25+ Bullet Pointūü¶∑High Yield Notes From Oral Pathology

25+ Bullet Pointūü¶∑High Yield Notes From Oral Pathology

Chondroma

Chondroma : This neoplasm may develop at any age and shows no apparent gender predilection. The chondroma usually arises as a painless, slowly progressive swelling of the jaw which, like many other neoplasms, may cause loosening of the teeth. The overlying mucosa is seldom ulcerated. The anterior portion of the maxilla is the most frequent site of involvement by this tumor because it is here that vestigial cartilage rests are found, particularly  in  the  midline  lingual  to  or  between  the  central incisors. In the mandible the most common site of occurrence is posterior to the cuspid tooth, involving the body of the mandible, or the coronoid or condylar processes

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Benign osteoblastoma

The most common site of occurrence of Benign osteoblastoma (Giant osteoid osteoma)  is the vertebral column. Other frequently affected sites include the sacrum, long tubular bones and calvarium.

Nodular fasciitis

Nodular  fasciitis : A  benign  and  probably  reactive fibroblastic  growth  extending  as  a  solitary  nodule  from  the superficial fascia into the subcutaneous fat, or less frequently, into  the  subjacent  muscle.  Confusion  with  a  sarcoma  is possible because of its cellularity, its mitotic activity, its richly mucoid  stroma,  and  its  rapid  growth.  Other  fibroblastic proliferations, such as proliferative myositis, are probably akin to this lesion. Nodular fasciitis is most common in the upper extremity, the trunk and the neck region of young adults.

Aggressive fibromatosis

Aggressive  fibromatosis : A  nonmetastasizing  tumor like fibroblastic growth of unknown pathogenesis involving voluntary muscle as well as aponeurotic and fascial structures. Histologically,  it  is indistinguishable  from  an  abdominal fibromatosis.  The  lesion  has  a  strong  tendency  to  local recurrence  and  aggressive,  infiltrating  growth.  It  is  most common in the shoulder girdle, the thigh, and the buttock of young adults

Fibrous histiocytoma

Fibrous  histiocytoma : A  benign,  unencapsulated  and often  richly  vascular  growth  made  up  of  histiocytes  and collagen-producing  fibroblast-like  cells,  which  are  arranged in  a  whorled  or  cartwheel  pattern.  Frequently,  the  growth contains lipid-carrying macrophages. It may occur anywhere but is most common in the dermis

Gastrointestinal cyst

Surgical  excision  is  the  treatment  of  choice for heterotopic oral gastrointestinal cyst, although  this  lesion  cannot  be  diagnosed  clinically  and  is seldom suspected.

Nasopharyngeal carcinoma

Nasopharyngeal carcinoma  is  difficult  to  treat  surgically  because  of the early metastasis to regional lymph nodes. The tumor is resistant to chemotherapy, and radiotherapy is the treatment of choice. However, because the tumor usually presents late, the prognosis is poor with a five-year survival rate of 20%. It may be possible to prevent the development of NPC with the use of an EBV vaccine at an early age

Granular cell tumor

Conservative  excision  is  the treatment of choice for granular cell tumor. Recurrence is seen in fewer than 7% of cases thus treated, even if granular cells extend beyond the surgical margins of the biopsy sample.   A few reported metastasizing granular cell tumors have appeared to be histologically benign, and for this reason, tumors that recur, grow rapidly or reach a size greater than 5 cm should be viewed with grave suspicion

Leiomyosarcoma

Radical surgery is the treatment of choice for leiomyosarcoma, with adjunctive chemotherapy or radiotherapy used occasionally. The prognosis is poor, with numerous¬† recurrences¬† and¬† distant¬† metastases.¬† Overall¬† five-year survival is approximately 35‚Äď50%

MNTI

The¬† treatment¬† of¬† choice for Melanotic Neuroectodermal Tumor of Infancy (MNTI)¬† is¬† surgical¬† excision,¬† and¬† it¬† is¬† usually¬† curative. This¬† treatment¬† can¬† usually¬† be¬† accomplished¬† with¬† a¬† partial maxillectomy.¬† Many¬† clinicians¬† advocate¬† a¬† 5¬† mm¬† margin¬† of healthy tissue to be included with the surgical specimen. Local¬† recurrence¬† has¬† been¬† documented¬† in¬† 10‚Äď60%¬† of patients.¬† Overall,¬† the¬† average¬† recurrence¬† rate¬† is¬† 15‚Äď20%. Approximately¬† 1%¬† of¬† tumors¬† are¬† malignant,¬† with¬† only¬† rare tumors producing metastases

Oncocytoma

The  treatment  of  choice for oncocytoma  is surgical  excision,  and  the  tumor  does  not  tend  to  recur. Malignant  transformation  is  uncommon,  but  malignant oncocytoma  is  now  a  well-established  entity

Canalicular adenoma

Conservative excision seems to be the treatment of choice in canalicular adenoma

Tularemia

Tularemia responds well to antibiotic therapy. Streptomycin is the drug of choice. This disease also responds to adequate doses of gentamicin and tetracycline.

Melioidosis

Incision and drainage, accompanied by massive antibiotic therapy, have proven moderately successful in treating  the  disease.  Tetracycline  alone  or  in  combination  with chloramphenicol were considered to be drugs of choice in Melioidosis

Congenital syphillis

Penicillin is the drug of choice in congenital syphillis. Erythromycin or tetracycline is used if the patient is allergic to penicillin. Surgical correction of the facial defects gives good esthetic results.

Herpes zoster

Herpes  zoster  virus  infection  is  a  recurrent  viral  infection seen  in  HIV-infected  patients  and  presents  a  clinical  course, which is more severe in morbidity than that encountered in immunocompetent  patients.  In  AIDS  patients  herpes  zoster begins as a unilateral cluster of vesicles and ulcers in a classical dermatome distribution but subsequently extends beyond the dermatomal boundary and heals by scarring. Oral acyclovir is the drug of choice in the treatment of herpes zoster

Rhinosporidiosis

Surgical removal of the growths is recommended as treatment of choice in Rhinosporidiosis

Zinc Oxide and Eugenol

Zinc Oxide and Eugenol :  It is used routinely as a temporary filling material or root canal sealer. Eugenol of this cement fixes cells, depresses the cell respiration, and reduces the neural transmission in vitro. There is almost universal agreement that zinc oxide and eugenol is the least injurious of all filling materials to the dental pulp. Not only is there no irritation produced by this substance, but actually it exerts a palliative and sedative effect on the mildly damaged pulp, since it inhibits synthesis of prostaglandins and leukotrienes. It seems to be such a bland substance that it may lack even the necessary irritating properties requisite to the stimulation of secondary dentin formation. In view of these findings, zinc oxide and eugenol is the material of choice for use over injured pulps or as a base in deep cavity preparations.

Cracked tooth syndrome

The site, direction, and size of the crack or fracture dictates the choice of the treatment in cracked tooth syndrome. It ranges from stabilization with a stainless steel band or crown to endodontic treatment and restoration. If untreated, CTS can lead to severe pain, possible pulpal necrosis and periapical abscess.  Unfortunately,  management  of  CTS  is  not  always successful.  In  some  cases,  such  as  in  vertical  root  fractures (split root) in single rooted teeth, the only treatment option is tooth extraction

Lip biting

Counselling and psychotherapy are the treatment of choice in lip biting and cheek biting. However an acrylic shield will help to prevent the access of the teeth to lips and cheeks

NaOCl

Sodium  hypochlorite  (NaOCl)  is  commonly  used  as root  canal  irrigant.  Due  to  its  efficacy  against  pathogenic organisms  and  pulp  digestion  it  is  considered  to  be  the medicament  of  choice.  It  is  found  to  be  sporicidal  and virucidal  and  shows  far  greater  tissue  dissolving  effects on  necrotic  than  on  vital  tissues  as  well  as  the  organic components of the smear layer.

Needle biopsy

Needle  biopsy  has  little  value  in  the  diagnosis  of  oral lesions. The scalpel is the instrument of choice, since it cleanly removes the tissue and does not dehydrate it as cautery or the high-frequency cutting knife may. This latter instrument is of great value, however, in dealing with vascular lesions, where it controls bleeding at the biopsy site

Rickets

In  all  cases  of  rickets,  the  study of  choice  is  radiography  of  the  wrists,  knees,  ankles,  and long bones. No pathognomonic sign on X-ray distinguishes hypophosphatemic rickets from other variants of rickets.

Septic arthritis

For  septic  arthritis,  treatment  of  choice  is antibiotics and arthrocentesis under low pressure. If treatment is  instituted  in  the  acute  phase,  the  sequelae  will  be  less deforming or disabling than if the disease has been allowed to enter a chronic phase. After infection subsides, physiotherapy may help in improving mobility of the joint

Synovial Chondromatosis

Surgery is the treatment of choice in Synovial Chondromatosis (loose joint bodies). Arthroscopy and open surgery are used to remove the loose joint bodies and resection of the diseased synovial tissues. After surgical removal, recurrence is low

TMJ

Radiographic  findings  in  TMJ correlate  to  the  etiology  of  TMD;  in  cases  of  rheumatoid arthritis and seronegative spondyloarthropathies, conventional radiographs  show  erosions,  osteophytes,  subchondral  bony sclerosis, and condylar-glenoid fossa remodeling. A variety of new imaging techniques are being used and perfected to study TMJ. CT scan can explore both bony structures and muscular soft tissues. It is relatively less expensive and can be done with contrasting material injected into the joint cavity. MRI, though costly, should be used as the study of choice if an articular or meniscal pathology is suspected and an endoscopic or surgical procedure  is  contemplated  in  a  case  of  traumatic  TMD

Hand-Sch√ľller-Christian disease

The prognosis in¬†Hand-Sch√ľller-Christian disease¬†is good. Approximately half of the patients undergo spontaneous remission over a period of years.¬†The¬† treatment¬† of¬† choice¬† is¬† curettage¬† or¬† excision¬† of¬† lesions. Inaccessible lesions may be irradiated. Some patients benefit from chemotherapeutic drugs, including prednisone, vinblastine, and cyclophosphamide. One of the most significant factors influencing the morbidity and mortality of the disease is the extent of the disease at the time of initial diagnosis and¬†number of organ systems involved.

Dental hard tissues

Dental hard tissues gain importance in identification based on the condition of the human remains. Teeth are one of the strongest structures in the body, and are usually resistant to postmortem decomposition. Moreover, most materials used by the dentist for restoring and replacing teeth are also resistant to postmortem changes. Therefore, the use of dental evidence is the method of choice in establishing identity of badly burned, traumatized, decomposed, and skeletonized remains

Human Bite

Impression  of  the  human bite  area  may  be  made when tooth indentations exist. The material of choice is Vinyl Polysiloxane.  The  impression  material  may  be  reinforced with  dental  stone,  autopolymerizing  acrylic  or  impression compound to prevent dimensional change. It is to be noted that if the bite mark is on an area accessible to the victim’s own dentition, impressions of the victim’s teeth should be made to rule out self-inflicted bites