DHE120 Chapter 2 Pg.49-67 Quiz#2 Quiz#3

  1. Methamphetamine Abuse:
    • “Meth Mouth”
    • Rapid destruction of teeth as a result of:
    • Methamphetamine acid content
    • Decreased salivary flow
    • Cravings for high-sugar beverages
    • Lack of oral hygiene
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  2. Aspirin Burn
    • Topical application is a common misuse of this product
    • The tissue becomes necrotic and white
    • The surface may slough off, leaving a painful ulcer
    • The ulcer usually heals in 7 to 21 days
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  3. Phenol Burn:
    • Used in dentistry as a cavity-sterilizing agent and a cauterizing agent
    • Will cause whitening and sloughing of the area as a result of tissue destruction
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  4. Dental Materials That Can Cause Burns?
    • Phenol
    • Sodium hypochlorite
    • Ferric sulfate
    • Formocresol
    • Eugenol
  5. Electric Burn?
    • May be seen in infants or young children who have chewed an electrical cord
    •   May be quite extensive, damaging oral tissue and even tooth buds
    •   May cause permanent disfigurement and scarring
    • Treatment:
    •   Plastic surgery
    •   Oral surgery
    •   Orthodontic therapy
  6. Thermal Burns
    • Hot food burns
    • From soup or cheese on pizza
    • Products containing hydrogen peroxide or eugenol
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  7. Lesions Associated With Cocaine Use:
    • Lesions located at the midline of the hard palate may vary from ulcers to keratotic lesions to exophytic reactive lesions as a result of smoking crack cocaine
    • Necrotic ulcers of the tongue and epiglottis have been reported as a result of freebasing cocaine
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  8. Lesions From Self-Induced Injuries:
    • Chronic lip, cheek, or tongue biting
    • Trauma to the gingiva from a fingernail
    • Lesions may range from ulceration to epithelial hyperplasia and hyperkeratosis
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  9. Traumatic Ulcer:
    • Cheek, lip, or tongue biting
    • Denture irritation
    • Mucosal injury
    • Overzealous brushing
    • Treatment
    • Usually heals within 7 to 14 days unless the trauma persists
    • May require a biopsy
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  10. Traumatic Granuloma:
    • The result of persistent trauma
    • Appearance: Hard (indurated), raised lesion
    • Heals rapidly after biopsy
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  11. Hematoma:
    • Accumulation of blood within tissue as a result of trauma
    • Appears as a red to purple to bluish-gray mass
    • Frequently seen on labial or buccal mucosa
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  12. Frictional Keratosis:
    • A form of hyperkeratosis
    • Cause: Chronic rubbing or friction against an oral mucosal surface; resembles a callus on skin
    • Appearance: Opaque white

    • Treatment
    • Identify the traumatic cause of the lesion
    • Eliminate the cause
    • Must be differentiated from idiopathic leukoplakia because leukoplakia may be premalignant
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  13. Linea Alba:
    • A white, raised line most commonly on the buccal mucosa at the occlusal plane
    • May be the result of a teeth-clenching habit
    • Sometimes the pattern of the teeth can be seen in the lesion
    • Microscopic appearance: Epithelial hyperplasia and hyperkeratosis
    • No treatment necessary
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  14. Nicotine Stomatitis:
    • A benign lesion typically associated with pipe and/or cigar smoking; may also occur with cigarette smoking
    • Initial appearance: Erythema
    • Increased opacity as keratinization occurs
    • Raised red areas occur at the openings of ducts of inflamed minor salivary glands
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  15. Smokeless Tobacco Keratosis:
    • A white lesion located where chewing tobacco is placed, most often in the mucobuccal fold
    • Early lesions may have a granular or wrinkled appearance
    • Long-standing lesions may be more opaquely white and have a corrugated surface
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  16. Tobacco Pouch Keratosis:
    • Treatment
    • Tobacco cessation
    • May require biopsy
    • Long-term exposure to chewing tobacco has been associated with increased risk of squamous cell carcinoma
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  17. Traumatic Neuroma:
    • A lesion caused by injury to a peripheral nerve
    • When the nerve sheath of Schwann cells is disrupted, occasionally the proximal end of the damaged nerve proliferates into a mass of nerve and Schwann cells mixed with dense fibrous scar tissue
    • Painful, ranging from pain on palpation to severe, intractable pain
    • Diagnosis
    •    Biopsy and microscopic examination
    • Treatment
    •    Surgical excision
  18. Palisaded Encapsulated Neuroma (PEN):
    • Benign lesion
    • Clinical appearance: Mucosal nodule
    • Microscopic appearance: Well-circumscribed lesion that is composed of nerve tissue partially surrounded by fibrous connective tissue
    • Considered a reactive, hyperplastic lesion
  19. Amalgam Tattoo:
    • A flat, bluish-gray lesion of the oral mucosa, caused by the introduction of amalgam into tissue
    • May occur during placement or removal of an amalgam restoration or during an extraction
    • May be seen in any location in the oral cavity, most commonly on the gingiva or alveolar

    • Amalgam particles may be seen on radiograph, aiding in diagnosis
    • Patient history may help
    • Must be differentiated from malignant melanoma
    • Treatment
    • None, providing melanoma has been ruled outridgeImage Upload 16
  20. Melanosis:
    • Normal physiologic pigmentation of oral mucosa
    • May be genetic
    • May occur as a result of inflammation: Postinflammatory melanosis
    • If presenting as a macule, a biopsy may be warranted
    • Labial melanotic macule on vermilion of lips
    • Smoker’s melanosis
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  21. Solar Cheilitis (Actinic Cheilitis)
    • A degeneration of the tissue of the lips, caused by exposure to the sun
    • Appearance
    • Lips appear dry and cracked
    • The vermilion appears pale pink and mottled
    • The interface between lips and skin is indistinct
    • Microscopically: Epithelium is thinner than normal; degenerative CT changes

    • Smoking and alcohol use increase risk of squamous cell carcinoma
    • Biopsy may be indicated for persistent scaling or ulceration
    • Prevention
    •   Avoid sun exposure
    •   Use sun-blocking agents
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  22. Mucous Retention Lesion: Mucocele
    • A lesion formed when a salivary gland duct is severed and the mucous salivary gland secretion spills into the adjacent connective tissue
    • Not a true cyst because it is not lined with epithelium
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  23. Mucous Retention Lesion: Ranula
    • A unilateral mucocele-like lesion that forms on the floor of the mouth
    • Associated with the ducts of submandibular and sublingual glands
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  24. Sialolith:
    • A salivary gland stone
    • May be found in both minor and major salivary glands
    • Formed by precipitation of calcium salts around a central core
    • May often be seen on radiographs
    • Treatment
    • Sometimes the calcification can be “milked” from the duct
    • It may require surgical removal; this may damage the duct
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  25. Necrotizing Sialometaplasia:
    • A benign condition of salivary glands
    •     Moderately painful swelling and ulceration
    •     Thought to result from blockage of blood supply to affected area, resulting in salivary gland necrosis
    • Salivary gland epithelium is replaced by squamous epithelium
    • The ulcer usually heals by secondary intention
    • Biopsy is needed to establish diagnosis
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  26. Acute and Chronic Sialadenitis:
    • Painful swelling of the involved salivary gland caused by obstruction of the salivary gland duct
    • Diagnosis
    •     May involve injection of a radiopaque dye into the gland, followed by a radiograph (sialogram)
    • Treatment
    •     May require antibiotics
  27. Reactive Connective Tissue Hyperplasia
    • Pyogenic granuloma
    • Giant cell granuloma
    • Irritation fibroma
    • Denture-induced fibrous hyperplasia
    • Papillary hyperplasia of the palate
    • Gingival enlargement
    • Chronic hyperplastic pulpitis
  28. Pyogenic Granuloma:
    • A proliferation of connective tissue containing numerous blood vessels and inflammatory cells occurring as a response to injury
    • The name is a misnomer; the lesion is neither pyogenic (pus forming) nor a true granuloma
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  29. Pregnancy Tumor:
    • A pyogenic granuloma seen in a pregnant woman
    • The lesions are identical to those seen in men and nonpregnant women
    • May be caused by hormonal changes and increased response to plaque
    • They often regress after delivery
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  30. Peripheral Giant Cell Granuloma
    • A lesion that contains many multinucleated giant cells, well-vascularized connective tissue, RBCs, and chronic inflammatory cells
    • Reactive lesion
    • Clinical appearance resembles that of pyogenic granuloma
    • Treatment: Surgical excisionImage Upload 25
  31. Peripheral Ossifying Fibroma:
    • Exophytic, usually well-demarcated sessile or pedunculated gingival lesion
    • Clinically it appears to emanate from the interdental papilla
    • Has been reported in both children and adults
    • Composed of cellular fibrous connective tissue
    • Treatment consists of complete surgical excision with thorough scaling of the adjacent teeth
  32. Fibroma, Irritation Fibroma, Traumatic Fibroma, and Focal Fibrous Hyperplasia:
    • The most common mass on the gingiva
    • Caused by trauma
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  33. Denture-Induced Fibrous Hyperplasia
    • Cause: Ill-fitting denture
    • Location: In elongated folds of tissue adjacent to denture flange
    • Composed of dense, fibrous CT surfaced with stratified squamous epithelium
    • Treatment:
    •    Surgical removal
    •    Relining of prosthesis
    •    New denture
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  34. Inflammatory Papillary Hyperplasia of the Palate
    • Denture-induced hyperplasia
    • Appearance: Palatal mucosa covered by multiple erythematous papillary projections; “cobblestone” appearance
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  35. Gingival Enlargement
    • An increase in the bulk of free and attached gingiva, especially the interdental papillae
    • Gingival margins are rounded
    • Color may vary from normal pink to pale or erythematous depending on the degree of inflammation and vascularity
    • May be generalized or localized
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  36. Chronic Hyperplastic Pulpitis  (Pulp Polyp)
    • An excessive proliferation of chronically inflamed dental pulp tissue
    • Occurs in teeth with large, open carious lesions often in primary and permanent molars
    • Usually asymptomatic
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  37. Periapical Abscess:
    • Acute periapical abscess: Purulent exudate surrounded by connective tissue containing neutrophils and lymphocytes
    • Inflammation produces severe pain
    • Tooth may slightly extrude from tooth socket
    • May or may not test positive with electric pulp testing
    • Fistula
  38. Periapical Granuloma:
    • A localized mass of chronically inflamed granulation tissue that forms at the opening of the pulp canal, generally at the apex of a nonvital tooth root
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  39. Radicular Cyst (Periapical Cyst):
    • A true epithelium-lined cyst
    • Associated with the root of a nonvital tooth
    • The most commonly occurring cyst in the oral region
    • A result of proliferation of the rests of Malassez
    • Usually asymptomatic and discovered on radiograph
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  40. Residual Cyst:
    • Forms after tooth extraction and all or part of radicular cyst is left behind
    • Treatment: Surgical removal
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  41. Tooth Resorption:
    • External resorption: Nonreversible resorption of the tooth structure, beginning at the outside of the tooth
    • Causes:
    •   Inflammation
    •   Pressure
    •   Reimplantation
    •   Idiopathic
    • Image Upload 34
  42. Focal Sclerosing Osteomyelitis (Condensing Osteitis)
    • A change in the bone near the apices of teeth
    • Thought to be a reaction to low-grade infection
    • Generally asymptomatic
    • If painful, may be associated with pulpal inflammatory disease
    • Radiopaque
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  43. Alveolar Osteitis (“Dry Socket”):
    • A postoperative complication following tooth removal in which the blood clot is lost before healing can take place, leaving raw, exposed nerve endings
    •      Most often occurring in mandibular third molar areas
    •      Patient may complain of pain, bad odor, and bad taste
    • Risk factors:
    •     Dissolution of the clot at the surgical site
    •     Traumatic extraction
    •     Presence of infection before extraction
    •     Tobacco smoking after extraction
    • Treatment:
    •      Gentle irrigation
    •      Daily application of Dry Socket Paste containing eucalyptol until symptoms are relieved
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dentalhygiene
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DHE120 Chapter 2 Pg.49-67 Quiz#2 Quiz#3
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DHE120 Chapter 2 Pg.49-67 Quiz#2 Quiz#3
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