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Questions and Answers
Which gene is commonly associated with defects affecting 1st & 2nd branchial arch structures that leads to Treacher Collin's Syndrome?
Which gene is commonly associated with defects affecting 1st & 2nd branchial arch structures that leads to Treacher Collin's Syndrome?
What is the developmental timeline of a cleft lip with or without cleft palate?
What is the developmental timeline of a cleft lip with or without cleft palate?
Match the following oral condition with its description:
Match the following oral condition with its description:
Fissured tongue = Deep grooves on dorsal tongue Geographic tongue = Deep grooves with 2%-5% population prevalence Solitary varix = Dilated, tortuous veins as age-related degeneration
Which condition is characterized by double-headed condyle with the heads oriented more along the medial-lateral axis than the anterior-posterior axis?
Which condition is characterized by double-headed condyle with the heads oriented more along the medial-lateral axis than the anterior-posterior axis?
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What is the origin of a nasopalatine duct cyst?
What is the origin of a nasopalatine duct cyst?
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What is the name of the cyst that occurs in the upper lip, lateral to the midline?
What is the name of the cyst that occurs in the upper lip, lateral to the midline?
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Which of the following cysts is associated with misplaced nasolacrimal duct epithelium?
Which of the following cysts is associated with misplaced nasolacrimal duct epithelium?
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What is the name of the cyst that occurs in the hair follicle?
What is the name of the cyst that occurs in the hair follicle?
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Which cyst is the most common non-odontogenic cyst found in the oral cavity?
Which cyst is the most common non-odontogenic cyst found in the oral cavity?
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What is the location of a nasolabial cyst?
What is the location of a nasolabial cyst?
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What type of cyst is derived from thyroglossal tract remnants?
What type of cyst is derived from thyroglossal tract remnants?
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What is a characteristic of a dermatoid cyst?
What is a characteristic of a dermatoid cyst?
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Which of the following cysts is derived from the germlayer?
Which of the following cysts is derived from the germlayer?
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What is a characteristic of a gingival cyst?
What is a characteristic of a gingival cyst?
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Which of the following cysts is typically located in the nasolabial fold?
Which of the following cysts is typically located in the nasolabial fold?
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Which of the following cysts is a type of odontogenic cyst?
Which of the following cysts is a type of odontogenic cyst?
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What is the typical consistency of a dermatoid cyst?
What is the typical consistency of a dermatoid cyst?
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What is the origin of thyroglossal duct cysts?
What is the origin of thyroglossal duct cysts?
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What type of cyst is typically found in the midline of the neck?
What type of cyst is typically found in the midline of the neck?
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What type of cyst is typically found in the scalp?
What type of cyst is typically found in the scalp?
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What is the typical location of a Pilar cyst?
What is the typical location of a Pilar cyst?
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What is the causative factor for Gardner's syndrome?
What is the causative factor for Gardner's syndrome?
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What is a feature of a Trichilemmal cyst?
What is a feature of a Trichilemmal cyst?
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What is the characteristic feature of sebaceous glands in oral mucosa?
What is the characteristic feature of sebaceous glands in oral mucosa?
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Which syndrome is associated with blepharochalasis and double lip?
Which syndrome is associated with blepharochalasis and double lip?
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What is the etiology of Ascher syndrome?
What is the etiology of Ascher syndrome?
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Which of the following is NOT a characteristic of Ascher syndrome?
Which of the following is NOT a characteristic of Ascher syndrome?
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What is the prevalence of sebaceous glands in oral mucosa in the general population?
What is the prevalence of sebaceous glands in oral mucosa in the general population?
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What is the timing of developmental defect in congenital conditions?
What is the timing of developmental defect in congenital conditions?
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Study Notes
Cleft Lip and Palate
- Cleft lip: unilateral > bilateral, left > right
- Cleft lip with cleft palate: more common than isolated cleft lip
- Causes: genetic and environmental factors, maternal EtOH, smoking, anticonvulsants, retinoids, folate deficiency
Bifid Uvula
- A congenital invagination at the commissure of the lip
- Failure of fusion of maxillary and mandibular processes
Commissural Lip Pit
- Congenital invagination on the lower lip near the midline
- Persistence of lateral sulci of embryonic mandibular arch
Ascher Syndrome
- Characterized by double lip, blepharochalasis (edema of the upper eyelid), and non-toxic thyroid enlargement
- Etiology unknown, thought to be autosomal dominant
Ectopic Sebaceous Glands
- Normal anatomic variation found in 80% of the population
- Not truly "ectopic" as they are present in the oral mucosa
Abnormal Tongue Size and Shape
- Hypoglossia (abnormally small tongue): rare, associated with oromandibular limb hypogenesis syndrome
- Macroglossia (enlarged tongue): congenital or acquired, associated with Beckwith-Wiedemann syndrome
Ankyloglossia (Tongue-Tie)
- Failure of descent of the thyroid anlage (3rd to 4th week of development)
- Can be treated with diode laser treatment
Melkersson-Rosenthal Syndrome
- Idiopathic, characterized by intraoral and facial swelling
- Associated with fissured tongue and cheilitis
Fissured and Geographic Tongue
- Fissured tongue: deep grooves on the dorsal surface, found in 2%-5% of the population
- Geographic tongue: benign condition characterized by loss of papillae on the tongue surface
Varices
- Solitary varix: a dilated, tortuous vein, often seen in older adults
- Sublingual varices: relatively common in adults >60 years old
Caliber-Persistent Artery
- A relatively large-caliber artery in a superficial location, often seen in older adults
- May be associated with systemic diseases or trauma
Condylar Hyperplasia
- Unilateral or bilateral enlargement of the condylar head
- Causes: unknown, may be associated with local circulatory problems, endocrine influences, or trauma
Double-Headed Condyle
- Medial-lateral > anterior-posterior heads
- Possible causes: trauma, abnormal muscle attachment, or teratogens
Reactive Subpontine Exostosis
- Localized bony protuberances from the cortical plate
- Causes: unknown, may be associated with genetic and environmental factors, masticatory stress, or heredity
Torus Mandibularis and Torus Palatinus
- Torus mandibularis: a bony outgrowth on the lingual surface of the mandible
- Torus palatinus: a bony outgrowth on the hard palate
Calcified Stylohyoid Ligament or Elongated Styloid Process
- Can impinge on adjacent nerves and vessels
- May occur after tonsillectomy or neck trauma
Stafne Bone Defect
- A lingual cortical concavity of the mandible
- May contain salivary glands, fibrous tissue, or fat
Epstein Pearls
- Small, benign cysts found on the gums or roof of the mouth in neonates
- Formed from embryonic remnants of the dental lamina### Gardners Syndrome
- Caused by APC mutations
- Characterized by keratin-filled cysts arising from hair follicles in skin (Pilar cyst)
Developmental Cysts
- Benign cystic form of teratoma, derived from dit germlayer
- Sublingual dermoid cyst: a case of extending the limits of the oral approach
- Thyroglossal duct cyst: developmental cyst derived from thyroglossal tract remnants
- Branchial cleft cyst: origin from epithelial remnants of branchial arches (especially 2nd arch)
Branchial Cleft Cyst
- Possible estrogen dependency in pathogenesis
- Unusually rapid development of a lateral neck mass: diagnosis and treatment
- Anterior to SCM, treatment: surgical removal, prognosis: recurrence rare
Mandible Maxilla
- Lymphoepithelial cyst: rare developmental condition, etiology unknown
- Atrophy on one side of face, etiology unknown (trauma, Lyme disease, or form of localized scleroderma?)
Craniosynostosis Syndromes
- FGFR2 mutations, autosomal dominant, often sporadic (increased paternal age)
- Characterized by "beaten metal" pattern
Specific Syndromes
- Apert Syndrome: FGFR2 mutations, autosomal dominant, often sporadic (increased paternal age)
- Characterized by defects of 1st and 2nd branchial arch structures
- Treacher Collins Syndrome: TCOF1 mutations, autosomal dominant, 1 in 50,000 births
- Characterized by defects of 1st and 2nd branchial arch structures
Nasolabial Cyst
- Most common non-odontogenic cyst in the oral cavity
- Affects approximately 1% of the population
- Originates from remnants of the nasopalatine duct
- Theories on origin: fissural cyst vs. misplaced nasolacrimal duct epithelium
Nasopalatine Duct Cyst
- Benign cystic form of teratoma
- Derived from the germ layer
- Can be treated with volumetric reformatting
Sublingual Dermoid Cyst
- Developmental cyst derived from thyroglossal tract remnants
- Can extend to the oral approach
Pilar Cyst
- Keratin-filled cysts arising from hair follicles in the skin
- Also known as trichilemmal cysts
Thyroglossal Duct Cyst
- Developmental cyst derived from thyroglossal tract remnants
- Can be associated with Gardner's syndrome, caused by APC mutations
Branchial Cleft Cyst
- Originates from epithelial remnants of branchial arches (especially the 2nd arch)
- Can be estrogen-dependent in pathogenesis
- Can have an unusually rapid development
Other Cysts
- Sebaceous cysts: normal anatomic variation in the oral mucosa (affects 80% of the population)
- Ascher syndrome: associated with double lip, blepharochalasis, and non-toxic thyroid enlargement
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