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January 2015

A 40-year-old female presented to dental clinic with 0.5 x 0.5 cm mucosa colored, sessile gingival nodule. Upon histopathologic examination, the lesion showed bone formation surrounded by fibrous connective tissue. What is your diagnosis?

 

INCORRECT.

Peripheral odontogenic fibroma is a benign neoplasm of odontogenic ectomesenchymal origin. Histopathologically, it is characterized by relatively mature collagenous fibrous tissue with scattered odontogenic epithelium.

 

 

INCORRECT.

 

 

 

INCORRECT.

Peripheral giant cell granuloma represents a reactive lesion, not a true granuloma, caused by local irritation or trauma. Microscopic examination shows a proliferation of multinucleated giant cells. The clinical appearance is similar to pyogenic granuloma, where the peripheral giant cell granuloma often is more blue-purple compared with the bright red of a typical pyogenic granuloma

 

 

CORRECT.

Peripheral ossifying fibroma is a relatively common gingival growth that is considered to be reactive rather than neoplastic in nature. It occurs exclusively on the gingiva. The microscopic pattern of shows fibrous proliferation associated with the formation of a mineralized product. Excision is usually curative; however a recurrence rate of 8% to 16% has been reported.

 

 

INCORRECT.

Pyogenic granuloma is a common tumor-like growth considered to be reactive in nature. It is not a true granuloma but a tissue response to local irritation or trauma.

 


January 2015 References

Neville B, Damm DD, Allen CM, Bouquot J. Oral and Maxillofacial Pathology, 3rd Edition, W.B. Saunders Co.; 2009


December 2014

A 71 y.o. Caucasian male presents to the dental clinic for initial exam. Radiographic examination revealed radiopaque mass with irregular border at mid-posterior portion of right ramus. What is the most likely diagnosis?

 

INCORRECT.

 

 

 

CORRECT.

Tonsilloliths are discovered on panoramic radiographs as radiopaque objects superimposed on the midportion of the mandibular ramus. Small tonsoliths are asymptomatic. However, these calcifications can promote recurrent tonsillar infections that may lead to pain, abscess formation, ulceration, dysphagia, chronic sore throat, irritable cough, otalgia, or halitosis. In older adult patients, large tonsilloliths can be aspirated and produce significant secondary pulmonary complications.

 

 

INCORRECT.

Benign fibro-osseous lesions, such as osseous dysplasia, present as a radiopaque mass with radiolucent rim and occur in the tooth-bearing region in the jaw.

 

 

INCORRECT.

Sialoliths involving parotid gland appear as a round to cylindrical in shape radiopacity and will superimpose on the body of the ramus radiographically.

 

 

INCORRECT.

Idiopathic osteosclerosis presents as a focal area of increased radiodensity that is of unknown cause. Radiographically, the lesions are characterized by a well-defined, smooth border, rounded, or elliptic radiodense mass.

 


December 2014 References

Neville B, Damm DD, Allen CM, Bouquot J. Oral and Maxillofacial Pathology, 3rd Edition, W.B. Saunders Co.; 2009

White SC, Pharoah MJ. Oral Radiology: Principles and Interpretation, 6th Edition, Mosby; 2009


November 2014

An 11-year-old African-American male presented to the pediatric clinic with a red lesion at marginal gingiva of #6. What is the most likely diagnosis?

 

INCORRECT.

Pyogenic granuloma represents an exuberant tissue response to local irritation or trauma that grows rapidly. In spite of its name, it is not a true granuloma. It is a smooth or lobulated mass that is usually pedunculated. The surface is characteristically ulcerated and ranges from pink to red to purple.

 

 

CORRECT.

Localized juvenile spongiotic gingival hyperplasia is characterized by gingival overgrowth as determined by clinical or histopathologic features rather than a pure inflammatory process with minimal to no tissue swelling. The lesion occurs between 5-15 years of age and classically presents as a small, localized, papillary or velvety, bright red, and easily bleeding gingival overgrowth with predilection for facial gingiva. The hyperplasias are confined to attached gingiva, but not all cases involve marginal gingiva.

 

 

INCORRECT.

Inflammatory papillary hyperplasia is characterized by reactive tissue growth as a result of ill-fitting maxillary denture or poor denture hygiene. Clinically, the mucosa is erythematous and has a pebbly or papillary surface.

 

 

INCORRECT.

Squamous papilloma is a benign proliferation of stratified squamous epithelium which has papillary presentation. The lesion appears as a soft, painless, exophytic lesion with numerous fingerlike projections that can be pointed or blunted.

 

 

INCORRECT.

Puberty gingivitis occurs around the time of puberty (period of increased susceptibility to gingivitis). The inflammatory lesion exhibits diffuse involvement of marginal gingiva.

 


November 2014 References

Chang JY, Kessler HP, Wright JM. “Localized juvenile spongiotic gingival hyperplasia.” Oral Surg Oral Med Oral Pathol Oral Radiol Endod 106, no. 3 (2008): 411-8.

Neville B, Damm DD, Allen CM, Bouquot J. Oral and Maxillofacial Pathology, 3rd Edition, W.B. Saunders Co.; 2009