most highly mineralized tissue in the body
enamel
specialized connective tissue that makes up hard tissue of tooth
dentin
Caries
focal degradation of tooth structure
What is the most common cause of tooth loss before age 35?
caries
What is the gingiva?
squamous mucosa between teeth
Gingivitis
inflammation of the mucosa and associated soft tissues
inflammatory process that affects supporting structures of teeth
periodontitis
This condition is caused by bacteria and associated w/ poor hygiene. It can be reversed
gingivitis
This inflammation affects deeper structures and is more involved.
periodontitis
What is the most common inflammatory/reactive ulceration of the oral cavity?
Apthous ulcer
What are the possible outcomes for pyogenic granuloma?
regression or ossify to fibroma
What is the treatment for pyogenic granuloma?
excision
What is a pyogenic granuloma?
highly vascular, pedunculated lesion in gingiva of children, young adults and pregnant women
What can cause glossitis?
Truama (jagged teeth, biting tongue)
vitamin B12 deficiency
inflammation of the tongue: beefy red
glossitis
glossitis, Fe deficiency anemia and esophageal dysphagia are associated w/ what syndrome?
Plummer-Vinson (Patterson-Kelly) syndrome
What type of herpes infection is most common in the oral cavity?
HSV-1
This condition displays intranuclear viral inclusions or fuse-multinucleate polykarons and can be demonstrated via the Tzanck test.
Herpes simplex virus infection
What is the most common fungal infection of the oral cavity?
Oral Candidiasis
What is the normal oral flora mostly composed of?
candidia albicans
What is the most common form of oral candidiasis?
Pseudomembranous
In this condition, the grey-white inflammatory layer can be scraped off.
Pseudomembranous oral candidiasis
White, confluent patches of hyperkeratotic thickenings
hairy leukoplakia
Where are the lesions in hairy leukoplakia most often located?
lateral border of tongue
In hairy leukoplakia, can the lesions be scraped off?
No
white plaque that cannot be scraped off and cannot be characterized as any other disease
leukoplakia
Which lesions in leukoplakia are considered premalignant?
all of them
incidence and prognosis of erythroplakia vs. leukoplakia
less common, more ominious: high risk of malignancy
What is the most common cancer of the oral cavity?
squamous cell carcinoma
Where is the most likely site for SCC to develop in the oral cavity?
Floor of mouth
What are some other cancers that can develop in the oral cavity?
Adenocarcinomas, melanomas, other various carcinomas
multiple individual primary tumors, develop as a result of years of chronic exposure to carcinogens
Field cancerization
What are some risk factors for SCC?
EtOH, smoking, HPV
A tumor is indigenous to the tissue that it is growing in
hamartoma
what are the 2 classifications of odontogenic cysts/tumors?
developmental
inflammatory
This developmental cyst is locally aggressive, presents in the posterior mandible and has a high rate of recurrence.
odontogenic keratocyst (OKC)
This inflammatory odontogenic tumor is slow growing, but locally invasive and shows no ectomesenchymal differentiation.
Ameloblastoma
This inflammatory odontogenic tumor shows deposits of dentin and enamel and is probably a hamartoma.
odontoma
Which odontogenic tumor is most common?
odontoma
What is the most common disorder of the nose?
Inflammatory diseases (common cold), usually viral
What are the 5 causes of nasal inflammation?
1. infectious rhinitis
2. Allergic rhinitis
3. Nasal polyps
4. Chronic rhinitis
5. Sinusitis
common cold, virus
infectious rhinitis
allergens, IgE, hay fever
allergic rhinitis
edematous mucosa, inflammatory cells
nasal polyps
contributes to microbial invasion due to impaired drainage
chronic rhinitis
preceded by acute or chronic rhinitis
sinusitis
What 3 things can cause necrotizing lesions of the nose and upper airways?
1. acute fungal infections
2. Wegner's granulomatosus
3. Lymphoma
This aggressive fungal infection is treated seriously due to its location and potential to invade the orbits or brain
mucormycosis
Produces necrotizing granulomas, vasculitis and glomerulonephritis
Wegner's granulomatosus
NK cells infected w/ EBV that can cause necrotizing lesions in the nose and upper airways.
lymphoma (previously know as lethal midline granuloma)
what is the most common disorder of the larynx?
inflammation
inflammatory narrowing of the airways leading to inspiratory stridor in children
Croup (laryngotracheobronchitis)
Sudden swelling of vocal cords and epiglottis caused by H. influenzae or B-hemolytic strep
laryngoepiglottis
unilateral reactive nodules are found in what patients
heavy smokers
singer's nodules
bilateral, never give rise to cancer
Where in the larynx are reactive nodules found?
true vocal cords
These lesions begin on the true vocal cords, are associated w/ HPV 6 and 11, and only rarely turn into cancer
juvenile laryngeal papillomatosis
Most carcinomas of larynx are of what type
SCC
This region includes areas from the epiglottis to the ventricle
supraglottic
This region includes the ventricle and the true cords
glottic
This region begins 1 cm below the true cords and extends until the cricoid cartilage
subglottic
when a laryngeal tumor extends over more than one region it is called
translgottic
what are the most important factors in staging a laryngeal tumor?
depth of invasion and whether the tumor is unilateral or bilateral
Most common disorder of the ear
otitis media
Ear infections are caused by what organisms (3)
Strep. pneumonae
H. influenzae
M. catarrhalis
what is the most common cancer of the ear and its location.
BCC or SCC, located on pinna of ear
Cholesteatomas
cystic lesions containing keratin debris, cholesterol, associated w/ chronic otitis media
Are cholesteatomas neoplastic?
No
this neoplasm of the ear is located in the inner ear canal and is not associated with sun exposure
SCC
benign cysts found on the anterolateral aspect of neck, along SCM muscle
branchial cyst
remnants of developmental tract of thyroid, cysts located on anterior midline of neck
thyroglossal duct cysts
Paraganglioma
clusters of neuroendocrine cells, associated w/ sympathetic and parasympathetic nervous systems
What is the most common location for a paraganglioma and what is it called?
adrenal medulla
pheochromacytoma
what % of extramedullary paragangliomas occur in the head and neck?
70%
what are the 2 locations paragangliomas of the head and neck?
1. organ of Zuckerkandl (paravertebral)
2. carotid body
what is a paraganglioma on the carotid body called?
chemodecktoma
xerostomia
dry mouth resulting from decreased production of saliva
what condition is xerostomia associated with?
Sjogren's syndrome (auto-immune)
Inflammation of salivary gland
sialadenitis
what is the most common lesion of the salivary gland?
mucocele
what is the usual location and cause of a mucocele
lower lip, caused by trauma
mucoceles that arise when the duct of the sublingual gland has been damaged
ranula
viral cause of sialadenitis
mumps
stone production in the salivary gland
sialolithiasis
sialolith
salivary stone
most common tumor of salivary glands
pleomorphic adenoma
where is the usual site for a pleomorphic adenoma?
parotid gland
rounded, well-demarcated mass, with grey white cut surface w/ myxoid and blue translucent areas of chondroid
appearance of pleomorphic adenoma
myxoid
mucin
2nd most common tumor of salivary glands and its location
Warthin tumor, parotid gland
warthin tumor
papillary cystadenoma lymphomatosum
encapsulated, pale grey surface w/ narrow cystic spaces filled w/ mucinous secretions, papillary projections
warthin tumor
the most common primary malignant tumor of salivary glands
mucoepidermoid carcinoma
two less common tumors of salivary glands
1. adenoid cystic carcinoma
2. acinic cell tumor