FK-6-General and disease-specific pathology to assess patient risk-DIAGNOSIS AND TREATMENT PLANNING

Acoustic Schwannoma and Cranial Nerve Involvement

• A 62-year-old female presents with right-sided hearing loss, tinnitus, and dizziness
• An acoustic schwannoma occluding the right internal acoustic meatus (IAM) is diagnosed
• The vestibulocochlear nerve (CN VIII) is most likely involved to cause these symptoms
• The vestibulocochlear nerve (CN VIII) is responsible for hearing and balance
• An acoustic schwannoma in the IAM would likely compress the vestibulocochlear nerve (CN VIII), leading to hearing loss and dizziness
• The facial nerve (CN VII) also passes through the IAM and it can be affected, causing tinnitus

Penicillin Allergy and Cephalosporin Cross-Allergenicity

• It is important to consider the cross-allergenicity when prescribing cephalosporins to a patient who is allergic to penicillin
• It is important to know the statistical likelihood of cross-reactivity to assess the risk of an allergic reaction

Expected Tooth Eruption in 1-Year-Olds

• At approximately 1 year of age, a child is typically expected to have erupted their primary central incisors, lateral incisors, and first molars in both the maxillary and mandibular arches

Diagnosing Symptomatic Irreversible Pulpitis

• Lingering pain to thermal stimulation, spontaneous pain, and referred pain are classic signs of symptomatic irreversible pulpitis
• Accurate pulpal diagnosis is the first step in treatment planning for endodontic conditions and assessing the risk of further pulpal and periapical inflammation

Diagnosis of Acute Apical Abscess

• Rapid onset of spontaneous pain, a nonresponsive pulp, tenderness of the tooth to pressure, pus formation, and swelling of associated tissues indicates an acute apical abscess

Characteristics of Enamel Hypocalcification

• Enamel hypocalcification is a defect resulting in enamel with a reduced mineral content, leading to a decreased quantity of enamel
• Enamel with a reduced mineral content is also softer than normal

Potential Complications in Patients with Cerebral Palsy

• Cerebral palsy patients often experience motor impairments affecting oral hygiene practices, mastication, and swallowing, which can lead to a higher risk of periodontal disease, caries, and attrition

Muscle Weakness Causing Mandibular Deviation

• Weakness of the right lateral pterygoid muscle will cause the mandible to deviate to the left upon opening because the left lateral pterygoid, unopposed, pulls the mandible to its side

Degree of Gingival Enlargement

• Grade I medication-related gingival enlargement involves the papillae and marginal gingiva with enlargement covering less than one-third of the crown

Risk of Fluoride Exposure

• Exposure to high levels of fluoride during tooth development can lead to moderate dental fluorosis
• Since tooth development is largely complete by age 15, the primary risk with high level fluoride exposure is fluorosis, not caries reduction or significant bone fluoride uptake

Significance of Glossy Zinc Polycarboxylate Cement

• A glossy appearance of zinc polycarboxylate cement indicates the presence of free carboxylic acid groups, which can cause pulpal irritation

Characteristics of Chronic Caries

• Chronic caries typically progresses slowly, may become arrested, is more common in adults, and often presents with a small entrance and a deep, narrow lesion

Favorable Factors for Avoiding Root Canal Treatment

• Small mechanical exposures in asymptomatic teeth with healthy-appearing pulp tissue have a better prognosis for direct pulp capping compared to large carious exposures or symptomatic teeth

Indication of Symptomatic Irreversible Pulpitis

• The patient's behavior of tilting their head to avoid contact of cold water with a specific area suggests significant pain upon stimulation, consistent with symptomatic irreversible pulpitis

Key Indicator of Symptomatic Irreversible Pulpitis

• Lingering pain lasting several seconds after removal of the cold stimulus is a key indicator of symptomatic irreversible pulpitis

Enamel Hypoplasia

• Enamel hypoplasia results from a disturbance during enamel matrix formation, leading to a defect in the quantity of enamel

Greenish Discoloration of Primary Teeth

• Greenish discoloration of primary teeth can be associated with erythroblastosis fetalis (Rh incompatibility) during pregnancy, where bilirubin deposition occurs in the developing enamel and dentin

Characteristics of Neurofibromas

• Neurofibromas are benign nerve sheath tumors composed of Schwann cells, perineural fibroblasts, and axons
• Neurofibromas are typically not encapsulated and can occur intraosseously

Origin of Granular Cell Tumors

• Granular cell tumors are thought to be of neural or Schwann cell origin, not skeletal muscle origin

Severe Oral Epithelial Dysplasia (OED)

• Severe oral epithelial dysplasia (grade-3) or carcinoma in situ exhibits marked cellular and nuclear pleomorphism and abnormal proliferation extending into the upper third of the epithelium

Developmental or Fissural Cysts

• Nasopalatine duct cysts, nasolabial cysts, and median palatal cysts are considered developmental or fissural cysts, arising from epithelial remnants trapped along embryonic fusion lines

Characteristics of Central Giant Cell Granulomas

• Central giant cell granulomas are more common that peripheral giant cell granulomas, occur predominantly in children and young adults, and show a predilection for females
• They are found in the jaws, not primarily in the small bones of the hands and feet

Tongue Deviation After Stroke

• Following a stroke on one side of the brain, the tongue deviates to the opposite side on protrusion
• A stroke on one side of the brain typically affects the contralateral hypoglossal nerve innervation to the tongue.
• The genioglossus muscle on the unaffected side will be stronger, causing the tongue to deviate towards the paralyzed side (the right in this case) upon protrusion

Palate Sensory Innervation

• Sensory innervation to the palate is supplied by CN V2 (maxillary division), and motor innervation to the tensor veli palatini is supplied by CN V3 (mandibular division)
• A greater palatine block can anesthetize the palate as anteriorly as the maxillary canine

Anatomical Evaluation of Implant Site

• Cross-sectional imaging, such as cone-beam computed tomography (CBCT), provides the most detailed three-dimensional view of the alveolar bone, allowing for accurate assessment of bone width, height, and the location of vital structures, which is crucial for implant treatment planning and risk assessment