• Actinomycosis (Sulfur Granules):

  • Yellow sulfur granules: Are actually bacterial colonies.

  • Histopathology: Colonies appear "cotton wool" shaped. (Note: "Cotton wool appearance" is seen radiographically in Paget's disease).

• Tuberculosis (TB):

  • Diagnosis (Gold Standard): Presence of acid-fast bacilli in sputum.

  • Staining Method: Ziehl-Neelsen staining method is used to identify acid-fast bacilli.

  • Scrofula: TB of cervical lymph nodes.

  • Lupus Vulgaris: TB of skin.

• Tongue & Gingival Appearance in Systemic Conditions:

  • Strawberry tongue and Raspberry tongue: Seen in stomatitis of Scarlet Fever.

  • Strawberry Gingivitis: Seen in Wegener's Granulomatosis.

 Benign Migratory Glossitis

• Also called Erythema migrans, wandering rash, or geographic tongue.

• Associated with fissured tongue.

Fissured Tongue

• Seen in:

  • Melkersson-Rosenthal syndrome

  • Down syndrome

  • Benign migratory glossitis

Melkersson-Rosenthal Syndrome

• Triad:

  • Bell’s palsy

  • Cheilitis granulomatosa (lip/facial swelling)

  • Fissured tongue

Ankyloglossia

• Tongue-tie may cause speech defects.

• Affects articulation of: l, r, t, d, n, th, sh, z

Intraepithelial Bulla

• Location: Within the epithelium

• Associated Conditions:

  • Herpes simplex

  • Herpes zoster

  • Chicken pox

  • Pemphigus

  • Hailey-Hailey disease (Familial benign pemphigus)

  • Epidermolysis bullosa (dystrophic recessive form)

  • Oral lesions of erythema multiforme

 Subepithelial Bulla

• Location: Below the epithelium

• Associated Conditions:

  • Pemphigoid

  • Bullous pemphigoid (most common subepithelial blistering disease)

  • Bullous lichen planus

  • Dermatitis herpetiformis

  • Epidermolysis bullosa

  • Skin lesions of erythema multiforme

Leukoplakia

• Type: Clinical term
• Histology: Hyperkeratosis ± Dysplasia

Verrucous Carcinoma

• Type: Variant of SCC
• Features:
  • Intact basement membrane
  • Parakeratin plugging
  • Broad "elephant-foot" rete ridges

Adenosquamous Carcinoma

• Features: Mixed adenocarcinoma + SCC

 Streptococcus mutans Mechanism

• Key Substrate: Sucrose
• Metabolic Pathway: Phosphorylation → Glycolysis → Lactic acid
• Enzymes:
  • Invertase: Converts sucrose to glucose + fructose
  • Glucosyltransferase (GTF): Forms sticky glucans
  • Fructosyltransferase (FTF): Produces fructans

Actinomyces naeslundii

• Fimbriated surface → fuzzy texture
• Type 1 fimbriae: Bind tooth surfaces/collagen
• Type 2 fimbriae: Bind galactose/galactosamine (epithelial/bacterial targets)

• Radicular Cysts: Derived from Rests of Malassez.

• Impacted Canine Associations:

  • Most common odontogenic cyst: Dentigerous cyst.

  • Most common odontogenic tumor: Adenomatoid Odontogenic Tumor (AOT).

• Eruption Cyst: Considered an extra-alveolar dentigerous cyst (soft tissue counterpart).