Oral Path Review
Name this oral lesion:
Varix (Varices, pl.)
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Sometimes called
caviar tongue
Distended vein (like a
hemorrhoid)
No treatment usually
required
Diff. diagnosis:
mucocele and
hemangioma
Name this oral lesion:
Mucocele
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Collection of saliva in the
oral mucosa
Common symptom: gets
bigger, then smaller,
bigger, etc.
Traumatic severance of
salivary ducts
Treated by surgical
excision of the entire gland
that feeds the duct
Could be confused with
salivary gland neoplasm,
varix, and hemangioma
Name this oral lesion:
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You should know this by now…
Torus palatinus and Torus mandibularis
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Bony bumps in the mouth…midline if on the hard
palate…single or bilateral for mandibular
Could be inherited…developmental overgrowths
Won’t grow past their “programmed size”
May require removal if they interfere with prosthetics
Name this oral lesion:
Leukoedema
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Filmy, white/grey discoloration
of oral mucosa (mostly buccal)
Variation of normal caused by
intracellular edema of the
superficial epithelial cells
Seen primarily in blacks
(90%) and smokers
No treatment required
Could only be confused for a
bunch of really rare
conditions.
Name this oral lesion:
Papillary hyperplasia (PH) and/or
Denture sore mouth (DSM)
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See the book for other pictures
and more detailed information.
This can be highly variable in
appearance.
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PH and DSM may be the
same thing, thought to be
caused by Candida albicans
Can be small red spots.
When it worsens, it turns
bright red and produces the
red, pebbly look of papillary
hyperplasia.
Treatment with antifungals,
but recurrence is common
Good oral/denture hygiene
may help
Benign and unmistakable
Name this oral lesion:
Geographic tongue (AKA: benign
migratory glossitis)
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Usually asymptomatic
Hard to misdiagnose
this “maplike” nastiness
on the dorsal tongue
Affects all ages
Cause is unknown
Chronic: lasts months
to years with periods of
remission and
exacerbation.
Name this oral lesion:
Nicotine Stomatitis
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Caused by smoking
(particularly pipe)
Asymptomatic and
usually disappears
after quitting smoking
Name this oral lesion:
Periapical dental granuloma
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Periapical radiolucency
found at the apex of a
tooth with chronic
inflammation
Usually round or oval
with a distinct border
If there is a sinus tract,
may be asymptomatic
Endo therapy or
extraction necessary
Could be confused with
radicular cyst or
periapical abscess
Name this oral lesion:
Periapical cyst (Radicular cyst)
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Looks a lot like the
last one, eh?
ONLY difference is the
presence of an
epithelium lined
central cavity in the
cyst.
Name this oral lesion:
Angular cheilosis
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Dry corners of the
mouth
May be caused by
slobber accumulating
in the corners of the
mouth in patients with
a deep bite. Candida
likes to hang out in
the drool.
May be a riboflavin
defficiency???
Name these oral lesions:
(Hint: they’re different!)
Top: Periferal Fibroma
Bottom: Pyogenic Granuloma
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Usually in children & young
adults
Histologically, this is mostly
connective tissue
Can be excised, but may recur
Histologic examination may be
the only way to distinguish this
from Periferal Fibroma
Vascular and sometimes painful
Common in pregnancy
Name this oral lesion:
Peripheral giant cell granuloma
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Much the same as
peripheral fibroma and
pyogenic granuloma,
but these are
histologically different
(contain fibroblasts
and multinucleated
giant cells)
Surgical excision
May recur
Name this oral lesion:
Amalgam tattoo
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Blue-grey and
permanent
Caused by accidental
implantation amalgam
into soft oral tissues
No treatment
required, but didn’t
your Mama warn you
against getting
tattoos?
Name this oral lesion:
Condensing Osteitis
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Sclerotic reaction to
infection commonly seen
in young patients
Caused by infection of
periapical tissues of low
virulence
Treat only cases where
the infection is
symptomatic or carious
in the associated tooth.
Follow up with regular xrays.
Name this oral lesion:
Nasopalatine duct cyst
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Heart-shaped radiolucency
at theincisive canal
Developmental from
epithelial remnants of the
nasopalatine duct
Can be confused with other
types of cysts (remember
the radicular cysts?)
Surgical removal is
treatment
Name this oral lesion:
Dentigerous Cyst
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Very common & found around
an unerupted tooth
Most commonly around 3rd
molars, but any tooth could be
affected (rarely on deciduous
teeth)
Large cysts can cause
parasthesia and/or pain
Surgical enucleation should be
followed up with histological
examination
Name this oral lesion:
Lichen planus
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Lacy, white lines are characteristic of reticular
type. Erosive type and plaque type are
variations.
Only erosive type requires treatment
May predispose patient to oral cancer
Name this oral lesion:
Dilantin gingival hyperplasia
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Can also be caused by
cyclosporin and nephedapine
(sp?)
Fibrous overgrowth of the
gingiva, particularly the
anterior (as opposed to the
posterior and lingual areas)
Scrupulous dental hygiene
recommended
Overgrowth requires surgical
removal. Or ceasing to take
the anticonvulsant may cause
gradual recession within one
year.
Name this oral lesion:
Papilloma
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Sessile or pedunculated
& look like cauliflower
Usually on palate-uvula
area, or on tongue or lips
Lasts weeks to years, but
usually months
Could be viral origin
Surgical removal
No evidence that they
are premalignant
Name this oral lesion
(be specific):
Herpes Labialis
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Recurrent oral infection
caused by herpesvirus
Recurrences vary from
person to person and are
thought to be triggered
by exposure to sunlight,
fever, trauma, and other
irritants.
Virus “hides” in the
nearest ganglion and lies
dormant
Acyclovir ointment
shortens healing time
…systemic acyclovir
doesn’t work for oral
herpes
Name this oral lesion:
Primary herpetic stomatitis
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Generalized
involvement of the
oral cavity infected
with herpesvirus
Usually seen in
children
Blisters break easily
and are VERY
painful (can’t eat or
drink)
Accompanied by
fever
Name this oral lesion:
Fordyce granules
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Ectopic sebaceous glands caused by a
developmental anomaly
Seen in greatest numbers during puberty
Most common on buccal mucosa
No treatment required
Name this oral lesion:
Ideopathic osteosclerosis
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Area of dense but
normal bone found
anywhere in the jaw,
but usually in
mandibular molarpremolar area
Shape varies and
may be associated
with a tooth, but
does not require
treatment
Name this oral lesion:
Candidosis (Candidiasis, Moniliasis,
Thrush)
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Infection with Candida
albicans
Involved mucus membrane
develops a white, necrotic
slough.
White lesions can be wiped
off, leaving a bleeding,
white surface
Occurs in the very young,
very old, those with reduced
resistance and those on
long-term antibiotic therapy
or immunosuppression
(AIDS victim shown here)
Name this oral lesion:
Squamous Cell Carcinoma
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90% oral cancers are SCC
May appear as leukoplakia or
erythroplasia or a mixture (white
and/or red, respectively)
More often in men than women,
and higher incidence in smokers
and drinkers
5 year survival rate is 50%
Can be confused with a lot of
things…need a biopsy to confirm
diagnosis
Name this oral lesion:
Aphthous stomatitis (Canker sore)
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One of the most common oral diseases (20-60% of the
population)
Major aphthae known as Sutton’s disease
Begins as a macule or papule until ulceration
Occurs on freely movable mucosa (herpes, in contrast, can
occur on palate or gingival mucosa)
Unknown etiology and very painful
Name this oral lesion:
Kaposi’s Sarcoma
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Found in AIDS
patients
Appear as red or
purple bruises, but
can progress to a
hemorrhagic mass
Painful and invasive
Radiation therapy
Name this oral lesion:
Leukoplakia
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Means a white lesion
of the mucous
membrane
Biopsy will usually
show hyperkeraosis
(harmless)
Some may be
premalignant
More common in
males and older
patients
Unknown etiology
Name this oral lesion:
Hairy leukoplakia
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Found in AIDS patients and
other
immunocompromised
patients
Usually on the lateral
tongue
Caused by Epstein-Barr
virus
Can easily be confused
with candidiasis
Treat with anti-fungal
first…if it doesn’t heal,
then it is most likely hairy
leukoplakia
Name this oral lesion:
Erythroplakia (erythroplasia)
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Red but non-ulcerated
area
Usually asymptomatic,
but could be early
carcinoma
Lots of things this could
be
Prognosis and treatment
varies according to
histologic findings
Name this oral lesion:
Epulis Fissuratum
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Two or more folds of
soft tissue separated
by a central groove
caused by an ill-fitting
denture
Inflamatory
hyperplasia that can
surgically removed
(denture border
should also be
reduced to prevent
recurrence)
Name this oral lesion:
Foliate papillae…not really a lesion
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Vertical grooves,
typically bilaterally
symmetrical
Normal anatomical
structures, but can
be prominent in
some people
Name this oral lesion:
Hairy Tongue
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Dorsal tongue
becomes discolored
and “hairy” due to
hyperkeratinization of
the filliform papillae
Color can vary
Unknown etiology, but
frequent in heavy
smokers
Brushing the tongue
can help
Name this oral lesion:
Periapical cemental dysplasia (listed in the book as
cementoma but this is a misnomer; AKA
periapical cementodysplasia)
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Lesion around the apices of
vital teeth
Principally in the lower
anteriors; mostly women;
more common in blacks
Asymptomatic and does
not require treatment
Begins as proliferation of
benign fibrous connective
tissue… cementum forms…
the mass becomes
mineralized
Name this oral lesion:
Snuff lesion:
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Develops adjacent to
where smokeless
tobacco is held
Biopsy should be
done, but no
treatment necessary
Carcinomas often
occur
I think half the guys in
my high school had
this (I lived in
Georgia…where it was
cool to have a gun
rack and wear flannel)
Name this oral lesion:
Osteoporotic bone marrow defect
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Localized increase of
marrow, usually in the
mandible at molar
extraction sites
Common in middle aged
women
They don’t have sharp
borders like cysts
(scattered trabeculae
may interrupt the space)
Unknown etiology; no
treatment necessary
Irritation fibroma
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Dome-shaped soft
tissue found on buccal
mucosa near line of
occlusion
Don’t you hate it
when you bite your
cheek… and then you
bite it OVER and OVER
AGAIN?
Good luck
on finals!!!