronic hyperplastic pulpitis growth of granulation tissue from pulp molars of children |
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Apical abscess |
form of liquefactive necrosis inflammatory response to bacterial infect or necrosis of pulp |
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Dental Abscess accum of neutrophils and exudate and necrotic cells =PUS |
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Parulis |
mass of granulation tissue where sinus tract reaches mucosa |
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Untreated dental abscess |
cellulitis (space infection) cavernous sinus thrombosis (infection from maxilla) ludwig angina (infection of mandible ) |
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Periapical granuloma |
mass of inflammed granulation tissue at apex of non vital tooth from pulpal necrosis radiolucent |
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Internal Resorption trauma induced pink crown |
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What causes pulpal stones ? |
Chronic inflammation of the pulp 2 types : dystrophic calcification denticles (contain dentinal tubules surrounded by odontoblasts) |
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Abfraction wedge shape notch at cervical region from flex of tooth from pressure |
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What can cause external resorption? |
chronic inflam from trauma infection reimplantation of avulsed tooth orthodontic treatment tumors ex: ameloblastoma |
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Osteoradionecrosis from radiation moth-eaten appear mandible |
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what does the drug bisphosphonate do? |
inhibits activity of osteoclasts= slow bone turnover |
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Clinical indications of bisphosphonate - related osteonecrosis of the jaws? |
osteoporosis cancers that have metastasized to bone multiple myeloma paget's disease of bone ghost outline of sockets 1 yr after extraction |
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Sialadenitis MC= mumps = viral form S. aureus =MC bacterial cause from result of dec saliva flow or duct obstruct = spread bacteria |
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Acute sialadenitis of parotid gland |
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Mucocele mucous spill into soft tissue from rupture of minor salivary gland duct trauma MC= Lower lip |
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Ranula |
mucocele in floor of mouth from trauma |
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Superficial Mucocele vs Mucocele |
Superficial = minor saliva ducts at surface from mucosal inflam clear and bubble like regular= cause by rupture of duct |
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Ranula |
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Salivary duct cyst |
mucous retention phenomenon True cyst looks like mucocele clinically |
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Cyst of blandin nuhn mucocele form in blandin nuhn glands |
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Salivary stones |
partial chronic duct obstruction causes MC= submandibular gland duct |
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Sialadenosis non malig non inflam salivary gland enlarge from peripheral neuropahty of autonomic nerve supply |
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Adenomatoid hyperplasia Inc in # gland acini in minor salivary glands firm mass mimick minor salivary gland tumor MC=hard palate |
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Necrotizing sialometaplasia inflammatory from ischemia-infarction-necrosis and ulcer-slough of necrotic tissue- healing Posterior palate heals spontaneously predisposing: trauma, ill fit denture, adjacent tumor |
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Sjogren Syndrome |
autoimmune disease, affects salivary and lacrimal glands Primary= xerostomia +dry eye secondary = primary +chronic inflammatory CT disease (rheumatoid arthritis) aka dry , irritation |
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Keratoconjunctivitis associated with sjogren syndrome |
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What are 4 signs of Sjogren Syndrome? |
keratoconjunctivitis (dry eye) Swelling of the salivary glands Raynaud's phenomenon Oral: atrophy of the dorsal of the tongue also cervical caries and candidiasis |
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What is the MC site for salivary gland tumors? |
Parotid Gland |
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Where is the MC site for malignant salivary gland tumors ? |
Sublingual gland |
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Where is the most common anatomical position for minor salivary gland tumors? |
Palate |
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What are the 5 types of benign salivary gland tumors? |
Pleomorphic adenoma Warthin tumor canalicular adenoma basal cell adenoma salivary duct papilloma |
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Pleomorphic Adenoma MC salivary neoplasm benign salivary gland tumor firm slow grow Females Recurrant |
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Warthin's tumor MALE most likely to occur bilaterally 2nd MC benign parotid tumor |
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Canalicular Adenoma benign tumor of the salivary gland exclusive minor salivary gland MC= upper lip Female |
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Mucocele vs canalicular adenoma |
Mucocele= from rupture of salivary duct cyst canalicular adenoma= benign tumor of minor salivary gland |
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What are the 5 types of malignant salivary gland tumors? |
Mucoepidermoid carcinoma polymorphoud low-grade adenocarcinoma adenoid cystic carcinoma acinic cell carcinoma carcinoma ex- pleomorphic adenoma |
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What are 3 things that a malignant salivary gland tumor is associated with ? |
paresthesia tumor fixation ulceration |
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Mucoepidermoid Carcinoma |
MC malignant salivary tumor |
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Mucoepidermoid carcinoma parotid= MC site asymptomatic swelling can have cyst formation |
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Polymorphous low grade adenocarcinoma 2nd MC malignant salivary tumor almost exclusive to minor glands Palate **PAIN bone destruction |
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Acinic Cell Carcinoma cells have acinar differentiation parotid |
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Carcinoma Ex- pleiomorphic adenoma malignant salivary gland tumor form of pleiomorphic adenoma formed in an existing one or in a patient that has already had one removed shows sudden rapid growth |
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What are the 3 P's for bump on gums? |
Soft skin lesions= Pyogenic granuloma Peripheral Ossifying fibroma Peripheral Giant cell granuloma |
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Pyogenic granuloma Not a true granuloma non tumor from trauma Pregnancy / hormones bleeds easy Gingiva |
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Peripheral Ossifying Fibroma reactive soft skin lesion exclusive on gingiva from PDL Maxilla ulcerated |
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Peripheral giant cell granuloma blue/purple exclusive to gingiva/ alveolar ridge Radiograph= SAUCERIZATION (cupping resorption) |
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Fibroma usually along bite line buccal mucosa smooth pink raised nodule MC tumor of oral cavity Prob not true neoplasm from trauma/ irritation |
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Traumatic Neuroma smooth sub mucosal nodule in mental foramen area prolif of neural tissue not true neoplasm after disrupt schwann cells |
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What are common drugs that relate to gingival hyperplasia ? |
phenytoin ca channel blockers cyclosporine |
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Denture stomatitis form of candidiasis |
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Epulis Fissturatum from ill fit denture single/multi folds fibrous tissue in vestibule fibroepithelial polyp = pedunculated lesion of palate from max denture |
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Inflammatory Papillary Hyperplasia hard palate asymptomatic pebbly surface erythematous from: ill fit denture, poor OH, wearing denture all the time and superimposed candidiasis |
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Fibroma benign tumor of fat usually in buccal mucosa normal or yellow color if cut off floats in water |
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Schwannoma benign tumor origin = schwan cell if oral =tongue usually can be in bone = unilocular radiolucency |
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Granular cell tumor solitary dorsal of tongue asymp tumor of schwann cell origin |
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Neurofibroma typical solitary tongue or buccal mucosa can occur in bone multiple=neurofibromatosis assoc- lead to malignant transform |
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Neurofibromatosis Multiple neurofibromas pleixform neurofibroma cafe au lait pigment Crowe's sign -armpit freckles lish nodules - pigment spot on iris of eyes 5% develop neurofibrosarcoma mental foramen/ alveolar nerve enlarge |
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What are the 3 types of Lymphangioma? |
Capillary-small Cavernous- med Cystic (cystic hygroma)- large in neck and armpit |
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Lymphangioma usually in posterior triangle Oral lesions: TONGUE frog eggs deep tumors ill defined masses |
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Lymphangioma tongue of pt frog egg |
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What is the most common tumor of infancy? |
Hemangioma= benign prolif of blood vessiles |
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Hemangioma MC tumor infancy raised red nodular masses of skin regresses on own |
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Vascular malformation ***present at birth and persists all life port wine stains on skin |
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Hemangioma vs vascular malformation |
H= not present at birth, arise in infancy and goes away VM= present at birth, does not go away |
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What are the 3 types of soft tissue sarcomas? |
Fibrosarcoma Kaposi's sarcoma Rhabdomyosarcoma |
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Fibrosarcoma |
Malignant tumor soft tissue sarcoma tumor of extremities grows slow and is painless Nose and sinus involve most |
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Karposi's sarcoma vascular malignant tumor common in AIDs 4 types: Classic-old ppl, lower extremities, slow Endemic-African, benign nodule aggressive Iatrogenic -organ transplants , aggressive AID's related-homo males , oral lesion common |
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Rhabdomyosarcoma Malignant tumor skeletal muscle 3 types:embryonal, alveolar, pleomorphic(undiff, anaplastic) MC malignant tumor in kids Males orbit, nasal cavity, and nasopharynx metastatis: embryonal>alveolar>pleomorphic |