Oral Conditions: Cleft and Fissured Tongue

Study Notes

Occurs due to the lack of merging of lateral lingual swellings.
A complete cleft tongue is a rare condition where the tongue is split in two.
A partial cleft tongue is more common and is characterized by a deep groove in the midline of the dorsal surface of the tongue.

Deep fissures may be seen in children or adults but increase with age.
Down syndrome and Melkersson-Rosenthal Syndrome are associated with fissured tongues.
Histologic examination shows an increase in the thickness of the lamina propria, loss of filiform papillae of the surface mucosa, hyperplasia of the rete pegs, neutrophilic micro abscesses within the epithelium, and a mixed inflammatory infiltrate in the lamina propria.

Central papillary atrophy of the tongue/posterior lingual papillary atrophy.
It is an asymptomatic elongated erythematous patch of atrophic mucosa on the mid-dorsal surface of the tongue.
Etiology is unknown but may be due to vascular or lymphatic absence, CNS disturbances, or chromosomal absence.

Malformation: A defect due to localized error in morphogenesis resulting in an abnormal shape or structure, with interference in function. e.g., cleft palate.
Deformation: An alteration in shape or structure of a previously normally formed part. e.g., torticollis.
Anomaly: Any deviation from normal. It is the same as malformation, but there is no interference with function. e.g., peg-shaped lateral incisors.
Anomalad: Malformation and subsequently derived structural changes. e.g., abnormal matrix structure & mineral deposition.

Type II: Both dentitions are affected. The tooth has a cheesy consistency.
Type III: Similar to type II, but with multiple pulp exposures, periapical radiolucencies, and variable radiographic appearance. Both dentitions are affected.
Histologic Features: Enamel and mantle dentin are normal. Dentin is composed of irregular tubules with large areas of uncalcified matrix. The widening of the pre-dentin layer. Remaining dentin is severely dysplastic and exhibits vast areas of inter-globular dentin. Dentinal tubules are short, disoriented, irregular, and widely spaced. Scanty odontoblasts line the pulp and can be seen in the defective dentin. The DEJ is smooth.

A condition where a child has a very small lower jaw.
Bird face appearance.
Two Types:
- True Micrognathia:
  - Congenital: Present at birth.
  - Acquired: Develops after birth.
- Pseudo Micrognathia: The apparent size of the mandible is affected, but the jaw itself is normal.