Card Set Information
Part Ibsen Phelan
(8) Diagnostic Categories, Variants of Normal, Benign Conditions of Unknown Cause
List the (8) Diagnostic Categories
Ability to diagnose lesions based on the basis of:
-history of lesion (sometimes historical information is needed for clinical diagnosis)
Lesions that can be clinically diagnosed
Benign Conditions of Unknown Cuase:
-Median Rhomboid Glossitis
Radiograph provides sufficient information to establish diagnosis.
-IE: Periapical pathosis
--Heavy Interproximal calculus
-Historical data constitutes important information in every diagnosis.
--Past, Present, Medical & Dental histories
--History of drug ingestion
--History of presenting disease/lesion
Examples of Pathologic conditions in which family history contributes in diagnosis:
-Other Genetic Disorders
-Lab tests that provide information & contribute to a diagnosis
-Form of laboratory diagnosis
-Main component of definitive diagnosis
-Biopsy is taken-->
--skill of practitioner taking biopsy is important
Formerly known as: Brush Biopsy
-Uses circular brush to obtain cells from the full thickness of the epithelium.
-Includes ceslls from the keratin layer through the basal layer
-Assess whether normal, abnormal, or dysplastic cells are present.
-Results help determine if scalpel biopsy is needed to establish definitive diagnosis.
-Diagnosis is made using the information gained during the surgical procedure
-Rx meds & observing the results w/out culturing the bacteria applies the principle of therapeutic diagnosis
-It is based solely on clinical & historical information w/confirmation by the response of the condition to therapy
-The point in the process when the practitioner decides which test or procedure is required to rule out the conditions originally suspected
--Establish the definitive or final diagnosis
(8) Variants of Normal
1. Fordyce Granules
2. Torus Palatinus
3. Mandibular Tori
4. Melanin Pigmentation
5. Retrocuspid Papilla
6. Lingual Varicosities
7. Linea Alba
(5) Benign Conditions of Unknown Cause
1.Lingual Thyroid Nodule
2.Median Rhomboid Glossitis
-Clusters of ectopic sebaceous glands
-Most commonly observed on the lips and buccal mucosa
-Clinically: tiny yellow lobules distributed over buccal mucosa and vermillion border of lips
-80% of adults over the age of 20 have fordyce granules
-require no treatment
-Exophytic growth of normal compact bone
-Occur more often in women
-Occur at the midline of the hard palate
-Take on various shapes, sizes
-May be lobulated
-Covered by normal soft tissue
-when large enough may be seen as radiopaque mass on radiograph
-No treatment indicated unless interferes with:
-Outgrowths of normal dense bone
-Found on the lingual aspect of the mandible --(premolars above the mylohyoid ridge)
-Often lobulated or nodular
-Can appear fused
-No predilection for either sex
-No Tx required unless patient needs prosthontic appliance & interferes w/fabrication and placement
-pigment that gives color to:
**In oral mucosa normally observed in dark-skinned individuals
-sessile nodule on the gingival margin of the lingual aspect of the mandibular cuspids.
-Prominent lingual veins
-Usually observed on the lateral and ventral aspects
-Red to purple vessels or clusters
-Thought to be related to the aging process.
-"white line" that extends anteroposteriorly on the buccal mucosa along the occlusal plate
-May be bilateral
-Can be prominent in Pts who clench or brux
-Generalized opalescence imparted to the buccal mucosa
-Most commonly observed in black adults (85%(
-Gray-White film diffused throughout the buccal mucosa, giving opaque quality.
--If mucosa is stretched becomes less prominent.
-More pronounced in smokers
-Integral part of buccal mucosa and cannot be removed.
-Requires No Tx.
Lingual Thyroid Nodule
-Thyroid gland develops in 1st month of fetal life.
-Located initially in the foramen cecum on posterior of tongue.
-Normal development descends to the neck
-Does not DESCEND--Lingual Thyroid Nodule results.
--HIGH Predilection in females
--emergence linked with:
*Usually sessile base 2-3cm wide
**Tx requires careful evaluation of the patient to determine whether thyroid gland is present in normal location
****Surgical intervention not always required.
Median Rhomboid Glossitis
-Cause not clear
--Associated w/chronic Candida albicans
--Appears flat, or slightly raised oval or rectangular erythematous area in the midline of the dorsal surface of the tongue.
--Devoid of filiform papillae
--Texture is smooth
**No specific Tx
**antifungal agent can be applied
**Sometimes resolves with no specific Tx.
-Genetic factor suggested
-Exacerbated by stress
-Histologic factors w/those found in psoriasis
-Involves the dorsal and lateral borders of the tongue
-Diffuse areas devoid of filiform papillae can be observed.
-Erythematous patches that are surrounded by a white or yellow perimeter
-Does not remain static
-Burning discomfort associated
**No Tx indicated
**ECTOPIC GEOGRAPHIC TONGUE: found on mucosal surfaces other than the tongue.
-Seen in about 5% of the population
-Genetic patterns probably involved
-Dorsal surfaces appear to have deep fissures or grooves
-Fissures can become irritated if food debris collects
-Increased accumulation of keratin on the filiform papillae resulting in white "hairy" appearance
-Tobacco and certain foods may discolor papillae
-Hydrogen peroxide, alcohol, or chemical rinses have been suggest to stimulate elongation of the filiform papillae
** Direct Pt to brush tongue gently w/ toothbrush wet with water only.