Cleft lip - 80% unilateral 20% bilateral, defect between medial nasal process and

maxillary process, 1/1000 births

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Cleft palate - 25% cleft lip 25% cleft palate 50% cleft lip and palate, lack of fusion
between palatal shelves, 1/2000 births
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Lip pits - invaginations at commissures or near midline
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Fordyce granules - ectopic sebaceous glands, on buccal mucosa and/or lip
__________________________________________________________________
Leukoedema - bilateral opacification of buccal mucosa, stretch test will make it go
away, no real significance
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Lingual thyroid - thyroid tissue mass at midline of tongue base, caused by incomplete
decent of thyroid anlage, may be pt's only thyroid
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Thyroglossal tract cyst - midline neck swelling due to cystic change of remnants of
thyroid tissue, along embryonic path of thyroid descent
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Macroglossia - can be caused by congenital hyperplasia/hypertrophy, tumors
(lymphangioma, vascular malformation, neurofibroma, multiple granular cell tumors,
salivary gland tumors), endocrine abnormality, acromegaly, cretinism, infections
obstructing lymphatics, Beckwith-Wiedemann syndrome, macroglossia, exophthalmos,
gigantism, amyloidosis
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Geographic tongue - benign migratory glossitis, erythema migrans, pretty common,
occasional mild pain or burning, no treatment
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Fissured tongue - pretty common, usually asymptomatic, associated with Melkerson-
Rosenthal syndrome
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Melkerson Rosenthal syndrome - fissured tongue, granulomatous cheilitis, facial
paralysis
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Congenital hemangioma - focal proliferation of capillaries, most lesions undergo
involution, persistent lesions are excised
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Vascular malformation - persistent malformation of capillaries, veins, and arteries,
exhibits thrill (pulse when palpated) and bruit (pulse that you can hear)
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Sturge-Weber syndrome - encephalotrigeminal angiomatosis, lesions involve skin
along one of the branches of the trigeminal nerve, leptomeninges of cerebral cortex may
be involved by malformations, leading to mental retardation and seizures
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Lymphangioma - congenital focal proliferation of lymphatic channels, can be
associated with macroglossia
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Hygroma coli - lymphangioma in the neck
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Dermoid cyst - mass in midline floor of mouth if above mylohyoid muscle, mass in
upper neck if below mylohyoid muscle
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Branchial cyst - epithelial cyst within lymph node of neck
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Oral lymphoepithelial cyst - cyst within lymphoid tissue that is counterpart of branchial
cyst of neck, nodule commonly in soft palate, oral floor, or lateral tongue
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Stafne (static) bone defect - diagnostic lucency of mand due to invagination of lingual
surface of the jaw, located in posterior mandible below IA canal, filled with
submandibular gland tissue
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Nasopalatine duct cyst - lucency often heart shaped in nasopalatine canal, caused by
cystification of nasopalatine duct remnants
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Globulomaxillary lesion - any pathologic lucency between maxillary cuspid and lateral
incisor
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Traumatic bone cyst - radiolucent dead space (no epithelial lining) in mandible of some
teenagers, some associated with jaw trauma
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Focal osteoporotic bone marrow defect - lucency in jaw that contains hematopoietic
bone marrow, often in an extraction site
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Melanotic macule - most common melanocytic lesion, may be post-inflammatory,
syndrome associated (Peutz-Jegher's)
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Peutz-Jegher's syndrome - freckles and benign intestinal polyps or idiopathic
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Drug-induced pigmentation - minocycline, chloroquine, cyclophosphamide,
azidothymidine (AZT)
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Hairy tongue - elongation of filiform papillae of cosmetic significance only, several
causes including extended use of antbiotics, corticosteroids, H2O2
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Coxsackie infections - herpangina lesions will be in posterior oral cavity
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Measles (rubeola) - buccal mucosa ulcers (Koplick's spots) precede the skin rash
(maculopapular rash)
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Focal epithelial hyperplasia - Heck's disease, multiple small dome shaped warts on
oral mucosa
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Hairy leukoplakia - EBV infection, white patches of lateral tongue, mostly associated
with HIV, biopsy will show intranuclea viral inclusions
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EBV infection associated malignancies - Burkitt's lymphoma, nasopharyngeal
carcinoma
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Primary syphilis - chancre
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Secondary syphilis - oral mucous patches, condyloma latum, maculopapular rash
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Tertiary syphilis - gumma, CNS/CV involvement
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Congenital syphilis - Hutchinson's triad (notched incisors, deafness, ocular keratitis)
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Tuberculosis - oral nonhealing chronic ulcers follow lung infection, caseating
granulomas with multinucleated giant cells, treated with isoniazid, rifampin, ethambutol
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Gonorrhea - oral pharyngitis rarely seen
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Actinomycosis - opportunistic infection, chronic jaw infection follow dental surgery, will
see sulfur granules, treated with long-term, high-dose penicillin
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Cervicofacial actinomycosis - head and neck infections by Actinomyces
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Scarlet fever - group A streptococci, in kids will se skin rash caused by erythrogenic
toxin, strawberry tongue, treated with penicillin to prevent complications of rheumatic
fever
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Behcet's syndrome - immunodysfunction in which vasculitis is prominent feature, oral
adn genital aphthous-type ulcers, conjunctivitis, uveitis, arthritis, headache, other CNS
manifestations, treated with corticosteroids and other immunosuppressive drugs
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Wegener's granulomatosis - destructive granulomatous lesions with necrotizing
vasculitis of unknown cause, affects upp resp, lungs, kidney, will see cANCAs, treated
with cyclophosphamide and corticosteroids
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Midline granuloma - destructive necrotizing midfacial phenomenon, represents
peripheral Tcell lymphomas of upp resp tract or mouth (may see perforation of hard
palate)
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Lichen planus - Tlymphocytes destroy basal keratinocytes, will see lymphocyte
infiltrate at epithelial CT interface, basal zone vacuolation due to basal keratinocyte
destruction, saw tooth pattern in epithelium as it remodels after basal cell damage
__________________________________________________________________
Lupus erythematosus discoid (chronic) type - skin and oral mucosa (buccal mucosa,
gingival, vermillion), erythematous lesions, rarely progresses to systemic form
__________________________________________________________________
Lupus erythematosus systemic (acute) type - involves multiple organs (heart, kidney,
joints, skin, oral), butterfly rash over bridge of nose, antibodies directed against nuclear
and cytoplasmic antigens, will see ANA and LE cell tests
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Scleroderma - autoimmune, multiorgan disease of adults, fibrosis of tissues leads to
organ dysfunction, may occur with other autoimmune diseases, will see induration,
rigidity, atrophy, telangiectasias cutaneously, oral changes include restriction of orifice,
uniform widening of perio membrane, bony resorption of posterior mandible
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Pemphigus vulgaris - autoimmune mucocutaneous disease in which antibodies are
directed against desmosomal protein (desmoglein 3), multiple painful ulcers, Nikolsky
sign, may be fatal if untreated
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Mucous membrane pemphigoid - autoimmune disease of mucous membranes,
antibodies directed against basement membrane antigens (laminin 5, BP180), older
adults, multiple painful ulcers, Nikolsky sign, persistent disease
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Idiopathic leukoplakia - white/opaque oral mucosa lesions that don't rub off and are not
clinically diagnostic for any other white lesion, biopsy mandatory, 5-15% transformation
to SCC
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Proliferative verrucous leukoplakia - some associated with HPV 16 and 18, may start
with flat profile but progress to broad-based, wartlike verruciform lesions, high risk of
malignant transformation to verrucous carcinoma or SCC
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Erythroplakia - erythroplasia, high-risk idiopathic red patch of mucosa, mostly
dysplasia or malignancy, biopsy mandatory
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Actinic cheilitis - caused by UV light, lower lip shows epithelial atrophy and focal
keratosis, upper lip minimally affected because there is more protection from UV light,
junction of vermillion and skin becomes indistinct
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Oral submucous fibrosis - irreversible mucosal change thought to be due to
hypersensitivity to dietary substances, esp betel nut, mucosa opaque because of
submucosal scarring, may progress to SCC
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Smokeless tobacco-associated white lesion - white mucosal change due to direct
effects of smokeless tobacco and additives, malignant transformation is rare
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Verrucous carcinoma - well-differentiated and slow-growing form of carcinoma that
infrequently metastasizes, broad-based verruciform architecture, treated by surgical
excision, good prognosis
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SCC - accumulation of genetic alterations results in loss of cell cycle control, abnormal
signaling, increased cell survival, cell motility, treated with excision and/or radiation,
prognosis depends on stage
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Plummer-Vinson syndrome - mucosal atrophy, dysphagia, iron deficiency syndrome,
increased risk of oral cancer
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Basal cell carcinoma - common low-grade skin cancer that rarely metastasizes, usually
in sun-damaged skin, rare in mucosa, nonhealing indurated chronic ulcer, treated with
surgery
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Oral melanoma - malignancy of melanocytes, high risk sites on palate and gingiva,
mostly in adults, some have prolonged in situ phase preceding vertical growth
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Peripheral fibroma - fibrous hyperplasia of gingiva, caused by trauma or chronic
irritation
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Generalized gingival hyperplasia - caused by local factors and modified by systemic
conditions // some drugs, hormonal changes, leukemic infiltrates, genetic factors
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Focal fibrous hyperplasia - fibrous hyperplasia of oral mucosa, caused by chronic
trauma of chronic irritation
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Denture-induced fibrous hyperplasia - fibrous hyperplasia associated with ill-fitting
dentures, no malignant potential
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Traumatic neuroma - entangled submucosal mass of neural tissue and scar, caused
by injury to nerve, commonly seen at mental foramen in oral cavity
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Pyogenic granuloma - hyperplasia of capillaries and fibroblasts, caused by trauma or
chronic irritation, common in gingiva but can be seen anywhere there is mucosal trauma
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Nodular faciitis - rare submucosal proliferation of fibroblasts, reactive lesion that
exhibits rapid growth, treated with surgical excision, rare recurrence
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Fibromatosis - locally aggressive and infiltrative, difficult to eradicate and often recurs,
behavior similar to low-grade fibrosarcoma
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Granular cell tumor - myoblastoma, benign nonrecurring submucosal neoplasm of
Schwann cells, granular or grainy cytoplasm, epithelium may exhibit
pseudoepitheliomatous hyperplasia, commonly seen in tongue
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Congenital epulis - infant counterpart of granular cell tumor, occurs on gingiva only as
pedunculated mass, no pseudoepitheliomatous hyperplasia, surgical excision, no
recurrence
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Schwannoma - neurilemmoma, benign neoplasm of Schwann cells, any site, tongue
favored, solitary
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Neurofibroma - benign neoplasm of Schwann cells and perineural fibroblasts,
anywhere
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Neurofibromatosis 1 - von Recklinghausen, multiple neurofibromas, cafe au lait
macules, axillary freckling (Crowe's sign), iris freckling (Lisch spots), 5-15% have
malignant transformation
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Mucosal neuromas of multiple endocrine neoplasia syndrome type III (MEN III) - oral
mucosal neuromas (hamartomas), medullary carcinoma of the thyroid,
pheochromocytoma of the adrenal gland
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Fibrosarcoma - rare sarcoma showing microscopic evidence of fibroblast differentiation
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Neurosarcoma - malignant peripheral nerve sheath tumor, rare sarcoma showing
microscopic evidence of neural differentiation, may arise from pre-existing neurofibroma
or de novo
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Kaposi's sarcoma - malignant proliferation of endothelial cells, HHV8 has etiologic role,
mostly seend with AIDS
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Necrotizing sialometaplasia - chronic ulcer of the palate due to ischemic necrosis of
palatal salivary glands, triggered by trauma, surgery, or local anesthesia
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Sarcoidosis - chronic granulomatous disease of unknown cause (bacteria are
suspected), predominantly pulmonary but may affect salivary glands and mucosa,
granulomas cause organ nodularity and loss of parenchyma, diagnosis by serum
hypercalcemia and ACE, chest films for pulmonary involvement, radiographs for bone
involvement
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Sjogren's syndrome - chronic lymphocyte mediated autoimmune disease affecting
exocrine glands and other organ systems, asses by looking for RF, ANA, SS-A and SS-
B antigens, at risk of developing lymphoma
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Primary Sjogren's syndrome - keratoconjunctivitis sicca, xerostomia
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Secondary Sjogren's syndrome - dry eyes and mouth plus another autoimmune
disease, usually rheumatoid arthritis
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Mikulicz's syndrome - enlargement of the parotid
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Pleomorphic adenoma - mixed tumor, most common benign salivary gland tumor,
epithelial and CT elements in many patterns, palate is most common site for minor
gland lesions
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Monomorphic adenomas - benign salivary tumors composed of single cell type,
includes basal cell adenomas, canalicular adenomas, myoepitheliomas, oncocytic
tumors, treat with surgical excision
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Warthin's tumor - oncocytic tumor associated with smoking, comtains lymphoid tissue,
in parotid of older men, bilateral, lots of michondria
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Mucoepidermoid carcinoma - most common salivary malignancy in both minor and
major glands, palate most common intraoral site, composed of mucous and epithelial
cells
microscopic low grade lesions (mucous cells > epidermoid cells) rarely metastasize and
have excellent prognosis, microscopic high grade lesions (epidermoid cells > mucous
cells) frequently metastasize and have fair prognosis
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Polymorphous low-grade adenocarcinoma - secomd most common minor salivary
gland malignancy, rare in major glands, palate most common site, low grade
malignancy
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Adenoid cystic carcinoma - cylindroma, high grade salivary malignancy, palate most
common site, cribriform or swiss cheese microscopic pattern, spreads through
perineural spaces, will have facial palsy
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Non-Hodgkin's lymphoma - malignancy of one of the cells making up lymphoid tissue
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Multiple myeloma/plasma cell myeloma - punched out radiolucencies, abnormal
immunoglobulin protiein peak (M protein), Bence-Jones protein (urinary monoclonal
light chains), pain, swelling, numbness, anemia, bleeding, infection, fracture associated
with extensive marrow involvement
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Amyloidosis in multiple myeloma patients - 10% of multiple myeloma pts, due to
formation of complex proteins in which immunoglobulin light chains are precursors,
amyloid deposited in various organs and can lead to organ dysfunction
__________________________________________________________________
Secondary amyloidosis - developing in pts with chronic diseases like rheumatoid
arthritis, chronic osteomyelitis, chronic renal failure
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Single organ/localized amyloidosis - may be seen on tongue
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Leukemia - group of neoplasms of bone marrow, malignant cells occupy and replace
normal marrow cells, will see bleeding, fatigue, infection, infiltration of gingival tissues
by leukemic cells, red boggy hemorrhagic gingiva
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Odontogenic keratocyst (OKC) - clinically aggressive, recurrent, associated with
Gorlin's syndrome, mutation of PTCH gene, thin lining epithelium, is parakeratinized
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Nevoid basal cell carcinoma - multiple odontogenic keratocysts, bifid ribs, calcified falx
__________________________________________________________________
Orthokeratinized odontogenic cyst - lower recurrence rate and is not syndrome
associated
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Calcifying odontogenic cyst (COC) - Gorlin cyst, there is recurrence potential, ghost
cell keratinization, may undergo calcification that may be seen radiographically
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Glandular odontogenic cyst (GOC_ - sialo-odontogenic cyst, rare, may be locally
aggressive and exhibit recurrence potential, can be large and cross midline
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Ameloblastoma - benign but aggressive odontogenic tumor with significant recurrence
potential, several subtypes
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Cystic ameloblastoma - less aggressive and less likely to recur
__________________________________________________________________
Calcifying epithelial odontogenic tumor (CEOT) - Pindborg tumor, rare, sheets of large
epithelioid cells with areas of amyloid, some may become calcified, similar age
distribution and location to ameloblastoma but less aggressive
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Adenomatoid odontogenic tumor (AOT) - rare odontogenic hamartoma that contains
epithelial ductlike spaces and calcified enameloid material, most in maxilla, females,
anterior jaws, over crown of impacted tooth (max canine)
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Odontogenic myxoma - fibromyxoma, tumor of myxomatous CT, primitive-appearing
CT containing little collagen similar to dental pulp, affects either jaw, honey comb
pattern radiolucency
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Central odontogenic fibroma - similar to or identical to ossifying fibroma, well-defined
radiolucency in either jaw, multilocular
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Cementifying fibroma - well-circumscribed lucency, some are lucent with opaque foci,
in adults and young adults
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Cementoblastoma - well-circumscribed radioopaque mass of cementum and
cementoblasts replacing root of tooth, treat by removing lesion and associated tooth
__________________________________________________________________
Periapical cemento-osseous dysplasia - reactive process of unknown cause that
requires no treatment, at apices of one or more mand ant teeth, African American
middle aged women
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Florid osseous dysplasia - exuberant form of periapical cemento-osseous dysplasia,
may involve entire jaw, African American middle aged women
__________________________________________________________________
Focal osseous dysplasia - form of periapical cemento-osseous dysplasia but in
posterior mandible, Caucasian women
__________________________________________________________________
Ameloblastic fibroma - mand molar region, radiolucency, encapsulated myxomatous
CT lesion containing strands of epithelium
__________________________________________________________________
Ameloblastic fibro-odontoma - same as ameloblastic fibroma except will have opacity
because of odontoma
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Odontoma - opaque lesion composed of dental hard tissues, treat with curettage
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Ossifying fibroma - relatively common fibro-osseous lesion, well-circumscribed lucency
or lucency with opaque foci, in body of the mandible, fibroblastic stroma in which new
bony islands or trabeculae are formed
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Juvenile ossifying fibroma - in younger pts, may be aggressive
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Fibrous dysplasia - involve entire half jaw, more common in max, in kids, stops
growing after puberty, ground glass radiographic pattern
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McCune-Albright syndrome - polyostotic fibrous dysplasia, cutaneous cafe au lait
macules, endocrine abnormalities, precocious puberty
__________________________________________________________________
Osteoblastoma - circumscribed opaque mass of bone and osteoblasts, affects mostly
young adults, some have pain
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Peripheral giant cell cranuloma - reactive red to purple gingival mass believed to be
caused by local factors, in gingiva, anterior to perm molars, fibroblasts and
multinucleated giant cells
__________________________________________________________________
Central giant cell granuloma - unpredictable clinical behavior, some aggressive and
have recurrence potential, radiolucency in anterior mand, crosses midline, fibroblasts
and multinucleated giant cells
__________________________________________________________________
Aneurysmal bone cyst - pseudocyst, no epithelial lining, blood-filled spaces lined by
fibroblasts and multinucleated giant cells, lucency
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Hyperparathyroidism - von Recklinghausen's disease of bone, brown tumor, bone
lesions due to effects of excessive PTH, radiolucent foci of fibroblasts and
multinucelated giant cells as well as loss of lamina dura around tooth roots, kidney
stones, metastatic calcification, osteoporosis, neurologic problems, arrhythmias,
elevated alkaline phosphatase
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Cherubism - bilateral swelling of one or both jaws, stabilizes after puberty, not
treatment, soap bubble appearance, giant cell lesion with perivascular collagen
condensation
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Langerhans cell disease - punched-out lesions and/or lucencies around tooth roots
(floating teeth) eosinophils are mixed with tumor Langerhans cells
__________________________________________________________________
Paget's disease - progressive metabolic disturbance of many bones, symmetrical
enlargement of jaws, dentures become too tight, diastemas and hypercementosis
appear, bone pain, headache, altered vision and healing, cotton wool radiolucency
__________________________________________________________________
Acute osteomyelitis - acute inflammation of bone and bone marrow of jaws, usually
Strep or Staph, will only see radiographic changes when inflammation has been present
for a while
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Chronic osteomyelitis - chronic inflammation of bone and bone marrow, lucent or
mottled radiographic pattern
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Garre's osteomyelitis - chronic osteomyelitis with prolierative periostitis, involves the
periosteum, usually associated with carious molar in kids
__________________________________________________________________
Focal sclerosing osteomyelitis - bone sclerosis due to low-rage inflammation (usually
chronic pulpitis)
__________________________________________________________________
Diffuse sclerosing osteomyelitis - bone sclerosis due to low-rage inflammation, usually
from chronic pulpitis or perio disease
__________________________________________________________________
Osteosarcoma - sun-burst x-ray pattern, sarcoma in which new bone osteoid is
formed, uniform widening of PDL, mand more than max
__________________________________________________________________
Chondrosarcoma - cartilage is produced by tumor cells
__________________________________________________________________
Ewing's sarcoma - round cell malignant radiolucency of kids
__________________________________________________________________
White sponge nevus - mutations in keratin 4 and/or 13, white spongy appearing buccal
mucosa bilaterally, is genetic
__________________________________________________________________
Epidermolysis bullosa - bullae from minor trauma, oral esions (blsiters, scarring,
hypoplastic teeth) seen in severe recessive form
__________________________________________________________________
Hereditary hemorrhagic telangiectasia - telangiectatic vessels are seen in mucosa,
skin and viscera, red macules/papules, occasional bleeding, frequent epistaxis (nose
bleeds)
__________________________________________________________________
Cleidocranial dysplasia - supernumerary teeth, delayed tooth eruption,
hypoplastic/aplastic clavicles, cranial bossing, hypertelorism
__________________________________________________________________
Hereditary ectodermal dysplasia - partial or complete anodontia, hypoplasia of other
ectodermal structures like hair, sweat glands, nails
__________________________________________________________________
Gardner's syndrome - intestinal polyposis, osteomas, skin lesions, impacted perm and
supernumerary teeth, odontomas, high rate of malignant conversion to colorectal
carcinoma
__________________________________________________________________
Osteopetrosis - Albers-Schonberg disease, marble bone, lack of bone remodeling and
resorption, bone sclerosis, bone pain, blindness, deafness, anemia, osteomyelitis
__________________________________________________________________
Amelogenesis imperfecta - rare group of hereditary conditions that affect enamel
tissue intrinsically, yellow enamel, reduced in volume, pitted, dentin and pulps normal,
no increase in caries rate
__________________________________________________________________
Dentinogenesis imperfecta - yellow or opalescent color teeth, extreme occlusal wear
due to enamel fracture, short roots, bell-shaped crowns, obliterated pulps, may be seen
with osteogenesis imperfecta
__________________________________________________________________
Dentin dysplasia - normal color teeth, pulps obliterated but may have residual spaces
(chevrons), short roots surrounded by dental granulomas or cysts that may contribute to
tooth loss
__________________________________________________________________
Regional odontodysplasia - quad of teeth exhibit short roots, open apices, enlarged
pulp chambers, ghost teeth radiographic appearance, teeth usually extracted because
of poor quality of enamel and dentin
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