NEET MDS Lessons
Oral Pathology
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
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Retention Cyst of Maxillary Sinus: Characteristic X-ray feature is a dome-shaped/hemispherical radio-opacity in the antrum.
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Abfraction: Appears as a subgingival, deep, narrow "V" shaped notch in the cervical areas of teeth.
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Abrasion vs. Abfraction:
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Abrasion: Commonly affects cuspids and bicuspids.
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Abfraction: Affects only a single tooth (adjacent tooth is unaffected).
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Erosion (Gastric): Erosion due to gastric secretions is termed Perimolysis.
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Radicular Cysts: Derived from Rests of Malassez.
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Impacted Canine Associations:
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Most common odontogenic cyst: Dentigerous cyst.
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Most common odontogenic tumor: Adenomatoid Odontogenic Tumor (AOT).
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Eruption Cyst: Considered an extra-alveolar dentigerous cyst (soft tissue counterpart).
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Solitary Bone Cyst (Traumatic Bone Cyst): Usually situated above the inferior dental canal.
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Stafne's Bone Defect (Static Bone Cavity/Lingual Mandibular Bone Defect): Located below the inferior dental canal. (Note: Stafne's is a pseudocyst/developmental defect, not a true cyst).
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Calcifying Odontogenic Cyst (COC) / Gorlin Cyst: Characterized by Ghost Cells.
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Aneurysmal Bone Cyst (ABC): Associated with a "blood-soaked" appearance on gross examination.
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Radicular Cyst - Common Site: Maxillary anterior teeth (due to higher incidence of trauma).
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Odontogenic Keratocyst (OKC) / Keratocystic Odontogenic Tumor (KCOT):
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Most common site: Posterior mandible (similar to ameloblastoma).
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Expansion: Tends to expand antero-posteriorly; buccal and lingual expansion seen in late stages.
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Basal layer histology: Tall columnar cells with palisaded nuclei – "row of tombstones" or "picket fence appearance."
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Classification: Now considered a benign odontogenic neoplasm (KCOT) in recent WHO classifications.
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Epithelial Plaques (localized thickenings): Found in:
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Lateral Periodontal Cyst
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Botryoid Odontogenic Cyst
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Gingival Cyst of Adults
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Glandular Odontogenic Cyst
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