oral pathology exam 1

EC: what is her cats name

roo

what is the cause of oral clefts

disruption of orchestrated development and merger of tissue processes

what are the components of intermaxillary segment

1. labial: philtrum

2. upper jaw: carries four incisors

3. palatal: forms primary triangular palate

what forms the intermaxillary segment

primary palate

which palate makes up the primary palate

only hard palate

which palate makes up the secondary palate

90% of hard and soft palates

what is the cause of cleft lip

defective fusion of medial nasal processes with maxillary process

What is the consequence of a failure of the palatal shelves to fuse?

cleft palate

what is one of the most common major congenital defects

clefting

what is included in a complete cleft lip (CCL)

from the lip to the nostril

what is included in an incomplete cleft lip

the nose is not involved

who is involved in the treatment of orofacial clefts

Multidisciplinary approach:

pediatrician

oral and maxillofacial surgeon

otolaryngologist

plastic surgeon

pediatric dentist

orthodontist

prosthodontist

speech pathologist

geneticist

what is leukoedema

common oral mucosa condition

what is the cause of leukoedema

unknown cause

what race is leukoedema more prevalent in

african american

is leukoedema benign?

yes

what type of people is leukeodema more common in?

smokers

what is the appearance of the mucosa in someone with leukeodema

diffuse, gray-white, milky, opalescent

how is leukeodema diagnosed

white appearance diminishes or disappears with eversion of the cheek (stretch the cheek)

what condition causes issues with breast feeding

ankyloglossia (tongue-tied)

what is fissured tongue (scrotal tongue)

multiple grooves or fissures on dorsal lingual surface

What is the treatment for asymptomatic fissured tongue/scrotal tongue?

prophylaxis against accumulation of debris

is treatment needed for fissured tongue

no, encourage patients to brush the tongue

what are varicosities

abnormally dilated, tortuous veins

what is varicosities associated with

smoking and cardiovascular disease

what is the most common type of varicosities

sublingual varix

what is the appearance of varicosities

purple papules (elevated lesions)

what may occur if you have varicosities

thrombosis

what are other less common areas one could get varices

lips and buccal mucosa

what is the normal appearance of a solitary varices

blue-purple nodule

what are exostoses

benign bony protuberances

what are the best known exostoses

Torus palatinus

Torus mandibularis

Who are exostoses more frequently seen in

adults

what else will a patient also have if they have buccal or palatal exostoses

palatal or mandibular tori

where do palatal exostoses develop from

from lingual aspect of maxillary tuberosities

what is the appearance of a palatal cyst of a newborn

white or yellow-white papules

where do you find a palatal cyst in a newborn

along the midline, near the junction of soft and hard palates

other things to know about palatal cysts of a newborn

asymptomatic

no treatment

self-healing

where are nasolabial cysts located

Upper lip lateral to the midline

how do you know someone has a nasolabial cyst

swelling of upper lip

elevate the ala of the nose

what does a nasolabial cyst obliterate

the maxillary mucolabial fold

what is the most common nonodontogenic cyst

nasopalatine duct cyst

what are the presenting symptoms of a nasopalatine duct cyst

1. swelling of anterior palate

2. drainage

3. pain

where are nasopalatine cysts located

in or near midline (anterior maxilla)

between apices of central incisor teeth

what does the location of the defects of environmental enamel hypoplasia tell you

location correlates with the developmental stage of affected teeth

how do systemic influences effect environmental enamel hypoplasia

it produces a specific pattern

-bilateral and symmetrical enamel loss

what teeth does turner hypoplasis effect

permanent teeth

what is the cause of turner hypoplasia

by periapical inflammatory disease of the overlying deciduous tooth

does turner hypoplasia affect one or more teeth

one tooth

what are the types of syphilis hypoplasia

hutchinson teeth and mulberry molars

what teeth do hutchinson teeth affect

anterior teeth

what teeth do mulberry molars affect

posterior teeth

what are the main causes of tooth wear

1. attrition

2. abrasion

3. erosion

4. abfraction

what is attrition in terms of tooth wear

loss of tooth structure due to tooth-to-tooth contact during occlusion and mastication

What is abrasion in terms of tooth wear

wearing away or restoration, secondary to mechanical action of external agent

what is abrasion mostly caused by

inadequate tooth brushing

what do you see with toothbrush abrasions

-horizontal cervical notches on buccal surface of exposed radicular cementum and dentin

-defined margins

-smooth and hard surface

What is erosion in the context of tooth wear?

loss of tooth structure caused by nonbacterial chemical process

what is erosion also known as

dental corrosion

what is the cause of erosion

chelating agents(primary)

acidic agents

salivary gland hypofunction

acidic foods/drinks

some medications

pools w/ poor pH

chronic involuntary regurgitation

voluntary regurgitation

industrial environmental exposure

what surfaces are most frequently affected by erosion

1. facial and palatal surfaces of anterior maxillary teeth

2. facial and occlusal surfaces of mandibular posterior teeth

what areas are more affected by erosion

areas not protected by serous secretions

what is tooth loss due to erosion typically associated with

known abrasives

what is a cupped lesion

classic pattern of dental erosion

what is abfraction in terms of tooth wear

loss of tooth structure from occlusal stresses

where do you typically see abfraction of teeth

limited to the cervical area of the teeth

what are the two types of abnormal discoloration of teeth

intrinsic and extrinsic

what is the difference between intrinsic and extrinsic discoloration

intrinsic cannot be removed by prophylaxis, extrinsic can be removed with surface treatment

what causes extrinsic bacterial stains

exposed enamel, dentin, and cementum

what cause extrinsic black-brown stains

usually secondary to formation to ferric sulfide

what type of medication cause bright yellow to dark brown intrinsic discoloration

tetracyclines

what causes intrinsic discoloration of teeth

medications

what is the treatment of extrinsic discolorations

polishing with fine pumice with:

- prophylaxis paste

-3% hydrogen peroxide

what is the prognosis of extrinsic discolorations

eliminate cause and improve oral hygiene

what is the treatment of intrinsic discolorations

more difficult to treat; individualized esthetic remedies

what is eruption

movement of a tooth from its position of development w/in the bone to its functional location in the mouth

what is emergence

moment of eruption when the first part of the cusp or drown is visible through the gingiva

what is delayed eruption

when emergence has not occurred w/in 12 months of normal range or by the time 75% of root formation is complete

what does eruption occur

continues after tooth is in full occlusion and normal attrition and vertical growth of face

when does emergence occur

when dental root is about 2/3 if its full length and at a broad chronologic age range

who can be affected by emergence

differs according to race and gender among other factors

what is the treatment of localized delayed eruption

removal

what is impaction

eruption stopped after emergence occurred

what is the cause of impaction

crowding

how do impacted teeth look w/in the bone

may be partially erupted or completely encased w/in bone

what are the risks if you leave impacted teeth

-crowding of dentition

-resorption, caries, and worsening of the periodontal status of adjacent teeth

-development of pathologic conditions, such as infections, cysts, and tumors

what are the risks of intervention of impacted teeth

- transient/ permanent sensory loss

- alveolitis

- trismus

- infection

- fracture

- TMJ injury

- periodontal injury

- injury to adjacent teeth

what is anodontia

total lack of tooth development

what is hypodontia

lack of development of one or more teeth

what is oligodontia

lack of development of six or more teeth excluding third molars

what is hyperdontia

development of an increased number of teeth

what are supernumerary teeth

the additional teeth in hyperdontia

where is hyperdontia most present

in the maxilla

what is single-tooth hyperdontia more frequent in

permanent teeth

what is pulpitis

progression of inflammatory process may obstruct blood supply

what are the four main groups of common causes of pulpitis

1. mechanical damage

2. thermal injury

3. chemical irritation

4. bacterial effects

what are the causes of mechanical damage of pulpitis

- traumatic accidents

- latrogenic damage from dental procedures

- attrition and abrasion

- barometric changes

what are the causes of thermal injury of pulpitis

- transmitted through large uninsulated metallic restorations

- result of dental procedures

what causes chemical irritation of pulpitis

inappropriate use of acidic dental materials

what causes bacterial effects of pulpitis

-indirectly (bacterial toxins)

- directly (caries and blood)