L7: developmental conditions pt 1

Question 1

features of retrocuspid papillae

• is it unilateral or bilateral
• symptomatic?
• how big
• moderately ___
• ____- surfaced
• sessile or pedunculated
• what shape
• what colour

Answer 1

• usually bilateral
• asymptomatic
• small (2-3mm)
• moderately firm
• smooth-surfaced
• sessile
• round
• pink (normal gingiva colour) to red papule

Question 2

where are retrocuspid papillae located

Answer 2

located on the attached lingual gingiva of mandibular canine

Question 3

how to dx retrocuspid papillae and what is the treatment

Answer 3

dx is usually clinical,
no tx needed as it resolves spontaneously with age

Question 4

what are the features of fordyce granules

Answer 4

sebaceous glands that present as multiple, small, yellow, papules

Question 5

location of fordyce granules

where is the most common?

Answer 5

most common on buccal mucosal and lateral portion of the vermillion border of the upper lip

other locations:
- retromolar areas
- anterior tonsillar pillar

Question 6

who are fordyce granules more commonly seen in

Answer 6

seen more commonly in adults even though they are considered developmentl

Question 7

how to dx and tx fordyce granules

Answer 7

• clinical dx
  no tx

Question 8

what are the 3 types of developmental oral cyst of the newborn

Answer 8

• Bohn nodules
• epstein pearls
• dental lamina cysts

Question 9

where are Bohn nodules found in the mouth, and what is the origin?

Answer 9

Location: junction of the hard and soft palate or on the vestibular region (rare)

Origin: epithelial remnants of minor salivary glands

Question 10

where are Epstein pearls found in the mouth, and what is the origin?

Answer 10

location: mid palatal raphe

origin: epithelium entrapment between the palatal shelves

Question 11

where are dental lamina cysts found in the mouth, and what is the origin?

is there tx?

Answer 11

location: crest of the alveolar ridge

origin: odontogenic in origin and arise from the cell rests of Serres

no tx needed, spontaneously resolve

Question 12

what are eruption cysts and their origin

soft tissue variant of _______

origin: develop from the _____ of the ______ from the crown of the tooth

Answer 12

soft tissue variant of dentigerous cyst

origin: develop from the separation of the reduced enamel epithelium from the crown of the tooth

Question 13

appearance of eruption cyst

• hard or soft?
• fluctuant or rigid?
• sessile or pedunculated?
• shape
• translucent swelling overlying ____
• swelling may appear ________ when it is filled with ____

Answer 13

• soft
• fluctuant
• sessile
• dome shaped
• translucent swelling overlying erupting tooth
• swelling may appear blue/ blue black when it is filled with blood

Question 14

how to diagnose eruption cyst

Answer 14

• clinical
• radiographs are generally not needed because its in soft tissue

Question 15

what is the tx of eruption cyst

• if px is pain, do what?
• the thing naturally marsupializes as _________?
• symptomatic tx: ______

Answer 15

• if px is pain, can cut a slit to relieve pressure, let fluid come out
• the thing naturally marsupializes as the tooth erupts through the gingiva
• symptomatic tx: simple removal of roof of cyst

Question 16

what is the other name of congenital granular cell tumour

Answer 16

congenital epulis

Question 17

congenital epulis affects which age group, which sex?

Answer 17

• newborns (0.0006%) very rare
• 8-10 more common in females

Question 18

features of congenital epulis

• single or multiple
• firm or soft
• ____ surfaced
• sessile or pedunculated
• shape?
• colour?

Answer 18

• single
• firm
• smooth surfaced
• can be sessile or pedunculated
• round
• mucosa coloured

Question 19

where is the most common location for congenital epulis

Answer 19

anterior maxillary alveolar ridge

Question 20

how to diagnose congenital epulis?

Answer 20

• clinical appearance
• histology
  resembles granular cell tumour but does not display a strong reactivity to s100 protein

Question 21

what histo resembles granular cell tumour but dont display a strong reactivity to s100 protein

Answer 21

congenital epulis

Question 22

what is the tx for congenital epulis

Answer 22

surgical excision
reccurence is unlikely even when the removal is incomplete

Question 23

what age group does melanotic neuroectodermal tumour affect?

Answer 23

usually in children 1 year or less

Question 24

what developmental defect is described as hard but brittle like an eggshell, if you press very hard it will crack

Answer 24

melanotic neuroectodermal tumor of infancy

Question 25

origin of melanotic neuroectodermal tumour of infancy

Answer 25

neural crest origin

Question 26

appearance of melanotic neuroectodermal tumour of infancy - painless or painful - ulcerative or not? - firm or soft - smooth or rough? - _____ swelling on the _____________ ridge

Answer 26

- painless - non ulcerative - firm - smooth surfaced - sessile swelling on the anterior maxillary alveolar ridge

Question 27

how to diagnose melanotic neuroectodermal tumour of infancy

Answer 27

- clinical presentation - high urinary vanillylmandelic acid - histology

Question 28

what defect will result in high urinary vanillylmandelic acid

Answer 28

melanotic neuroectodermal tumour of infancy

Question 29

how to treat melanotic neuroectodermal tumour of infancy

Answer 29

- surgery intervention - recurrence 10-60% need to take out as it is very disruptive and blocks airway

Question 30

what are the 2 types of vascular abnormalities

Answer 30

- vascular tumours = true neoplasms of endothelial cells (overgrowth problem, endothelial cells are growing) - vascular malformations = abnormalities of the vessel structure ( structural problem)

Question 31

what defect gives sunburst look

Answer 31

arteriovenous malformation

Question 32

what is an oral sign of AV malformation

Answer 32

losing teeth very severe, can see in the late stage

Question 33

what happens in AV malformation

Answer 33

blood passes quickly from artery to vein, bypassing the normal capillary network

Question 34

what is lymphagioma

Answer 34

vascular malformation in lymph vessles not a vascular tumour

Question 35

what is ankyloglossia

Answer 35

short lingual frenum or a frenum attachment at or near the tongue tip resulting in restricted tongue movement

Question 36

ankyglossia is associated with ____ difficulty

Answer 36

breastfeeding

Question 37

how to dx and tx ankyloglossia?

Answer 37

- clinical diagnosis - tx = frenotomy

Question 38

how does cleft palate form

Answer 38

due to failure of palatal shelves to fuse

Question 39

risk factors of cleft palate

Answer 39

maternal risk factors eg ETOH and tobocco use, stress, meds

Question 40

what type of syndromes are cleft lip associated with

Answer 40

Van der woude syndrome Treacher collins syndrome

Question 41

tx of cleft lip and palate

Answer 41

- feeding and airway management - surgical repair of lip and palate at 3 and 6 months of age - future needs: speech therapy, orthodontic therapy, additional surgery

Question 42

Paramedian lip pits is associated with ____ syndrome, which is associated with what other defect?

Answer 42

- van der woude syndrome - associated with cleft palate too

Question 43

the white border seen in geographical tongue is because of ____

Answer 43

keratin

Question 44

the white patch in leukoedema is because each cell ____

Answer 44

is water logged and edematous so when we stretch then water get spaced out, so the white disappears too

Question 45

what is the cause of leukoedema

Answer 45

unknown

Question 46

features of leukoedema - colour - can be wiped off?

Answer 46

- diffuse, grayish whitish milk appearance of mucosa - do not rub off but disappears on stretching the mucosa

Question 47

location of leukoedema?

Answer 47

bilateral buccal mucosa rarely on floor of mouth

Question 48

how to dx leukoedema

Answer 48

clinical

Question 49

what is the histo of leukoedema

Answer 49

increase in epithelium thickness with striking intracellular edema of the spinous layer

Question 50

what is tx for leukoedemea

Answer 50

no tx needed as it is a benign condition

Question 51

where can racial pigmentation be seen in the oral cavity

Answer 51

- attached gingiva most common location - also observed on the tip of the fungiform papillae

Question 52

what is another name for ephelis , and when does it appear

Answer 52

freckles, first decade of life

Question 53

features of ephelis (freckles) - size - colour - what sort of lesion eg papule, blister - ______ borders on sun exposed skin that ____ with sunlight

Answer 53

- 1-3mm uniformly - tan/ brown colour - macule - regularly defined borders on sun exposed skin that darkens with sunlight

Question 54

what is ephelis caused by?

Answer 54

caused by an increase production/ deposition of melanin witout increasae in melanocyte

Question 55

features of cafe au lait pigmentation - borders? - colour? - what kind of lesion eg papule, blister - size ? - location

Answer 55

- well circumscribed - uniformly light to dark brown macules that are typically 2 to 3 shades darker than normal skin colour - size vary from a few mm to > 10cm - can occur anywhere on body

Question 56

what are genodermatoses

Answer 56

inherited skin disorders

Question 57

what is an inherited systemic condition that leads to ulceration in oral cavity

Answer 57

epidermolysis bullosa collagen defect, affects teeth because teeth got collagen

Question 58

what are 2 inherited systemic conditions that lead to lumps and bumps in oral cavity

Answer 58

1) multiple neuroendocrine neoplasia type 2B (i/o neuromas) 2) neurofibromatosis type 1 (i/o neurofibromas)

Question 59

what systemic condition causes the patient to be very prone to thyroid cancer, almost 100%?

Answer 59

multiple neuroendocrine neoplasia type 2b (i/o neuromas)

Question 60

what 3 systemic diseases may cause cafe au lait pigmentation

Answer 60

1) Peutz Jeghers disease 2) Neurofibromatosis type 1 3) McCune Albright syndrome

Question 61

what type of presentation can neurofibromatosis type 1 cause in the oral cavity

Answer 61

1) Lumps and Bumps 2) Cafe au lait pigmentation

Question 62

what systemic condition is associated with cafe au lait pigmentation and polyostotic fibrous dysplasia

Answer 62

McCune albright syndrome

Question 63

what kind of disease is Sturge weber syndrome?

Answer 63

venous malformation

Question 64

where is lateral periodontal cyst commonly found?

Answer 64

80% occur in mandibular premolar-canine-lateral incisor area

Question 65

where does lateral periodontal cyst originate from

Answer 65

rests of dental lamina

Question 66

how to dx lateral periodontal cyst

Answer 66

radiographic finding

Question 67

what is the tx for lateral perio cyst

Answer 67

conservative enucleation (aka take out the cyst)