Oral and Maxillofacial Pathology - Tips and Tricks: Your Guide to Success

By Adel M Abdel-Azim and Ahmed A Abdel-Azim

A unique book that collects similar disease manifestations, related histopathological features, similar confusable cell names, phenomena, radiographic pictures, and important syndromes. The book is indispensable for the last-minute review of the pathology before you are subjected to written, oral, practical, chair-side exams or board certification.

• Language: English
• Publisher: theWay
• Release date: Dec 29, 2019
• ISBN: 9781734188226

Adel M Abdel-Azim

Adel M Abdel-Azim, MDSC, PhD Dr. Adel M Abdel-Azim is the professor and former chairman of oral pathology in the Faculty of Dentistry, Ain Shams University. He also held the position of professor of oral pathology at the Faculty of Dentistry, King Abdulaziz University in Jeddah, KSA for 10 years. Additionally, He acted as a visiting professor in Glasgow and many other Arab countries. He has over 40 years of experience in teaching pathology, oral pathology, oral medicine and oral diagnosis for postgraduate, undergraduate dental students, dental assistants, and dental hygienists. Dr. Adel supervised many Master and Ph.D. theses and has a distinguished record of 25 publications in reputable academic journals all over the world. Dr. Adel is interested and expert in using free open source software (FOSS) in scientific, medical and dental research. Starting from operating systems such as Debian, Ubuntu, Linux Mint, Manjaro, and Arch Linux and ending with ImageJ (an image analysis software) are all the major interests of Dr. Adel. He is expert in (1) free operating systems, (2) free graphics software (Inkscape, Gimp, Dia, FreePlane and FreeMind), (3) desktop publishing software (Scribus, LaTeX, and LyX), (4) free statical software (R, R-friends, Jamovi, and JASP, (5) plotting, data analysis and scientific visualization software ( QtiPlot and SciDAVis), (6) image analysis software (ImageJ and Fiji). These interests granted him the ability to master scientific books and article editing. He believes that “I am using FOSS, then I am free”. He started using commercial cousins such as (Adobe Indesign, Adobe Illustrator, Photoshop and SPSS) of this software then shifted completely into the FOSS. Dr. Adel is also interested in many agricultural, horticultural, animal husbandry and production systems aiming at sustainable, clean, alternative strategies with integrated agriculture that promote the reduction of poverty in developing countries and producing safe food for man. He is the owner of two farms in Egypt to apply his thoughts and practice.

Book preview

2 Normal Variants That Could be Mistaken as Disease

Some normal variants of the oral mucosa or teeth might be mistaken as diseases. The general practitioner should be aware of them.

2.1 Cusp of Carabelli

Is an extra cusp or tubercle or groove found on the palatal surface of the upper first molar and to a lesser extent in the upper second molar.

This cusp may be entirely absent in some individuals and present in others but in a variety of sizes, sometimes very prominent, and in other instances, be very small and unrecognizable.

Most common among Europeans (75–85% of individuals).

It was found that more than half of the Saudi population have a degree of expression of the Carabelli cusp and the Carabelli trait is associated with increased caries incidence [5].

It appears to be genetically determined.

2.2 Peg-shaped Lateral Incisor

A peg-shaped lateral is a small, tapered, maxillary lateral incisor.

The tooth is conical in shape and tapers incisally to a blunt point.

Peg shaped teeth develop from a single lobe instead of four.

The condition appears to have a genetic basis.

The condition is considered as a type of microdontia.

Prevalence of unilateral and bilateral lateral incisors is the same, however, the left side was twice as common as the right side.

Individuals with unilateral peg-shaped maxillary lateral incisors might have a 55% chance of having lateral incisor anodontia on the contralateral side [27].

2.3 Retrocuspid papillae

Retrocuspid papillae are small (2–3 mm in diameter), firm, round, pink, fibroepithelial papules on the gingivae behind the lower canines in many children.

They are often bilateral.

They are asymptomatic and decrease in size with age.

No treatment is necessary.

2.4 Tissue Tag

Tissue tags are nodules or papules projecting from a tissue

They are similar histologically to the tissue from they originates. Usually, a fibrous connective tissue covered by normal stratified squamous epithelium.

Their most common site is on the lingual and labial frenum.

Tags are mistaken for tumors and look like a fibroma or other tumor because they are nodular.

Treatment: No treatment required unless becomes traumatized and requires an excisional biopsy.

2.5 Torus Palatinus

A condition in which there are multiple bony exostoses or projections in the midline of the palate covered by thin mucosa.

Tori, if large can interfere with the stability of upper dentures and may need surgical removal or denture relief.

2.6 Torus Mandibularis

A unilateral or bilateral bony projection presents on the lingual aspect of the mandible and can interfere with the stability of lower dentures.

May need surgical removal or denture relief.

2.7 Leukodema

Is a bilateral, diffuse, translucent white thickening of the oral mucosa

Many authors consider leukodema a variation of normal, present in 90% of blacks and variable numbers of whites.

Treatment: No treatment is necessary

2.8 Racial or Ethnic Pigmentation

This is brown or black pigmentation occurring in dark skinned people, usually affecting the gingiva but the inner aspect of lips is typically spared.

Ruling out other sources of pigmentation is necessary.

Differential Diagnosis: Addison’s disease, smoker’s melanosis, drug-induced pigmentation.

3 Tumors and Tumor-like Lesions of childhood

There are many cysts, tumors, and tumor-like conditions that occur exclusively in infants or during early childhood. You should refer to standard textbooks for the details of individual lesions; these lesions are mentioned here, with an abridged memorandum for each lesion just for collecting data. The most common lesions you may be asked for are:

3.1 Cysts

3.1.1 Eruption Cyst or Eruption Hematoma

Eruption cysts are dome-shaped soft tissue lesions associated with the eruption of primary or permanent teeth. They are caused by fluid accumulation within the follicular space of the erupting tooth. Eruption cysts are called eruption hematomas when the cyst fluid is mixed with blood.

No treatment is needed; eruption cysts resolve spontaneously as the tooth erupts through the lesion. If the tooth does not erupt within two weeks, the child should be reexamined to evaluate other causes.

3.1.2 Gingival Cyst of Newborn (Bohn’s Nodule)

These are small whitish swellings occurring on the alveolar crest of newly born infants. They are small cysts thought to arise from cystic degeneration of remnants of the dental lamina.

If a gingival cyst of newborn persists till the time of eruption of teeth and interferes with the process of eruption, then it may be termed eruption cyst or eruption hematoma. Eruption cyst is considered by some authors to be a type of dentigerous