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April 2015

A 25-year-old male presented to the dental clinic with a chief complaint of intermittent soreness in the mouth for several months. The patient has no significant medical history and does not take any medications. Intraoral examination revealed lace-like, white striations on right and left buccal mucosa. The lesion cannot be wiped off. No other findings noted. What is the most likely diagnosis?

 

INCORRECT.

 

 

 

INCORRECT.

Though allergic contact stomatitis has several clinical features, the patient did not have any history of recent dental restorations or new medicaments.

 

 

INCORRECT.

Chronic nibbling produces lesions most frequently located on buccal mucosa. It is found in people under stress or psychological conditions. Clinically, it can be bilateral or unilateral. It appears as thickened, shredded, white areas combined with intervening zones of erythema, erosion or focal traumatic ulceration. Areas of white mucosa show irregular ragged surface.  Altered mucosa located in mid-portion of anterior buccal mucosa along occlusal plane. No treatment is required.

 

 

CORRECT.

It is immunologically mediated mucocutaneous disorder. It occurs in middle-aged patients with female predominance. Skin lesions appear as purple, pruritic, polygonal papules. Reticular type has no symptoms and involves posterior buccal mucosa bilaterally. Other oral mucosal surfaces involved are lateral and dorsal tongue, gingiva, palate and vermillion border. White lesions appear as papules. They can wax and wane. For asymptomatic cases, no treatment required. Topical or systemic corticosteroids recommended for symptomatic patients.

 

 

INCORRECT.

Linea alba is a common alteration of buccal mucosa which is associated with pressure, frictional irritation, sucking trauma from facial surface of teeth. Clinically it appears as white line (usually bilateral) and may be scalloped. It is located on buccal mucosa at level of occlusal plane of adjacent teeth. No treatment is required.

 


April 2015 References

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

 


March 2015

A 16-year-old male reported to the dental clinic for a regular checkup. Radiographic examination revealed a well-defined, mixed density lesion, and a radiolucent margin in the left mandibular region is noted. The tooth #21 is impacted and a retained deciduous molar is noted as well. What is the most likely diagnosis?

 

INCORRECT.

A calcifying cystic odontogenic tumor appears as a unilocular, well-defined radiolucency, although the lesion may occasionally appear multilocular. Radiopaque structures within the lesion, either irregular calcifications or toothlike densities can be present as small flecks or smooth pebbles. In some cases, it may be associated with an odontoma.

 

 

INCORRECT.

An adenomatoid odontogenic tumor can appear as a circumscribed, unilocular radiolucency that involves the crown of an unerupted tooth or located between the roots of erupted teeth. The lesion is usually completely radiolucent; however, it can contain fine (snowflake) calcifications.

 

 

CORRECT.

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

 

 

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 calcifying epithelial odontogenic tumor exhibits either a unilocular or a multilocular radiolucent defect usually associated with an impacted tooth. The margins of the lytic defect are often scalloped and usually relatively well-defined. However, in some cases they exhibit an ill-defined periphery. The lesion may be entirely radiolucent, but the defect usually contains scattered calcified structures of varying size and density. One of the characteristic features is appearance of radiopacities close to the crown of an embedded tooth.

 


March 2015 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, 7th Edition, Mosby; 2014


February 2015

A 14-year-old male presents to the dental clinic with upper and lower lip swelling present for several days. The patient has noncontributory medical history. The incisional biopsy revealed chronic inflammatory infiltrate with formation of noncaseating granulomas. What is the diagnosis?

 

INCORRECT.

Angioedema is diffuse edematous swelling of the soft tissues that most commonly involves the subcutaneous and submucosal connective tissues. It is commonly caused by histamine release from mast cells due to presence of allergen.

 

 

INCORRECT.

 

 

 

CORRECT.

Orofacial granulomatosis is a term used to describe swelling of the orofacial area, mainly in the lips, due to an underlying granulomatous inflammatory process. It can be an oral manifestation of diseases like sarcoidosis and Crohn’s disease and possibly may be associated with a dietary trigger. It is also commonly seen as a sign of allergic reaction to common food allergens, such as cinnamon and benzoate. The labial tissues demonstrate a nontender, persistent swelling that may involve one or both lips. The diagnosis of orofacial granulomatosis is made on histopathologic demonstration of granulomatous inflammation that is associated with negative special stains for organisms and no foreign material.

 

 

INCORRECT.

 

 

 

INCORRECT.

 

 


February 2015 References

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