Developmental Defects

in a clinical description, you should describe what 5 things

• color

• consistency

• location

• shape and base

• architexture

color definition

predominant impression

consistency definition

how the area feels

location definition

anatomic site

shape and base definition

general outline

architecture definition

surface appearance

how do you describe a flat shape/base

sessile

how do you describe a stalk-like shape/base

pedunculated

how do you describe a shape/base of a lesion that is in between pedunculated and sessile

polypoid

what is the shape/base description

sessile

what is the shape/base description

polypoid

what is the shape/base description

pedunculated

what are the four descriptions you can use to describe architecture

• corrugated

• fissure

• papillary

• folded

describe corrugated

wrinkled

describe fissure

a cleft/deep groove showing predominant depth

describe papillary

small projections or elevations found in clusters

when the descriptor words are “folded, smooth, rough, or ulcer”, what is this describing

the surface appearance (architexture) of a lesion

describe the architecture

corrugated

describe the architecture

fissure

describe the architecture

papillary

describe the architecture

folded

describe a macule

distinguished by its different color from its surroundings, is flat (freckle)

describe a papule

small and elevated lesion (<1 cm)

describe a nodule

palpable, solid, small lesion- can be above, level w/, or beneath skin surface

describe a lobule

segment or lobe that is part of a whole lesion → appears fused together

is this a macule, papule, nodule, or lobule

macule

is this a macule, papule, nodule, or lobule

papule

is this a macule, papule, nodule, or lobule

lobule

s this a macule, papule, nodule, or lobule

nodule

describe a vesicle

small, elevated lesion that contains serous fluid

describe a pustule

variously sized, circumscribed lesion that contains pus

describe bulla

circumscribed, elevated, large (>5 mm) lesion that contains serous fluid

vesicle, pustule, or bulla

vesicle

vesicle, pustule, or bulla

pustule

vesicle, pustule, or bulla

bulla

what descriptions do you wanna include when describing a radiograph

• density

• border

• shape

• adjacent structures

what are the three descriptions you can use to describe density

• radiolucent

• radiopaque

• mixed

describe the density of lesion at the apex of #7

radiolucent

describe the density at the apex of the D root of #19

radiopaque

describe the density of the lesion adjacent to the molar

radiolucent and radiopaque

what can cause a radiolucent and radiopaque lesion

mix of different densities of tissue

what are the two descriptors you can use to describe a border of a lesion

• ill-defined

• well-circumscribed

describe an ill-defined border

cannot detect the exact parameters of the lesion bc borders are not defined

describe a well-circumscribed border

borders are defined well enough to see the exact margins

well circumscribed or ill defined

ill defined

well circumscribed or ill defined

well circumscribed

what are the four descriptor names you can use to describe shape in a radiograph

• uniocular

• multilocular

• round

• oval

describe a uniocular shape

a single, well-defined unit

describe a multiocular shape

multiple uniocular lesions somewhat fused together (soap bubbles)

what are the three descriptors that can be used to describe adjacent structures in radiograph

• resorption

• fracture

• divergence

resorptions usually starts…

at the apex of a root

describe what resorption looks like

apex of the tooth appears shortened, blunted, irregular

describe scalloping

radiolucent lesion that extends between roots and teeth

describe the radiolucency is relation to the adjacent structures

scalloping

describe the radiolucency is relation to the adjacent structures

resorption (usually wouldn’t see the L image, not v common to start outside of the apex)

origin of Fordyce Granules

clusters of ectopic sebaceous glands- common in adults and during puberty

clinical appearance of Fordyce Granules

yellow/yellow-white papular lesions

location for Fordyce Granules

buccal mucosa, lateral portion of vermillion upper lip

tx for Fordyce Granules

none

dx

Fordyce Granules

origin for Leukoedema

90% of African American adults (50% in children)

clinical appearance for Leukoedema

diffuse, gray-white, milky, opalescent lesion

location for leukoedema

bilaterally on B mucosa → localized, NOT generalized

tx for leukoedema

none

how to confirm leukoedema dx

when stretched, the white appearance will disappear

dx

leukoedema

origin of linea alba

prominent in clenching or bruxing

clinical appearance of linea alba

white line

location of linea alba

extends A-P on B mucosa along occlusal plane

tx for linea alba

none- in parafunx habit is severe, consider NG

dx

linea alba

origin of physiological pigmentation

most common is dark-skinned people

clinical appearance of physiological pigmentation

melanin pigmentation of oral mucosa

location of physiological pigmentation

generalized along gingival margin

tx for physiological pigmentation

none

dx

physiological pigmentation

origin of lingual varicosities

most common in people >60 yrs, NOT associated w systemics

clinical appearance of lingual varicosities

ventral/lateral surface of the tongue

tx for lingual varicosities

none- DO NOT BIOPSY

dx

lingual varicosities

clinical appearance of retrocuspid papilla

sessile nodule

location of retrocuspid papilla

gingival margin on the lingual of mandibular canines/cuspids

tx for retrocuspid papilla

none

dx

retrocuspid papilla

what is a diascopy

use a clear slide and put pressure on the lesion → will blanch if vascularized → if doesn’t blanch, is a concern

origin of torus palatinus

exophytic growth of normal compact bone

location of torus palatinus

hard palate

tx for torus palatinus

none unless affecting pts QOL

dx

torus palatinus

origin of mandibular tori

outgrowths of normal dense bone

location of mandibular tori

lingual aspect of mandibular premolars

tx for mandibular tori

none unless affecting pts QOL

dx

mandibular tori

origin of lingual thyroid

thyroid doesn’t end up descending in the 7th week of fetal development, F>M, 90% of ectopic thyroids are in this position

clinical appearance of lingual thyroid

normal thyroid

location of lingual thyroid

posterior midline dorsum of the tongue, posterior to circumvallate papillae- in area of foramen cecum

tx for lingual thyroid

to dx- use radioactive iodine

DO NOT BIOPSY

no tx unless problems → otherwise surgery

dx

lingual thyroid

origin of geographic tongue

etiology unknown, F have 2:1, 10% of psoriasis pts have

clinical appearance of geographic tongue

erythematous patches surrounds by white/yellow serpentine borders, can be multiples or single