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Oral Pathology - NEETMDS- courses
NEET MDS Lessons
Oral Pathology

  • Dentigerous Cyst (Follicular Cyst):

    • Most common Developmental Odontogenic Cyst.

    • Always associated with the crown of an unerupted/impacted tooth.

    • Derived from Reduced Enamel Epithelium (REE).

    • Differential diagnosis: Eruption cyst, Paradental cyst (also from REE).

  • Nasopalatine Duct Cyst (Incisive Canal Cyst/Median Anterior Maxillary Cyst - MAMC):

    • Most common Developmental Non-odontogenic Cyst.

    • Located in the midline of the anterior maxilla.

  • Radicular Cyst (Periapical Cyst):

    • Most common Odontogenic Cyst overall.

    • Always associated with a non-vital tooth.

    • Inflammatory origin.

  • Odontogenic Keratocyst (OKC) / Keratocystic Odontogenic Tumor (KCOT):

    • Primordial Cyst: An OKC found in place of a missing tooth.

    • Protein Content: Less than 4 gm/dL.

    • Aggressive Behavior: High mitotic activity, high PCNA index, and Ki67 activity.

    • Derived from Rests of Serres (remnants of dental lamina).

  • Mucocele:

    • Common term for:

      • Mucous Extravasation Phenomenon (Pseudocyst): No epithelial lining.

      • Mucous Retention Cyst (True Cyst): Has an epithelial lining.

  • Lichen Planus:

    • Reticular form: Most common type, characterized by Wickham's striae.

    • Malignant potential: Atrophic and erosive forms are associated with significant malignant transformation risk.

    • Histology: Saw-tooth shaped rete pegs.

  • Solar Elastosis: Characterized clinically by "sailor's skin" or "farmer's skin" (due to chronic sun exposure).

  • Psoriasis & Hereditary Gingival Fibromatosis: Both show test tube-shaped rete pegs histologically.

  • LE Cell Test: LE cells represent rosettes of neutrophils that have phagocytosed other leukocytes (seen in Systemic Lupus Erythematosus).

  • Tzanck Cells: Seen in vesiculobullous conditions like Pemphigus, Herpes Simplex, Varicella, Herpes Zoster, and CMV infection.

  • Ectodermal Dysplasia: Characterized by truncated, conical teeth and missing teeth (hypodontia).

  • Widened Periodontal Ligament Space: Extreme widening seen in Scleroderma and Osteosarcoma.

  • Geographic Tongue & Psoriasis: Share a common histological feature: Munro's abscesses (neutrophilic microabscesses).

Condition

Key Features

Paget's Disease

- Denture tightening (arch expansion)
- Chalk-stick fractures
- Leontiasis ossea

Osteopetrosis

- Rugger jersey spine
- Chalk-stick fractures

Fibrous Dysplasia

- Leontiasis ossea
- Chinese script trabeculae
- Ground glass appearance
- Hockey stick femur

Cemento-Ossifying Fibroma

- Leontiasis ossea
- Chinese script trabeculae

Hyperparathyroidism

- Ground glass appearance (Brown tumor)
- Giant cells + vascular stroma + hemosiderin

Cherubism

- Giant cells + vascular stroma + hemosiderin

Central Giant Cell Granuloma

- Giant cells + vascular stroma + hemosiderin

Juvenile Ossifying Fibroma

- More aggressive than COF
- Trabecular type → jaws
- Psammomatoid type → skull base

Mnemonics Flashcards

Mnemonic

Meaning

Paget's Patients Prefer Tight Dentures

Paget's → Denture tightening due to arch expansion

Fibrous Faces Feel Funny

Fibrous dysplasia → Leontiasis ossea, Chinese script, Ground glass, Hockey stick femur

Giant Cells Have Three Homes

Seen in: Hyperparathyroidism, Cherubism, CGCG

Leukoedema

  • Diagnostic Feature: Lesions do not rub off; disappear when cheek is stretched

Heck's Disease (Focal Epithelial Hyperplasia)

  • Appearance: Cobblestone mucosa
  • Also Seen In: Pyostomatitis vegetans, Keratosis follicularis

Infectious Mononucleosis

  • Nickname: Kissing disease
  • Etiology: Epstein–Barr Virus (EBV)

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

  • Pioneer Bacteria: S. mutans are considered pioneer bacteria as they multiply and synthesize extracellular matrix polymers, initiating biofilm formation.

  • Caries Progression - Key Bacteria:

    • Initiation of caries: S. mutans.

    • Progression of caries / Dentinal caries: Lactobacillus.

    • Root surface caries: Actinomycetes.

  • Body of the Lesion (Enamel Caries): Shows increased prominence of the striae of Retzius.

  • Sugar Intake: Frequency of sugar intake is of more importance than the total amount consumed in caries development.

Epithelial cysts

    Developmental odontogenic cysts
        Odontogenic keratocyst
        Dentigerous cyst (follicular cyst)
        Eruption cyst
        Lateral periodontal cyst
        Gingival cyst of adults
        Glandular odontogenic cyst (sialo-odontogenic)
        
        
    Inflammatory odontogenic cysts

        Radicular cyst (apical and lateral)
        Residual cyst
        Paradental cyst
        
    Non-odontogenic cysts

        Nasopalatine cyst
        Nasolabial cyst
    
Non-epithelial cysts (not true cysts)

    Solitary bone cyst
    Aneurysmal bone cyst

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