PALM 302: CHAPTER 1 and 2

base of lesion can be described as:
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Terms in this set (97)
base of lesion can be described as:
sessile
polypoid
pedunculated
sessile
flat base
Image: sessile
polypoid
between sessile and. pedunculated
Image: polypoid
pedunculated
stalk like
Image: pedunculated
surface of a lesion can be described as:
-smooth
-rough/shaggy
-cobblestone (irregular)
-papilloma (cauliflower-like)
macule
An area that is usually distinguished by a color different from that of the surrounding tissue; it is flat and does not protrude above the surface of the normal tissue
-ex: freckle
Image: macule
papule
A small, circumscribed lesion usually less than 1 cm in diameter that is elevated or protrudes above the surface of normal surrounding tissue.
Image: papule
nodule
A palpable solid lesion up to 1 cm in diameter found in soft tissue; it can occur above, level with, or beneath the skin surface.
Image: nodule
lobule
A segment or lobe that is a part of the whole; these lobes sometimes appear fused together
bulla
A circumscribed, elevated lesion that is more than 5mm in diameter, usually contains serous fluid, and looks like a blister
Image: bulla
pustulesVariously sized circumscribed elevations containing pusvesicleA small, elevated lesion less than 1 cm in diameter that contains serous fluidcolors of lesions can be described as:erythema erythroplakia leukoplakia pallorerythemaAn abnormal redness of the mucosa or gingivaerythroplakiaA clinical term used to describe an oral mucosal lesion that appears as a smooth red patch or granular red and velvety patch. *concerning b/c it has no real reason for being presentleukoplakiaA clinical term for a white plaquelike lesion on the oral mucosa that cannot be rubbed off or diagnosed as a specific disease.pallorpaleness of the skin/mucosal tissues *anemic patientssurface texture of a lesion can be described as:corrugated fissure papillary smooth, rough, foldedcorrugatedwrinkled; ridgedfissureA cleft or groove, normal or otherwise, showing prominent depthpapillaryResembling small, nipple-shaped projections or elevations found in clusterssmooth, rough, foldedterms used to describe the surface texture of a lesionradiographic terms to describe a lesion:-radiolucent/radiopaque (or mixed) -multilocular -unilocular -diffuse -well-circumscribed -root resorption -scallopingradiolucent-black or dark areas on a radiograph; less dense tissue such as the pulpradiopaque-light or white areas on a radiograph that results from the inability of radiant energy to pass through the structure -the denser the structure, the lighter/whiter it appears on the radiographmixed (radiopaque/radiolucent)mixture of light and dark areas within a lesion, usually denoting a stage in the development of the lesion *COD (cements-osseous dysplasia)multilocularmany lobes or parts that are somewhat fused together, making up the entire lesion; these can appear "soap bubble-like" or "honeycomb-like"unilocularHaving one compartment or unit that is well defined or outlined, as in a simple radicular cystdiffuseboarders that are not well defined, making it impossible to detect the exact parameters of the lesion; this may make treatment more difficultwell-circumscribedboarders that are specifically defined and in which one can clearly see the exact margins and extentroot resorptionobserved radiographically when the apes of the tooth appears shorted or blunted and irregularly shaped; occurs as a response to stimuli, which can include cyst, tumor, or traumascallopingA radiolucent lesion that extends between the roots, as seen in a traumatic bone cyst (TBC)types of diagnoses1. clinical diagnosis 2. radiographic diagnosis 3. historical diagnosis (med/dent hx) 4. laboratory diagnosis 5. microscopic diagnosisclinical diagnosiswhen biopsy or surgical intervention is not necessarywhat types of things can you find in a clinical diagnosis?-fordyce granules -tori -physiological pigmentation -retrocuspid papillae -lingual varicosities -fissured tongue -median rhomboid glossitis -geographic tongue -hairy tongueradiographic diagnosisthe radiographic provides sufficient information to establish the diagnosisconditions for which the radiographic provides the most significant information include:-internal/external resorption -heavy inter proximal calc -caries -odontoma -supernumerary teeth -impacted/unerupted teeth -calcified pulp -anatomic landmarks -unusual findingsmesiodensdental cariesodontomainternal resorptionexternal resorptionpulp stonedental calculushistorical diagnosisPersonal history Family history Past and present medical and dental histories History of drug ingestion History of the presenting disease or lesionwhat findings can be found in a historical diagnosis?-hypersensitiviy -allergies -amleogenesis imperfecta (AI) -dentinigenesis imperfecta (DI)laboratory diagnosis-blood chemistry and urinalysis -an *elevated serum alkaline phosphatase level* is significant in the diagnosis of *paget disease* -oral infectionsmicroscopic diagnosis-this procedure is often the main component of the definitive diagnosis -biopsy is equally importantvariants of normal1. fordyce granules 2. torus palatinus 3. mandibular tori 4. physiological pigmentation 5. retrocuspid papilla 6. lingual varicosities 7. linea alba 8. leukoedema1. fordyce granules-clusters of ectopic sebaceous glands -clinically they appear as tiny, yellow lobules in clusters are in usually distributed over the buccal mucosa or vermilion border of the involved lips -more than 80% of adults have them -asymptomatic2. torus palatinus-exophytic growth of normal compact bone -asymptomatic, midline of the hard palate -various shapes/sizes, may be lobulated -discomfort, possible ulceration -large = radiopaque on radiograph3. mandibular tori-outgrowths of normal dense bone found on the lingual aspect of the md in area of premolars -usually bilateral -can be lobulated, nodular, or fused -no treatment unless patient needs denture and interference4. physiological pigmentationmelanin pigmentation of the oral mucosa or gingiva is most commonly observed in dark skinned individuals *90% of most African American*5. retrocuspid papillaa sessile nodule on the gingival margin of the lingual aspect of the mandibular cuspids6. lingual varicositiesusually observed on the ventral and lateral surfaces of the tongue, clinically red to purple enlarged vessels or clusters are seen. *most common in 60< years old (aging)7. linea albaA "white line" that extends anteroposteriorly on the buccal mucosa along the occlusal plane -can be bilateral -more prominent in individuals who have clenching/bruxism habit8. leukoedema-a generalized gray-white (opaque) diffused throughout the buccal mucosa -85% african-americans -if mucosa is stretched, it becomes less prominent -more pronounced in smokers -no treatmentbenign conditions of unknown cause1. lingual thyroid 2. median rhomboid glossitis 3. geographic tongue 4. fissured tonguelingual thyroid-normal thyroid on posterior midline dorm of the tongue posterior to the circumvallate papillae in the area of the foramen cecum -more common in females -most of the time only thyroid issue -do not removemedian rhomboid glossitis-cause is unclear' may be associated w/ fungal infection by Candida albicans -oval flat or slightly raised -erythematous smooth areas in midline dorsal of tongue -anterior to circumvallate papillae -no specific treatment -if burning/tender: presume candidiasisgeographic tongue-etiology unknown -erythematous patchers surrounded by white parameter -on tongue, but can be called erythema migrans if anything else -10% of psoriasis pts have it -usually asymptomatic -no treatmentfissured tongue-developmental groves in lingual dorsum -2-5% population -associated with geographic tongue -if deep: have pt use toothbrush in groves -if burning: rx for candidahairy tongue-excess keratin on surface of filiform papillae -starts white, may become darkened -from food/drink stains, chromogenic bacteria -often halitosis -rx: antibacterials, antifungals/brushing tonguethree categories of oral injuries1. trauma 2. reactive 3. inflammatorytrama injuries-frictional keratosis -linea alba -chewing trauma -TUGSE -denture stomatitis -nicotine stomatitis -actinic cheilosis -amalgam tattoo -mucocele -chemical burn -thermal burn -chemo/radiation -sialolithiasisfrictional keratosiswhite keratonic area (excess keratin) due to trauma such as chronic friction rubbing against teeth ex: linea alba, cheek bitelinea alba-a white keratotic line, a variation of normal -bilateral on buccal mucosa -trauma (biting) -often regresses spontaneously -no need for biopsy/treatmentchronic cheek biting (morsicatio buccarum)-irregular, wide white buccal keratotic, plaque or lesion -bilateral or unilateral -from chewing habitmorsicatio labiorumbiting on labial mucosamorsicatio linguarumbiting on tonguetraumatic ulcerative granuloma with stroll eosinophilia (TUGSE)-deep chronic ulceration due to damage muscle -repetitive trauma -very slow resolution (months-year) -usually adults -on tongue mostly -biopsy and remove cause of trama -similar to squamous cell carcinoma, so biopsy is a MUSTdenture stomatitis-from mild, repeated trauma from loss denture -if pt never takes out denture -bacteria-induced inflammation may contribute to it -due to candidiasis (maybe)nicotine stomatitis-from repeated contact with pipe/cigar -not a precancer -inflammed salivary glands = elevated, volcano-like papule with red central dots -takes years to develop -disappears 1-3 months after habit stopsactinic cheilosis (farmers lip/sailors lip)-premalignant alteration of the lower lip -due to UV light exposure -outdoor occupations -more common in males -common over the age of 45 -more common in rural areas -surgical excision treatmentsmokeless tobacco keratosis (snuff pouch)-located in md vestibule -precancerous white macule -leathery white fissured plaque or fissures -gingival recession -increase caries risk -stop habit: gone in 2-4 monthsamalgam tattoo (localized argyrosis)-amalgam trauma introduced into mucosa -steel gray/blue/black macule -borders not well demarcated -may enlarge over time -last indefinitely -no treatmentmucocele-rupture of salivary gland duct and spillage of mucin into the surrounding soft tissue -due to trauma -located on lower lip -most common in children/young adults -dome shaped swelling/bluish translucent hueranulaa term used in a mucocele found in the floor of the mouthchemical burn (aspirin)-placing aspirin tablet next to toothache -low pH -pseudomembrane that can be rubbed off -takes few days to heal after removed -no scarelectrical/thermal burns-thermal: contact w/ hot beverage and food -electrical: contact w/ electricity -zones of erythema, ulceration, necrotic epithelium at peripherychemotherapy mucosistis-begins few days after chemo begins -ulcerations and sloughing of the epithelium -lips, tongue, gingiva -resolves slowly within weeks after txradiation therapy-frequency = >90% -mucositis, dermatitis, xerostomia, radiation caries, hypogeusia (loss of taste), candidiasis/bacterial infection, osteoradionecrosis (ORN), truismssialolithiasis (salivary stones)-calcified structures that develop within the salivary ductal system -calcium salts + debris within the duct lumen -most common in submandibular gland -swells up just before and during mealsreactive oral injuries1. irritation fibroma* 2. PGCG* 3. PG* 4. IFH 5. IPH 6. Gingival hyperplasia 7. Chronic hyperplastic pulpitis 8. POF* *most commonirritation fibroma*most common "tumor" in the oral cavity* -not true neoplasm -reactive hyperplasia of fibrous connective tissue due to irritation -clinical: smooth surfaced pink sessile nodule; asymptomatic -located on buccal mucosaperipheral giant cell granuloma (PGCG)-reactive lesion of well vascularized fibrous connective tissue containing numerous multinucleate giant cells (MNGCs) -asymptomatic, any age -clinically presents exclusively on gingiva, red/blue nodular masspyogenic granuloma (PG)-reactive tumor due to irritation -75-85% gingiva but can occur anywhere in oral mucosa -asymptomatic, reddish, ulcerated, sessile, or pedunculated mass -present in children/young adults -pregnancy tumorInflammatory Fibrous Hyperplasia (Epulis Fissuratum) (IFH)-reactive (hyperplastic) folds of fibrous connective tissue associated with flanges of ill-fitting, over extended denture -located anteriorly more -single or multiple folds of connective tissue on alveolar ridgeInflammatory Papillary Hyperplasia (IPH)*denture papillomatosis* reactive response of palatal mucosa primary due to: -ill-fitting denture -poor denture hygiene -wearing dentures 24hrs -candida can also be associated -erythematous pebbly surface -located on hard palateChronic hyperplastic pulpitis (pulp polyp)-found in children -located in molars -asymptomaticgingival enlargement (gingival hyperplasia)-an increase in the size of the marginal and attached gingiva usually involving interdental papillae (hyperplasia) -no stippling, bulbous and rounded (gen or local) -mild focal to serve that may cover the crowns of the teeth -due to local irritants such as: dental biofilm/calculus, hormonal changes, drugs (calcium channel blockers), hereditary forms, leukemiainflammatory oral injuries1. periapical granuloma 2. apical periodontal cyst 3. resorption 4. condensing osteitis 5. alveolar osteitisperiapical granuloma-most common periodical pathosis -accumulation of inflammatory tissue at the peripex in response to noxious products of pulp necrosis -asymptomatic/not mobile -no epithelial lining (vs. apical periodontal cyst) -radiolucent lesion (variable size, symmetrical, well defined, root resorption can be seen)apical periodontal cyst-classic pattern of surrounding root tip (radicular cyst/periapical cyst) -lateral apical periodontal cyst (lateral radicular cyst): found on side of root, prob arises in association w/ lateral root canal -residual apical periodontal cyst: cyst remains following extractionexternal vs. internal resorption*external* -common; apical/mid-root -associateed with: cysts and tumors, ortho, excessive occlusal stress, reimplantation of avulsed tooth *internal* -rare -injury to the pulp tissue (TRAUMA) -when crown is affected known as pink tooth of mummeryfocal chronic sclerosing osteomyelitis (condensing osteitis)-focal area of increased bone density -often associated with the apex of an infected tooth -most common in md 1st molar -usually shows caries, large resorption, crown coverage, or endodontic therapyalveolar osteitis "dry socket"-a postoperative complication of tooth extraction -extracted md third molar -caused by blood clot is lost before healing has taken place -pain develops several days after -tooth socket appears empty -bone surfaces are exposed