Developmental Anomalies Of Oral Tissues PDF

Developmental anomalies of oral tissues Dr. Heba Elhendawy Associate professor of Oral Pathology 1 Orofacial Clefts + Anomalies 2 Tongue Anomalies 3 Exostoses  Orofacial clefts Cleft lip Cleft palate Pathogenesis & incidence - Cleftlip: Failure of fusion betw...

Developmental anomalies of oral tissues Dr. Heba Elhendawy Associate professor of Oral Pathology 1 Orofacial Clefts + Anomalies 2 Tongue Anomalies 3 Exostoses  Orofacial clefts Cleft lip Cleft palate Pathogenesis & incidence - Cleftlip: Failure of fusion between medial nasal processes and maxillary processes. - During 6th and 7th week intrauterine life. - Incidence: - 45% cleft lip and palate together. - 30% isolated cleft palate. - 25% isolated cleft lip. - 80% unilateral cleft lip. - 20% bilateral cleft lip. - 70% unilateral cleft lip on the left side. - Cleft lip and palate more common in males. - Isolated cleft palate is more in females.  Clinical picture - Failure contact between soft palate and pharyngeal wall. - Feeding and swallowing problems. - Speech→ hyper nasal voice. - Respiratory difficulty (Asphyxia) - Psychosocial difficulty. - Dental abnormality (missing, supernumerary, microdontia, macrodontia, hypoplasia of enamel, malocclusion. Veau`s class 1: Unilateral notching of the vermilion border doesn`t extend into the lip.  Class II Unilateral notching involving the lip only, not extend to the base of nose (incomplete cleft) Class III Unilateral complete cleft involves the lip and floor of the nose. Class IV Bilateral cleft notching or complete cleft. Class IV b- cleft palate Medial nasal processes merge to form the primary palate. The palatine shelves fuse to form secondary palate. Fusion between primary and secondary palate starts from anteriorly (8 Weeks) then progress posteriorly (12 weeks completed). Veau classification Class I (bifid uvula) Soft palate cleft. Class II Cleft in soft & hard palate not extend beyond incisive foramen. (incomplete)  Class III Complete cleft extend in soft and hard palate and pass incisive foramen unilaterally through the alveolar process. Class IV Complete bilateral cleft involving soft and hard palate and alveolar prosses on both sides of premaxilla leaving it free and mobile. Class IV  DOUBLE LIP A redundant fold of tissue partially covers the right anterior maxillary teeth. Types: 1. Congenital. 2. Acquired: a component of Ascher syndrome, or it may result from trauma or oral habits, such as sucking on the lip. 2- TONGUE ANOMALIES Macroglossia Macroglossia: enlarged tongue. Causes: congenital malformation or acquired disease. C/P: - Noisy breathing, drooling of saliva, difficulty in eating and speaking. - Crenated lateral border of the tongue & ulceration and necrosis. - Open bite, mandibular prognathism, if sever cause asphyxia. Congenital causes: 1. Lymphangioma and hemangioma. 2. Down syndrome: papillary, fissured tongue. 3. Neurofibromatosis: multinodular appearance. 4. Beckwith Wiedemann syndrome (visceral tumors as adrenal carcinoma, hepatoblastoma, kidney tumors). Acquired cause: 1. Amyloidosis→ deposition of abnormal protein in tissues. 2. Hemifacial hyperplasia→ unilateral tongue enlargement. 3. Edentulous cases. 4. Tumors Amyloidosis Hemifacial hyperplasia lymphangiomas  Microglossia - Isolated or syndrome associated. - Cleft palate. - Micrognathia. - Missing of lower incisors. Microglossia. Abnormally small tongue associated with constricted mandibular arch and maxillary arch.  Ankyloglossia= tongue tie Short lingual frenum.  Lingual Thyroid Nodule - Asymptomatic to large mass at dorsum of tongue in area of foramen cecum. - Primitive thyroid nodule. - Thyroid scan, MRI, CT scan. - Incisional biopsy is avoided due to risk of hemorrhage. Lingual Thyroid Nodule  FISSURED TONGUE - Burning sensation. - Mekerson Rosenthial syndrome. FISSURED TONGUE (SCROTAL TONGUE)  GEOGRAPHIC TONGUE Areas of atrophy and hypertrophy of tongue papilla. GEOGRAPHIC TONGUE  Hairy Tongue Marked elongation and brown staining of the filiform papillae, resulting in a hairlike appearance.  VARICOSITIES (SUBLINGUAL VARIX) ▪ Abnormal dilated tortuous vein. ▪ Common in old age. Tongue & lower lip varicosities FORDYCE GRANULES ▪ Sebaceous glands that occur on the oral mucosa. ▪ Incidence: more than 80% of the population. ▪ Is considered normal anatomic variation or ectopic tissue. Clinical Features ▪ Multiple yellow or yellow-white papules. ▪ Site: buccal mucosa (common) and lateral portion of the vermilion of the upper lip. H/P: Multiple sebaceous glands below the surface epithelium. 3- EXOSTOSES  Torus palatinus Localized bony protubrances arise from cortical plate. Benign condition common in adults. Site: palatal vault. Dental complication: fitting of denture H/P: mass of dense lamellar bone with small amount of fibro-fatty marrow.  Torus mandibularies Bony protuberances arise from the inner aspect of the mandible. Exostoses. Multiple buccal exostoses of the maxillary and mandibular alveolar ridges. NAME THE TYPE OF ANOMALY PRESENTED IN THE IMAGES NAME THE TYPE OF CLEFT PRESENTED IN THE IMAGES Name the type of anomaly in each image  Match 2 A-Hemifacial hyperplasia 1 B-macroglossia C-douple lip 3 D-Microglossia E-Lingual Thyroid Nodule 4 5 F-lymphangiomas G- Lingual varices  Match A B 1Geographic tongue 2Lingual thyroid nodule 3 Fissured tongue 4 Ankyloglossia 5 Sublingual varix D C Thank you