DHY 207: Introduction to Preliminary Diagnosis of Oral Lesions Vocabulary

\ DHY 207

Introduction to Preliminary Diagnosis of Oral Lesions Vocabulary

\ Describing and Recording Clinical Findings

  • Detailed descriptions

  • History

  • Location

  • Distribution

  • Definition

  • Size

  • Shape

  • Color

  • Consistency

  • Surface texture

  • Photographs

  • History

  • Location

\ Terminology: Clinical Appearance of Soft Tissue Lesions

  • Distribution

  • Localized vs generalized

 

  • Margins

  • Well-defined vs poorly defined

  • Regular vs irregular

 

 

  • Number multiple configuration

  • discrete vs coalescing

 

\ Size of Lesion

  • Centimeter (cm)

  • one hundredth of a meter; equivalent to a less than one half inch

  • Millimeter (mm)

  • One thousandth of a meter

  • the periodontal probe is of great assistance in documenting the size or diameter of a lesion that can be measured in millimeters

\ Size and Shape

  • Note general shape, measure size of lesion with a probe

  • Measure diameter of round lesions

  • Measure width and length of square, rectangular, and oval lesions

  • Record measurements- width first then length

  • Height is listed after the length of the lesion

  • Relate size of a large lesion to the area it cover

\ Size and Shape: Flat

  • Macule: Flat lesion differentiated from. the surrounding tissue b color alone (less than 1 cm in diameter)
  • Patch: May also describe area with a different surface texture with or without a color change (more than 1 cm)

 

\ Size and Shape: Elevated Fluid Filled

  • Vesicle: A small (0.5 cm or less) elevated lesion filled with clear fluid. It is a small, elevated lesion that contains serous fluid
  • Bulla: Larger (larger than 0.5 cm) elevated lesion filled with clear fluid. It is a circumscribed, elevated lesion that is more than 5 mm in diameter. It usually contains serous fluid, and looks like a blister
  • Pustule: A raised lesion filled with pus or purulent exudate like an acne pimple It is various sized circumscribed elevations containing pus

 

Size and Shape: Elevated Solid

  • Papule: Solid raised lesion 0.5 cm or less
  • Nodule: Solid raised lesion larger than 0.5 cm but less than 2 cm
  • Tumor: Solid raised lesion larger than 2 cm

 

  • Lobule: An elevated solid segment or lobe that is part of a whole. These lobes sometimes appear fused together

 

\ Size and Shape: Plaque Broad Flat

  • The slightly raised and flat configuration of this white lichen planus lesion covering a relatively broad area is indicative of a plaque. Also note the well-defined irregular margin

 

\ Size and Shape: Base/Attachment

  • Sessile: Describing the base of a lesion that is flat or broad instead of stemlike
  • Pedunculated: Attached by a stemlike or stalklike base similar to that of a mushroom

 

\ Size and Shape: Depressed

  • Ulcers
  • Erosions/abrasions

 

\ Direction of Growth

  • Endophytic: Grow into the surrounding tissues with little or no observable swelling
  • Exophytic

 

\ Color of Lesion

  • Most frequent color descriptions:

  • Red

  • Pink

  • Salmon

  • White

  • Blue-black

  • Gray

  • Brown

  • Black

  • Used to identify specific lesions

  • may be incorporated into general descriptions

\ Color: White

  • White lesions usually involve excess keratin in the tissues, making them more opaque

  • Leukoplakia: A clinical term for a white, plaque-like lesion on the oral mucosa that cannot be rubbed off or diagnosed as a specific disease

  • Pallor: Paleness of the skin or mucosal tissues

  

\ Color: Red

  • Erythema is an abnormal redness of the mucosa or gingiva
  • Erythroplakia: A clinical term used to describe an oral lesion that appears as a smooth red patch or glandular red and velvety patch
  • less common than leukoplakia
  • 90% of erythroplakias demonstrate epithelial dysplasia or squamous cell carcinoma

 

\ Color: Yellow

  • Xanthelasma: A yellowish plaque located around the eyelids, is associated with high levels of cholesterol

 

\ Color: Pigmented

  • Endogenous: Come from within the body- melanin pigmentations
  • Exogenous: Come from outside the body- lead, amalgam, and others
  • Black
  • Brown
  • Blue

 

\ Consistency

  • The consistency of soft tissue abnormalities is often soft or normal feeling
  • Indurated soft tissue lesions, such as an inflamed lymph node, feel quite hard
  • Fluctuate is used to describe a fluid-filled lesion that moves fluid from one area to another when the lesion is pressed

\ Surface Texture

  • Corrugated: Wrinkled
  • Fissure: A cleft or groove, normal or otherwise, showing prominent depth
  • Papillary: Resembling small, nipple-shaped projections or elevations found in clusters
  • Smooth
  • Rough
  • Folded

 

Describing Radiographic Findings/Lesions in Bone 

  • History-aware/not aware
  • Location and size

\ Opacity

  • Radiopaque

  • Describes the light or white area on a radiograph that results from the inability of radiant energy to pass through the structure

  • the more dense the structure, the more light or white it appears on the radiograph

  • Radiolucent

  • Describes the black or dark areas on a radiograph

  • Radiant energy can pass through these structures

  • Less dense tissue, such as pulp, is seen as a radiolucent structure

 

\ Radiolucent and Radiopaque

  • A mixture of light and dark areas within a lesion
  • Denotes a stage in lesion development

 

\ Inner Appearance

  • Unilocular: Having one compartment or unit that is well defined or outlined as in a simple radicular cyst
  • Multilocular: Describes a lesion that extends beyond the confines of one distinct area. Defined as many lobes or parts that are somewhat fused together. A multilocular radiolucency is sometimes described as resembling soap bubbles

 

  • Coalescence: The process by which parts of a whole join together, or fuse, to make one

 

Radiographic Terms Used to Describe Lesions in Bone

  • Diffuse

  • Describes a lesion with borders that are not well defined, making it impossible to detect the exact parameters of the lesion

  • Can make treatment more difficult and depending on the biopsy results, more radical

 

  • Margins

  • Well-defined vs poorly defined

 

  • Well circumscribed: Used to describe a lesion with borders that are specially defined and in which one can clearly see the exact margins and extent

 

\ Surrounding Tissues

  • Root resorption

  • Radiographically, the apex of the tooth appears shortened or blunted and irregularly shaped

  • Occurs as a response to stimuli, which can include a cyst, tumor, or trauma

 

  • External root resorption

  • Arises from tissue outside the tooth, such as the PDL

 

  • Internal root resorption

  • Triggered by pupal tissue reaction from within the tooth

  • The pulpal area can be seen as a diffuse radiolucency beyond the confines of the normal pulp area

 

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  • Scalloping around the root

  • A radiolucent lesion that appears to extend up the PDL and between the roots

 

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\ Additional Vocabulary Words

  • Anomaly: Something that deviates from what is standard or normal
  • Dysphasia: Difficulty swallowing
  • Dysphonia: Difficulty speaking
  • Dyspnea: Difficulty breathing

\ Reactive Tissue Responses: Hyperplasia, Hypertrophy, and Atrophy

  • Hyperplasia: An increase in the number of cells, often in response to chronic irritation or abrasion. May return to normal if the insult subsides, or may persist after removal of the irritant
  • Hypertrophy: An increase in the size of cells. May be seen in cardiac muscle as a response to hypertension
  • Atrophy: A decrease in size or function of a cell, tissue, organ, or entire body

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