| Question | Answer |
| Disease caused by a healthcare worker | Iatrogenic |
| what is the scientific study of disease | Pathology |
| Unknown cause | Idiopathic |
| '5' Clinical signs of Inflammation | Redness, Heat
Pain, Swelling
loss of normal tissue functiom |
| Systemic signs of Inflammation | Fever- pyrogen production
Leukocytosis- more WBC in blood
Lymphadenopathy- Hyperplasia & Hypertropy of Lymphocytes |
| 4 stages of Mitosis | Prophase, Metaphase, Anaphase, Telophase
P M A T |
| A complete 2nd set of chromosomes (92) incompatible with life | Euploid |
| Larger than normal, extra segment is identical to a segment of the normal chromosome | Duplication |
| Aneuploid | and extra number, but isn't an exact multiple of chromosomes |
| The observable appearance of an individual | Phenotype |
| Identical Allelic Genes(genes located same level/same function) | Homozygote i.e. Blood type AA |
| Different Allelic Genes | Heterozygote |
| The pathological wearing away of tooth structure from repetitive mechanical habit | Abrasion |
| Wedge shaped lesion cervical areas of tooth
weakened/fatigued structure=susceptibility | Abfraction |
| 70-75% of defense pool, major antibody in the blood serum Initial Defense, (Fetal-1st passive immunity)) | IgG (Immunoglobin or antibodies) |
| Defends body fluids from microorganisms | IgA (Immunoglobin) |
| Activation of B lymphocytes (along w/ IgD) involved in early immune response | IgM |
| Activates of B lymphocytes | IgD |
| Involved in hypersensitivity reactions- release histamines | IgE |
| level of a specific antibody | Antibody Titer |
| link between inflammatory & immune response, act as antigen presenting cells, amplifies the immune response phagocytosis
does NOT have Memory | Macrophages |
| develop from bone marrow stem cells, reside in lymphoid tissue. Produces plasma cells and B memory cells. | B lymphocytes |
| Pin wheel shaped nucleus, visible cytoplasm. Produces antibody proteins or Immunoglobulins | Plasma Cells |
| develop from bone marrow stem cells, mature in the Thymus. Memory Cells, T-helper cell (T4 marker, T-Cytotoxic cells (viral surveillance) & T supressor cells (turn off B lymphocites) T8 marker | T lymphocytes
Cell Mediated Immunity |
| 'B' Lymphocytes primary role and the production of Antibodies | Humoral Immunity |
| 'T' Lymphocytes assisted by macrophages are the predominant role in: | (CMI) Cell Mediated Immunity |
| Type I hypersensitivity | occurs within minutes
IgE--> histamine release
constricts smooth muscle in lungs
swelling edema i.e. asthma, hay fever, anaphylaxis |
| IgG and IgM antibodies combine with antigen. Tissue destruction where antigen is present | Type II hypersensitivity
i.e. incompatible blood transfusions |
| Immune complexes formed (microorganisms+antibody) deposit in circulation, Acute inflammatory response. neutrophils->phagocytosis->
lysosomal enzymes->Tissue destruction | Type III hypersensitivity
(Auto Immune disease) |
| Delayed hypersensitivity,
Cell Mediated Immunity | Type IV hypersensitivity
(i.e. Tuberculosis Dx, Organ Transplant rejection) |
| What is Uticaria? | Hives, multiple well demarcated swelling w/ Itching |
| Arthritis, Urethritis, Conjuctivitis
Antigenic marker HLA-B27
Men 10:1 Oral ulcers & tongue depapillation. lower extremities affected (knees ankles) | Reiter Syndrome aka Reactive arthritis |
| Histocytosis X
Letter-Siwe disease-
Hand Schuller Christian disease
Eosinophilic Granuloma of bone | Langerhans Cell Disease
Langerhans cell present (type of macrophage) |
| Acute, rapid, children under 3yrs
can be fatal, oral manifestations rare | Letter-Siwe disease
(Langerhans) |
| Chronic, multifocal, children under 5yrs
'punched out' skull radiolucencies
mimics advanced perio disease | Hand Schuller Christian disease
(Langerhans disease) |
| Chronic. localized
older children,young adults
skull & mandible commonly involved eosinophilic granuloma
males affected 2x as much | Solitary Eosinphilic Granuloma of the Bone (Langerhans) |
| Combination of dry mouth and dry eyes | Sicca Syndrome |
| Auto-immune, Just sicca=Primary w another auto immune disease=
Secondary
bilateral enlarged parotid glands
Sicca and Raynaud's Syndrome
(fingers and toe circulation)
90% positive reaction to Rheumatoid factor | Sjogren Syndrome |
| 85% sin lesions (butterfly rash) Oral Lesions 25%, Raynaund 15% arthritis, arthralgis, kidneys
possible sjorgen's present
(bloodwork before dental work may need to pre-med) | SLE Systemic Lupus Erythematous |
| confined to skin & mucous membranes
mildest form: | DLE Discoid Lupus Erythematous |
| Severe, progressive auto-immune disease affecting skin and mucous membranes.50% 1st sign in oral cavity
Nikolsky's sign: gentle pressure on mucosa form bulla
Epithelial cell destruction | Pemphigus Vulgaris
mortality now 8-10%
Corticosteroids |
| Acantholytic or Tzanck cells- | detached epithelial cells (rounded appearance)biopsy to confirm |
| Cicatrical Pemphigoid aka(benign) Mucous membrane pemphigoid | Gingiva-most common site
affects oral & genital mucosa, skin, conjuctiva Cicatrical- 'healing w/ scarring'
severe eye lesions may occur desquamative gingivitis. Nikolsky's sign
hard to control. corticosteroids
periods of exacerberation-> remission |
| 60yrs +
lesions more extensive, painful
anti-inflammatory, corticosteroids | Bullous Pemphigoid |
| Chronic, recurrent, autoimmune disease. Avg age 30yrs, must have 2 of 3 lesions present
Oral, Genital, Eye lesions, (Skin) | Behcet Syndrome |
| 60-70% of entire WBC population
1st wbc recruited by chemotaxis
Main Function: Phagocytosis | Neutrophils (PMN) |
| 3-8% of entire wbc pop.
2nd to injury site
longer lifespan than neutrophil
function: phagocytosis, and immune response | Monocyte becomes MACROPHAGE |
| Non specific response to injury, occurs in the same manner regardless of the nature of the injury | Inflammation |
| Arterioles, capillaries, venules | (MC) Microcirculation
Constricts than Dilates during inflammation |
| Salivary gland stone formed by calcium salts around a central core
(major and minor glands) | Sialolith |
| Unilateral 'frog-pouch' mucocele-like lesion
sublingual and submandibular glands duct obstruction likely cause | Ranula |
| Radicular or Periapical cyst | True cyst (lined w/ epithelium)
most commonly occuring oral cyst
epi rest of Malassez proliferation
usually asymptomatic |
| Alveolar Osteitis | 'Dry Socket'
lost blood clot after tooth extraction
bone surface exposed. Painful, but no inflammation because no infection exists |
| Trisomy 21 (Down Syndrome) | most common abnormality in humans
fissured/pebbly tongue, Macroglossia w/ protrusion, High arch palate, Enamel hypoplasia, microdontia, >90% Perio disease |
| Trisomy 13 | 70% live to 7mos only
Bilateral cleft lip and palate
small/No eyes micro/anophthalmia, supernumerary digits |
| Missing an 'X' chromosome
short,neck webbing, hands &feet edema, broad chest, genital underdeveloped, lack the 'Barr bodies' | Turner Syndrome |
| XXY, male phenotype
Taller, wide hips, female pubic hair, >50% breasts
Maxilla slighty hypoplastic, detected after puberty
1 barr body for each extra x | Klinefelter Syndrome |
| Caused by deletions on the short arm of CH5
Mental retardation, (No Oral abnormalities)
'catlike cry' | Cri du Chat Syndrome |
| Wolf-Hirschhorn Syndrome | Deletion on CH4
Cleft Palate
IQ > 30 |
| Autosomal(non-sex chromosomes) dominant,cyclic decrease in Neutrophils 21-27dys intervals, lasting 2-3dys, Oral ulcers
G-CSF Tx | Cyclic neutropenia
Chronic= Kotsmann Syndrome |
| Autosomal Recessice Inheritance
Periodontal destruction, perm. tooth loss before age 14,
Palmer & Plantar hyperkeratosis (retinoid Tx) | Papillon-Lefevre Syndrome |
| Gingival Hyperkeratosis | band-like, few mm in width, Free gingiva not affected |
| Gingival Hypertrophy, Very firm, corrugated, paler, lips may protrude | Gingival Fibromatosis |
| Laband Syndrome | Gingival Fibromatosis, nail loss,malformed nose & ears, enlarged liver & spleen, fingers/toes frog-like appearance |
| 'Soap bubble' radiographic jaw appearance, eyes far apart, delayed eruption=pseudoanodontia
Fibrous CT | Cherubism |
| Ellis-Van Creveld Syndrome | affects dwarfs, Polydactyl, toenails missing, 50% heart defects, and present natal teeth, no anterior Max. Vestibule, Conical tooth shape |
| > size of mand. teeth, supernumerary teeth,missing/minimal clavicles
skull defects, open fontanelles | Cleidocranial Dysplasia |
| Gardner Syndrome | Osteomas (jaw,skull,long bones) and Odontaomas, Intestinal Polyps become malignant age 30+ |
| Mandibulofacial Dysostosis
(Assoc. w/ Treacher's Collins Syndrome) | 'fish-like' commisures
Deafness
Hypoplastic mandible, Open bite, 30% high palate or cleft |
| Nevoid Basal Cell Carcinoma Syndrome
(Gorlin Syndrome) | wide spaced eyes, Jaw cysts, basal cell carcinomas,Nevi: pigmented skin lesions |
| Osteogenesis Imperfecta | 30% W/ Family Hx, brittle bones
Dentinogenesis imperfecta (dentin can't suppoprt enamel) 80% Primary teeth affected. 35% Permanent |
| Tori | Mandibular: rare before age 15 smooth or lobulated
Palate: mucosa thin, trauma easy
2:1 women > Native Americans
Rare younger than 14yrs |
| Ehlers-Danlos Syndrome | Collagen & CT defect, very elastic, joint hypermobility |
| Cleft palate/lip | 1 in 800 births
cogenital lip pits
midline of lower lip vermillion border |
| Hereditary Hemorrhagic Telangiectasia | Serious Nosebleeds (Note in DX Tx)
Pinpoint/spider-like red lesions lips,eyelids,nose
Tip Anterior Dorsom tongue |
| Multiple Mucosal Neuroma Syndrome
MEN2 B | Thyroid Carcinoma 75%, early Dx can become malignant
oral neuromas, tip of tongue
Pt: tall, large thick lips, everted eyelids |
| Von Recklinghausen Disease | Neurofibromatosis of CNS, eyelids, nasoloabial fold (hearing/visual)
Cafe au lait
105 Oral involvment |
| Peutz-Jeghers syndrome | 98% lip & buccal mucosa lesions
multiple melanin macules skin and mucosa, diminish w age
GI Polyposis (rarely malignant) |
| White Sponge Nevus | birth or after puberty
white, corrugated, soft mucosa
Always the buccal, never free gingiva, usually bilateral
Keratin desquamates- raw mucosa |
| Amolgenesis Imperfecta
4 TYPES | HYPO:(1)Plastic-irregular thickness,pitted(2)Calcified,yelloworange,chips easily-openbite? 3)Maturation-i.e. snowcap,soft enamel (4)Plastic-Maturation- yellow,brown pitted
ALL teeth, Severe Sensitivity |
| Dentinogenesis Imperfecta | most common
AKA Hereditary Opalescent Dentin
dentin soft (restorations fail), enamel chips-Attrition, NO PULP CHAMBERS, Roots are short blunt |
| Dentin Dysplasia
Type I RADICULAR | Normal crowns, Short roots-early exfoliation. half moon pulp chamber appearance. Disturbance in Hertwig's epi root sheath |
| Dentin Dysplasia
Type II CORONAL | pulp stones, Translucent/amber primary teeth Permanent: Normal crown/color, small roots no pulp chambers shown radiographically |
| Hypohydrotic ectodermal Dysplasia | X linked recessive
less hair,sweat
hypo or anodontia, alveolar ridge-only if teeth present
no minor salivary glands or respiratory tract mucosa
soft,dry skin
incisors,canines small conical |
| Hypophosphatasia | decrease in serum alkaline phosphates (calcifies bone and cementum) bow-legged, fractures
no pdl, spontaneous loss of primary teeth |
| Hypophosphatemic Vitamin D resistant rickets | Large pulp chambers, gingival abscesses, pulpal disease, Dentin cracks, bowlegged
low phosphorous serum levels |
| Pegged/Absent Max. Laterals | primary and Secondary dentition
1-3% white 7% Asian
Premolars missing 10-20% |
| Taurodontism | Large, Pyramid Molars
Large Pulp chambers, furcations, freq found in Klinefelter (XXY) Syndrome |
| Giant Cell Granuloma | CENTRAL_Within bone, multi-nucleated giant cells
only in jaw
PERIPHERAL- Outside bone, Dk red, on gingiva or alveolar mucosa |
| Pyogenic Granuloma | No pus, response to injury
pregnant, teenagers, young adults |
| Chronic Hyperplastic Pulpitis | Granulation tissue fill caries void |
| Increased dilation of blood vessels | Kinin System |
| c-Reactive protein | produced in liver
acute & chronic
> 10mg is high |
| Parenteral | Injection |
| Serum sickness
Drug Hypersensitivity | Type III allergy
i.e. horse anti-toxin (no longer done) for immunity
penicillin, barbituates |
| Lichen Planus | 1% pop
almost always bilateral
Wickham's Striae
benign, chronic skin(lumbar), oral mucosa (buccal)
desquamative gingivitis
basal cell layer degeneration |
| Dental or Periapical granuloma | painful, localized
slightly extruded from socket
opening in pulp canal (apex usually)
thickened PDL (slight) |
| Focal Sclerosing Osteomyelitis
aka condensing osteomitis | change in bone, near apex (usually Mand 1st Molar) usually reaction to infection, asymptomatic, no tx |
