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Oral Pathology - NEETMDS- courses
NEET MDS Lessons
Oral Pathology

  • Blood: Aneurysmal bone cyst, Vascular lesion, Vessel puncture.

  • Air: Traumatic bony cyst (Simple Bone Cyst/Hemorrhagic Bone Cyst), Maxillary sinus.

  • Chocolate Colored Fluid: Warthin's Tumor (salivary gland cyst).

Gemination

  • Attempted division of a single tooth germ before calcification.

  • Results in two crowns (complete/incomplete) with one root and canal.

  • Tooth count remains normal.

  • Difficult to differentiate from fusion with a supernumerary tooth.

 Twinning

  • Complete division of a single tooth germ.

  • Results in one normal + one supernumerary tooth.

  • Tooth count is more than normal.

Fusion

  • Union of two separate tooth germs.

  • If before calcification → single large tooth.

  • If after calcification → roots fused, crowns may be separate.

  • More common in deciduous teeth.

Concrescence

  • Union by cementum only.

  • Occurs after root formation.

  • Common in maxillary molars.

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

Macroglossia

  • Feature: Crenated (scalloped) lateral tongue borders

Lymphangioma of Tongue

  • Appearance: Tapioca pudding/Frog's egg

Geographic Tongue

  • Associated With: Fissured tongue
  • Histopathology: Similar to psoriasis
  • Key Feature: Munro's abscesses

Median Rhomboid Glossitis

  • Unique Sign: "Kissing lesion" on soft palate due to tongue contact

Hairy Tongue

  • Misnomer: Elongated filiform papillae—not actual hair

Disease Serum Marker Changes
Paget’s Disease ↑ Alkaline phosphatase
Caffey’s Disease Fibrous dysplasia; may show ↑ alkaline phosphatase
Hyperparathyroidism ↑ Alkaline phosphatase
Osteopetrosis (Marble Bone Disease) ↑ Acid phosphatase
Osteogenesis Imperfecta Normal calcium & phosphate; ↑ bone fragility due to collagen defect
Chondrodysplasia Normal alkaline phosphatase
Odontogenic Myxoma ↑ Acid phosphatase
Thalassemia Prominent premaxilla; marrow expansion may affect jaw bones

Exception Alert: Serum alkaline phosphatase is raised in all of the following except: ➡️ Osteogenesis Imperfecta

📝 QUICK MEMORY AIDS

  1. "Paget's Patients Prefer Tight Dentures" - Paget's disease causes denture tightening
  2. "Fibrous Faces Feel Funny" - Fibrous dysplasia features (leontiasis, Chinese script, ground glass, hockey stick)
  3. "Giant Cells Have Three Homes" - Hyperparathyroidism, Cherubism, Central Giant Cell Granuloma

⚡ HIGH-YIELD FACTS

  • Chalk-stick fractures: Paget's disease & Osteopetrosis
  • Leontiasis ossea: Paget's, Fibrous dysplasia, Cemento-ossifying fibroma
  • Chinese script pattern: Fibrous dysplasia & COF
  • Ground glass appearance: Fibrous dysplasia & Hyperparathyroidism
  • Giant cells + vascular stroma + hemosiderin: Hyperparathyroidism, Cherubism, CGCG
  • Triads to remember: Hutchinson's, Melkersson-Rosenthal, Ascher syndrome

 General Features

  • Caused by mutation in DSPP gene (dentin sialophosphoprotein).

  • Teeth appear translucent or opalescent.

  • Enamel fractures easily due to poor dentin support.

  • Pulp chambers are obliterated or enlarged depending on type.

  • Also called Hereditary Opalescent Dentin or Shell Teeth.

Type II DI

  • Pulp chambers are normal but rapidly obliterate.

  • Associated with progressive hearing loss.

Type III DI

  • Pulp chambers are large and shell-like.

  • Seen in Brandywine isolate population.

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