Oral path ch 5

  1. Image Upload 1 Ankyloglossia:
    • 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
  2. Anomaly:
    Marked deviation from normal. especially as a result of congenital or hereditary defects.
  3. Commissure:
    the site of union of corresponding parts (e.g., the corners of the lips) (labial commissure, commissural lip pits).
  4. Congenital disorder:
    A disorder that is present at and existing from the time of birth.
  5. Cyst:
    An abnormal sac or cavity lined by epithelial and surrounded by fibrous connective tissue.
  6. Dentiogenesis:
    the formation of dentin.
  7. Differentiation:
    the distinguishing of one tissue from another.
  8. Hypodontia:
    • 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
  9. Hypercementosis: AKA cemental hyperplasia
    • excessive cementum on the roots of the teeth.
    • occurs in adults, incidence increases w/ age
    • frequently seen in Paget disease of the bone
  10. Macrognathia:
    Enlarged jaw.
  11. Multilocular:
    A radiographic appearance in which many circular radiolucencis exist; these can appear "soap-bubble-like" or "honeycomb-like".
  12. Nodule:
    A small solid mass that can be detected through touch.
  13. Oligodontia:
    a subcategory of hypodontia in which six or more teeth are missing.
  14. Predilection:
    A disposition in favor of something; preference.
  15. Proliferation:
    The multiplication of cells.
  16. Stomodeum:
    The embryonic invagination that becomes the oral cavity.
  17. Supernumerary:
    In excess of the normal or regular number , as in teeth.
  18. Development of the face is a process of______.
    selective growth, or proliferation and differentiation.
  19. All of the face and most of the structures of the oral cavity develop from ______.
    frontal process or the first branchial arch.
  20. The first branchial arch divides into ______.
    two maxillary processes and the mandibular process.
  21. The maxillary processes give rise to _____.
    • upper part of the cheeks
    • the lateral portion of the upper lip
    • part of the palate
  22. The mandibular arch forms ______.
    • the lower part of the cheeks
    • the mandible
    • part of the tongue
  23. Olfactory pits:
    • 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
  24. Lateral nasal processes form ______.
    sides of the nose
  25. The first brachial arch divides into:
    two maxillary processes and one mandibular process.
  26. median nasal process form:
    • 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
  27. The tongue develops from _____.
    • the first three branchial arches.
    • - body of the tongue forms from the 1st branchial arch
    • - the base forms from the 2nd & 3rd branchial arches.
  28. Tooth development or odontogenesis begins at about the ___ week of embryonic life and involves _____and ____.
    • fifth 
    • ectoderm
    • ectomesenchyme
  29. The tooth germ is composed of three parts:
    • 1. enamel organ (developed from ectoderm)
    • 2. the dental papilla ( developed from mesoderm)
    • 3. the dental sac or follicle (dev. from mesoderm)
  30. Enamel organ progresses to produce ____.
    ameloblasts, which form enamel.
  31. Amelogenesis:
    • the formation of enamel.
    • - enamel is highly mineralized epithelial tissue, and 90% of its volume is hydroxyapatite crystals.
  32. Dental sac (fillicle):
    provides cells that form cementum, PDL, & alveolar bone
  33. Herwig epithelial root sheath:
    • 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.
  34. Ankyloglossia:Image Upload 2
    • 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.
  35. Commissural lip pits:Image Upload 3
    • May be shallow or they may be several MM deep.
    • can be bilateral or unilateral
    • more often seen in adult males
  36. Paramedian lip pit:
    • 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
  37. Lingual thyroid:Image Upload 4
    • appears as a smooth nodular mass at the base of the tongue posterior to the circumvallate papillae at midline.
    • can be asymptomatic or symtomatic
  38. Radicular cyst AKA periapical cyst
    • 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
  39. Intraosseous cyst:
    oral cysts that occur within the bone
  40. extraosseous cysts:
    cysts that occur in soft tissue
  41. Dentigerous cyst AKA follicular cyst:
    Image Upload 5
    Image Upload 6
    • 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.
  42. Eruption cyst:
    Image Upload 7
    • 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

  43. Premordial Cyst:
    Image Upload 8
    • 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
  44. Odontogenic keratocyst (OKC):
    Image Upload 9
    • 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%)
  45. Orthokeratotic odontogenic cyst:
    • odontogenic cyst that is lined by orthokeratin
    • much lower rate reccurance than OKC/KOT
  46. Calcifying Odontogenic cyst AKA Gorlin cyst:
    • 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
  47. Lateral periodontal cyst:
    Image Upload 10
    • 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
  48. Botryoid odontogenic cyst:
    • 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
  49. Gingival cyst:
    • appears as a small bulge or swelling of the attached gingiva or interdental papillae
    • Treatment: surgical excision
  50. Glandular odontogenic Cyst:
    • 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
  51. Nasopalatine canal cyst (incisive canal cyst):
    Image Upload 11
    • 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
  52. Median palatine cyst:
    Image Upload 12
    • 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
  53. Globulomaxillary cyst:
    Image Upload 13
    • 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
  54. Median mandibular cyst:
    Image Upload 14
    • 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
  55. Cervical lymphoepithelial cyst (branchial cleft cyst):
    • 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
  56. intraoral lymphoepithelial cyst:
    • 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
  57. Epidermal cyst:
    • A raised nodule on the skin of the face or neck
    • May be noted intraorally on occasion
    • Treatment: Surgical excision
  58. Dermoid cyst:
    • 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.
  59. benign cystic teratoma:
    • 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
  60. Thyroglossal tract (duct) cyst:
    Image Upload 15
    • 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
  61. Psedocyst:
    • intraosseous lesions that appear as radiolucencies.
    • NOT true cysts because they are not lined by epithelium.
  62. Stafne Defect (lingual mandibular bone concavity or static bone cyst)
    Image Upload 16
    • 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
  63. Simple bone cyst (traumatic bone cyst, hemorrhagic bone cyst):
    Image Upload 17

    Image Upload 18
    • 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
  64. Aneurysmal bone cyst:
    • 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

  65. Hypodontia:
    Image Upload 19
    • 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
  66. Supernumerary teeth:
    Image Upload 20
    • 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
  67. Microdontia:
    Image Upload 21
    • 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
  68. Macrodontia:
    Image Upload 22
    • 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
  69. Gemination:
    Image Upload 23
    • 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
  70. Fusion:
    • Image Upload 24
    • 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
  71. Hypercementosis:
    Image Upload 25
    • 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.
  72. Concrescences:
    Image Upload 26
    • Two adjacent teeth are united by cementum
    • Form of fusion on the roots
    • Usually discovered on radiograph
  73. Dilaceration:
    Image Upload 27
    • 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
  74. Enamel pearl:
    Image Upload 28
    • 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
  75. Talon cusp:
    Image Upload 29
    • An accessory cusp located in the cingulum area of a maxillary or mandibular permanent incisor
    • Contains a pulp horn
    • May interfere with occlusion
  76. Taurodontism:
    Image Upload 30
    • The teeth have elongated pulp chambers and short roots
    • May occur in both deciduous and permanent dentition
    • Identified on radiographs
  77. Dens invaginatus: AKA Dens in dente
    Image Upload 31
    • 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
  78. Dens Evaginatus:
    Image Upload 32
    • An accessory enamel cusp found on the occlusal tooth surface
    • Most often seen on mandibular premolars
    • May cause occlusal problems
  79. Supernumerary roots:
    Image Upload 33
    • 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
  80. Enamel hypoplasia:
    • 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
  81. Enamel Hypoplasia Caused by Febrile Illness or Vitamin Deficiency:
    Image Upload 34
    • Ameloblasts are one of the most sensitive cell groups in the body
    • Any serious systemic disease or severe nutritional deficiency can produce enamel hypoplasia
  82. Enamel hypoplasia resulting from local infection or trauma:
    • 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
  83. Enamel Hypoplasia Resulting from Fluoride Ingestion:
    Image Upload 35
    • 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
  84. Enamel Hypoplasia Resulting from Congenital Syphilis:
    Image Upload 36
    • 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
  85. Enamel Hypoplasia Resulting from Birth Injury, Premature Birth, or Idiopathic Factors:
    • 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
  86. Enamel Hypocalcification:
    • 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
  87. Endogenous Staining of Teeth:
    • 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
  88. Regional Odontodysplasia (Ghost Teeth):
    Image Upload 37
    • Exhibit a marked reduction in radiodensity and a characteristic ghostlike appearance
    • Very thin enamel and dentin are present
    • Usually treated by extraction
  89. Impacted and Embedded Teeth:
    • 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
  90. Ankylosed Teeth:
    • 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
Card Set
Oral path ch 5
ch 5