Developmental Anomalies of Oral and Paraoral Structures

YIKES!

A diverse group of deformities in the growth of the head and facial bones

Cranofacial anomalies

A medical term meaning ‘irregularity’ or ‘different from normal’ ; is congenital ; has numerous variations

Anomaly

What are the factors contributing to craniofacial anomalies?

Combination of genes
Environmental
Folic acid deficiency

These are agents that may cause birth defects when present in the fetal environment

Teratogens

The extent to which an individual may be adversely affected by exposure to a given teratogen depends on what factors?

Differences in dose
Developmental timing of exposure
Differences in susceptibility
Interactions among environmental exposures

A separation that occurs in the lip or the palate or both

Cleft lip and/or palate

Abnormality in which the lip does not completely form

Cheiloschisis

Abnormality in which the roof of the mouth does not completely close, leaving an opening that can extend into the nasal cavity

Palatoschisis

A condition in which the sutures in the skull of an infant close too early causing problems with normal brain and skull growth

Craniosynostosis

A condition in which the tissues on one side of the face are underdeveloped, affecting primarily the ear, mouth, and jaw areas.

Hemifacial microsomia (Lateral Facial Dysplasia)

A misshapen shape of the head from repeated pressure to the same area of the head (oblique head)

Deformational plagiocephaly

A lethal anomaly characterized by hypoplasia or absence of the mandible with abnormally positioned ears

Agnathia

Literally means small jaw, and either the maxilla or mandible may be affected

Micrognathia

The condition of abnormally large jaws

Macrognathia

A condition in which overgrowth of the cranium and maxilla or occasionally the mandible occurs

Paget’s disease

A condition in which there is progressive enlargement owing to hyperpituaritism in the adult

Acromegaly

A form of fibrous dysplasia in which there is overgrowth of the facial and skull bones

Leontiasis ossea

A rare developmental anomaly characterized by asymmetric overgrowth of one or more body parts

Facial hemihypertrophy/hemihyperplasia

Slow progressive atrophy of the soft tissues of essentially half the face of skin, cartilage, bone and muscle

Facial Hemiatrophy (Parry-Romberg syndrome)

This is the most common early sign of facial hemiatrophy; it is a painless cleft near the midline of the face or forehead

coup de sabre

An uncommon and poorly understood inflammatory disorder of the lip characterized by progressive enlargement and eversion of the lower labial mucosa.

Cheilitis glandularis (Actinic Cheilitis)

Which classification of Cheilitis Glandularis is described?

Multiple, painless, papular surface lesions with central depressions and dilated canals are seen.

Simple type

Which classification of Cheilitis Glandularis is described?

Painless, indurated swelling of the lip with shallow ulceration and crusting.

Superficial type (suppurative or Baelz disease)

Which classification of Cheilitis Glandularis is described?

Deep-seated infection with formation of abscesses, sinus tracts and fistulas, and potential for scarring.

Deep suppurative type

Condition characterized by the chronic swelling of the lip due to granulomatous inflammation

Cheilitis granulomatosa (Miescher-Melkerson-Rosenthal syndrome)

These are heterotopic collections of sebaceous glands at various sites in the oral cavity, appearing as small yellow spots often projecting slightly above the surface of the tissue

Fordyce’s granules

An HPV-related infection that produces extreme acanthosis or hyperplasia of the prickle cell layer of the epithelium. Lesions take on a cobblestone or fissured appearance. Lesion rete ridges are at the same depth as adjacent normal rete ridges.

Focal epithelial hyperplasia (Heck’s disease)

A condition in which the inferior frenulum attaches to the bottom of the tongue and subsequently restricts free movement of the tongue.

Ankyloglossia

A rare condition that is due to the lack of merging of the lateral lingual swellings of the tongue.

Cleft tongue

A condition characterized by grooves that vary in depth and are noted along the dorsal and lateral aspects of the tongue.

Fissured tongue (Scrotal tongue/Lingua Plicata)

A condition in which the posterior point of fusion of the tongue is defective, leaving a rhomboid-shaped, smooth erythematous mucosa lacking in papillae or taste buds

Median rhomboid glossitis

This is a psoriaform mucositis on the dorsum of the tongue characterized by a constantly changing pattern of serpiginous white lines surrounding areas of smooth, depapillated mucosa. Also called the wandering rash of the tongue.

Benign migratory glossitis (Geographic tongue)

In the histologic features of geographic tongue, what do you call the spongiform pustules that are formed in the upper epithelial layers?

Munro abscesses

This is a defective desquamation of the filiform papillae that results from a variety of precipitating factors. Characterized mainly by hypertrophy of filiform papillae on the dorsal surface of the tongue usually due to lack of mechanical stimulation and debridement

Hairy tongue

Absence of any one or group of salivary glands, unilaterally or bilaterally.

Aplasia (Agenesis)