18 Questions
What is the characteristic of the epithelium in pyogenic granuloma?
It is generally thin and atrophic
What is the main component of the connective tissue mass in pyogenic granuloma?
Granulation tissue
What is the presumed etiology of pyogenic granuloma?
Trauma leading to microbial invasion
What is the characteristic of the connective tissue in pyogenic granuloma?
It is delicate and vascular
What is the characteristic of the pregnancy tumor?
It is a well-defined gingival mass
What is the histological similarity between pyogenic granuloma and pregnancy tumor?
Both have a similar granulation tissue
What is the most common mechanism leading to the development of a soft tissue tumor-like lesion in the oral cavity?
Reactive hyperplasia
What is the result of chronic inflammation in the tissue site?
Formation of granuloma and fibrosis
What is the role of inflammatory cytokines in chronic inflammation?
Contributing to the progression of tissue damage
What is characteristic of the epithelium in tori?
Atrophic with no rete ridges
What is the characteristic of chronic inflammation in terms of duration?
Slow onset and long duration
What is a common predisposing factor for keratoacanthoma?
Sun exposure
What is the result of epithelial atrophy in tumor-like lesions?
Color lighter than normal due to epithelial atrophy
What type of bone is characteristic of tori?
Dense lamellar, cortical bone
What is an example of a cause of chronic inflammation?
Failure to eliminate the agent causing acute inflammation
What is a possible treatment for tori?
Surgical correction for repeated trauma or ulceration
What is the histological characteristic of tori?
Small amount of fibrofatty marrow
What is the cause of keratoacanthoma?
Unknown
Study Notes
Tumor-like Lesions (Fibrous Overgrowths)
- Definition: Any pathologic growth that projects above the normal contour of the oral surface
Pathophysiology
- Different mechanisms lead to development of soft tissue tumor-like lesions in the oral cavity
- Most common mechanism: Reactive hyperplasia due to inflammation
Inflammation
- Part of the body's defense mechanism to recognize and remove harmful foreign stimuli
- Acute inflammation: Rapid, severe, and short-term (e.g. acute pulpitis and acute periapical abscess)
- Chronic inflammation: Slow, long-term, and prolonged (e.g. chronic pulpitis and chronic periapical abscess)
General Features
- Submucosal and/or epithelial masses that may ulcerate when traumatized
- Color ranges: Lighter than normal (due to collagen or keratinization), reddish (due to epithelial atrophy or abundance of vascularized granulation tissue), or bleeds easily due to ulceration and increased vascularity
- Painless, as nerves do not proliferate with reactive tissue
Types of Tumor-like Lesions
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- Pyogenic granuloma
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- Peripheral fibroma and peripheral ossifying fibroma
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- Peripheral giant cell granuloma (PGCG)
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- Denture-induced fibrous hyperplasia (denture fissuratum)
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- Inflammatory papillary hyperplasia (palatal papillomatosis)
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- Fibro-epithelial polyp (leaf-like denture fibroma)
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- Generalized gingival hyperplasia (drug-induced) and fibromatosis
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- Tori and exostosis
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- Keratoacanthoma
Pyogenic Granuloma
- Etiology: Trauma → pathway to non-specific microbial invasion → oral mucous membrane
- Clinical: Elevated, smooth, lobulated, or warty mass, painless, soft, deep red or reddish purple, and easily hemorrhagic on slight touch
- Histology: Epithelium (thin, atrophic, eroded, or ulcerated), connective tissue mass (granulation tissue, endothelium-lined vascular spaces, and budding endothelial cells)
Pregnancy Tumor
- Etiology: Combination of dental plaque buildup, hormonal shifts, inadequate brushing, and poorly fitted fillings
- Clinical: Well-defined gingival mass, appears at about the third month of pregnancy or slightly later
- Histology: Similar to pyogenic granuloma
Tori and Exostosis
- Clinical: Exostosis (bony outgrowth), tori (bony protuberance on the palate or mandible)
- Histology: Dense lamellar, cortical bone with small amount of fibrofatty marrow
- Treatment: Surgical correction if exposed to trauma repeatedly or if ulcerated, surgical excision for denture construction
Keratoacanthoma
- Etiology: Unknown, but sun exposure is a common predisposing factor, virus-like intranuclear inclusions have been described in these lesions
Test your knowledge of oral pathology with this quiz covering various types of lesions, including pyogenic granuloma, generalized gingival hyperplasia, and keratoacanthoma. Learn about their etiology, clinical features, and more.
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