Oral path ch 5

• Extensive adhesion of the tongue to the floor of the mouth or the lingual aspect of the anterior portion of the mandible.
• Complete or partial fusion of the lingual frenum.
• Predilection: male
• Treatment: Frenectomy

Marked deviation from normal. especially as a result of congenital or hereditary defects.

the site of union of corresponding parts (e.g., the corners of the lips) (labial commissure, commissural lip pits).

A disorder that is present at and existing from the time of birth.

An abnormal sac or cavity lined by epithelial and surrounded by fibrous connective tissue.

the formation of dentin.

the distinguishing of one tissue from another.

• Partial anodontia; the lack of one or more teeth.
• permanent dentition is most commonly affected
• most often missing are max & mand. 3rd molars and max. lateral incisors
• Oligodontia- subcategory of hypodontia in which 6 or more teeth (excluding the 3rd molars) are congenital missing

• excessive cementum on the roots of the teeth.
• occurs in adults, incidence increases w/ age
• frequently seen in Paget disease of the bone

Enlarged jaw.

A radiographic appearance in which many circular radiolucencis exist; these can appear "soap-bubble-like" or "honeycomb-like".

A small solid mass that can be detected through touch.

a subcategory of hypodontia in which six or more teeth are missing.

A disposition in favor of something; preference.

The multiplication of cells.

The embryonic invagination that becomes the oral cavity.

In excess of the normal or regular number , as in teeth.

selective growth, or proliferation and differentiation.

frontal process or the first branchial arch.

two maxillary processes and the mandibular process.

• upper part of the cheeks
• the lateral portion of the upper lip
• part of the palate

• the lower part of the cheeks
• the mandible
• part of the tongue

• future opening s of the nose that develop on the surface on the frontal process.
• They divide the frontal process into three parts:
• 1. median nasal process
• 2. right lateral nasal process
• 3. left lateral nasal process

sides of the nose

two maxillary processes and one mandibular process.

• the center and tip of the nose.
• Later, it grows downward btw the maxillary process to form a pair of bulges called glubular process.
• This continues to grow dwnwrd to form the philtrim (upper lip).
• gives rise to the nasal septum

• the first three branchial arches.
• - body of the tongue forms from the 1st branchial arch
• - the base forms from the 2nd & 3rd branchial arches.

• fifth 
• ectoderm
• ectomesenchyme

• 1. enamel organ (developed from ectoderm)
• 2. the dental papilla ( developed from mesoderm)
• 3. the dental sac or follicle (dev. from mesoderm)

ameloblasts, which form enamel.

• the formation of enamel.
• - enamel is highly mineralized epithelial tissue, and 90% of its volume is hydroxyapatite crystals.

provides cells that form cementum, PDL, & alveolar bone

• proliferates to shape the root of the tooth and includes the formation of root dentin.
• cells must break up & pull away from root surface before cementum can be produce.
• very little cementum is produced until tooth has erupted & its in occlusion & functioning.
• Root is completed 1-4 yrs after tooth eruption.

• Four times more common in boys than girls.
• Gingival recession & bone loss can occur if the frenum is attached high on the lingual alveolar ridge.

• May be shallow or they may be several MM deep.
• can be bilateral or unilateral
• more often seen in adult males

• occurs near midline of the vermillion border of the lower lip.
• lateral or bilateral
• referred as congenital fistulas of the lower lip because they may contain salivary secretions.
• seen in pts. w/ cleft lip or cleft palate
• inherited as an autosomal-dominant trait

• appears as a smooth nodular mass at the base of the tongue posterior to the circumvallate papillae at midline.
• can be asymptomatic or symtomatic

• MOST COMMON cyst observed in the oral cavity 
• ALWAYS associated w/a nonvital tooth
• diagnosis ONLY through microscopic examination
• It is an inflammatory cyst, NOT a developmental cyst

oral cysts that occur within the bone

cysts that occur in soft tissue

• forms around the crown of an unerupted or developing tooth.
• MOST COMMONLY occuring type of developmental odontogenic cyst
• most common location is around the crown of an unerupted or impacteed mandibular third molar
• higher incidence in males;from 15-30 yrs old
• higher predilection for whites than blacks
• can appear as a well-defined unilocular radiolucency
• microscopically, is a TRUE cyst
• Treatment: removal of cyst and tooth involved. If not removed, risk of carcinoma may develop.

• similar to a dentigerous, but is found in the soft tissue around the crown of an erupting tooth.
• presents as swelling of the gingival mucosa over crown of erupting tooth.
• If there is blood- purplish color and termed eruption hematoma
• most commonly associated w/ decedious mand. central incisors & max. 1st permanent molars.
• Does NOT require treatment

• develops in place of a tooth.
• found in place of 3rd molar or posterior to an erupted 3rd molar.
• originates from remnants & degeneration of the enamel organ.
• Microscopically, often turn out to be odonogenic keratocyst (OKC)
• seen in young adults
• asymptomatic & discovered in radiographs as well defined radiolucent unilocular or multilocular lesions
• Biopsy & microscoping examinations are essential
• Treatment: surgical removal of entire lession

• an odontogenic developmental cyst lesion characterized by its unique microscopic apperance & frequent recurrence.
• Diagnosis based on histopathologic findings
• lumen lined by 8-10 cell layers thick & surfaced by parakeratin
• Reclassified in 2005 as Keratocystic odontogenic tumor
• seen on mand. 3rd molar region
• slight predilection for males 10-50 years old
• well-definedmultilocular radiolucent lesion but unilocular can also occur and can be identical to an odontogenic tumor.
• Moves teeth & resorb tooth strcture, but does NOT cause expansion of bone.
• associated w/ nevoid basal cell carcinoma
• Aggressive treatment: surgical excision & osseous curettage are essential because of the high recurrence rate (up to 25%)

• odontogenic cyst that is lined by orthokeratin
• much lower rate reccurance than OKC/KOT

• developmental nonaggressive cystic lession lined ny odontogenic epithelium that closely resembles the epithelium of the odontogenic tumor called ameloblastoma
• Microscopically characteristics called ghost cells.
• Avarage age of diagnosis is 30
• usually found in incisor or canine area of either arch.
• does NOT recur

• developmental odontogenic cyst that occurs on the lateral root surface of mand and max canine and premolar teeth
• asymptomatic, unilocular or multilocular radiolucent lesion
• males  btw 50-70 yrs old
• Treatment: surgical excision

• considered a variant of the lateral periodontal cyst
• usually multilocular but can be unilocular
• most common in mand. cuspid & premolar area
• greater recurrence potential than lateral periodontal cyst

• appears as a small bulge or swelling of the attached gingiva or interdental papillae
• Treatment: surgical excision

• a rare developmental odontogenic cyst
• was called sialo-odontogenic cyst
• distinctive microscopic apperance usually multicystic lesions
• often presents enlargement of the bone
• anterior & posterior mandible and anterior maxilla are the most common reported areas
• peak incidence in the 5th decade
• when not completely surgically removed recurrence of up to 30% has been reported

• developmental cyst located w/in the nasopalatine canal or the incisive papilla
• when found in the papilla it is called a cyst of the palatine papilla
• arises from epithelial remnants of the embryonal nasopalatine ducts.
• adults 40-60 yrs old
• predilection for males
• asymptomatic, small pink bulge near the apices & btw the roots of the max central incisors on the lingual surface.
• adjacent teeth are usually vital
• well-defined radiolucent  heart-shaped lesion, 1-2 cm in diameter
• Treatment: surgical enucleation especially on edentulous patient before fabrication od dentures. 
• recurrence is rare

• rare fissural cyst that appears as a well-defined unilocular radiolucency and is located in the midline of the hard palate.
• firm mass in the midline of hard palate
• young adults
• Treatment: surgical enucleation

• a well-defined, pear-shaped radiolucency found btw the roots of the maxillary lateral incisor and cuspid
• size can vary; however, when large enough, a divergence of the roots can result
• treatment: surgical enucleation
• recurrance depends on final diagnosis

• A soft tissue cyst
• Thought to originate from the lower anterior portion of the nasolacrimal duct
• Observed in adults 40 to 50 years of age
• 4:1 ratio in favor of females
• Clinical
• An expansion or swelling in the mucobuccal fold in the area of the maxillary canine and the floor of the nose
• Treatment: Surgical excision

• located on the lateral neckat the ant. border of the sternocleidomastoid muscle
• common in children and young adults
• stratified squamous epithelial lining surrounded by a well-circumscribed component of lymphoid & connective tissue
• treatment: surgical excision

• young adults
• on floor of the mouth, ventral tongue, and lateral borders of the posterior tongue
• appears pinkish-yellow, raise nodule
• may contain creamy material
• treatment: surgical excision

• A raised nodule on the skin of the face or neck
• May be noted intraorally on occasion
• Treatment: Surgical excision

• developmental cyst that is often present at birth or noted in young children
• more common in other parts of the body than in head and neck area
• in the oral cavity, usually found in the ant. floor of the mouth
• may cause displacement of the tongue and may have a doughlike consistency when palpated.

• Histologic: hair follicles, sebaceous glands, and sweat glands may be seen in the cyst wall
• resembles a dermoid cyst
• teeth, bone, muscle, and nerve may be found in the walls of this lesion.
• teeth are usually NOT found in the malignant form of the teratoma

• forms along the same tract that the thyroid gland follows in development.
• most of these cysts occur bellow the hyoid bone
• young individuals under the age of 20 
• treatment: complete excision of the cyst and the tract, usually including a part of the hyoid bone and muscle

• intraosseous lesions that appear as radiolucencies.
• NOT true cysts because they are not lined by epithelium.

• NOT a true cyst
• often reffered to as a psedocyst
• seen in adults and RARE in children
• anatomic depression may be felt on post. lingual area of mandible
• Rad. a well-defined radiolucency in post. region od mandible inferior to the mandibular canal.
• NO treatment is required

• a pathologic cavity in bone that is not lined w/ epithelium
• cuase is uncertain
• young individuals
• mandible is most common location
• scalloping around the roots of teeth
• asymptomatic and discovered during routine xrays
• Treatment: a curettage is performed on the wall lining the void to establish bleeding. The void or space fills up w/ bone in 6 months -a year  
• prognosis is excellent and recurrence is unusual

• a pseudocyst that consists of blood-filled spaces surrounded by multinucleated giant cells and fibrous conective tissu
• NO epithelial lining
• radiolucent lesion appears as "honey-comb" or "soap bubble"
• individuals less than 30 yrs of age
• slight predilection for females

• The lack of one or more teeth
• The most common missing permanent teeth are:
• Mandibular and maxillary third molars
• Maxillary lateral incisors
• Mandibular second premolars
• The most common missing deciduous tooth is the mandibular incisor
• Tends to be familial
• May be a component of a syndrome
• Treatment
• May require prosthetic replacement
• Orthodontic evaluation and treatment may be necessary

• Extra teeth
• May result from formation of extra tooth buds in the dental lamina or from the cleavage of already existing tooth buds
• May occur in either deciduous or permanent dentition
• Most often seen in the maxilla
• Mesiodens:
• The most common supernumerary tooth
• Located between the maxillary incisors
• May be inverted when seen on radiographs
• Distomolar:
• The second most common supernumerary tooth
• Located distal to the third molar
• Treatment:
• Erupted teeth may require removal if they cause crowding, malposition of adjacent teeth, or noneruption of normal teeth
• Nonerupted teeth should be extracted because a risk exists for cyst development around the crown
• Multiple supernumerary teeth may be associated with cleidocranial dysplasia or Gardner syndrome

• One or more teeth is (are) smaller than normal
• Microdontia involving a single tooth is far more common
• Maxillary lateral incisor and maxillary third molar are the most commonly involved teeth
• True generalized microdontia
• Seen in a pituitary dwarf; all teeth are smaller than normal
• Generalized relative microdontia
• Normal-size teeth appear small in a large jaw

• One or more teeth are larger than normal
• True generalized macrodontia
• Seen in cases of pituitary gigantism
• Relative generalized macrodontia
• Large teeth in a small jaw
• Macrodontia affecting a single tooth
• May be seen in cases of facial hemihypertrophy

• A single tooth germ attempts to divide in two
• Appears as two crowns joined together by a notched incisal area
• Radiographically, usually one single root and one common pulp canal exist
• The patient has a full complement of teeth
• fusion ot deciduous teeth occur more often than fusion of permanent teeth

• 
• The union of two normally separate adjacent tooth germs
• Appears as a single large crown that occurs in place of two normal teeth
• Radiographically, either separate or fused roots and root canals are seen
• The patient is usually short one tooth
• True fusion ALWAYS involves confluence of dentin

• Excessive cementum on the roots of the teeth
• Occurs in adults; incidence and amount increase with age
• Feature associated with several local and systemic factors
• No treatment necessary
• Frequently seen in Paget disease of bone.

• Two adjacent teeth are united by cementum
• Form of fusion on the roots
• Usually discovered on radiograph

• an abnormal curve or bend in the root of  tooth.
• Usually discovered on radiograph
• May cause a problem if the tooth must be removed or a root canal performed

• A small, spherical enamel projection on a root surface
• Usually found on maxillary molars
• Radiographically, it appears as a small, spherical radiopacity
• Removal may be necessary if periodontal problems occur in the furcation

• An accessory cusp located in the cingulum area of a maxillary or mandibular permanent incisor
• Contains a pulp horn
• May interfere with occlusion

• The teeth have elongated pulp chambers and short roots
• May occur in both deciduous and permanent dentition
• Identified on radiographs

• Occurs when the enamel organ invaginates into the crown of a tooth before mineralization
• Radiographically, it appears as a toothlike structure within a tooth
• Vulnerable to caries, pulpal infection, and necrosis

• An accessory enamel cusp found on the occlusal tooth surface
• Most often seen on mandibular premolars
• May cause occlusal problems

• May involve any tooth
• Most commonly, maxillary and mandibular third molars if multirooted teeth are involved
• May become clinically significant if removal or endodontia is necessary

• The incomplete or defective formation of enamel
• May be due to many factors, including:
• Amelogenesis imperfecta
• Febrile illness (measles, chickenpox, scarlet fever)
• Vitamin deficiency
• Infection of a deciduous tooth
• Ingestion of fluoride
• Congenital syphilis
• Birth injury, premature birth
• Idiopathic factors

• Ameloblasts are one of the most sensitive cell groups in the body
• Any serious systemic disease or severe nutritional deficiency can produce enamel hypoplasia

• Enamel hypoplasia of an adult tooth may result from infection of a deciduous tooth
• A single tooth is usually affected; it is referred to as a Turner tooth
• The color of the enamel may range from yellow to brown, or severe pitting and deformity may be involved

• Affected teeth exhibit a mottled discoloration of enamel
• Ingestion of water with two to three times the recommended amount of fluoride (0.7ppm) leads to white flecks and chalky opaque areas of enamel
• Four times the recommended amount of fluoride causes brown or black staining

• Congenital syphilis is transmitted from an infected mother to her fetus via the placenta
• Hutchinson incisors are shaped like screwdrivers
• Mulberry molars have a berrylike appearance

• Enamel hypoplasia may occur as a result of trauma or injury at the time of birth
• Even a mild illness or systemic problem can result in enamel hypoplasia

• A developmental anomaly resulting in a disturbance in the maturation of the enamel matrix
• Usually appears as a chalky, white spot on the middle third of smooth crowns
• The underlying enamel may be soft and susceptible to caries

• The result of deposition of substances circulating systemically during tooth development
• May be due to:
• Tetracycline stain
• Erythroblastosis fetalis: Rh incompatibility
• Neonatal liver disease
• Congenital porphyria: An inherited metabolic disease

• Exhibit a marked reduction in radiodensity and a characteristic ghostlike appearance
• Very thin enamel and dentin are present
• Usually treated by extraction

• Any tooth can be impacted
• Third-molar impactions are classified according to the position of the tooth
• Teeth can be completely impacted in bone or they may be partially impacted
• Partially impacted teeth are prone to infection
• Impacted teeth may be surgically removed to prevent odontogenic cyst and tumor formation or damage to adjacent teeth
• The optimal time is between 12 and 24 years of age

• Tooth cementum fused to bone
• Prevents exfoliation of the deciduous tooth and eruption of the underlying adult tooth
• The ankylosed deciduous tooth appears submerged and has a different sound when percussed (a kind of dull thud)
• The periodontal ligament space is lacking
• Difficult to extract
• Removal of deciduous teeth is necessary for eruption of the adult successor
• Removal of adult teeth may be necessary to prevent malocclusion, caries, and periodontal disease