diff dx

2 weeks after therapy/tx

leukoplakia, erythroplakia, persistent/widespread ulcerations

persistent color change/new growth

inflammatory PA lesions, intrabony cysts/tumors

color
consistency
architecture
distribution
pain

flat focal area, color blue/ brown/ black, no elevate/depress, 1cm>

amalgam/ graphite tattoos

flat lesion larger than macule, diff by color/texture, no elev/dep

hormone replacement therapy, birth control

oral melanoma

amalgam/etc tattoos
oral melanotic macule
blue nevus
melanoma

physiologic or drug induced pigmentation

peutz-jeghers syndrome
addison's disease

ellipse/punch
small = entire
large = transition

slight elev lesion
flat surface
can be 1cm+

plaque! lateral tongue common

hyperkeratosis/frictional keratosis
epith dysplasia (oral cancer)

linea alba
tobacco pouch keratosis
leukoplakia

transition zone
if too large, central area or two sites

small exophytic growths
cauliflower/ round mass
thin stalk

squamous papilloma
verruca vulgaris
squamous cell carcinoma

inflam papillary hyperplasia
condyloma acuminatum (STI)
heck's disease

scissors > snip
avoid forcep squeeze artifact

depressed superficial lesion, partial mucosa loss

vesicle/ bulla rupture or irritant

ill defined border

well circumscribed

GO BEYOND BASAL LAYER

involves underlying CT (erosion don't)

traumatic/aphthous ulcer

squamous cell carcinoma

herpetic lesions
mucosal burns
erosive lichen planus

near transition zone
need good clinical hx

when it is mycosis, looks black; indicates fungal inf and necrosis with fungal elements in it

various origin

usually solitary, slow grow

nontender and asympto unless trauma

moves teeth (not loosen)

most benign

bubble shaped projection/elevation

caused by proliferation of soft tissue

<1cm

fibroma
pyogenic granuloma

fordyce granules (hair)
neurofibromatosis
cowden syndrome

avoid tearing
usually excise entire lesion

systemic etiology or syndrome (neurofibromatosis)

raised dome shape

1cm+

can palpate

sessile

fibroma
lower lip mucocele
pyogenic granuloma
ossifying fibroma
salivary gland tumor
squamous cell carcinoma

neurofibromatosis

excise entire lesion

if large, sample adequately

tiny round brown-red spots

bleeding under mucosa

red-purple rash spots

bleeding from small bv

discoloration of subcutaneous from bleeding
1cm+

blood collecting in CT

dilated vessel

BV proliferation

blanching an area by pressing against it, seeing if vascular vs salivary

if vascular it will blanch blood

hemangioma
epith dysplasia
pyogenic granuloma
submucosal hemorrhage

URI
leukemia

biopsy pearls (entire lesion)

fluid/pus below epith

ulcer if ruptured

difficult biopsy

small fluid filled cyst/vacuoles

sub or intra epith

transient if intraoral

less than 5mm

herpes
superficial mucocele

fluid filled sac

5mm+

transient if intraoral

bullous pemphigoid
pemphigus vulgaris

small circumscribed elevated collection of pus

usually <5mm

chrons disease

peri-lesional areas to avoid surface floating away

avoid gingiva

multi: multiple bubbles (Honeycomb)

uni: one big bubble

uni/multilocular

well-defined or thick corticated

ill defined or wide zone of transition

radiopaque, radiolucent, mixed luc/paq

expansion

displacement or resorption of hard tissues

INDISTINGUISHABLE

residual cyst has SCLEROTIC BORDER @ apical area of missing tooth

heart shaped

between roots of max centrals

6mm+

usually PM-canine region
lucency interradicular to 2 adj teeth

stafne bone defect

males

pseudocyst because it has no epithelial lining

traumatic bone cyst
stafne bone defect
lat perio cyst
incisive canal cyst
residual cyst
dentigerous cyst
radicular cyst
odontogenic keratocyst

ameloblastoma
central giant cell granuloma

ameloblastoma

giant cell granuloma

cherubism

aspirate prior, assess, remove

radicular cyst
dentigerous cyst
odontogenic keratocyst
stafne bone defect

ameloblastoma
central giant cell granuloma
cherubism

nevoid basal cell carsinoma (Gorlins)
cherubism

small: complete enucleate

some cystic need ostectomy

immune compromise/hypovascular

subacute: ill defined lucent
chronic: lucent and opaque

chronic osteomyelitis
focal/periapical/florid cemento-osseous dysplasia
ossifying fibroma

RCT

middle aged black women

tori
root tips
condensing osteitis
focal idiopathic osteosclerosis
compound/complex odontoma
fibrous dysplasia
osteosarcoma

large sample
surgical findings are impt (demarcated, easy remove, etc)

host bone rxn to wall off inflam products

focal idiopathic osteosclerosis

no radiolucent rim

collection of mini teeth in fibrous sac

complex odontoma