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July 2015


 

A 25-year-old male reported to the dental clinic for a regular check-up. Clinical examination WNL and radiographic examination revealed a well-defined, radiopaque structure in the upper anterior maxillary region. What is the most likely diagnosis?

 

INCORRECT.

Complex odontomas appear as an irregular calcified mass (no tooth-like structures are noted) on radiographs and are surrounded by a radiolucent rim.

 

INCORRECT.

Radiographically, a compound odontoma appears as multiple, tooth-like structures with varying dimensions and these structures are surrounded by a radiolucent rim.

 

 

CORRECT.

The supernumerary that occur in between maxillary teeth are called as mesiodens. These teeth are in addition to normal compliment of the teeth and can be identified by counting the teeth. These teeth appear as miniature tooth.


July 2015 References

White SC, Pharoah MJ. Oral Radiology: Principles and Interpretation, 7th Edition, Mosby; 2014

 


June 2015

35-year-old female presented to the dental clinic with desquamative gingiva and severe ragged erosions on the palate and buccal mucosa. Biopsy of the lesion showed intraepithelial separation, occurring just above the basal cell layer of the epithelium. Direct immunofluorescence examination of tissue submitted in Michel’s solution revealed IgG, IgM and C3 localization in the intercellular spaces between the epithelial cells. What is the most likely diagnosis?

 

INCORRECT.

Histopathologic feature of mucous membrane pemphigoid shows a split between the surface epithelium and the underlying connective tissue in the region of the basement membrane. Direct immunofluorescence studies of perilesional mucosa show a continuous linear band of immunoreactants (IgG, C3 and occasionally IgA and IgM) at the basement membrane zone in nearly 90% of affected patients.

 

CORRECT.

 

 

 

INCORRECT.

Subepithelial or intraepithelial vesiculation may be seen in association with necrotic basal keratinocytes with mixed inflammatory infiltrate. Because the immunopathologic features are also nonspecific, the diagnosis is often based on the clinical presentation and the exclusion of other vesiculobullous disorders.

 

 

INCORRECT.

Chronic ulcerative stomatitis is similar to those of lichen planus. The diagnosis is essentially based on its characteristic immunopathologic pattern. With direct immunofluorescence studies, autoantibodies (usually IgG) that are directed against the nuclei of stratified squamous epithelial cells in the basal and parabasal regions of the epithelium are detected.

 

 

INCORRECT.

The histopathology of lichen planus shows destruction of the basal cell layer of the epithelium, accompanied by an intense, bandlike infiltrate of predominantly T lymphocytes immediately subjacent to the epithelium. The immunopathologic features of lichen planus are nonspecific. Most lesions show the deposition of a shaggy band of fibrinogen at the basement membrane zone.

 


June 2015 References

Neville B, Damm DD, Allen CM, Bouquot J. Oral and Maxillofacial Pathology, 4th Edition, W.B. Saunders Co.; 2015

 


May 2015

62-year-old female presented to the dental clinic with burning sensation in the mouth, especially the tongue. Clinically, the tongue exhibited erythroleukoplakic areas where the leukoplakic regions could be rubbed off. What is the most likely diagnosis?

 

INCORRECT.

Also known as perlèche, it involves the angles of the mouth (angular is characterized by erythema, fissuring, and scaling).

 

 

INCORRECT.

Chronic hyperplastic candidiasis is characterized by a white patch that cannot be removed by scraping. Such lesions are usually located on the anterior buccal mucosa and cannot clinically be distinguished from a routine leukoplakia. The diagnosis is confirmed by the presence of candidal hyphae associated with the lesion and by complete resolution of the lesion after antifungal therapy.

 

 

INCORRECT.

Also known as “antibiotic sore mouth”, erythematous candidiasis usually follows a course of broad-spectrum antibiotic therapy. Patients often complain that the mouth feels as if a hot beverage had scalded it. This burning sensation is usually accompanied by a diffuse loss of the filiform papillae of the dorsal tongue, resulting in a reddened, “bald” appearance of the tongue.

 

 

CORRECT.

Also known as thrush, it is characterized by the presence of adherent white plaques that resemble cottage cheese or curdled milk on the oral mucosa. The white plaques are composed of tangled masses of hyphae, yeasts, desquamated epithelial cells, and debris that can be scraped off. The underlying mucosa may appear normal or erythematous. Antibiotic exposure is typically responsible for an acute (rapid) expression of the condition; immunologic problems usually produce a chronic (slow-onset, long-standing) form.

 

 

INCORRECT.

More commonly known as “denture stomatitis”, it is often classified as a form of erythematous candidiasis. This condition is characterized by varying degrees of erythema localized to the denture-bearing areas of a maxillary removable dental prosthesis. The condition is rarely symptomatic. Usually the patient admits to wearing the denture continuously, removing it only periodically to clean it. The denture typically shows much heavier colonization by yeast than the palatal mucosa.

 


May 2015 References

Neville B, Damm DD, Allen CM, Bouquot J. Oral and Maxillofacial Pathology, 4th Edition, W.B. Saunders Co.; 2015