Gingival Enlargements Overview

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Questions and Answers

Which of the following lesions is specifically characterized by its possible presence of bone and cementum tissue?

  • Pyogenic Granuloma
  • Peripheral Ossifying Fibroma (correct)
  • Peripheral Fibroma
  • Peripheral Giant Cell Granuloma

Which of the following lesions is most likely to be found in the interdental papilla?

  • Peripheral Ossifying Fibroma (correct)
  • Peripheral Giant Cell Granuloma
  • Pyogenic Granuloma
  • Peripheral Fibroma

Which of the following conditions is primarily linked to improper denture fit?

  • Inflammatory Fibrous Hyperplasia (correct)
  • C-Vitamin Deficiency Gingival Enlargement
  • Peripheral Fibroma
  • Gingivitis in Mouth Breathers

What is the most common treatment for both Peripheral Giant Cell Granuloma and Central Giant Cell Granuloma?

<p>Surgical excision (B)</p> Signup and view all the answers

Which of the following conditions is characterized by a red, friable, and easily bleeding gingival appearance?

<p>Atypical Gingivitis (D)</p> Signup and view all the answers

Which of the following medications is NOT known to cause gingival hyperplasia?

<p>Aspirin (C)</p> Signup and view all the answers

What is the primary clinical feature of Gingivitis in Mouth Breathers?

<p>Swollen, red, dry, and shiny gingiva (B)</p> Signup and view all the answers

Which of the following conditions is most likely to be confused with a mesenchymal lesion during clinical examination?

<p>Peripheral Fibroma (C)</p> Signup and view all the answers

Which type of gingival enlargement includes the papilla and marginal gingiva?

<p>Grade II (C)</p> Signup and view all the answers

What is the primary cause of infection in infective gingivitis?

<p>Bacterial infection (C)</p> Signup and view all the answers

What term describes the enlargement primarily associated with hormonal changes during puberty and pregnancy?

<p>Focal Hyperplastic Gingivitis (B)</p> Signup and view all the answers

What characterized the gingival condition known as hormonal gingivitis?

<p>Condition that regresses after hormonal changes (B)</p> Signup and view all the answers

Which grade indicates no signs of gingival enlargement?

<p>Grade 0 (D)</p> Signup and view all the answers

Which clinical presentation is characteristic of focal hyperplastic gingivitis?

<p>Firm, fibrous, and easily bleeding gingiva (B)</p> Signup and view all the answers

What is the difference between localized and generalized gingival enlargement?

<p>Localized affects only a specific tooth or area while generalized affects broader regions. (C)</p> Signup and view all the answers

What is a common non-inflammatory cause of focal fibrous hyperplasia?

<p>Chronic irritation (A)</p> Signup and view all the answers

Which of the following muscles is classified as an intrinsic muscle of the tongue?

<p>Inferior longitudinal (B)</p> Signup and view all the answers

Which arteries are involved in the blood supply of the tongue?

<p>Sublingual artery (A), Lingual artery (D)</p> Signup and view all the answers

Which nerve is primarily responsible for the motor control of the tongue?

<p>Hypoglossal nerve (C)</p> Signup and view all the answers

Which of the following functions is NOT associated with the tongue?

<p>Respiration (D)</p> Signup and view all the answers

The lymphatic drainage of the tongue includes which of the following nodes?

<p>Submental nodes (B)</p> Signup and view all the answers

What is the primary role of the chorda tympani nerve in relation to the tongue?

<p>Taste sensation (A)</p> Signup and view all the answers

Which of the following is an extrinsic muscle of the tongue?

<p>Styloglossus (B)</p> Signup and view all the answers

Which function of the tongue aids in maintaining oral hygiene?

<p>High mobility (C)</p> Signup and view all the answers

What condition is characterized by multiple raised wart-like lesions on the dorsum of the tongue?

<p>Condyloma Acuminatum (B)</p> Signup and view all the answers

In the case of tongue paralysis, which direction does the tongue turn when protruded?

<p>Towards the healthy side (B)</p> Signup and view all the answers

What is a common cause of paresthesia in the tongue?

<p>Traumatic injuries (C)</p> Signup and view all the answers

Which condition is associated with pain and unpleasant sensations in the tongue?

<p>Glossodynia (D)</p> Signup and view all the answers

What is the primary symptom of ageusia?

<p>Loss of taste (A)</p> Signup and view all the answers

Which of the following may lead to anesthesia in the tongue?

<p>Local anesthesia accidents (B)</p> Signup and view all the answers

Which nerve disorder results from muscle spasms in the tongue and masticatory muscles?

<p>Tongue Spasm and Tremor (A)</p> Signup and view all the answers

What could potentially cause a burning sensation in the tongue besides galvanic currents?

<p>Anemia or blood diseases (B)</p> Signup and view all the answers

What is the primary reason for planning periodontal treatments before chemotherapy?

<p>To reduce the risk of oral infections (D)</p> Signup and view all the answers

Where is the most common site for traumatic neuroma in the oral cavity?

<p>Around the mental foramen (D)</p> Signup and view all the answers

Which of the following conditions is often associated with angular cheilitis?

<p>Glossitis (C)</p> Signup and view all the answers

What is the most important initial step in the treatment of angular cheilitis?

<p>Assessment for diabetes and anemia (C)</p> Signup and view all the answers

What is a key predisposing factor for angular cheilitis?

<p>Long-term use of broad-spectrum antibiotics (B)</p> Signup and view all the answers

Which of the following treatments is specifically recommended for metal dentures when treating angular cheilitis?

<p>Submersion in chlorhexidine solution (B)</p> Signup and view all the answers

Which group of individuals is particularly susceptible to actinic cheilitis?

<p>Men exposed to high sunlight levels (C)</p> Signup and view all the answers

What is the primary treatment method for a congenital granular gingival tumor?

<p>Surgical excision (C)</p> Signup and view all the answers

Which of the following correctly describes a characteristic of actinic cheilitis?

<p>The vermilion border may disappear. (C)</p> Signup and view all the answers

What treatment is most effective for simple contact cheilitis?

<p>Elimination of the causative substances. (D)</p> Signup and view all the answers

In exfoliative cheilitis, what is the primary complaint of patients?

<p>Burning sensation on the lips. (C)</p> Signup and view all the answers

What is a known risk factor for developing exfoliative cheilitis?

<p>Habitual lip-biting. (B)</p> Signup and view all the answers

What common condition can occur alongside perioral dermatitis?

<p>Eczema-like irritation on the surrounding skin. (D)</p> Signup and view all the answers

Which of the following statements about the treatment of exfoliative cheilitis is accurate?

<p>Antifungal ointments are a recommended treatment. (A)</p> Signup and view all the answers

What condition is characterized by epithelial atypia and potential transformation into cancer?

<p>Actinic cheilitis. (C)</p> Signup and view all the answers

Which of the following causes irritation in contact cheilitis?

<p>Certain foods. (C)</p> Signup and view all the answers

Flashcards

Gingival Enlargement

An increase in the volume of the gum tissue, making it appear excessively grown.

Localized Gingival Enlargement

A type of gingival enlargement that affects only a specific area of the gums.

Generalized Gingival Enlargement

A type of gingival enlargement that affects the entire gum tissue.

Marginal Gingival Enlargement

A type of gingival enlargement that primarily affects the gum tissue near the crown of the tooth.

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Focal Hyperplastic Gingivitis

A type of inflammatory and fibrous enlargement that occurs in the interdental papilla and is often caused by elevated hormone levels.

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Infective Gingivitis

A type of gingivitis caused by an infection, usually by streptococcus.

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Pubertal Gingivitis

A type of gingivitis seen during puberty, often under poor oral hygiene conditions.

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Pregnancy Gingivitis

A type of gingivitis seen during pregnancy, often under poor oral hygiene conditions.

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Peripheral Ossifying Fibroma

A fibrous growth on the gingiva, potentially containing bone and cementum. More common in women and typically requires excision.

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Pyogenic Granuloma

A tumor-like gingival enlargement arising from minor trauma. Characterized by a red, ulcerated, spherical appearance with pus discharge.

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Peripheral Giant Cell Granuloma

A benign growth on the gingiva, typically pedunculated or attached to a wide base.

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Atypical Gingivitis (Plasma Cell Gingivostomatitis)

A type of gingivitis characterized by redness, friability, and easy bleeding. Often associated with plasma cells.

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Inflammatory Fibrous Hyperplasia (Epulis Fissuratum)

Gingival enlargement caused by poorly fitting dentures, often in elderly patients. Characterized by bleeding and a fissured appearance.

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C-Vitamin Deficiency Gingival Enlargement

Gingival swelling caused by vitamin C deficiency. Features include marginal gingivitis, bleeding, pseudomembrane formation, and edema.

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Gingivitis in Mouth Breathers

Gingivitis seen in individuals who breathe through their mouth. Affects the anterior gingiva, often in young people.

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Drug-Induced Gingival Enlargements

Gingival enlargement triggered by certain medications, including phenytoin, cyclosporine, and nifedipine. Plaque and irritation can exacerbate the condition.

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Contact Cheilitis

A type of lip condition where the lips get irritated and peel due to contact with substances like lipsticks, certain medications, toothpaste, and even some foods or lip creams.

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Actinic Cheilitis

A common type of cheilitis that is caused by prolonged exposure to sunlight, often affecting the lower lip.

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Exfoliative Cheilitis

A type of cheilitis characterized by fissures, peeling, and crust formation on the lips, often associated with conditions like Candida albicans, oral sepsis, stress, and biting the lips.

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Exfoliative Cheilitis - Presentation

A type of cheilitis that starts as a single fissure near the middle of the lower lip and then spreads, forming multiple fissures that appear yellow-white or ulcerated with hemorrhagic crusts.

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Exfoliative Cheilitis - Patients

A type of cheilitis often seen in young women, where stress and tension are potential contributing factors.

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Contact Cheilitis - Treatment

Treating contact cheilitis involves identifying and eliminating the substance causing the allergy.

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Contact Cheilitis - Medication

Topical steroids are used to provide temporary relief for contact cheilitis.

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Actinic Cheilitis - Prevention

Actinic cheilitis, a precancerous condition, can be prevented by applying sunscreen.

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Angular Cheilitis

Refers to the condition involving inflammation of the skin and labial mucosa at the corners of the mouth, often seen in individuals over 50 and associated with dentures.

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Traumatic Neuroma

A common site for these lesions is where the mental nerve distributes, particularly around the mental foramen. Often associated with a history of nerve severance.

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Congenital Granular Gingival Tumor

It's a pedunculated tumor, often seen in the anterior maxilla of newborns.

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Angular Cheilitis Etiology

This condition can be caused by various factors including anemia, poor oral hygiene, broad-spectrum antibiotics, decreased vertical dimension, B group vitamin deficiencies, diabetes mellitus, xerostomia, and Sjogren's syndrome.

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Angular Cheilitis Treatment

Treat the underlying causes, such as diabetes or anemia. Ensure good oral hygiene. Correct the vertical dimension if needed. Use topical antifungal creams, like miconazole. Keep dentures in hypochlorite solution (bleach) or chlorhexidine solution to prevent candida infections.

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Traumatic Neuroma Treatment

These lesions are painful and require surgical excision. They often occur due to nerve severance.

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Congenital Granular Gingival Tumor Treatment

These lesions are often treated by surgical excision. This tumor is a benign condition.

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Tongue's Role in Jaw Development

The tongue's role in shaping the lower jaw, which is influenced by the pressure exerted by tongue muscles.

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Tongue's Role in Oral Hygiene

The tongue's ability to remove food debris from the gums and teeth, contributing to oral hygiene.

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Tongue's Role in Oral Moistening

The tongue's secretion of saliva, which keeps the mouth moist.

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Tongue's Immune Function

The tongue's involvement in the body's defense mechanism through its secretory immunoglobulin system.

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Tongue's Role in Suckling

The tongue's role in sucking, crucial for infants to feed from bottles or breasts.

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Functions of the Tongue

The tongue's various functions, including speech, chewing, digestion, taste, and protection.

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Extrinsic Tongue Muscles

The tongue's muscles that are attached to other structures outside the tongue and help with movement and positioning.

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Intrinsic Tongue Muscles

The tongue's muscles that are located within the tongue itself and responsible for its shape and movement.

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Glossodynia (Tongue Pain)

A condition characterized by pain, burning, or itching on the tongue, often caused by nutritional deficiencies, anemias, dry mouth, or metal poisoning.

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Tongue Paralysis (Glossoplegia)

A condition where the tongue is unable to move properly, commonly resulting from central nervous system issues like tumors, syphilis, or stroke. The paralyzed tongue will turn towards the healthy side when protruded.

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Tongue Spasm and Tremor

A condition where the tongue muscles involuntarily contract and tremble. It can be an early sign of general paralysis, or a symptom of various diseases.

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Tongue Anesthesia

A condition where the tongue experiences a loss of sensation. This can happen after injuries, due to infections, during anesthesia procedures, or from nerve damage during tooth extraction.

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Tongue Paresthesia

An abnormal sensation in the tongue, often described as numbness, burning, tingling, or needle-prick feeling. It may be triggered by irritation of the lingual nerve.

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Taste Disorders

A condition where the ability to taste is reduced (hypogeusia) or completely lost (ageusia). This can be caused by central or peripheral lesions, affecting the tongue mucosa, nose, or middle ear. It can be a symptom in the later stages of syphilis.

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Condyloma Acuminatum of the Tongue

A condition where the tongue exhibits multiple wart-like raised lesions on its upper surface. It can be easily confused with Median Rhomboid Glossitis.

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Median Rhomboid Glossitis

A condition where the tongue's midline features a raised, diamond-shaped area, often mistaken for Condyloma Acuminatum.

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Study Notes

Gingival Enlargements

  • Definition: Increase in gum volume or excessive gum growth.
  • Classification by Location:
    • Localized
    • Generalized
    • Marginal
  • Classification by Distribution:
    • Papillary
    • Diffuse
    • Isolated
  • Gingival Enlargement Grades:
    • Grade 0: No enlargement
    • Grade I: Enlargement limited to interdental papilla
    • Grade II: Enlargement includes papilla and marginal gingiva
    • Grade III: Enlargement covers more than three-quarters of crown
  • Normal Gingiva: Light pink, strip-like shape, distinguishable from redder vestibular mucosa.
  • Gingivitis: Local irritations (plaque, tartar, restorations, poor hygiene) can cause gingivitis. Infective gingivitis, is caused by an infection (like streptococcus), with intense leukocyte infiltration, edema, redness, swelling, and pain. Antibiotics are used to treat it.
  • Focal Hyperplastic Gingivitis: Hormonal-related inflammatory and fibrous enlargement in the interdental papilla, often seen during puberty and pregnancy, due to elevated estrogen levels.
  • Irritation Fibroma (Focal Fibrous Hyperplasia): A lesion seen on gingiva, lips, buccal mucosa, and tongue edges. Characterized by no color change and can persist for years. Histological exam is required.
  • Peripheral Ossifying Fibroma: A fibrous proliferation, potentially originating from periosteum or periodontal ligament, containing bone and cementum tissue. Often firm and pedunculated/non-pedunculated from interdental papilla. More common in women and excision is recommended.
  • Pyogenic Granuloma: Tumor-like gingival enlargement responding to minor trauma; spherical, ulcerated, red with purulent exudation. Treatment involves surgical excision.
  • Peripheral Giant Cell Granuloma: Pedunculated or attached. Histologically similar to pyogenic granuloma. If in bone, it is called a central giant cell granuloma. Surgical excision is the treatment.
  • Atypical Gingivitis (Plasma Cell Gingivostomatitis): Marginal/attached gingiva. Red, friable, easily bleeding. Plasma cell infiltration.
  • Inflammatory Fibrous Hyperplasia (Epulis Fissuratum): Caused by poorly fitted dentures. Often found in upper/lower buccal or labial vestibules. Lesion bleeds easily, commonly in elderly patients.

Additional Topics

  • C-Vitamin Deficiency: Characterized by marginal gingivitis, bleeding, pseudomembrane formation, surface necrosis, widespread edema, and collagen degeneration.
  • Gingivitis in Mouth Breathers: Swelling, redness, dryness, and shininess in the anterior gingiva in young people who breathe through their mouth.
  • Drug-Induced Gingival Enlargements: Phenytoin (Dilantin), cyclosporine, and nifedipine can cause gingival fibroblast proliferation, resulting in gum enlargement. Plaque and irritation can exacerbate this. Treatment involves local treatment as medications cannot be discontinued.
  • Hereditary Gingival Fibromatosis: Associated with hypertrichosis, craniofacial deformities, epilepsy, mental retardation. Diffuse gingival hyperplasia. Involves gingivectomy as treatment.
  • Malignant Fibrous Neoplasms: Aggressive, causes tissue damage. Fibrosarcoma (mandible) and malignant fibrous histiocytoma (maxilla) can develop. Treatment involves radical excision and sometimes jaw resection.
  • Leukemic Hyperplasia: Malignant disease of white blood cells. Often acute in children and young people, characterized by fever, fatigue, swelling of spleen and lymph nodes, and petechial bleeding. Often results in death in a few weeks.
  • Atypical/Other Discomfort/Injury:
    • Oral lesions: gingival enlargement, necrosis, bleeding, ecchymosis and necrosis in oral mucosa.
    • Neurological issues:
      • Neural Tissue related lesions (often in head and neck region):
      • Traumatic neuroma, mental nerve distribution site
      • Congenital Granular Gingival Tumor, anterior maxilla, surgical excision
  • Lip/Tongue Changes:
    • Angular Cheilitis (angular stomatitis, Perlesche): Acute/chronic inflammation at corners of mouth, often bilateral; fissures, erythema. Associated with denture stomatitis, glossitis, often in individuals over 50, and women.
    • Actinic Cheilitis: Epithelial atypia observed, hardness, and crust formation commonly on lower lip. Erythema (redness), edema/sensitivity, peeling (acute), and atrophy/keratosis (chronic) visible. Vermilion border may disappear in chronic cases.
  • Contact Cheilitis: Irritation/peeling of lips caused by contact with substances like lipsticks, medications, toothpaste, or lip creams (allergic reaction)
  • Perioral Dermatitis: Irritation limited to vermilion border or extending to the surrounding skin. Treatment: eliminate offending substance.
  • Exfoliative Cheilitis: Fissures, desquamation, hemorrhagic crust formation affecting lips in young women, associated with stressors, oral hygiene, etc. Treatment: eliminate predisposing factors and antifungal ointments.
  • Tongue Pain: (Glossodynia) Burning/itching in tongue. Many factors can cause it (nutritional deficiencies, anemias, xerostomia).
  • Taste Disorders: Reduction in taste sensation (hypogeusia or loss of taste (ageusia). Due to central or peripheral lesions. Possible causes: middle ear, nose, and tongue mucosa.

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