Hard tissue enlargements are found periodically in the mouth and must be evaluated to determine whether there is pathology. Some are benign, and others are malignant. The suffix “oma” refers to a tumor or neoplasm. The prefix “osteo” (bone forming), added to the root word “sarcoma” (neoplasm of connective tissue) is one example of the various word forms that are joined together to name a disease.
The majority of the diseases found in a textbook on oral and maxillofacial pathology involve some type of cellular proliferation. Tissue masses are often generically referred to as tumors without distinguishing their specific pathology and their anticipated behavior or natural course.
Pigmented lesions may be physiologic or pathologic. Some are considered to be benign and some are extremely malignant. In early stages of both physiologic and pathologic lesions, it is often difficult to determine the seriousness of the lesion simply by a clinical examination. When a direct cause of a lesion cannot be determined, further investigation is always warranted, including a biopsy with microscopic examination of the tissue.
A cystis defined as a pathologic cavity lined by epithelium. All cysts described in this chapter arise from epithelial remnants related to some embryologic development and are therefore referred to as developmental cysts. Some arise from epithelial cells left over from tooth development (eg, odontogenic keratocysts), from embryonic ducts (eg, nasopalatine duct cysts), or from organ or facial unit development and fusion (eg, thyroglossal tract cysts, nasolabial cysts, and branchial cysts).
Raised lesions with a rough or papillary surface comprise a distinct group of oral mucosal masses that represent an epithelial abnormality. Among these are diverse malignancies, contagious infections (including viral proliferations associated with a large number of human papillomaviruses), sexually transmitted diseases (STDs), and reactive or inflammatory lesions.
The rich tradition of pathology has been taughtfor decades using the names of discoverers and pioneers in the field. Most all dental students and medical students alike have looked at Antoni A and Antoni B patterns, Civatte bodies, and Merkel cells and learned about Ewing sarcoma, Frey syndrome, Gardner syndrome, Crohn disease, and many others without knowing how these individuals came to have their names placed in the legacy of pathology and who they really were.
While the clinical presentation of a salivary gland neoplasm is usually an asymptomatic mass that may occasionally be ulcerated or cause pain, the histologic presentation is far more complex. The tumor spectrum is vast, and yet similar features may be seen in a variety of neoplasms with differing biologic behavior.
Disease terminology should be simple, descriptive, and, most of all, representative of our most up-to-date knowledge and information. Consequently, disease names undergo perpetual change, and with good reason. Nomenclature is like a chrysalis—necessary for development and advancement to a new stage but easily discarded when no longer necessary or appropriate.
Oral lesions are often the first indicators of a potential systemic illness, and as a result, oral healthcare providers are in a unique position to provide initial intervention, diagnosis, and treatment of HIV-related illnesses.
As a group, odontogenic tumors are cellular proliferations with a wide range of biologic potentials and behaviors. A correct understanding of each type of biologic behavior upon which to base rational treatments is required. Odontogenic tumors represent four classic biologies encompassed under the general term tumor, which connotes a dysmorphic increase in cellular mass.
Vesiculobullous disorders are sometimes grouped as similar inappearance when seen by the clinician. However, with carefulevaluation clinically and with the help of diagnostic tests, theselesions can usually be differentiated quite successfully.
The oral and maxillofacial specialist does not treat lymphomas or leukemias directly; nevertheless, he or she becomes involved in the first two of the four classic phases of lymphoma and leukemia management: (1)recognition, (2)diagnosis, (3)staging, and (4)treatment.
Pathologies with abnormal coloration related to the presence of pigment occur most commonly in skin and less commonly in the oral mucosa. They will span a spectrum ranging from innocuous lesions, such as the amalgam tattoo and the oral melanotic macule, to various benign nevi to life-threatening melanomas on skin or within the oral cavity.
Lesions that are radiopaque appear to have a dense, white presentation on the radiograph .Often times, lesions may have a combined radiopaque and radiolucent appearance, depending upon the stage of calcification involved. An example is the cementoblastoma, which manifests a halo effect with the radiolucent lesion appearing as a darker area on the radiograph and forming a definite contrast between the lesion, the bone, and the existing tissue.
This chapter provides the student and the practitioner with information related to the extraoral examination.The dental hygienist begins the pathology examination by observing, palpating, and thoroughly examining the external surfaces of the patient. Skin lesions are often evident on the exposed surfaces of the arms, legs, neck, face,and scalp regions.
This chapter introduces the clinical, microscopic, and diagnostic aspects of both benign and malignant soft tissue enlargements. Soft tissue enlargements originate from several sources, some of which include epithelial tissue, connective tissue, and neural tissue. Some of the lesions are traumatic or reactive, which means they are associated with an inflammatory process.
Diseases of the oral mucosa commonly manifest as white lesions, which is a change that is easily detected clinically.White lesions can be the result of hyperkeratosis (a thickening of the horny layer of the epidermis or mucosa by increased keratin production), necrosis of epithelial cells (usually caused by an injury), or ischemia (a defectiveblood supply to the tissues), which undermines the epithelium and results in whiteness.