Oral Path- Midterm

Pulp stones

Appears as a round-to-oval opacity within the pulp chamber or root canal space. Incidence increases with advancing age

Pedunculated

Attached by a stemlike or stalklike base similar to that of a mushroom

Geographic tongue DD?

Candidiasis Lichen planus (LP)

Frictional keratosis

Chronic rubbing or friction against an oral mucosa surface resulting in hyperkeratosis, a thickening of keratin on the surface Does not rub off Cause and effect relationship with irritant

Erosion

Contact of chemical agents with the tooth - acidic foods (lemons) - restorations appear smooth and polished in gingival 3rd area

ulcer

Depressed lesion which extends into epithelium but not into dermis. Red surrounding with white center

Fluctuant

Describes fluid-filled lesions that moves fluid from one area to another when lesion is pressed

Internal resorption

Destruction of the tooth initiated within the pulp chamber or root canal Caused by injury (trauma) to the pulp. Appears as a radiolucent enlargement, symmetric

Papillary Lesions

Finger-like projections, similar to verrucous lesion

Macule

Flat lesion less than 1 cm

Irreversible pulpitis

Form of pulpal inflammation in which the patient experiences continuous, lingering pain until pulp dies (appears as radiographic radiolucency)

Reversible pulpitis

Form of pulpal inflammation in which the pulp may be salvageable (usually resolves)

Gardner syndrome

Hyperdontia, genetic- autosomal dominant. Multiple supernumerary teeth, odontomas, and osteomas. Associated with colorectal cancer

Hyperdontia

Increase in number of teeth (supernumerary) - Most common extra tooth: mesiodens (between central incisors) 2nd most common: Distomolars- distal to 3rd molars

Macrodontia

Increase in size of teeth Associated with pituitary giantism

Pulpitis (definition and cause)

Inflammation of the pulp Causes: caries, trauma, dental procedures, extreme temperature changes. Abrasion, attrition, erosion and abfraction may be implicated too

Vesicle

Less than 1/2 cm (5mm), filled with clear fluid

DD Frictional keratosis

Leukoplakia LP *call it leukoplakia if cause not determined, need biopsy esp if smoker

Oligodontia

Missing 6 or more teeth

cheek chewing

Morsciatio buccarum physical irritation, chronic trauma overproduction of keratin can be confused with white sponge nevus

Rough lesion

Papillary corrugated Crusted Fissured

Abrasion

Pathological wearing away of tooth structure due to external factors - can be mechanical or frictional - V or U shape just above gingival margin or parallel to occlusal/incisal surface

corrugated lesion

Rippled or washboard like. Comes from chewing tobacco, appears fissured

Alteration in tooth shape

Shovel shaped incisors, thickened mesial and distal marginal ridges

Enamel pearl

Sphere of enamel on root

Microdontia- Most common teeth affected

Third molars Mx lateral incisors

hairy tongue tx

Tx: remove predisposing factors, Chx rinse, tongue scraper, antigfungal if candida present

Abfraction

Wedge shaped enamel loss at cervical region of tooth Occurs with lateral bruxism *sensitivity and caries risk

hyperkeratosis

a thickening of the horny layer of epidermis/mucosa caused by increased keratin production

Talon cusp

accessory cusp on the lingual of the permanent incisors or canine. Contains a pulp chamber, may affect occlusion

External resorption

arises from tissues outside the tooth such as the periodontal ligament being activated. Seen on radiographs. Originates from 2 sources: inflammation and pressure (from impacted 3rd molar adding pressure)

sessile

base is larger than the lesion itself

Bulla

bigger than 1/2 cm (5mm), filled with clear fluid

plaque

broad, flat topped (not very common term)

Hairy tongue

cause unknown. Predisposing factors: tobacco, mouthrinse, radiation therapy Elongation of filiform papillae on dorsal surface Hairlike projections - white, brown, black Tx: remove predisposing factors, Chx rinse, tongue scraper, antigfungal if candida present

endogenous

come from within the body (melanin pigmentation)

Brown lesions

comes from melanin - ex: melanoma

exogenous

comes from outside the body (amalgam tattoo)

Microdontia

decrease in size of the tooth Most common: Third molars Second most common: Mx Lateral incisors (peg laterals)

Anodontia

decrease in the number of teeth. may be complete or partial.

erosion/abrasion

depressed lesion that does not extend through the epithelium

black lesion

example: pencil lead injury

Chemical and thermal burns DD?

frictional keratosis hyperplastic candidiasis lichen planus (LP)

Patch

greater than 1 cm

Exophytic

growing outward, clinically visible

endophytic

grows inward into the surrounding tissues with little or no observable swelling

Nicotine stomatitis

heavy smokers keratotic changes to palate from heat and irritation from smoked tobacco whitish plaque with small red dots not premalignant unless reverse smoking

Geographic tongue

inflammatory condition, cause unknown depapillated areas on dorsal surface of tongue atrophic and often reddened patches with yellow-white borders NOT PREMALIGNANT

Pink tooth of mummery

internal resorption in the coronal portion of the tooth. Tooth appears pink. EXT needed

Hypodontia

lack of 1-5 teeth

Smooth lesion

lesion has smooth appearance

linea alba

localized friction - frictional keratosis occurs along line of occlusion on buccal mucosa Dental Implications: may indication bruxism

Blue lesion

most likely vascular

nodule

solid lesion, larger than 1/2 cm (5mm) but less than 2 cm

tumor

solid lesion, larger than 2 cm. must be firm, not fluid filled

papule

solid lesion, less than 1/2 cm (5mm)

Cleidocranial dysplasia

supernumerary teeth, delayed tooth eruption. Often seen with cleft palate

fordyce granules

variation of normal sebaceous glands Found often bilaterally on lower lip & buccal mucosa males = females

Leukoedema

variation on normal whitish opaqueness with fine wrinkles on mucosa when stretched it disappears Does NOT rub off

Attrition

wearing away of the tooth caused by tooth to tooth contact *may experience sensitivity

Doak cusp

• Accessory cusp found on facial surface of maxillary molar teeth • Pulp horn extends into the cuspal elevation.

Chemical and Thermal Burns

• Caustic chemicals cause burns on mucosa. • Examples include aspirin placed on a tooth to relieve the pain, home remedies, phenols, silver nitrate, and hydrogen peroxide. • Necrosis of the epithelium causes a white color.

Hereditary Hypohidrotic Ectodermal Dysplasia

• Most common of genetic disease that produce a decrease in number of teeth. • Skin is soft, smooth, thin, and dry. Cone-shaped anterior teeth. Fine hair. Most are males

Hyperplastic pulpitis

(Pulp polyp) A form of pulpitis with growth of chronically inflamed young pulp into decayed occlusal surface. Most commonly affects children and 1st molars Appears as a red dome shaped tissue in center of tooth. Treatment: Endo tx or EXT

What is the most common missing teeth?

1st most: 3rd molars 2nd most: Max lateral incisors 3rd most: Mand 2nd premolars Least likely: permanent 1st molars

leukoplakia** definition by WHO

A white patch or plaque that does NOT rub off and that cannot be diagnosed clinically or pathologically as any specific disease