Essentials-of-Oral-Pathology-3rd-Edition by purkait

578 Essentials of Oral Pathology

IMPORTANT CAUSES OF LYMPHADENOPATHY

Infections Neoplasms

Bacterial infections Oral, tonsil, face and scalp Primary Hodgkin’s disease
Tuberculosis Secondary Non-Hodgkin’s lymphoma
Viral infection Syphilis Leukemia
Parasitic infections Cat-scratch disease Miscellaneous Carcinoma of oral, salivary gland
Lyme disease conditions and nasopharyngeal
Herpetic stomatitis Malignant melanoma
Infectious mononucleosis Mesenchymal tissue neoplasms
HIV infections Sarcoidosis
Toxoplasmosis Drug reactions
Connective tissue diseases

BLOOD DYSCRASIAS Important oral manifestations

Name of the disease Enlargement, bleeding and necrosis of gingiva, Ecchymosis, necrosis
Leukemias and ulceration of oral mucosa, profuse bleeding upon trauma or
Agranulocytosis following extraction of tooth.
Polycythemia
Multiple myeloma Gangrenous ulceration of the gingiva, buccal mucosa, soft palate and
Iron deficiency anemia lip. Delayed wound healing.
Plummer-Vinson’s syndrome Severe secondary infections.

Pernicious anemia Petechiae, ecchymosis, hematoma formation and ulceration of the
Folic acid deficiency anemia mucosa, gingiva and tongue. Spontaneous gingival bleeding. Purplish
Aplastic anemia red discoloration of tongue, cheek and lips.

Pain and swelling of the jaw, numbness of the lips, multiple punched-
out radiolucencies in the jaw bone, formation of epulis and
unexplained mobility of teeth.

Mucosal atrophy and pallor, bald tongue with atrophic glossitis.
Angular cheilitis, glossodynia and increased risk of candidiasis.

It is a rare condition characterized by Iron deficiency anemia, dys-
phagia and glossitis. Other features of the disease include atrophy of
the tongue papilla with smooth red surface, glossodynia, increased
risk of oral precancer and cancer, angular cheilitis and difficulty in
wearing prosthesis.

Erythematous oral mucosa with burning sensation, beefy red tongue
with depapillation (Hunter’s glossitis), focal areas of atypical mucosal
erythema.

Depapillation of tongue with glossitis and glossodynia, aphthous-
like ulceration.

Purpura, spontaneous gingival bleeding, ulceration and bad breath,
etc. Severe mucosal pallor.

Oral Manifestations of Generalized Diseases 579

Erythroblastosis fetalis Black, brown or bluish pigmentations of teeth, protrusion of upper
Thalassemia teeth, osteoporosis of bone, thinning of lamina dura.
Sickle cell anemia
Protrusion of upper teeth, osteoporosis of bone, thinning of lamina
Purpura dura, prominent premaxilla and cheek bone, Mongoloid facies.
Hemophilia
Hereditary hemorrhagic Mucosal pallor, “stepladder-like” arrangement of bony trabeculae
telangiectasia between the roots of the teeth, pain in the mandible with lip
paresthesia. Osteoporosis of the jaw bone including the alveolar
bone.

Gingival bleeding, petechiae and ecchymosis.

Petechiae, hemarthrosis, excessive bleeding upon trauma or
extraction of tooth.

Cherry red, pinpoint or large lesions resembling a crushed spider in
the mucosa. The lesion blanches on pressure.

METABOLIC DISORDERS Important oral manifestations

Name of the disease Severe periodontitis with loosening of teeth, gingivitis and painful
Diabetes mellitus gingiva, burning mouth syndrome, delayed wound healing, mucosal
ulceration, acetone breath, increased risk of infection, bilateral non-
Amyloidosis tendered enlargement of parotids (diabetic sialadenitis), xerostomia,
gingival hyperplasia, candidiasis and atrophy of tongue papillae.
Hurler’s syndrome
Jaundice Macroglossia with smooth, brawny and indurated tongue, localized,
Hypophosphatesia yellow, non-ulcerated nodules on the oral mucosa. Hoarseness of
voice, dry mouth, claudication of the jaw, petechiae and ecchymosis
Hypophosphatemia of the oral mucosa.

Protein-energy malnutrition Short and broad mandible, coarse lips, delayed eruption of teeth,
multiple radiolucencies in the jawbone, diastema, hyperplastic dental
follicles.

Icterus (diffuse yellow pigmentation) of the palatal and sublingual
area.

Premature loss of primary teeth, especially deciduous incisors.
Delayed eruption of permanent teeth, premature loss of permanent
teeth, thin cortex and lamina-dura of bone, decreased enamel
thickness and large pulp size of tooth.

Bone pain, muscle weakness, poorly formed teeth, large pulp
chambers of teeth with pulp horns extending up to the dentino-
enamel junction, increased incidences of periodontal and periapical
abscess formation with sinus tract. Deformity of tooth enamel with
microclefts helps in early pulp exposure.

Oral mucosal pallor, atrophy of the tongue papilla, enamel hypoplasia,
glossitis, angular cheilitis, generalized stomatitis, fissuring of lips,
delayed wound healing.

580 Essentials of Oral Pathology

Chronic alcoholism Inflamatory gingival lesion with bleeding tendency.
Chronic steroid therapy
Obesity of the upper part of the body, “buffalo-hump” or round
Uremic stomatitis shouldered person, mooning of the face, secondary oral infections
due to depressed immunity, osteoporosis.

It occurs due to renal failure and is characterized by development of
multiple ragged white plaques on the buccal mucosa, tongue and
floor of the mouth. Unpleasant taste in the mouth, oral burning
sensation and odor of ammonia or urine in the mouth.

HEAVY METAL POISONING

Name of the metal Oral manifestations

Arsenic Vomiting, diarrhea, hyperpigmentation, hyperkeratosis of oral mucosa.

Lead Excessive salivation, metallic taste and a dark lead line along the
gingival margin.

Bismuth Burning sensations of the oral mucosa, metallic taste and a bismuth
line (similar to lead line) along the gingival margin.

Mercury Stomatitis, increased salivation, glossitis and enlargement of salivary
glands.

Phosphorus Progressive osteomyelitis of the jaws

Silver-amalgam Gray-black discoloration of the oral mucosa.

Graphite Gray-black mucosal color change.

Lead-mercury Gray oral mucosa.

ENDOCRINE DISTURBANCES

Name of the disease Important oral manifestations

Pituitary gigantism Enlargement of jaw bone, enlargement of oral soft tissues, increased
vertical height of jawbone, macroglossia, true macrodontia, early
eruption of teeth and hypercementosis, etc.

Pituitary dwarfism Underdeveloped face and jaws, delayed shedding of primary teeth
and delayed eruption of permanent teeth, delayed root completion
of teeth, microdontia and absence of third molars.

Acromegaly Increased mandibular growth with development of class-III mal-
occlusion, diastemas, anterior open bite, increased soft tissue growth
with macroglossia, periodontitis, gingivitis and hypercementosis, etc.

Cushing’s syndrome Mooning of the face (face becomes round due to excessive deposition
of fat within the facial tissues), osteoporosis of bone, loss of lamina
dura, increased risk of infection due to lowered immunity, increased
incidences of pathological fractures of bone.

Hypoparathyroidism Hypocalcemia, tetany, delayed eruption of teeth, pitting enamel
hypoplasia, extensive bone resorptions. Positive Chvostek’s sign and
persistent oral candidiasis.

Oral Manifestations of Generalized Diseases 581

Hyperparathyroidism Loosening of teeth, brown tumors in the jaws, loss of lamina dura,
radiograph shows ground glass appearance of the bone (due to
Imbalance of sex hormones severely decreased bone density) and multicystic jaw lesions, bone
and joint pain, peptic ulcer, hypercalcemia, renal calculi. Massive
Pregnancy enlargement of jaw.
Addison’s disease
Hyperthyroidism Puberty—Puberty gingivitis
Cretinism Menstruation—Gingivitis, cyclical ulceration of the oral mucosa,
Myxedema gingival bleeding.
Menopause—Dry mouth, burning tongue.

Gingival bleeding, pregnancy tumor (epulis)
Aggravated gingivitis, recurrent aphthous ulcer.
Vomiting, hypo or hypertension.

Yellow to brown pigmentations of oral mucous membrane due to
increased melanin production.

Premature eruption of teeth and loss of deciduous dentition,
osteoporosis of the jaw bones.

Retarded tooth eruption or complete failure of tooth eruption, delayed
exfoliation of deciduous teeth, malocclusion, macroglossia, macrocheilia,
drooling of saliva, delayed closure of bony sutures, etc.

Thick lips, macroglossia and swollen face.

GRANULOMATOUS DISEASES

Name of the disease Important oral manifestations

Syphilis Oral chancres in primary syphilis, mucous patches in secondary
syphilis, gumma in tertiary syphilis and Hutchinson’s triad in
congenital syphilis.

Tuberculosis Oral tuberculous ulcer, tuberculous gingivitis and osteomyelitis,
scrofula.

Sarcoidosis Enlargement of salivary glands, circumscribed nodules in the soft
palate, gingiva and cheek, etc.

Histoplasmosis Ulceration and nodular growth on the gingiva, tongue or palate that
often simulates a carcinoma.

Candidiasis White or grayish white “curdled milk”-like patches on the oral mucosa,
which leave raw painful, bleeding surfaces upon their removal.

Actinomycosis Enlargement of mandible with many pus discharging sinuses,the pus
contains small yellowish sulfur granules.

Crohn’s disease Recurrent aphthous stomatitis, diffuse nodular swelling of the lips
and cheeks, cobble-stone appearance of the oral mucosa. Linear
granulomatous ulcer on buccal vestibule.

Ulcerative colitis Recurrent aphthous ulcer, pyostomatitis vegetans, hemorrhagic
ulcers.

582 Essentials of Oral Pathology

Pyostomatitis vegetans Multiple linear yellow pustules over the buccal and labial mucosa,
Celiac disease soft palate and undersurface of the tongue.

Recurrent aphthous stomatitis.

DERMATOLOGICAL DISEASES

Name of the disease Important oral manifestations

Ectodermal dysplasia Anodontia, salivary gland aplasia with xerostomia, depressed nasal
bridge, frontal bossing, dry skin, unexplained pyrexia, hoarseness of
voice.

Pemphigus Vesicle or bullae formation in oral mucosa, vesicles rupture with
subsequent ulcer formation, Nickolsky’s sign is positive, pain with
bleeding and secondary infection.

Pemphigoid Vesicle or bullae formation, desquamation of the gingiva.

Epidermolysis bullosa Multiple bullae in the area of trauma, hypoplasia of teeth.

Ehlers-Danlos syndrome Increased fragility of skin, gum bleeding, tooth mobility, delayed
wound healing, enamel hypoplasia.

Lichen planus Patchy white lesions on the oral mucosa that present lace-like
radiating striae at the periphery, burning sensations and mucosal
pigmentations often develop.

Scleroderma Atrophy of the oral mucous membrane with stiffening and fixation,
depapillation of tongue, difficulty in deglutition, and widening of the
periodontal ligament space.

Psoriasis Erythematous patches with white scaly surface on the oral mucosa.

Lupus erythematous Multiple white plaques in oral mucosa with dark-reddish purple
margins. Erythematous skin rash on the face with a butterfly
configuration across the bridge of the nose.

Keratosis follicularis Multiple small papules on the oral mucosa.

BONE DISEASES Important oral manifestations

Name of the disease Enlargement of the jaws, loosening of teeth and diastema formation,
Paget’s disease of bone “cotton-wool” type radiographic features of the bone,
hyercementosis of teeth and pulp calcification, etc.
Osteopetrosis
Osteogenesis imperfecta Delayed tooth eruption, retarded healing of the extraction wound,
spontaneous jaw fractures, etc.
Caffey’s disease
Frequent bone fractures, blue sclera, in case of associated
dentinogenesis imperfecta feature like obliteration of pulp chambers,
excessive tooth wear and short roots, etc.

Sudden jaw swelling that disappears in 3 to 12 months, cortical
thickening and bulging of the lower border of mandible.

Oral Manifestations of Generalized Diseases 583

Fibrous dysplasia Enlargement of the jaws, hypergonadism in females and café–au–
Fluorosis lait spots on the skin, etc. ground-glass radiographic appearance of
bone.

Lustless opaque white teeth with mottling or pitting, opaque
hypomineralized areas of tooth which may stain yellow to dark brown,
decreased caries incidence.

ACUTE INFECTIVE DISEASES

Rabies Excessive salivation, facial palsy, hydrophobia, difficulty in deglutition.

Tetanus Lock jaw, risus sardonicus.

Anthrax Malignant edema of the lip, oral mucosa, larynx and pharynx.
Malignant pustule formations in the labial and palatal mucosa.

Meningitis Bleeding from the mouth, stomatitis, mouth ulcers, foul breath, loss
of taste sensation, coating on the tongue.

HELMINTHIC DISEASES Teniasis: Edematous mucosal ulcerations, gingival bleeding.
Cysticercosis: Well-defined, painless, fluctuant swelling over the lips,
Tapeworm infections tongue and cheek, which often resembles mucoceles.
Hydatid cyst: Small, progressively increasing, painless, well-
Roundworm infections defined, soft fluctuant swelling on the tongue.

Protozoal infections Trichinosis: Bilateral gingival swelling, swelling of the tongue and
Leishmaniasis myelohyoid muscle.
Toxoplasmosis Ascariasis: Submental swelling, mucosal pigmentations, toxic
manifestations from worm by-products, e.g. facial edema and
urticaria etc.
Filariasis: Edematous swelling of the lips and tongue.

Tripanosomiasis: Unilateral facial edema with crepitations,
widening of the transverse diameter of face, salivary gland
swelling, cervical and preauricular lymphadenopathy.

Ulcerations of the oral mucosa, progressive destructions of
soft palate, uvula and gingiva.

Aphthous stomatitis, pharyngitis, lymphadenopathy, facial palsy.

RENAL DISEASES Bad odor or smell of ammonia in the mouth, gingivitis, stomatitis,
xerostomia, parotitis, mucosal erythema, oral thrush, bacterial
Renal failure plaques, mucosal ulcerations, purpura, giant-cell lesions (secondary
to hyperparathyroidism) mucosal pallor due to anemia.
Renal osteodystrophy
Demineralization of maxillary and mandibular bone, loss of
trabeculations, total or partial loss of lamina dura, ground-glass
radiolucency of bone.

584 Essentials of Oral Pathology

Kidney transplantation Xerostomia, metallic taste, mucosal pallor, low grade gingival
inflammation, increased bleeding tendency from gingiva and oral
NEURAL DISEASES mucosa, petechiae or ecchymosis, erosive glossitis, staining of teeth,
bone demineralization, gingival hyperplasia.
Multiple sclerosis
Epilepsy Anesthesia or paresthesia of all branches of trigeminal nerve, non-
Cerebral palsy specific neuralgia, glossopharyngeal neuralgia.
Gingival hyperplasia due to intake of phenytoin sodium, hirsutism,
lymphadenopathy.
Class II malocclusion with open bite is often seen, severe caries and
periodontal diseases, severe tooth erosion, enamel hypoplasia,
bruxism, mouth breathing, drooling, delayed tooth eruption,
traumatic damage of teeth, disturbance in swallowing.

SEXUALLY TRANSMITTED DISEASES

Syphilis Oral chancres—in primary syphilis.
Mucous patches—in secondary syphilis.
Gumma— in tertiary syphilis.
Hutchinson’s triad— in congenital syphilis.

Gonorrhoea Gonococcal stomatitis with ulcerations of the oral mucosa,
gingivostomatitis with red, yellow or greenish discoloration of the
tissue.

Granuloma inguinale Extensive superficial ulcerations in the oral mucosa with ill-defined
margins.

CARDIOVASCULAR DISEASES

Congestive cardiac failure Cyanosis of the lips, tongue and other parts of oral mucosa.

Coarctation of aorta Enlargement of the mandibular artery and it’s branches supplying
the teeth, enlargement of the dental pulp, excessive hemorrhage
after tooth extractions.

Congenital heart disease Generalized bluish discoloration of the gingiva, severe marginal
gingivitis, bleeding gums, delayed eruption of teeth.

Hypertension Uncontrolled hemorrhage following oral surgical procedures, gingival
hyperplasia due to intake of nifedipine, oral mucosal ulcers due to
intake of methyldopa, dryness of mouth due to use of diuretics.

Stroke Impaired speech, facial paralysis, poor oral hygiene, inability to wear
artificial prosthesis.

Oral Manifestations of Generalized Diseases 585

GENETIC DISORDERS Small mouth, large tongue, conical teeth, high arched palate,
microdontia, delayed eruption of teeth.
Down’s syndrome
Cleft palate, cleft uvula, malocclusion, high palatal vault.
Apert’s syndrome
Achondroplasia Hypoplastic maxilla, mandibular prognathism, malocclusion.
Cleidocranial dysplasia
Midfacial hypoplasia, high-arched palate with or without cleft,
Cruzon’s syndrome delayed eruption of teeth, multiple impacted or unerupted
Marfan syndrome supernumerary teeth.
Pierre-Robin syndrome
Trisomy- 13 syndrome Anodontia, peg-shaped teeth, palatal cyst.

TMJ-dysarthrosis, high arched palate, cleft palate.
Cleft palate, micrognathia, glossoptosis.

Cleft lip, cleft palate.

ALLERGIC CONDITIONS Multiple vesicles followed by ulcerations, in the oral mucosa, swelling
and fissuring of the lips.
Contact allergy
Type-I—Anaphylactic shock.
Systemic allergy Type-II, III, IV—Lichenoid reaction, pemphigus, pemphigoid and
erythema multiforme, etc.

GENERAL MANIFESTATIONS OF ORAL DISEASES

Diseases produced Oral diseases responsible for such conditions

Cavernous sinus thrombosis Cavernous sinus thrombosis and meningitis occurs in rare cases,
and meningitis when the infections from the “danger zone” of the face reaches the
cavernous sinus and the meninges.
Clinical features Exophthalmos, loss of vision, Photophobia,
lacrimation, fever, chills and vomiting.

Septicemia Extraction of an infected teeth without antibiotic coverage may lead
to septicemia or even death.

Oral infections Fever, malaise, leukocytosis, headache and lymphadenopathy, etc.
may develop when there is presence of a dentoalveolar abscess or
osteomyelitis of the jaw.

Subacute bacterial In case of careless tooth extraction in a cardiac patient without
endocarditis proper antibiotic therapy, the streptococcus beta–hemolyticus group
of organisms may spread from the oral cavity to the heart and produce
SABE.

Hypovolemic shock Excessive hemorrhage from the oral cavity following tooth extraction
may produce hypovolemic shock.

Malignant oral tumors Malignant oral tumors, e.g. squamous cell carcinoma, malignant
melanoma, osteosarcoma and lymphoma, etc. can metastasize to
the distant areas of the body and kill the patient.

586 Essentials of Oral Pathology

Loss of teeth If the lost teeth in the oral cavity are not replaced by artificial
Oral foci of infection dentures, the patients ability to masticate adequate nutritious food
Transitory bacteremia is decreased and nutritional deficiency symptoms develop.

The infected dental pulp, dental abscess, periodontal abscess,
inflammed gingiva, etc. harbor microorganisms and hence are called
oral foci of infections. The microorganisms from these oral foci may
produce secondary infections in the distant parts of the body.

Extraction, scaling or any other minor oral surgical procedure may
cause spread of bacteria from the oral cavity into the circulation.
This type of bacteremia lasts for about 30 minutes.

BIBLIOGRAPHY 8. Lewis R Eversole. Clinical Outline of Oral Pathology:
Diagnosis and treatment.
1. Ahmed R. WB. State Dental journal. Special issue on
102nd birth Anniversary celebration. 9. Major M Ash Jr. Oral Pathology, 6th edn.
10. Prabhu SR, Daftury DK, Johnson NW (EdS). Oral
2. Burket’s oral medicine–Diagnosis and Treatment, 9th
edn, M.A. Lynch/V J Brightman/M.S. Greenberg. Diseases in the Tropic.
11. Regezi JA, Sciubba JJ. Oral pathology: Chemical
3. Cawson RA. Oral pathology and Diagnosis–Color atlas
with integrated text, 1st edn. pathologic, correlations.
12. Shaper, Hine–Levy. A Text Book of Oral Pathology,
4. Eveson JW. Cysts of the Oral region 3rd edn, M. Shear.
5. Goaz-White. Oral Radiology: Principles and 4th edn.
13. Soames JV, Southam JC. Oral Pathology, 3rd edn.
interpretations. 14. Tencate AR. Oral Histology: Development, structure,
6. J Philip Sapp, Lewis R Eversole, Jeorge P Wysocki.
and function, 3rd edn.
Contemporary oral and maxillofacial pathology. 15. The Lippincott Manual of Nursing Practice, 2nd edn,
7. John Macleod (Eds). Davidson’s Principles and Practice
JB Lippincott company.
of Medicine: 14th edn. 16. Wood Goaz. Differential Diagnosis of Oral Lesions, 4th

edn.

A syndrome can be defined as a set of symptoms, a patient, care should always be taken to look

which collectively indicate or characterize a for the other possible symptoms, which might
disease, a psychological disorder or other be present elsewhere in the body so that an early
abnormal condition. Some investigators state and accurate diagnosis of a syndrome
that ‘a disease which has more than one could be made whenever it is present. Early
identifying features or symptoms is a syndrome’. diagnosis of a syndrome is always important
since severity of a disease can be much more
A large number of syndromes occur as when it is occurring in association with a
symptom complexes in association with many syndrome rather than when it is occurring as a
oral diseases, some of them are very common single entity.
while few others are extremely uncommon
entities. In the following section, salient features of
some important ‘oral disease related syndromes’
It is important to remember that once a single will be discussed.
component feature of a syndrome is found in

Name of the syndrome Important features
Aarskog syndrome
Acquired immunodeficiency Ocular hypertelorism, anteverted nostrils, broad upper lip, defective
syndrome penis and small hands, etc.
Acute radiation syndrome
Severe reduction in T-lymphocytes due to human immunodeficiency
Adrenogenital syndrome virus, breakdown of cell mediated as well as humoral immunity,
overwhelming opportunistic infections and neoplasms, etc.
Albright syndrome
Aldrich syndrome A syndrome caused by exposure to a whole body dose of over 1 gray
Ameloonycho-hypohydrotic radiation, features include erythema, nausea, vomiting, fatigue,
syndrome diarrhea, petechiae, bleeding from oral mucosa, hypotension and
Anderson syndrome tachycardia.

Angio-osteohypertrophy Pseudohermaphroditism, sexual precocity, virilism in women or
syndrome feminization in men, premature eruption of teeth, if the disease begins
in early life.

Polyostotic fibrous dysplasia of bone, café-au-lait spots on the skin,
endocrine disturbances, e.g. precocious puberty.

Thrombocytopenic purpura eczema, increased susceptibility to infection,
otitis media, petechiae, ecchymosis.

Severe hypoplastic-hypocalcified enamel, subungual hyperkeratosis,

defective nails, hypofunction of the sweat glands, seborrheic dermatitis.

Craniofacial and skelatal anomalies, hyperuricemia, diastolic
hypertension, maxillary hypoplasia, mandibular prognathism,
malocclusion.

Port-wine stains on the face, varices, hypertrophy of bone including
jaw bones, facial asymmetry, malocclusion, altered eruption pattern of
teeth.

588 Essentials of Oral Pathology

Anorexia-cachexia syndrome Systemic response to cancer occurring as a result of a poorly understood
relationship between anorexia and cachexia, manifested by malnutrition,
Apert syndrome weight loss, muscular weakness and toxemia.

Ascher’s syndrome Early synostosis of cranial sutures, triangular facial defects, high arched
Baby bottle syndrome palate, syndactyl and mandibular prognathism. Shovel-shaped incisors,
malocclusion, parrot-beak type nose.
Beckwith’s hypoglycemic
syndrome Acquired double lip, blepharochalasis and non-toxic thyroid
Behcet’s syndrome enlargement. Recurrent edema of both eyelids.
Bernard-Soulier syndrome
The condition occurs in children those, who drink excessive sugar
Bing-Neel syndrome containing milk or other drinks by feeding bottle for a longer period of
Baelz syndrome time (especially if the milk is kept in mouth overnight). There will be
multiple number of caries in several teeth.
Berry’s syndrome
Book’s syndrome Macroglossia, neonatal hypoglycemia, umbilical hernia, post-natal
B-K Mole syndrome
Bloch-Sulzberger syndrome gigantism.

Blepharonasofacial Oral ulceration, genital ulceration, photophobia, conjunctivitis, uveitis,
syndrome pyoderma and arthralgia.
Bowen syndrome
Brittle bone syndrome It’s a bleeding disorder due to some platelet defect and is characterized
by normal platelet aggregation to ADP and collagen but an abnormal
Brocq-Pautrier syndrome response to fibrinogen. Increased BT and decreased platelet count.
Borjeson’s syndrome
Burning mouth syndrome Hyperglobulinemia with CNS involvement on a toxic infectious basis.
Encephalopathy, hemorrhage, stroke and convulsions.

A rare disease of children or adolescents, characterized by enlargement,
hardening and finally eversion of the lip leading to exposure of the
opening of accessory salivary glands.

Mandibulofacial dysostosis evident at birth.

Premature whitening of hair, hyperhydrosis of palms and soles, aplasia
of premolars and third molars.

A hereditary condition characterized by the presence of large pigmented
nevi. It often carries a very high risk for development of melanoma.

Erythematous, vesiculobullous lesion on the trunk and extremities. The
initial lesion disappears, following which a lichenoid, papillary or
verrucous lesion develops. Finally, a brownish-gray macule develops over
the skin. Delayed tooth eruptions, conical tooth crowns, extra cusp,
anodontia.

Mental retardation, microcephaly, joint disorders, hypoplastic maxilla
and protruding lips.

Craniofacial anomalies, hypotonia, hepatomegaly, micrognathia,
protruding tongue, high arched palate, increased serum iron level.

Fragile bones, clear blue sclera, deafness, loose ligaments, open
fontanelles, repeated fractures of bone, opalescent teeth with short roots
and obliterated pulp chambers.

A rhomboid shaped, shiny lesion on the middle of the base of the tongue.

Mental retardation, epilepsy, swelling of the subcutaneous tissue of face,
large ears and marked obesity.

Acute intense pain and burning sensation in the mouth, altered taste
sensation and xerostomia, no clinically detectable lesion in the mouth,
middle-aged women are commonly affected.

Syndromes Related to Oral Diseases 589

Caffey-Silverman syndrome Development of a tender, deeply placed-soft tissue swelling in bone
especially mandible, increased cortical thickening of bone, severe
Candidiasis endocrinopathy malocclusion, fever, pseudo-paralysis, dysphagia, anemia, leukocytosis
syndrome
Carotid artery syndrome Chronic oral candidiasis, hypoparathyroidism, hypothyroidism,
hypoadrenocorticism, diabetes mellitus, enamel hypoplasia
Cerebrocostomandibular
syndrome Pressure or impingement on the external or internal carotid artery by
Chinese restaurant syndrome elongated or deviated styloid process or calcified stylohyoid ligament.
It often causes pain in the pharyngeal region.
Coffin-Lowry syndrome
Coffin-Siris syndrome Thoracic deformity with barking cough, mandibular micrognathia,
Cri-dui-chat syndrome palatal defects, absence of uvula or even soft palate, mental retardation,
Chediak-Higashi syndrome
Throbbing headache, lightness of the jaw, neck and shoulders,
Costen’s syndrome lightheadedness, etc. after taking Chinese foods. These symptoms occur
Cowden’s syndrome as a result of transient arterial dilatation due to ingestion of ‘monosodium
glutamate’ which is sometimes used liberally for seasoning the Chinese
CREST syndrome foods.

Cushing syndrome Incapability of speech, severe mental deficiency, muscle, ligament and
skeletal abnormality.
Cross syndrome
Cracked tooth syndrome Coarse facies, microcephaly, hypoplasia of fifth finger and toenails,
mental deficiency, mental deficiency and laxity of joints.
Crouzon syndrome
Hypertelorism, microcephaly, mental retardation and a plaintive cat-
Down syndrome like cry.

It is a progressive systemic disorder with oculo-cutaneous albinism,
photophobia, nystagmus, severe gingivitis, oral ulcer, glossitis,
pancytopenia and histiocytic inclusions in different organs.

Intermittent or continuous impairment of hearing, stuffy sensation in
the ear, tinnitus, otalgia, dizziness, headache, glissodynia.

Multiple papules on the lips and gingiva, papillomatosis of the oral
mucosa resulting in a “cobble-stone” appearance, follicular keratosis of
the perioral, perinasal and periorbital skin, variety of neoplastic changes
in many organs.

This phenomenon is a variant of progressive systemic sclerosis
characterized by calcinosis cutis, raynaud’s phenomenon, esophageal
dysfunction, sclerodactyly, telangiectasia.

It occurs due to hyperadrenocortism with development of adiposity,
mooning of the face, buffalo hump, abnormal hair distribution in the
body, vascular hypertension, glycosuria, osteoporosis, hypertrichosis

Microphthalmia, gingival enlargement, corneal clouding,
hypopigmentations, white hair, blond skin.

This syndrome is characterized by development of a crack in a restored
or an unrestored tooth due to excessive occlusal forces. There will be
sharp pain on biting, the pain can mimic trigeminal neuralgia and the
crack can’t be detected by the radiograph.

Craniosynostosis without syndactyly, early synostosis of bone, triangular
frontal defect, mandibular prognathism and high-arched palate,
nasomaxillary retrusion with mouth breathing.

Small slanting eyes with epicanthral folds, mongoloid facies, flat face, large
anterior fontanel, open sutures, sexual underdevelopment, open mouth
with macroglossia, mental retardation and cardiac abnormalities.

590 Essentials of Oral Pathology

Dejerine-Roussy syndrome Tumors of the pons or occlusion of the posterior cerebral artery with
Eagle’s syndrome sensory or motor abnormality on the contralateral side, severe episodes
of pain including orofacial pain, dysgeusia.
Edwards syndrome
Ehler’s-Danlos syndrome Elongation of the styloid process of temporal bone or ossificaton of
Ellis-Van Creveld syndrome styloid ligament causing dysphagia, glossodynia, sore throat and pain
Epidermal nevus syndrome along the distribution of the external carotid artery. The pain starts at
Elashy-Waters syndrome the tonsillar area during mandibular movements, radiates to the TMJ or
EEC syndrome base of the tongue and interestingly it subsides as the jaws are closed.
Fanconi’s syndrome
Favre-Racouchot syndrome Mental retardation, small eyes, prominent occiput, micrognathia, cleft
Fetal-alcohol syndrome palate and uvula, the index finger overlaps the third finger and fifth
finger overlaps the fourth.
Fragile X syndrome
Floppy infant syndrome Hyperelasticity of skin, hyperextensibility of joints. Increased capillary
Focal dermal hypoplasia fragility, easy bruising of the skin and mucosa, delayed wound healing,
syndrome increased bleeding tendency.
Frey’s syndrome
Dwarfism, polydactyly, cardiac malfunction, dysplasia of hair and nails,
Gardner’s syndrome hypodontia, fusion of the mid-portion of the upper lip to the anterior
maxillary alveolar ridge and hypoplasia of teeth.

Cutaneous nevi extending upto oral mucosa and gingiva, mental
deficiency, skeletal abnormality, hypoplastic teeth.

Mental retardation, brachycephaly, ocular hypertelorism, cleft
palate(submucous) and uvula, multiple jaw cysts.

Ectodermal dysplasia, hypopigmentation of skin and hair, cleft palate,
cleft lip and tooth abnormality.

Aplastic anemia, bone abnormality, microcephaly, hypogenitalism,
generalized olive brown pigmentation of skin.

Extensive sun damage of the facial skin. Numerous open, dialated and
cystic comedones, dermis shows solar elastosis characterized by dialated
pilosebaceous openings with distended, horn-filled hair follicles.

This abnormal condition occurs in children born of women, who were
chronically alcoholic during pregnancy. The features include maxillary
hypoplasia, prominent forehead and mandible, short palpebral fissures,
microcephaly and mental retardation.

X-linked mental retardation, macro-orchidism, large ears, long narrow
face, cleft palate, mitral valve prolapse.

Hypotonia, generalized muscle weakness, reduced tendon reflexes,
inability to sit, stand or walk due to generalized weakness.

Focal absence of dermis with herneation of the subcutaneous fat into
the defect, atrophy and pigmentation of skin, telangiectasias,
papillomatosis, syndactyly. Microdontia, enamel hypoplasia, cleft lip and
palate.

It occurs as a result of damage to the auriculotemporal nerve with
subsequent reinnervations of sweat glands by parasympathetic salivary
fibers. The feature include flushing and sweating of the temporal area
during taking foods.

Multiple polyposis of large intestine (colon), osteomas of bone, multiple
epidermoid or sebaceous cysts of the skin, desmoid tumor, multiple
impacted supernumerary and permanent teeth.

Syndromes Related to Oral Diseases 591

Gorlin-Goltz syndrome Basal cell carcinoma of the skin, multiple odontogenic kerocysts, bifid-
ribs, hypertelorism, mental retardation, hypogonadism, multiple basal
Goldenhar syndrome cell nevi.

Gorham syndrome Unilateral microstomia, mental retardation,hypoplastic zygomatic arch,
downward slanting of palpebral fissures, malformed pinna,high arched
Grinspan syndrome palate, cleft-palate and uvula.
Gorlin-Chaudhry-Moss
syndrome Osteolysis of single or multiple bones followed by replacement with
Gunn’s syndrome fibrous tissue, pain in the bone, pathological fractures. Cavernous
Giles de la Tourette syndrome angioma-like permeation of the affected bone.

Heerfordt’s syndrome It occurs in association with lichen planus and consists of lichen planus
of skin and mucosa, vascular hypertension, diabetes mellitus.
Horner’s syndrome
Craniofacial dysostosis, patent ductus arteriosus, hypertrichosis,
Horton’s syndrome hypotonia, hypoplasia of labia majora.

Hurler’s syndrome Unilateral ptosis of the eyelid with movement of the affected eyelid.

Hunter syndrome Spontaneous erratic behavior of the patient, incoherent facial expression
Hutchinson-Gilford syndrome and verbalizations, tendency for self-mutilation (often the oral tissues)
by the use of teeth and finger nails along with movement of the jaw.
Hand-Schuller-Christian
syndrome Painless, firm enlargement of the parotid and other glands due to
Hajadu-Cheney syndrome sarcoidosis, uveitis of the eye, fever, vomiting, facial palsy, xerostomia,
malaise, GI disturbances.
Hallermann-Streiff syndrome
It occurs due to ipsilateral brainstem lesion causing miosis or contraction
Hanhart syndrome of pupil, ptosis of the upper eye lid, anhidrosis and vasodilatation over
the facial or periorbital skin causing flushing.

Unilateral paroxysm of intense pain in the eye, maxilla, ear,mastoid
region, base of the nose and beneath the zygoma. Absence of trigger
zone, occurence of pain everyday exactly at the same time.

Inherited mucopolysaccharide metabolism effect characterized by
prominent forehead, saddle nose, hypertelorism, macroglossia, puffy
eyelids, corneal clouding, short broad mandible, gingival hyperplasias,
multiple cystlike osteolytic lesions of the jaws, dwarfism, deafness.

Mild but similar features like hurler’s syndrome but without corneal
clouding, death usually occurs before age of 15 years.

Alopecia, atrophic skin with areas of pigmentation, Prominent veins with
loss of subcutaneous fat, high pitched squeaky voice, young boys with
wizened old man like look. Small mandible, delayed eruption of teeth,
excessive secondary dentin formation.

Punched-out bone destruction in the skull, exophthalmos, diabetes
insipidus, premature exfoliation of teeth.

Short stature, long nose, low frontal hairline, disintegration of the
terminal phalanges of fingers and toes. Premature loss of teeth,
susceptibility to multiple fractures of bone.

Small face, microphthalmia, beak like nose, strabismus, double
cutaneous chin with central furrow, hypodontia, microstomia, retained
deciduous teeth.

Peromelia, micrognathia, syndactyly, microglossia, hypodontia.

592 Essentials of Oral Pathology

Hetch-Beals-Wilson syndrome Limited mandibular opening, campylodactyly, shortened leg and
Hyoid syndrome hamstring muscles, club foot.

Happy Puppet syndrome Elongation of the greater cornu of hyoid bone with impingement on
adjacent laryngeal tissue, pain in the lateral neck and carotid area when
Hay-Wells syndrome the neck is turned to one side, pain during swallowing. Ipsilateral referred
Jaffe-Lichtenstein syndrome pain in the ear, syncope, patient always feels as if a foreign body is lodged
Jugular foramen syndrome in the throat.
Jadassohn-Lewandowsky
syndrome Jerky puppet-like movements of the body, peculiar open mouthed
Jaw Winking syndrome appearance, frequent laughter, mental and motor retardation and
seizures.
Klinefelter’s syndrome
Inherited syndrome of ectodermal dysplasia, cleft lip and palate,
K B G syndrome adhesions of the margins of eyelids—tooth, skin and hair defects.
Lacrimal-auricular-dental and
digital syndrome Multiple bone lesions of fibrous dysplasia, skin pigmentations.
Larsen syndrome
Dysphagia, hoarseness of voice, glossopharyngeal neuralgia like pain,
Laugier-Hunziker syndrome palatal weakness, vocal cord paralysis.
Lesch-Nyhan syndrome
Bilateral oral white lesions involving the tongue and buccal mucosa,
Marfan’s syndrome laminated thickening of the finger and toenails.

Morquio’s syndrome Exaggerated opening of the eye on moving of the mandible in a
Marin-Amat syndrome contralateral direction, ptosis of the affected eye at rest, normal pupilar
reflexes.
Myofacial pain dysfunction
syndrome This syndrome occurs in males, whose sex chromosome constitution
includes one or more extra chromosomes. The patient may develop
taurodontism. Small testes, azoospermia and infertility.

Macrodontia, mental retardation, unusual facies, short stature.

Lacrimal duct obstruction with overflow of tears, cup-shaped deformed
ear with loss of hearing, peg-shaped teeth, enamel hypoplasia and
medial/lateral deviation of fingers.

Prominent forehead with frontal bossing, flat midface, depressed nasal
bridge, hypertelorism, congenital (bilateral) dislocation of tibia or femur
with displaced patella, cleft palate.

Acquired pigmented macules in the lips, oral cavity and fingers.

Hyperuricemia, spastic cerebral palsy with mental retardation,
compulsive aggressive behavior with self-mutilation of fingers and lips
by constant chewing or self biting. Teeth are often lost due to
prophylactic extractions to avoid self mutilation or injury.

Disproportionately long thin extremities, spidery fingers, long and
narrow face, hyperextensibility of joints, kyphosis or scoliosis, recurrent
joint dislocations.

Severe enamel hypoplasia with gray and pitted enamel , severe bone
changes, mild corneal clouding, aortic regurgitation, pigeon breast.

This condition occurs usually after peripheral facial paralysis and is
characterized by automatic closing of the eye during forceful wide mouth
opening like—chewing, etc. Tears may also flow.

This condition occurs in relation to the temporomandibular joint and is
characterized by the following features—pain, muscle tenderness,

Syndromes Related to Oral Diseases 593

Median cleft face syndrome clicking sound in TMJ, limitation of jaw movements, but no pain in the
joint when palpated through the external auditory meatus.
Melkersson-Rosenthal
syndrome Hereditary defect of abnormal midline development of face and head
Multiple endocrine nesplasia characterized by hypertelorism, median cleft of the lip, premaxilla and
syndrome (MEN-I) palate, cranium bifidum occultum, malocclusion.
Meniere’s syndrome
Migraine syndrome Cheilitis granulomatosa, facial paralysis and scrotal tongue, persistent
Miescher’s syndrome unlilateral edema of the orbit and eyelid.

Mikulicz’s syndrome Tumors or hyperplasia of the pituitary, parathyroids, adrenal cortex and
pancreatic islets. Peptic ulcer or gastric oversecretion.
Mobius syndrome
Tinnitus, vertigo, deafness, nausea and vomiting.
Mucocutaneous lymph
node syndrome Severe periodic headache, nausea, irritability, sleep disturbance,
photophobia.
Myxoma syndrome
Murray-Puretic-Drescher Diffuse swelling of the lip. Scaling, fissuring, vesicle or pustule formation
syndrome on the vermillion border. It is a monosymptomatic form of Melkersson-
Melnick-Needles syndrome Rosenthal syndrome.

Mohr syndrome Painless, chronic bilateral hypertrophy of the parotid or lacrimal glands
Middle fossa syndrome accompanied by enlargement of the lymph nodes, xerostomia. The
syndrome represents some generalized septic disease, e.g. lymphomas
Muir-Torre syndrome and tuberculosis.
Magic syndrome
Munchausen syndrome Congenital facial diplegia, expressionless face due to facial paralysis,
inability to close the eyes due to paralysis of the abducens, swollen lips,
Myelodysplastic syndrome deafness, epilepsy, etc.

Fever, bilateral congestion of ocular conjunctiva, edema of the
extremities, dryness and fissuring of the lips, strawberry-like redness
and swelling of the tongue, acute nonpurulent swelling of the lymph
node.

Perioral pigmented macules, soft tissue myxomas and endocrinopathies.

Gingival fibromatosis, tumors of the head, trunk and extremities, mental
retardation, suppurative skin lesions, flexon contractures.

Exophthalmos, full cheeks, large ears, micrognathia, transversely long
mouth, delayed closure of fontanels, defect in clavicles, ribs, vertebrae,
etc. Two unrelated patients may look like siblings.

Short stature, digital deformities, midline cleft lip, bifid tip of nose, high
arched palate, hypodontia. Lingual, facial and mandibular deformity.

The condition occurs due to a tumor in the region of the gasserian
ganglion and causes hypesthesia, paresthesia, paralysis of the ocular
muscles, deviated mandibular opening, unilateral soft palate paralysis.

Multiple sebaceous neoplasms, keratoacanthoma.

Mouth and genital ulcers with inflammed cartilage.

A factitious disorder with habitual seeking of hospital admission for
apparent acute illness, patient often gives a plausible and dramatic
history of the disease which is entirely false.

A group of bone marrow disorder preceding to development of acute
myelogenous leukemia, characterized by abnormal hematopoietic stem
cells, anemia, neutropenia and thrombocytopenia.

594 Essentials of Oral Pathology

Miller syndrome An inherited disorder characterized by extensive facial and limb defects,
MEN-III syndrome hearing loss and heart disease.
Maffucci’s syndrome
Nagar syndrome Medullary carcinoma of thyroid, pheochromocytoma, café-au-lait
Neck-Tongue syndrome pigmentation of skin, neurofibromatosis.

Noonan syndrome Multiple hemangiomas of the skin and oral mucosa, multiple
Occipital condyle syndrome chondromas of the jaw bone.
Oculoglandular syndrome
of parinaud Hypoplasia of malar bones, antimongoloid obliquity, palpebral fissures,
Olmsted syndrome defective hearing, cleft palate, micrognathia,
Oral facial digital syndrome
Unilateral upper nuchal or occipital pain with or without numbness in
Oromandibular-Limb the area, simultaneous numbness of the tongue on the same side.
hypogenesis syndrome malocclusion.
Otopalatodigital syndrome
Orbital syndrome Congenital heart disease, chest deformity, mental retardation, short
Paraneoplastic syndrome stature, facial bone anomalies, cryptorchidism.
Parasellar syndrome
Patau syndrome Occipital pain, which is exacerbated by neck fixation, weakness of the
Pfeiffer syndrome hypoglossal nerve.
Papillon-Lefevre syndrome
Localized granuloma of the eye, preauricular lymphadenopathy. It occurs
Paratrigeminal syndrome in association with Cat-scratch disease.

Rare congenital condition characterized by severe palmo-plantar
keratosis, peri-orofacial keratosis and hypertrichosis.

Cleft of the tongue, upper lip, palate and mandibular alveolar process,
micrognathia, depressed nasal bridge, frontal bossing, digital
malformation, thick fibrous bands in the lower mucobuccal fold
eliminating the sulcus, supernumerary canines and premolars, small
hands and feet.

Ocular hypotelorism, cranial nerve palsy, hypodactyly of hands and feet,
hypoglossia, cleft palate, conical shaped mandibular incisors.

Deafness, cleft palate, generalized bone dysplasia, prominent
supraorbital ridge, frontal bossing.

It occurs due to malignant disease of the orbit, supraorbital pain and
hyperesthesia, blurred vision or diplopia, ptosis, ophthalmoplegia.

A symptom complex arising in a cancer bearing patient that can’t be
explained by local or distant spread of the tumor.

It occurs due to encroachment of the cavernus sinus by any tumor, frontal
pain, ophthalmoplegia.

Microcephaly, microphthalmia, ocular hypertelorism, deafness,
polydactyly, heart anomalies, cleft lip and cleft palate.

Craniosynostosis, turribrachycephaly, broad thumbs, halluces, midface
hypoplasia, mandibular prognathism, high arched palate.

Hyperkeratosis palmoplantaris, generalized hyperhydrosis, fine body
hair, peculiar dirty-colored skin, aggressive periodontitis with severe
destruction of alveolar bone, gingival hyperplasia.

Severe pain or headache in the area of trigeminal distribution with sign
of ocular sympathetic paralysis. Onset of pain is sudden, middle aged
males are frequently affected.

Syndromes Related to Oral Diseases 595

Paray-Romberg syndrome Atrophy of the skin, subcutaneous tissue, bone and cartilage causing
hemifacial deformity, trigeminal neuralgia, loss of hair and vitiligo on
Plummer-Vinson syndrome the affected side. Contralateral jacksonian epilepsy.
(Paterson-Kelly syndrome)
Portsmouth syndrome Dysphagia, smooth, red, depapillated painful tongue. Lemon tinted
pallor of skin, cracks and fissures on the corner of the mouth, atrophy
PFAPA syndrome of the filiform and fungiform papillae of tongue.
Pierre Robin syndrome
Bleeding disorder due to defective platelet aggregation. The condition
Peutz-Jeghers syndrome shows normal ADP-induced platelet aggregation but an abnormal or
absent collagen induced aggregation. Severe bleeding tendency, easy
Pickwickian syndrome bruisability, epistaxis.
Ramon syndrome
Raley- day syndrome Periodic fever, aphthous- stomatitis, pharyngitis and adenitis.
Reiter’s syndrome
Ramsay-Hunt syndrome Cleft-palate, micrognathia, glossoptosis and congenital heart disease.
Absent gag-reflex, airway obstruction due to falling back of tongue on
Rubinstein-Tyabi syndrome the posterior pharyngeal wall due to micrognathia.
Rieger’s syndrome
Rutherford syndrome Recurrent abdominal pain due to familial intestinal polyposis, cutaneous
Scheie syndrome pigmentation in perioral region, precocious puberty, GI bleeding and
Sipple’s syndrome (MEN-II) pigmentation of the buccal mucosa.

Sjogren’s syndrome: Morbid obesity, hypersomnolence, periodic breathing with hypo-
Scheuthauer-Marie-Sainton ventilation, corpulmonale, difficult patients for dental treatments.
syndrome
Senear-Usher syndrome Hypertrichosis, gingival fibromatosis, cherubism, epilepsy, mental
retardation.

Congenital absence of tongue papilla, vasomotor dysfunctions, loss of
reflexes, feeding problems, lack of pain and taste sensations.

Urethritis, arthritis, conjunctivitis, keratotic macules and papules on the
skin.

Facial paralysis, pain in the external auditory meatus and pinna of the
ear, vesicular eruptions in the oral cavity and oropharynx, hoarseness
of voice, tinnitus, vertigo.

Developmental retardation, broad thumbs and great toes, delayed or
incomplete descent of testes in males.

Hypodontia, enamel hypoplasia, protruding lower lip, maxillary hypo-
plasia, blue sclera, coloboma, malformed anterior teeth, microdontia.

Congenitally enlarged gingiva, delayed tooth eruption, curtain-like
superior corneal opacities and mental retardation.

Stiff joints, corneal clouding, aortic regurgitation, normal intelligence.

Parathyroid hyperplasia or adenoma, pheochromocytomas of the
adrenal medulla, medullay carcinoma of thyroid, no peptic ulcer, no
pancreatic tumor.

Dry eyes, keratoconjunctivitis sicca, xerostomia, parotid swelling, burning
pain in the oral, nasal and pharyngeal mucosa, rheumatoid arthritis.

Open fontanel of the skull, partial or complete absence of clavicles,

underdeveloped maxilla, multiple impacted or unerupted permanent
or supernumerary teeth.
Occurence of vesicles or bullae on the skin and mucosa simultaneous
with appearance of crusted patches.

596 Essentials of Oral Pathology

Stevens-Johnson’s syndrome It’s a severe expression of erythema multiforme characterized by
widespread vesiculation, denudation, sloughing and necrosis involving
Sturge-Weber syndrome the skin, oral mucous membrane, eyes and genitalia.
Orofacial and meningeal angiomatosis with secondary mental deficiency,
Saethre-Chotzen syndrome intracranial calcifications, seizures, hemiplegia, nevus, gingival
Sanfillipo’s syndrome enlargement.
Sweet’s syndrome
Short stature, mild mental retardation, facial asymmetry, ptosis of
Sweat retention syndrome eyelids, prognathism, high arched palate.
Severe CNS defects, mild somatic disturbances, enamel hypoplasia,
Syndrome of crocodile tears excessive dentinogenesis with obliteration of pulp chambers.
Acute onset of fever, leukocytosis, erythematous papules and plaques
Treacher Collin’s syndrome in the skin, predominantly neutrophilic infiltrates in the dermis without
leukocytoclastic vasculitis, internal malignancy.
Turner syndrome
Trotter’s syndrome Extravassation of sweat or saliva in the tissue with subsequent
inflammation, keratin plug formation in sweat glands and accessory
Trichodento-osseous salivary glands.
syndrome This abnormal condition occurs following facial nerve paralysis, herpes
Urbach-Wiethe syndrome zoster and operative trauma in the cranium. It seems to occur due to
straying of the regenerating autonomic nerve fibers, some of those
Van Buchem syndrome destined for salivary glands go to the lacrimal gland instead, resulting in
Vander Woude’s syndrome a salivary-lacrimal reflex. It is characterized by spontaneous lacrimation
Von-Recklinghausen’s occurring parallel with normal salivation during meals.
syndrome Anti-mongoloid palpebral fissures with coloboma. Hypoplasia of the
Velocardiofacial syndrome facial, especially malar and mandibular bones. Microstomia and oral
Von-Hippel-Lindau syndrome fistulas, etc.
Short stature, cubitus vulgus, webbed neck, sexual infantalism, renal
disorders, micrognathia, premature eruption of teeth.

Nasopharyngeal tumor often producing trigeminal neuralgia-like pain,
in the mandible, tongue and side of the head in association with middle
ear deafness.
Tightly curled and kinky hair, osteosclerosis, hypoplastic hypocalcified
enamel, many unerupted teeth and taurodontism, diastema,
microdontia.
Pathologic accumulation of glycoprotein in most bodily tissues,
hoarseness of voice, multiple papules and nodules in the body,
intracranial calcifications, hypodontia.
Excessive deposition of endosteal bone throughout the skeliton, facial
swelling, visual acuity, occasional facial paralysis and deafness.
The simultaneous occurence of pits of the lower lip, cleft lip or cleft palate.
Multiple neurofibromatosis in the body including oral cavity,
pigmentation and hirsutism, risk of malignant transformation of one or
more lesions.

Elongated face, almond-shaped eyes, wide nose, cleft palate, nasal
regurgitation of foods, heart defect.

Hemangioblastomas in retina and cerebellum, pancreatic and renal
cysts, renal adenomas, hepatic hemangiomas, multiple endocrine
neoplasia.

Syndromes Related to Oral Diseases 597

Waterhouse-Friderichsen This syndrome occurs due to acute adrenal cortical insufficiency
syndrome
and is characterized by acute meningitis, septicemia, pronounced
Waber-Cockayne syndrome purpura, bilateral adrenal hemorrhage fever, coma , etc. death usually
Whistling face syndrome occurs within 48 to 72 hours.
It is a localized form of epidermolysis bullosa characterized by recurrant
Wolf-Hirschhorn syndrome bullous eruptions of hands and feet.
XXXXY syndrome
Zimmerman-Laband syndrome Sunken eyes, true ocular hypertelorism, antimongoloid obliquity of
Zinssner syndrome palpebral fissures, small nose, micrognathia, protruding lips as seen
Zinc deficiency syndrome during whistling, high arched palate.

Microcephaly, ocular hyperlelorism, cleft palate, micrognathia and lowly
placed ear.

Hypoplastic midface, short stature, mental retardation, taurodontism,
cleft uvula, hypertelorism.

Gingival fibromatosis with defects in ear, nose, bone and nails, frog-like
fingers and nails, hyperextensible joints and hepatosplenomegaly.

Oral leukoplakia, dystrophic nails, hyperpigmentation of skin,
pancytopenia, aplastic anemia.

Defective taste bud function secondary to zinc deficiency.

BIBLIOGRAPHY 8. Major M Ash Jr. Oral Pathology, 6th edn.
9. Philip Sapp J , Lewis R Eversole, Jeorge P Wysocki.
1. Ahmed R. WB. State Dental Journal. Special issue on
102nd birth anniversery celebration. Contemporary oral and Maxillofacial pathology.
10. Prabhu SR, Daftury DK, Johnson NW. Oral diseases in
2. Cawson RA. Oral pathology and diagnosis-color atlas
with integrated text, 1st edn. the tropic.
11. Regezi JA, Sciubba JJ. Oral pathology: chemical
3. Eveson JW. Cysts of the Oral region 3rd edn, M. Shear.
4. Goaz-White. Oral radiology: principles and pathologic, correlations.
12. Shaper, Hine-Levy. A Text Book of Oral Pathology, 4th
interpretations.
5. John Macleod (Eds). Davidson's Principles and Practice edn.
13. Soames JV, Southam JC. Oral Pathology, 3rd edn.
of medicine: 14th edn. 14. Tencate AR. Oral Histology: development, structure,
6. Lewis R Eversole. Clinical outline of oral pathology:
and function, 3rd edn.
diagnosis and treatment. 15. The Lippincott Manual of Nursing Practice, 2nd edn,
7. Lynch MA, Brightman VJ, Greenberg MS. Burket's Oral
JB Lippincott Company.
Medicine: Diagnosis and Treatment, 9th edn. 16. Wood Goaz. Differential Diagnosis of Oral Lesions, 4th

edn.

Classifications of diseases are important, since – Homogeneous leukoplakia
they not only help in understanding the disease – Ulcerative leukoplakia
in a better way, but also provide guidelines regar- – Nodular or speckeled leukoplakia
ding the diagnosis and prognosis of a particular • Leukoplakia associated with smokeless
disease belonging to a specific group or category. – Tobacco
In a sense, classification of diseases are as useful – Hairy leukoplakia
as the classifications of the animals and the plants • Actinic cheillitis
made in the field of biology. While making the • Carcinoma-in-situ
classification, some diseases are categorized from • Squamous cell carcinoma
others and put into certain specific groups on the • Verrucous carcinoma
basis of their clinical features or radiological • Stomatitis nicotina palati
features or biological behavior, etc. However, the • Verruciform xanthoma.
most important criteria in this regard will be the
histopathological nature of diseased tissue that DERMATOSIS
can determine finally regarding which category
a particular disease will belong to while making • Lichen planus
their classification. In the following section some • Lupus erythematosus.
important classifications of oral diseases are
discussed. INFLAMMATION

WHITE LESIONS OF THE ORAL • Koplik spots of measles
CAVITY • Mucous patches of syphilis
• Chemical burns
HEREDITARY CONDITIONS • Candidiasis
• Dentifrice associated slough.
• Leukoedema
• White sponge nevus MISCELLANEOUS CONDITIONS
• Hereditary benign
• Intraepithelial dyskeratosis • Fordyce’s granules
• Keratosis follicularis • Dental lamina cyst
• Pachyonychia congenita • Bohn’s nodules
• Dyskeratosis congenita • Epstein’s pearls
• Incontinentia pigmenti • Oral submucous fibrosis
• Ptylosis syndrome. • Ectopic lymphoid nodules
• Geographic tongue
LEUKOPLAKIA AND MALIGNANCIES • Papilloma
• Parulis
• Chronic cheek biting • Lipoma
• Friction or trauma associated leukoplakia • Systemic sclerosis
• Idiopathic leukoplakia • Hairy tongue
• Tobacco associated leukoplakia • Heck’s disease
• Oral lesions of chronic renal failure
• Paterson-Kelly syndrome.

RED-BLUE LESIONS OF THE Important Classifications of Oral Diseases 599
ORAL CAVITY
• Radiation mucositis
DEVELOPMENTAL LESIONS • Xerostomic mucositis
• Hemangioma • Traumatic wound
• Median rhomboid glossitis. • Dermatitis herpitiformis
• Mucosal burns
REACTIVE LESIONS • Nonspecific mucositis
• Pyogenic granuloma • Hematoma
• Peripheral giant cell granuloma. • Mucocele.

NEOPLASTIC LESIONS PIGMENTED LESIONS OF THE
• Erythroplakia ORAL CAVITY
• Kaposi’s sarcoma
• Squamous cell carcinoma BENIGN MELANOCYTIC LESIONS
• Field cancerization
• Angiosarcoma. • Racial pigmentations
• Physiologic pigmentations
METABOLIC CONDITIONS • Smoking associated pigmentations
• Vitamin C deficiency • Ephelis
• Vitamin B deficiency • Lentigo
• Pernicious anemia • Oral melanotic macules
• Iron-deficiency anemia • Nevi
• Burning mouth syndrome. • Hematoma.

INFECTIVE CONDITIONS NEOPLASTIC CONDITIONS
• Scarlet fever
• Atrophic candidiasis • Melanoma
• Lymphonodular pharyngitis • Multiple neurofibromatosis
• Infectious mononucleosis • Neuroectodermal tumor of infancy
• Herpetic ulcers • Hemangioma
• Aphthous ulcer. • Kaposi’s sarcoma.

IMMUNOLOGICAL ABNORMALITIES PIGMENTATIONS DUE TO EXOGENOUS
• Plasma cell gingivitis DEPOSITS
• Drug reactions
• Allergic mucositis. • Amalgam tattoo
• Graphite tattoo
PETECHIAE OR ECCHYMOSIS • Heavy metal pigmentations
• Suction petechiae • Drug-induced pigmentations.
• Thrombocyte disorders
• Hereditary hemorrhagic telangiectasia MISCELLANEOUS CONDITIONS
• Ecchymosis.
• Peutz-Jeghers syndrome
MISCELLANEOUS CONDITIONS • Addison’s disease
• Bullous and erosive mucosal disorders. • Pigmented lichen planus
• Hairy tongue
• HIV-associated oral pigmentations
• Mucocele
• Endocrinopathic pigmentations
• Café-au-lait pigmentations.

600 Essentials of Oral Pathology

CLASSIFICATION OF VESICULO- TRAUMATIC CONDITIONS
BULLOUS DISEASES
• Mechanical
VIRAL DISEASE • Thermal
• Chemical
• Herpetic gingivostomatitis • Factitious injury
• Herpetic labialis • Radiation.
• Recurrent herpitic stomatitis
• Herpangina IMMUNOLOGIC DISORDERS
• Hand foot and mouth disease
• Primary vericella zoster • Aphthous ulcer
• Secondary vericella zoster • Behcet’s syndrome
• Measles. • Reiter’s syndrome
• Erythema multiforme
IMMUNOLOGIC CONDITIONS • Pemphigus
• Pemphigoid
• Pemphigus vulgaris • Contact allergy
• Pemphigus vegetens • Ulcerative lichen planus
• Pemphigus foliaceous • Discoid lupus erythematosus.
• Bullous pemphigoid
• Cicatricial pemphigoid SYSTEMIC DISEASES
• Erythema multiforme
• Dermatitis herpetiformis • Leukemia
• Linear IgA disease • Agranulocytosis
• Epidermolysis bullosa aquisita • Cyclic neutropenia
• Bullous lichen planus • Pernicious anemia
• Contact vesicular stomatitis. • Gluten enteropathy
• Crohn’s disease
HEREDITARY CONDITIONS • Uremic stomatitis.

• Epidermolysis bullosa( inherited form) NECROTIC CONDITIONS
• Hailey-Hailey disease
• Darier’s disease. • Midline lethal granuloma
• Wegner’s granulomatosis
MISCELLANEOUS CONDITIONS • Malignant reticulosis
• Osteoradionecrosis.
• Impetigo
• Oral blood blisters. MALIGNANT CONDITIONS

CLASSIFICATION OF ULCERATIVE • Squamous cell carcinoma
CONDITIONS • Antral carcinoma
• Verrucous carcinoma.
INFECTIVE LESIONS
MISCELLANEOUS LESIONS
Bacterial diseases Viral diseases Fungal diseases
• Angular cheilitis
Syphilis Acute herpitic Sporotrichosis • Congenital lip pits
• Commissural pits
Gonorrhea gingivostomatitis Histoplasmosis • Necrotizing sialometaplasia
Tuberculosis • Oroantral fistula.
Leprosy Herpes labialis Cryptococcosis
Actinomycosis
Noma Herpangina Mucormycosis
ANUG
Nonspecific mixed HIV infections
bacterial infections
Infectious mononucleosis

Herpes zoster

Measles

Important Classifications of Oral Diseases 601

CLASSIFICATION OF • Glandular odontogenic (sialo odontogenic;
DISCOLORATION OF TOOTH mucoepidermoid odontogenic) cyst

EXTRINSIC STAINS • Calcifying epithelial odontogenic cyst.

• Substances in the diet Inflammatory
• Smoking
• Habitual chewing of tobacco, betel nut, etc. • Radicular cyst, apical and lateral
• Medicaments, e.g. chlorhexidines or • Residual cyst.
• Paradental cyst and mandibular infected
dentifrices
• Chromogenic microorganisms. buccal cyst.
• Inflammatory collateral cyst.

INTRINSIC STAINS NONODONTOGENIC

• Changes in structure or thickness of dental tissues • Nasopalatine duct (incisive canal) cyst.
- Enamel hypoplasias. • Nasolabial (nasoalveolar) cyst.
- Fluorosis. • Midpalatal raphe cyst of infants.
- Amelogenesis imperfecta. • Median palatine, median alveolar and median
- Enamel opacities
- Enamel caries. mandibular cysts.
- Dentinogenesis imperfecta. • Globulomaxillary cyst.
- Dentin dysplasia. (Type II)
- Age changes in dental tissues. Nonepithelial

• Diffusion of pigments into dental tissues after their • Solitary bone cyst (traumatic, simple,
hemorrrhagic bone cyst)
formation
- Extrinsic stains. • Aneurysmal bone cyst.
- Endodontic materials.
- Products of pulp necrosis. CYSTS ASSOCIATED WITH
• Pigments incorporated during formation of dental THE MAXILLARY ANTRUM

tissues • Benign mucosal cyst of the maxillary antrum
- Bile pigments in biliary atresia. • Postoperative maxillary cyst (surgical ciliated
- Hemosiderin pigments in erythroblastosis
cyst of the maxilla).
fetalis.
- Porphyrines in porphyria. CYST OF THE TISSUE OF THE MOUTH,
- Tetracycline stains. FACE AND NECK
- Postmortem pink tooth.
• Dermoid and epidermoid cysts
CLASSIFICATION OF CYSTS OF • Lymphoepithelial (branchial cleft) cyst
THE ORAL REGION • Thyroglossal duct cyst
• Anterior median lingual cyst (intralingual cyst
ODONTOGENIC
of foregut origin)
Developmental • Oral cysts with gastric or intestinal epithelium

• Gingival cyst of infants (oral alimentary tract cyst)
• Odontogenic keratocyst (primordial cyst) • Cystic hygroma
• Dentigerous (follicular) cyst • Nasopharyngeal cysts
• Eruption cyst • Thymic cyst
• Lateral periodontal cyst • Cysts of the salivary glands—Mucous extra-
• Gingival cyst of adults
• Botryoid odontogenic cyst vasation cyst, mucous retention cyst, ranula,
polycystic (dysgenetic) disease of the parotid.
• Parasitic cysts—Hydatid cyst, cysticercus
cellulosae, trichinosis.

602 Essentials of Oral Pathology

CLASSIFICATION OF • Aneurysmal bone cyst
ODONTOGENIC NEOPLASMS • Fibrous dysplasia of bone
• Cherubism
BENIGN TUMORS • Tuberculosis
• Fibrous histiocytoma
• Tumors of the epithelial tissue origin • Sarcoidosis
– Ameloblastoma • Hodgkin’s disease
– Squamous odontogenic tumor • Calcifying epithelial odontogenic cyst
– Calcifying epithelial odontogenic tumor • Eosinophilic granuloma
(CEOT) • Letterrer Siwe disease
• Giant cell arteritis
• Tumors of mixed tissue origin (made by both • Pulse granuloma
epithelium and mesenchyme) • Histoplasmosis.
– Adenomatoid odontogenic tumor (AOT)
– Ameloblastic fibroma CLASSIFICATION OF VERRUCAL–
– Ameloblastic fibro–odontoma PAPILLARY LESIONS OF ORAL
– Complex odontoma CAVITY
– Compound odontoma
REACTIVE LESIONS
• Tumors of the mesenchymal tissue origin
– Odontogenic fibroma • Papillary hyperplasia of palate
– Odontogenic myxoma • Condyloma latum
– Cementoma • Squamous papilloma
– Cementifying fibroma • Oral warts
– Benign cementoblastoma • Oral papillomatosis
• Condyloma acuminatum
MALIGNANT TUMORS • Heck’s disease.

• Odontogenic carcinomas NEOPLASMS
– Malignant ameloblastoma
– Primary intra-alveolar carcinoma • Keratoacanthoma
• Verrucous carcinoma
• Odontogenic sarcomas • Unknown etiology
– Ameloblastic fibrosarcoma • Pyostomatitis vegetans
– Ameloblastic carcinosarcoma • Verruciform xanthoma.

CLASSIFICATION OF GIANT CELL CLASSIFICATION OF DISEASES OF
LESIONS SALIVARY GLANDS

NEOPLASMS NON-NEOPLASTIC DISORDERS

• Giant cell tumor of the bone DEVELOPMENTAL ANOMALIES
• Central giant cell granuloma
• Peripheral giant cell granuloma • Agenesis (Aplasia)
• Giant cell epulis • Hypoplasia
• Brown tumor of hyperparathyroidism • Atresia
• Giant cell fibroma • Ectopia.
• Malignant fibrous histiocytoma.
REACTIVE LESIONS
OTHER LESIONS WHERE GIANT CELLS
MAY BE PRESENT • Mucus retention cyst
• Mucus extravasation cyst .
• Osteoblastoma
• Chondroblastoma

Important Classifications of Oral Diseases 603

• Sialolithiasis • Neurilemoma
• Post-radiation sialadenitis • Hemangioma
• Chronic sclerosing sialometaplasia. • Melanoma
• Lymphoma.
INFECTIVE LESIONS
CLASSIFICATION OF FIBRO-
Bacterial Sialadenitis OSSEOUS LESIONS

• Acute • Fibrous dysplasia of bone
• Chronic - polyostotic
• Recurrent. - monostotic

Viral Sialadenitis • Ossifying fibroma
• Cementing fibroma
• Mumps. • Central giant cell granuloma
• Cytomegalic inclusion disease. • Brown tumor of hyperparathyroidism
• Paget’s disease of bone
IMMUNE-MEDIATED DISEASE • Cherubism
• Aneurysmal bone cyst
• Mikulicz’s disease • Hemorrhagic bone cyst
• Sjogren’s syndrome. • Focal condensing osteitis
• Exostoses
MISCELLANEOUS DISEASES
- Torus palatinus
• Heerfordt’s syndrome - Torus mandibularis
• Sialosis • Focal osteoporotic bone marrow defect
• Ptyalism and aptyalism (FOBMD)
• HIV associated salivary gland disease. • Fibrous defect (non-ossifying fibroma) of the
mandible
NEOPLASTIC DISORDERS • Osteogenesis imperfecta
• Osteoporosis
A. Epithelial Tissue Neoplasms • Vanishing bone disease (massive osteolysis)
• Histiocytosis-X
Adenomas • Condylar hypertrophy
• Acromegaly
• Pleomorphic adenoma (mixed tumor) • Infantile cortical hyperostosis
• Monomorphic adenoma • Fragile-X syndrome
• Adenolymphoma • Cleidocranial dysplasia
• Oxyphil adenoma • Achondroplasia
• Other types • Rickets
• Mucoepidermoid tumor • Scurvy
• Acinic cell tumor • Hurler’s syndrome
• Carcinomas • Garres’ osteomyelitis.
• Adenoid cystic carcinoma
• Adenocarcinoma CLASSIFICATION OF VASCULAR
• Epidermoid carcinoma TISSUE DISEASES
• Undifferentiated carcinoma
• Carcinoma in pleomorphic (malignant mixed • The arteritides
– Polyarteritis nodosa
tumor).
• Midfacial granuloma syndrome
B. Connective Tissue Neoplasms – Wegner’s granulomatosis

• Fibroma
• Fibrosarcoma
• Lipoma

604 Essentials of Oral Pathology

– Stewart-type midfacial granuloma CLASSIFICATION OF STOMATITIS
– Giant cell arteritis
– Radiation arteritis • Infective stomatitis
• Vascular hamartomas – Primary herpetic stomatitis
– Hemangiomas – Herpes labialis
– Lymphangiomas – Chicken pox
• Telangiectases – Infectious mononucleosis
– Hereditary hemorrhagic telangiectasia – Hand-Foot-and-Mouth disease
– Radiation telangiectasia – Herpangina
• Vascular tumors – Candidiasis
– Leiomyoma – Tuberculosis
– Leiomyosarcoma – Syphilis
– Hemangiopericytoma
– Hemangioendothelioma • Stomatitis immunologically mediated or of
– Kaposi’s sarcoma dubious origin
– Angiolymphoid hyperplasia with eosino- – Aphthous stomatitis
– Behcet’s syndrome
phils and Kimura’s disease. – Lichen planus
– Lupus erythematosus
CLASSIFICATION OF DISEASES OF – Pemphigus vulgaris
– Pemphigus vegetans
THE HEMOPOIETIC TISSUES AND – Pyostomatitis vegetans
– Cicatricial pemphigoid
LYMPHORETICULAR SYSTEM – Desquamative gingivitis
– Bullous erythema multiform
• Anemia – Epidermolysis bullosa
• Sickle cell disease – Dermatitis herpetiformis
• Thalassemia – Reiter’s syndrome
• Leukopenia – Cowden’s syndrome
• Acquired immunodeficiency syndrome – Acanthosis nigricans

(lymph node changes) CLASSIFICATION OF SEVERE
• Purpura INFECTIONS OF THE OROFACIAL
• Leukemias
TISSUES
– Acute lymphocytic leukemia
– Acute myelocytic leukemia • Acute cellulitis
– Chronic lymphocytic leukemia • Ludwig’s angina
– Chronic myeloid leukemia • Space infections
– Granulocytic sarcoma • Cavernous sinus thrombosis
• Lymphomas • Actinomycosis
– Hodgkin’s lymphoma • Histoplasmosis
– Non-Hodgkin’s lymphoma • Phycomycosis
– Burkitt’s lymphona • Cryptococcosis
• Pseudolymphoma • Aspergillosis
• Mycosis fungoides • Blastomycosis
• Lymphomatoid granulomatosis • Cat scratch disease
• Multiple myeloma • Cancrum oris
• Solitary plasmacytoma • Midline lethal granuloma
• Amyloidosis • Suppurative parotitis
• Lymphoma and leukemia like reactions • Acute osteomyelitis of maxilla
• Infectious mononucleosis
• Angiofollicular lymphoid hyperplasia

Important Classifications of Oral Diseases 605

• Acute osteomyelitis of mandible LESION OF THE EAR, NOSE AND ORAL
• Acute infections in AIDS patients and other CAVITY

immunocompromised conditions. • Maxillary sinusitis
• Otitis media
CLASSIFICATION OF CHRONIC • Odontalgia
OROFACIAL PAIN
– Dentin defects
NEURALGIAS – Pulpitis
– Periapical pathology
• Primary trigeminal neuralgia (tic douloureux) – Periapical abscess
• Secondary trigeminal neuralgia (CNS lesions – Periodontal pathology
– Cracked tooth syndrome
or facial trauma) – Occlusal trauma
• Herpes zoster • Atypical odontalgia
• Postherpetic neuralgia • Cyst and tumors
• Geniculate neuralgia • Osteitits
• Glossopharyngeal neuralgia • Mucocutaneous diseases
• Superior laryngeal neuralgia • Salivary gland diseases
• Occipital neuralgia. • Atypical facial pain
• Glossodynia.
PAIN OF MUSCULAR ORIGIN
CLASSIFICATION OF DISEASES
• Cervical osteoarthritis OF TONGUE
• TMJ disorders
DEVELOPMENTAL DISORDERS
- TMJ rheumatoid arthritis
- TMJ osteoarthritis • Aglossia
- Myofacial pain dysfunction syndrome • Hypoglossia
• Fibromyalgia • Cleft tongue
• Cervical sprain or hyperextension • Ankyloglossia
• Eagle’s syndrome. • Fissured tongue
• Scrotal tongue
PRIMARY VASCULAR DISORDERS • Median rhomboid glossitis
• Benign migratory glossitis
• Migraine with aura • Hairy tongue
• Migraine without aura • Lingual thyroid
• Cluster headache • Thyroglossal duct cyst
• Tension–type headache • Microglossia
• Hypertensive vascular changes • Macroglossia
• Mixed headache • Bald tongue.
• Cranial arteritis
• Carotodynia
• Thrombophlebitis.

PSYCHOGENIC PAINS DISORDERS IN LINGUAL PAPILLAE

• Delusional/hallucinatory • Hairy tongue
• Hysterical/hypochondriac. • Oral thrush
• Chemicals burns
GENERALIZED PAIN SYNDROME • White sponge nevus
• Vesiculobullous lesions
• Post-traumatic pain • Lichen planus
• Sympathetically maintained pain (Causalgia) • Leukoplakia
• Phantom pain • Hairy leukoplakia
• Central pain.

606 Essentials of Oral Pathology

• Vitamin deficiency • Parulis
• Hunter’s glossitis • Denture irritation
• Atrophic glossitis in Plummer-Vinson’s • Peripheral giant cell granuloma
• Peripheral fibroma
syndrome or Paterson-Kelly syndrome. • Giant cell fibroma
• Glossitis due to syphilis • Fibrous histiocytoma
• Pigmentations • Malignant fibrous histiocytoma
• Traumatic ulcers • Fibrosarcoma
• Infectious diseases • Nodular fascitis
• Lingual varicosities • Localized fibromatosis
• Lingual hematoma. • Exostosis
• Gingival cyst
DISEASES AFFECTING BODY OF THE • Eruption cyst
TONGUE • Congental epulis of newborn

• Amyloidosis GENERALIZED GINGIVAL ENLARGEMENTS
• Lingual abscess
• Muscular dystrophy • Inflammatory enlargements
• Hypoglossal nerve palsy – Scurvy
• Actinomycosis – Puberty
• Cysticercosis – Pregnancy
• Trichinosis – Oral contraception
• Neck-tongue syndrome – Acute leukemias
• Glossoptosis – Hormonal imbalance
• Glossophyrosis – Crohn’s disease
• Glossodynia – Wegeners’ granulomatosis
• Intracts in the tongue
• Angioneurotic edema. • Fibrous overgrowths of the gingiva
– Hereditary gingival fibromatosis
BENIGN TUMORS – Drug induced gingival fibromatosis
- Phenytoin sodium
• Traumatic fibroma - Cyclosporine
• Pyogenic granuloma - Nifedipine and verapamil
• Granular cell myoblastoma – Chronic hyperplastic gingivitis
• Hemangioma – Orofacial angoiomatosis
• Lymphangioma – Idiopathic
• Neurofibroma
• Salivary gland tumor. • Syndrome associated gingival enlargements
– Rutherford syndrome
MALIGNANT TUMORS – Limmerman-Laband syndrome
– Cowden syndrome
• Squamous cell carcinoma – Tuberous sclerosis syndrome
• Verrucous carcinoma – Gorlin-Goltz syndrome
• Malignant fibrous histiocytoma. – Murry-Puretic-Drescher syndrome
– Cross syndrome
CLASSIFICATION OF GINGIVAL – Ramon syndrome
ENLARGEMENTS – Lysosomal storage disease
– Acanthosis nigricans
FOCAL GINGIVAL ENLARGEMENTS – Epidermal nevus syndrome

• Pyogenic granuloma
• Fibroepithelial polyp

CLASSIFICATION OF SKIN Important Classifications of Oral Diseases 607
DISEASES
– Lichen planus
MACULES AND PATCHES – Venous lake
– Blue nevous
• Hypopigmented vitiligo, – Angiosarcoma.
• Hyperpigmented ephelides
NODULES
– Café –au –lait macules
– Solar lentigo • Basal cell carcinoma
– Melasma • Keratoacanthoma
• Erythematous • Squamous cell carcinoma.
– Erysipelas
– Telangiectasia WHEALS
– Petechiae
– Purpura • Urticaria (Hives)
– Ecchymosis • Angioedema.
– Splinter hemorrhage
PAPULOSQUAMOUS DERMATOSIS
PAPULES AND PLAQUE
• Actinic keratosis (solar keratosis)
• Flesh colored or yellow • Seborrheic dermatitis
– Acrochordon • Psoriasis
– Fibrous papule • Atopic dermatitis
– Adenoma sebaceum • Keratosis pilaris
– Neurofibroma • Pityriasis Rosea
– Syringoma • Verruca vulgaris (Warts)
– Molluscum contagiosum • Flat wart (Verruca Plana).
– Sebaceous hyperplasia
– Xanthelasma VESICLES/BULLAE/PUSTULES
– Milia
– Favre-Racouchot syndrome • Herpes simplex infection
• Varicella-zoster infection
• Hyperpigmented • Contact dermatitis
– Nevus • Impetigo
– Melanoma • Rosacea
– Seborrheic keratitis • Erythema multiforme
• Pemphigus vulgaris/foliaceous/
• Erythematous
– Acne erythematosus.
– Perioral dermatitis
– Folliculitis EROSIONS/FISSURES/ULCERS/SCARS
– Furuncle
– Miliaria • Perleche
– Granuloma faciale • Pyoderma gangrenosum
– Cherry hemangioma • Burns
– Spitz Nevus • Keloid
– Acute febrile neutrophilic dermatosis • Radiodermatitis.
(Sweet’s Syndrome)
– Morbilliform drug eruptions CONNECTIVE TISSUE DISEASE
– Violaceous (Blue or Purple)
• Dermatomyositis
• Lupus erythematosus
• Scleroderma
• Temporal arteritis.

608 Essentials of Oral Pathology

CLASSIFICATION OF TASTE • Damage to taste nerves (facial and glosso-
pharyngeal).
DISORDERS
• Surgical trauma to lingual V, chorda tympani,
• Gustatory-Olfactory confusion in patients or facial nerve (third molar extraction, middle
with hyposmia. ear surgery).

• Post-upper respiratory tract infection. • Surgery trauma to glossopharyngeal nerve
• Any of the multiple causes of olfactory loss (tonsillectomy).
• Secondary dysgeusias and parageusias.
• Retained food, heavy dental plaque, calculus • Viral or bacterial infection of facial nerve
(Bell’s palsy) otitis media diphtheritic neuritis
caries, defective dental restorations, acute of seventh and ninth cranial nerves.
gingivitis, periodontitis, poorly cleaned
bridges or dentures, poor oral hygiene. • Head trauma.
• Abnormal compounds in saliva and nasal • Lesions affecting central taste pathways.
mucus sialadenitis, sialolithiasis, salivary • Head trauma.
hypofunction, Sjogren’s syndrome, post– • Brain tumors, cerebrovascular lesions, tertiary
therapeutic radiation, medications.
• Metabolic byproducts of ingested foods and neurosyphilis, and other neurodegenerative
medications. disease.
• Crevicular fluid and inflammatory transu- • Epilepsy.
dates. • Multiple sclerosis and demyelinating diseases.
• Gingivitis periondontitis, mucositis, extraction • Metabolic disorders.
socket and wounds. • Diabetes mellitus.
• Bacterial or fungal metabolic products. • Hypothyroidism and hyperthyroidism.
• Cryptic tonsillitis, tonsilloliths. • Adrenal insufficiency.
• Abnormal metabolic products circulating in • Hepatic disease.
the blood stream (intravascular taste). • Pregnancy.
• Metallic cations.
• Corrosion of metallic restorations, prosthesis. CLASSIFICATION OF ORAL
• Electric stimulation of taste receptors. SWELLINGS
• Transport disorders.
• Salivary hypofunction and xerostomia. SWELLING ON THE FLOOR OF THE MOUTH
• Sjogren’s syndrome, other sialadenitis, post–
therapeutic radiation, medications affecting • Mucous retention cyst
salivary flow. • Mucous extravasations cyst
• Blocking of taste bud pores by bacteria or other • Dermoid cyst
debris. • Lymphoepithelial cyst
• Blocking of taste bud pores by bacteria or • Salivary gland tumor
dental prosthesis. • Sialolithiasis
• Idiopathic taste abnormality • Benign and malignant tumors
• Age-related changes of gustatory function.
• Disorders affecting sensorineural structures SWELLING OF THE LIP AND BUCCAL
for taste inherited disorders. MUCOSA
• Loss of taste buds or taste bud function.
• Glossitis, lichen planus, leukoplakia, leprosy, • Upper lip
therapeutic radiation, chemotherapy, medi- – Salivary gland tumor
cations toxins, and other substances affecting – Mucocele
taste bud cell function or turnover rate (e.g.,
captopril, penicillamine, gymnemic acid, • Lower lip
cholinergic acid and cynarin), smokeless – Traumatic fibroma
tobacco bulimic purging. – Mucoceles
– Salivary gland tumor
– Benign and malignant tumors

Important Classifications of Oral Diseases 609

• Buccal mucosa swelling • Osteomas
– Traumatic fibroma – Osteoma cutis ( skin)
– Mucoceles – Osteoma of the tongue
– Salivary gland tumor – Miliary osteoma
– Benign and malignant tumors
• Calcified blood vessels
• Palatal swellings – Arteriosclerosis of facial artery
– Mucoceles – Sturge-Weber syndrome
– Salivary gland tumor – Phleboliths (dystrophic calcification in
– Palatal abscess from periapical lesions veins)
– Lymphoma
– Metastatic tumor • Myositis ossificans
– Torus – Localized (traumatic)
– Neoplasms of maxilla – Progressive myositis ossificans.
– Neoplasms of maxillary sinus
• Cysticercosis
CLASSIFICATION OF NECK – Calcification of worm larvae (in the muscles
SWELLINGS of mastication)

• Lateral neck swelling • Neoplasms
– Lymphadenitis—(nonspecific, bacterial , – Ossifying fibroma
viral, fungal) – CEOT
– Metastatic carcinoma to lymph nodes – CEOC
– Lymphoma – Cementifying fibroma
– Parotid lesion (neoplasms, mumps, – Calcifying fibroma
Sjogren’s syndrome).
– Metabolic diseases • Miscellaneous
– Carotid body tumor - Pulp calcifications
– Epidermoid cyst - Hypervitaminosis A
– Cystic hygroma - Chronic osteomyelitis
- CEOT
• Midline neck swelling - CEOC
– Thyroglossal duct cyst - Systemic sclerosis
– Thyroid tumor - Dystrophic calcifications in areas of tissue
– Dermoid cyst necrosis.

CLASSIFICATION OF ORAL CLASSIFICATION OF
SOFT TISSUE YELLOW CONDITIONS OF

• Lymph nodes ORAL MUCOSA
– Chronic infections (tuberculosis)
– Calcification following necrosis • Fordyces’ granules
– Calcification in metastatic tumor • Superficial abscess
• Superficial nodules of tonsillar tissue.
• Sialoliths • Acute lymphonodular pharyngitis
– In submandibular gland • Lipoma
– In other major salivary glands • Lymphoepithelial cyst
– In minor salivary glands • Epidermoid and dermoid cysts
• Pyostomatitis vegetans
• Antroliths • Jaundice or icterus
– In maxillary antrum • Lipoid proteinosis
• Carotenemia
• Calcified ligaments • Pseudoxansthoma clasticum.
– Eagle’s syndrome

610 Essentials of Oral Pathology

ANATOMIC RADIOLUCENCIES OF • Osteoblastoma
JAWBONES • Cementoblastoma
• Gaucher’s disease
• Structures related to mandible • Central giant cell granuloma
– Mandibular foramen • Hemangioma
– Mandibular canal • Brown tumor of hyperparathyroidism
– Mental foramen • Histiocytosis-X
– Lingual foramen • Leukemic cell invasion
– Airway shadow • Lingual mandibular salivary gland depression
– Mental fossa • Mandibular infected buccal cyst
– Midline symphysis • Odontoma (early stage)
– Medial sigmoid depression. • Periodontal cyst
• Solitary/multiple myeloma
• Structures related to maxilla • Metastatic tumor.
– Intermaxillary suture
– Incisive canal CLASSIFICATION OF
– Incisive foramen PERICORONAL RADIOLUCENT
– Nasal cavity
– Naris LESIONS
– Nasolacrimal duct or canal
– Maxillary sinus • Dentigerous cyst
– Greater palatine foramen. • Follicular space around the crown of an

• Structures common to the jaw impacted tooth
– Pulp chamber • Ameloblastoma
– Root canals • Calcifying epithelial odontogenic cyst
– Periodontal ligament space • Adenomatoid odontogenic tumor
– Marrow space • Ameloblastic fibroma
– Nutrient canals • Calcifying epithelial odontogenic tumor
– Developing root crypt. • Envelopmental odontogenic keratocyst
• Ewing’s sarcoma
RADIOLUCENT LESIONS OF THE • Histiocytosis-X
PERIAPICAL REGION • Teratoma
• Odontogenic carcinoma
• Periapical granuloma • Odontogenic fibroma
• Periapical cyst • Squamous odontogenic tumor
• Periapical abscess • Odontogenic myxoma
• Periapical scar • Odontoma in pericoronal area
• Surgical defect • Ossifying fibroma
• Dentigerous cyst • Paradental cyst
• Cementoma stage I • Pseudotumor of hemophilia
• Periodontal pathology • Nonodontogenic malignant tumors
• Traumatic bone cyst • Salivary gland tumors
• Benign nonodontogenic tumor
• Malignant nonodontogenic tumor CLASSIFICATION OF INTER-
• Ameloblastoma RADICULAR RADIOLUCENT
• Aneurysmal bone cyst
• Ameloblastic fibroma LESIONS
• Hemorrhagic bone cyst
• Buccal cyst • Periodontal pocket
• Cementifying fibroma (early stage) • Lateral radicular cyst
• Ossifying fibroma (early stage) • Lateral periodontal cyst
• Furcation involvement

Important Classifications of Oral Diseases 611

• Odontogenic keratocyst(collateral type) • Osteomyelitis—chronic
• Traumatic bone cyst • Adenomatoid odontogenic tumor
• Globulomaxillary cyst • Keratinizing and calcifying odontogenic cyst
• Odontogenic tumors • Ameloblastic fibro-odontoma
• Nasopalatine duct cyst • Calcifying epithelial odontogenic tumor
• Benign nonodontogenic tumors • Odontogenic fibroma
• Median mandibular cyst • Eruption sequestrum
• Paradental cyst
MIXED RADIOLUCENT-
CLASSIFICATION OF RADIOPAQUE LESIONS NOT
MULTILOCULAR RADIOLUCENT NECESSARILY ASSOCIATED

LESIONS OF THE JAWS WITH TEETH

• Odontogenic keratocyst • Chronic osteomyelitis
• Ameloblastoma • Osteoradionecrosis
• Central giant cell granuloma • Fibrous dysplasia
• Central hemangioma • Paget’s disease–intermediate stage
• Neurilemmoma • Cementifying and ossifying fibromas
• Giant cell tumor of hyperparathyroidism • Osteogenic sarcoma
• Cherubism • Osteoblastic metastatic carcinoma
• Odontogenic myxoma • Chondroma and chondrosarcoma
• Aneurysmal bone cyst • Ossifying subperiosteal hematoma
• Calcifying epithelial odontogenic tumor • Adenomatoid odontogenic tumor
• Calcifying epithelial odontogenic cyst • Ameloblastic fibrodentinoma
• Ameloblastic fibroma • Ameloblastic fibro-odontoma
• Lymphoma • Calcifying epithelial odontogenic tumor
• Central ossifying fibroma • Central hemangioma
• Central mucoepidermoid tumor • Ewing’s sarcoma
• Central odontogenic and nonodontogenic • Intrabony hamartoma
• Keratinizing and calcifying odontogenic cyst
fibroma • Lymphoma of bone
• Chondroma • Malignant tumors with superimposed osteo-
• Chondrosarcoma
• Eosinophilic granuloma myelitis
• Immature odontoma • Sclerosing cemental masses
• Neuroectodermal tumor of infancy osteo- • Osteoblastoma (intermediate)
• Osteoid osteoma.
mylitis

MIXED RADIOLUCENT- MULTIPLE SEPARATE RADIOPAQUE
RADIOPAQUE LESIONS
ASSOCIATED WITH TEETH LESIONS OF THE JAWS

• Rarefying and condensing osteitis • Tori and exostosis
• Periapical cementoma—intermediate stage • Multiple retained roots
• Cementifying and ossifying fibroma • Multiple socket sclerosis
• Calcifying and keratinizing odontogenic cyst • Multiple mature cementomas
• Cementoblastoma—intermediate stage • Multiple periapical condensing osteitis
• Foreign bodies • Multiple embedded or impacted teeth
• Generalized (nodular cemental masses) • Cleidocranial dysplasia
• Multiple hypercementosis
Paget’s disease • Rarities
• Odontoma—intermediate stage • Calcinosis cutis

612 Essentials of Oral Pathology

• Cretinism (unerupted teeth) • Fibrous or bony ankylosis following trauma
• Cysticercosis or infection
• Gardner’s syndrome (osteomas)
• Idiopathic hypoparathyroidism EXTRA-ARTICULAR
• Maffucci’s syndrome
• Multiple calcified nodes • Adjacent infection, inflammation, and absces-
• Multiple chondromas (Ollier’s disease) ses (e.g. mumps, pericoronitis, submasseteric
• Multiple odontomas abscess impacted 3rd, molar tonsil or periton-
• Multiple osteochondromas sillar infection)
• Multiple osteomas of skin
• Multiple phleboliths • Extracapsular fractures (mandible, zygoma,
• Multiple sialoliths middle third)
• Myositis ossificans
• Oral contraceptive sclerosis • Overgrowth (neoplasia) of the coronoid process
• Paget’s disease—intermediate stage • Fibrosis from burns or irradiation
• Sickle cell sclerosis. • Hematoma/fibrosis of medial pterygoid (e.g.

GENERALIZED RADIOPACITIES OF following inferior dental block)
THE JAWS • Myofascial pain-dysfunction syndrome
• Drug-associated dyskinesia and psychotic
• Sclerotic cemental masses
• Paget’s disease—mature stage disturbances
• Osteopetrosis • Tetanus
• Rarities • Tetany
• Albright’s syndrome • Parotitis, osteomyelitis of jaw, fractures of
• Caffy’s disease (infantile cortical hyperostosis)
• Camurati-Engelmann disease jawbone, rabies, hysteria, poliomyelitis and
• Craniometaphyseal dysplasia strychnine poisoining.
• Craniodiaphyseal dysplasia
• Fluorosis BIBLIOGRAPHY
• Gardner’s syndrome
• Hyperostosis deformans juvenilis 1. Ahmed R. WB. State Dental Journal. Special issue on
• Melorheostosis 102nd birth anniversery celebration.
• Metastatic carcinoma of prostate
• Multiple large exostoses and tori 2. Burket’s Oral Medicine: Diagnosis and treatment, 9th
• Osteogenesis imperfecta edn. M.A. Lynch/V J Brightman/M.S. Greenberg.
• Osteopathia striata
• Pyknodysostosis 3. Cawson RA. Oral pathology and diagnosis: color atlas
• Van Buchem’s disease. with integrated text, 1st edn.

CLASSIFICATION OF CAUSES OF 4. Eveson JW. Cysts of the oral region 3rd edn, M Shear.
TRISMUS 5. Goaz-White. Oral radiology: principles and

INTRA-ARTICULAR interpretations.
6. J Philip Sapp, Lewis R Eversole, Jeorge P Wysocki.
• Traumatic arthritis
• Infective arthritis Comtemporary oral and maxillofacial pathology.
• Rheumatoid arthritis 7. John Macleod (Eds). Davidson’s principles and practice
• Dislocation
• Intracapsular fracture of medicine: 14th edn.
8. Lewis R Eversole. Clinical outline of oral pathology:

diagnosis and treatment.
9. Major M Ash Jr. Oral pathology, 6th edn.
10. Prabhu SR, Daftury DK, Johnson NW (EdS). Oral

diseases in the tropic.
11. Regezi JA, Sciubba JJ. Oral pathology: chemical

pathologic, correlations.
12. Shaper, Hine–Levy. A textbook of oral pathology, 4th

edn.
13. Soames JV, Southam JC. Oral pathology, 3rd edn.
14. Tencate AR. Oral Histology: Development, structure,

and function, 3rd edn.
15. The Lippincott manual of nursing practice, 2nd edn,

JB Lippincott company.
16. Wood Goaz. Differential Diagnosis of Oral Lesions, 4th

edn.

Index...........................................

A pseudomembranous candidiasis Angiolipoma 66
359, 361 Angiolymphoid hyperplasia with
Aarskog syndrome 587
Abnormal pulpitis 390, 392 eosinophilia 31
radiation syndrome 587 Angiomatous tissue 147
chewing habits 307 suppurative osteomyelitis 403 Angiomyoma 66
occlusion 306 traumatic arthritis 506 Angiomyosarcoma 66
Abnormalities of teeth 32 Addison’s disease 3, 4, 581, 599 Angioneurotic edema 7, 442
Abrasion of teeth 307 Adenocarcinoma 199, 207, 219, 229, Angiosarcoma 148, 599
Acanthomatous Angular cheilitis 343, 362, 461, 510
ameloblastoma 251 232, 233 Anitschkow’s cells 356
pattern of ameloblastoma 241 Adenoid cystic carcinoma 199, 227, Ankyloglossia 22
Acanthosis 180 Ankyloglossum spurious syndrome
nigricans 549 229
Accessory ducts 200 Adenolymphoma 210, 219, 222 22
Acetic acid 373 Adenomatoid odontogenic tumor Ankylosing spondylitis 505
Acetylsalicylic acid 443 Ankylosis of
Achondroplasia 497, 585 244, 248, 279, 292
Acidic foods and beverages 310 Adipocytes 119 teeth 428
Acidogenic theory 374 Adisson’s disease 342 temporomandibular joint 503
Acinic cell tumor 199, 229, 232 Adrenal hormones 473 Anodontia 34, 434
Ackerman’s tumor 97 Adrenogenital syndrome 587 Anomalies of
Acoustic neuroma 136 Adult type periodontitis 534 lips and palate 1
Acquired Advanced enamel caries 382 oral
disturbances of enamel 49 Aerobic and facultative anaerobic
immunodeficiency syndrome lymphoid tissue 30
organisms 397 mucosa 7
339, 530 Aerodontalgia 390, 395 salivary gland 32
micrognathia 13 Agnathia 11 Anorexia-cachexia syndrome 588
pellicle 374 Agranulocytosis 521, 578 Anterior medi lingual cyst 269
syphilis 324 AIDS 342 Anthrax 583
syphilitic lesions 328 Albright syndrome 3, 587 Antibody-mediated hemolytic
Acral lentiginous melanoma 100 Aldosterone 474
Actinic Aldrich syndrome 587 disorders 512
cheilitis 6, 598 Allergic dermatitis 346 Antoni B tissue 136
radiation 176 Allergy and chronic asthma 355 Antrolith 128
Actinobacillus actino- Alveolar Apert’s syndrome 18, 585, 588
Aphthous ulcer 323, 356, 600
mycetemcomitans 528 osteitis 451 Aplastic anemia 511, 578
Actinomyces rhabdomyosarcoma 170, 171 Apparent macroglossia 21
Amalgam tattoo 4, 102 Arrested caries of
israelii 371, 396 Amelanotic melanomas 100, 101
naeslundii 371, 397 Ameloblastic dentin 380
odontolyticus 396 carcinoma 264 enamel 380
viscosus 371, 397, 528 fibrodentinoma 236, 255 Arteriovenous malformation of jaw
Actinomycosis 329, 363, 581 fibrodentinosarcoma 236
Acute fibroma 236, 251, 279, 299 15
atrophic candidiasis 359, 361 fibro-odontome 249, 255, 279 Ascariasis 583
exacerbation of chronic periapical fibro-odontosarcoma 236 Ascher’s syndrome 588
fibrosarcoma 236 Ascorbic acid 461
granuloma Ameloblastoma 97, 104, 116, 237, 248, Aspartic acid 373
400 Asteroid bodies 333
infective diseases 583 261, 272, 299 Atmospheric pollution 77
injuries 433 Amelogenesis imperfecta 40, 48, Atresia 200
leukemia 518 Atrophic candidiasis 511
necrotizing ulcerative 51-53 Attached pulp stones 316
gingivitis 538 Amyloidosis 462, 579 Attrition of teeth 306
periodontitis 538 Anachoretic infection 390 Atypical mycobacteriasis 342
nonspecific ulcers 343 Anaerobic organisms 396, 403 Auriculotemporal syndrome 572
osteomyelitis 402 Anderson syndrome 587 Autogenous transplantation 453
Aneurysmal bone cyst 116, 240, 261,

268, 272, 299, 489

614 Essentials of Oral Pathology

B marrow Cannon‘s disease 9
aspiration 521 Capillary hemangioma 122
Baby bottle syndrome 588 biopsy 161, 166 Capnocytophaga
Bacillary angiomatosis 343
Backward caries 381 Bony group 528
Bacterial artifact 286 ochracea 397
exostoses 409 Carcinoembryonic antigen 91
infections 6, 578 Carcinoma ex-pleomorphic
sialadenitis 198 Book’s syndrome 35, 36, 588
Bacteroides Borderline leprosy and adenoma 225
buccae 396 Carcinoma of
denticola 396 intermediate leprosy 333
endodontalis 396 Borjeson’s syndrome 588 buccal 84
gingivalis 396 Borrelia vincentii 336, 538 floor of mouth 83
Baelz syndrome 588 Botryoid odontogenic cysts 268, 290 gingiva/alveolar ridge 84
Balloon cells 183 Bowen syndrome 588 head and neck 93
Ballooning degeneration 350 Brain abscess 424 lip 80
Basal cell Branchial maxillary antrum 85
adenoma 220, 221 palate 83
carcinoma 70, 95, 229 cleft cyst 126 tongue 81
pattern of ameloblastoma 242 cyst 30 Cardiovascular diseases 584
Basal layer of oral epithelium 276 Brazili pemphigus 552, 554 Caries activity tests 385
Basement membrane 181 Brittle bone syndrome 588 Carotid artery syndrome 589
Basic steps in metastasis 92 Brocq-Pautrier syndrome 588 Caseation necrosis 320
Beckwith’s hypoglycemic 588 Brown stains 541 Causalgia 574
Behcet’s syndrome 357, 588, 600 Brush biopsy 91, 445, 446 Causes of
Bell’s palsy 572, 573 Bruxism 426 abrasion 308
Bence-Jones protein 167 Buccal mucosa 3 acute adrenocortical
Benign Buffering capacity 377
chondroblastoma 131 Bullous pemphigoid 557 insufficiency 474
fibrous histiocytoma 116 Burkitt’s lymphoma 66, 162, 342, 344 development of submerged
intraoral nevus 102 Burning mouth syndrome 588, 599
lymphoepithelial Butyric acid 373 tooth 429
failure of
cyst 304 C
lesions 157 biopsy 447
melanocytic lesions 599 Café-au-lait immunosurveillance system
neoplasm of pigmentations 599
adipose tissue origin 119 spots 138 91
bone 127 replantation 453
cartilage tissue 130 Caffey’s disease 489, 496, 582 transplantation 454
lymphatic vessels 124 Caffey-Silverman syndrome 589 fibrous hyperplasia 535
neural tissue 135 Calcifying folic acid deficiency 461
smooth muscles 131 gingival hyperplasia 535
striated muscle 133 epithelial odontogenic inflammatory hyperplasia 535
vascular tissue origin 120 cyst 116, 246, 259, 279, 290, 299 loss of enamel after tooth
Bernard-Soulier syndrome 588 tumor 246, 247, 255, 259, 261,
Berry’s syndrome 588 292 formation 306
Bifid uvula 16 macrodontia 34
Biliary atresia 440 odontogenic cyst 236, 268 microdontia 33
Bing-Neel syndrome 588 Calcium 456 pathological attrition 306
Biopsy 445 pulp calcification 315
Bitot’s spot 460 channel blockers 535 traumatic ulcer 431
B-K mole syndrome 588 Calculus 529 Cavernous
Black-Gray stains 541 Campylobactor sputorum 397 hemangiomas 123
Bloch-Sulzberger syndrome 588 Canalicular adenoma 220, 221 sinus thrombosis 421, 424, 585
Blood Cancrum oris 336 Celiac disease 582
diseases 530 Candida Cell proliferation 275
disorders 473 study 182
Blue nevus 70, 72 albicans 358 Cell rest of
Bohn’s nodules 288, 598 associated angular cheilitis 360 Malassez 237
Bone Candidal Serre 237
diseases 582 endocarditis 361 Cellular
infarct 153 hyphae 181 atypia 180
meningitis 361 pleomorphism 89, 180
septicemia 361 Cemental tear 426
Candidiasis 10, 73, 176, 182, 342, 358, Cementicles 318
Cementifying fibroma 246, 249, 259,
581
Candidiasis endocrinopathy 589 486

syndrome 361
Canine fossa infection 414

Index 615

Cementoblastoma 236, 262, 409 sialadenitis 205 Cobble-stone appearance 211
Cementomas 261, 410 sialometaplasia 198 Coccidioidomycosis 343, 362
Central osteomyelitis 130 Codman’s triangle 155
sialadenitis 210 Coffin-Lowry syndrome 589
cementifying fibroma 130 steroid therapy 580 Coffin-Siris syndrome 589
crusted ulcer 96 sun exposure 68 Collagen diseases 473
giant cell granuloma 106, 111, 113, suppurative osteomyelitis 406 Complete blood count 519
tongue biting habits 183 Completely impacted tooth 40
115, 240, 259, 261, 299, ulcers 322 Complex odontoma 236, 254, 409
489 of tongue 430 Complications of
Church spires 98
hemangiomas 122, 124 Cicatricial pemphigoid 356 diabetes mellitus 476
neurilemmoma 261 Classic Burkitt’s lymphoma 162 polycythemia vera 517
odontogenic fibroma 116, 258 Classification of Composition of
ossifying 249 chronic orofacial pain 605 diet 378
cysts of oral region 601 sialolith 204
fibroma 106, 109, 130, 299 diseases of tongue 605 tooth 376
Cerebral palsy 584 fibro-osseous lesions 603 Compound
Cerebrocostomandibular 589 giant cell lesions 602 nevus 70, 71
Chediak-Higashi syndrome 589 gingival enlargements 606 odontome 254, 279
Cheek and lip biting 432 leukemias 518 Computed tomographic scan 274
Cheilitis lymphomas 157 Condensing osteitis 262
multilocular radiolucent lesions Condyloma
glandularis 5, 7 acuminatum 68, 343
granulomatosa 6, 7 611 lata 325
Chemical neck swellings 609 Cone biopsy 445
burns 182, 207, 362, 443, 598 odontogenic Congenital
injuries 440 epulis of newborn 66
Cherubism 116, 486 neoplasms 602 heart disease 584
Chickenpox 344, 346, 348 tumors 236 mandibular micrognathia 13
Chinese restaurant syndrome 589 oral micrognathia 13
Chloramphenicol 523 neoplasms 65 porphyria 440
Cholesterol clefts 286 non-odontogenic neoplasms syphilis 33, 48, 324, 326
Chondroblastic type of osteosarcoma Congenitally missing premaxilla 13
65 Congestive cardiac failure 584
153 soft tissue 609 Conn’s syndrome 474
Chondroblastoma 66 swellings 608 Connective tissue
Chondroectodermal dysplasia 35, 36 osteomyelitis 402 disease 607
Chondroma 66, 130, 219 pericoronal radiolucent lesions neoplasms 199, 603
Chondromyxoid fibroma 66, 261 Consequences of
Chondrosarcoma 66, 150, 157 610 external resorption 313
Chronic pulpal diseases 390 HIV infection 340
salivary gland diseases 198 Constitutional diseases 342
adrenocortical insufficiency 474 skin diseases 607 Contact allergy 585
alcoholism 580 stomatitis 604 Contents of
apical periodontitis 398 taste disorders 608 cyst 268
atrophic candidiasis 360 tooth fracture 426 infratemporal space 415
bone abscess 130 vascular tissue diseases 603 Coomb’s test 513
candidiasis 175, 183 vesiculobullous diseases 600 Core
caries 380 yellow conditions of oral mucosa biopsy 445
cheek biting 598 needle biopsy 445
depression 511 609 Corneal ulceration 460
factitial injury. 6 Clear cell Costen’s syndrome 589
focal sclerosing osteomyelitis 408 Cotrimoxazole 344
hyperplastic adenoma 220 Cowden’s syndrome 589
odontogenic carcinoma 236 Coxsackie virus infections 353
candidiasis 99, 360, 362 Cleft Cracked tooth syndrome 589
pulpitis 390, 394 lip 16-18, 35 Craniofacial dysostosis 492
infections 73 of primary palate 16 Crest syndrome 564, 589
inflammatory cell infiltration 181 of secondary palate 16 Cretinism 469
injury 390 palate 16-18, 35, 40 Cribriform pattern 228
iron deficiency anemia 175 tongue 22 Crohn’s disease 6, 7, 356, 536, 581,
irritation 176, 177 Cleidocranial
leukemias 518 dyplasia 40 600
nonsuppurartive osteomyelitis dysostosis 492
dysplasia 18, 62, 491, 585
130 Clostridium tetani 334, 335
oral infections 77 Coarctation of aorta 584
osteomyelitis 131, 153, 402
pulpitis 390, 393
sclerosing

616 Essentials of Oral Pathology

Cross syndrome 589 Desquamative gingivitis 537 E
Crouzon syndrome 18, 589 Diabetes
Cryptococcosis 342, 363 Eagle’s
Cryptosporidiosis 342 insipidus 467 syndrome 574, 590
Cupid’s bow 2 mellitus 529, 579 talon 47
Cushing’s syndrome 580, 589 Diagnosis of
Cutaneous lesions of lichen planus AIDS 343 Early
herpes-zoster 350 bell stage 235
192 pulpal diseases 396 healing phase 450
Cyclic neutropenia 522 sialolithiasis 203
Cyclosporine 535 xerostomia 215 Ectodermal dysplasia 35, 582
Cyst of Diarrhea 342 Ectopic salivary glands 200
Dietary Eczematous cheilitis 6
salivary gland 301 carbohydrates 369 Edward’s syndrome 18, 590
tissue of mouth, face and neck 269 deficiency 176 EEC syndrome 590
Cystic Differential diagnosis of Egg-shell cracking 166, 240
fluid 284 leukoplakia 182 Ehlers-Danlos syndrome 315, 566,
hygroma 124, 269, 304 oral tuberculous lesions 323
Cysticercosis 583 squamous cell carcinoma 86 582, 590
Cytologic smear 346 Diffuse Eikenella corrodens 397, 528
Cytomegalic inclusion disease 198, linear calcifications of pulp 316 Elashy-Waters syndrome 18, 590
sclerosing osteomyelitis 409 Electrical burns in mouth 434
209 Dilantin sodium therapy 537 Ellis-Van Creveld syndrome 590
Cytomegalovirus 148 Diphtheria 332 Embedded tooth 38, 40
Diphtheric patch 332 Embryonal rhabdomyosarcoma 150,
infection 343, 350 Direct
Cytotoxic drug therapy 442 antibacterial action 377 169, 170
Cytotoxic drug 58 pulp capping. 393 Enamel
Discoid lupus erythematosus 74, 78,
therapy 157 caries 382
182, 195, 362, 561 defects 54
D Diseases of hypocalcification 48
hypoplasia 48, 49
Darier’s disease 600 muscles 574 matrix formation 48
Dark nerves 569 pearl 47
periapical tissues 398 solubility test 386
blue papule 72 Disorders of salivary gland 213 Encephalitis 342
zone 382 Disseminated tuberculosis 210 Encephalopathy 342
Daughter cysts 274 Distoangular impaction 40 Endemic
Deep Disturbance in Kaposi’s sarcoma 147
fungal infections 362 eruption of teeth 38 parotitis 209
mycotic infections 323 hormone metabolism 466 Endodontic-periodontic lesions 412
Defective amelogenesis 49 inductive tissue interactions 17 Endoscopic biopsy 445
Deficiency of vitamin lipid metabolism 464 Endosteal
C 462 mineral 456 hyperostosis 493
D 459 number of teeth 34 osteoma 127
Dejerine-Roussy syndrome 590 protein metabolism 462 Endothelial cells 145, 147
Dental shape of teeth 41 Enlarged
arch asymmetry 42 size of teeth 32 lymph nodes 233
caries 368, 369, 378, 381 structure of parotid lymph node 225
follicle 235 tooth follicle 293
lamina cyst 288, 598 cementum 61 Enlargement of cyst 275
Denticles 316 dentin 54 Environmental enamel hypoplasia
Dentigerous cyst 240, 246, 249, 268, enamel 48
teeth 48 48
272, 276, 279, 292 vitamin metabolism 458 Enzyme
Dentin Diverticuli 200
Double lip 2 histochemistry 181
dysplasia 59 Down syndrome 18, 35, 495, 585, 590 linked immunosorbent assay test
pulp complex 389 Dry socket 451
Dentinal sclerosis 318, 390 Dyskeratosis 180 324, 343
Dentinogenesis imperfecta 48, 55, 56 congenita 550, 598 Eosinophilia 191
Dentoalveolar abscess 400 Dysphagia 335 Eosinophilic granuloma 32, 157, 465
Denture sore mouth 433 Dysplasia 180 Epidemic Kaposi’s sarcoma 147
Dermatitis herpetiformis 548 Dystrophic calcification 457 Epidermal nevus syndrome 590
Dermatofibroma 102 Epidermoid
Dermatological diseases 582
Dermatosis 598 carcinoma 134, 199
Dermoid cyst 30, 31, 269, 304 cysts 269
Desmoplastic fibroma 105, 111 Epidermolysis bullosa 48, 54, 78, 558,

582

Index 617

Epilepsy 584 Fibromyxoma 240 Fusobacterium
Epithelial Fibrosarcoma 103, 119, 140, 157, 199 fusiformis 538
Fibrous necrophorum 336
dysplasia 180 nucleatum 396, 528
islands 89 dysplasia 116, 153, 583
tissue neoplasms 199, 603 of bone 111, 482 G
Epitheloid cells 71, 320
Epstein’s pearls 288, 598 histiocytoma 119 Galvanism 176, 177
Epstein-barr virus 73, 76, 344 Field cancerization 599 Ganglioneuroma 66
diseases 344 Filariasis 583 Gardner’s syndrome 40, 410, 494591
infection 343 Fine needle aspiration cytology 445 Garre’s osteomyelitis 150, 157, 262,
Epulis fissuratum 433 Fingernail injuries 432
Erosion of teeth 309 Fissured tongue 23 486
Eruption Fixation of biopsy specimen 447 Gastrointestinal
cyst 268, 286 Floppy infant syndrome 590
sequestrum 38, 41 Florid osseous dysplasia 262 diseases 424
Erythema multiforme 195, 346, 546, Flow cytometric detection 91 infections 342
Fluconazole 344 Gaucher’s disease 466
600 Fluorescent antibody test 346 Gemination of tooth 48
Erythroblastosis fetalis 440, 515, 579 Fluoride action 377 Genetic disorders 585
Erythromycin 535 Fluorosis 441, 583 Genital
Erythroplakia 78, 175, 185 Focal herpes 344, 347
Eubacterium lesions 357
dermal Geographic tongue 25, 183
alactolyticum 396 hyperplasia 68 Ghost tooth 48
brachy 396 hypoplasia 49, 590 Giant cell
lentum 396 fibroma 105, 106, 133, 411
nodatum 396 epithelial hyperplasia 8 tumor of bone 116, 153
Ewing’s infection 423 Giardia 342
sarcoma 66, 149, 153, 411 macrodontia 34 Gigantism 468
tumor 86 microdontia 33 Giles de la Tourette syndrome 591
Exanthematous disease 51 reversible pulpitis 390, 391 Gingival
Excisional biopsy 445 sclerosing osteomyelitis 128, 255, cyst of
Exfoliative cytology 90, 182, 445, 447
Exostoses 128 264 adults 268, 288
Experimental caries in animals 387 Folic acid 461 infants 268
Exposure to sunlight 347 newborn 288
External RCT and apicectomy 453 Folic acid deficiency 577 hyperplasia 535
Extraoral discharging sinus 80 anemia 578 lesions 322
Extrinsic stains of tooth 541 Follicular Gingivitis 531
ameloblastoma 241 Glandular
F keratosis of skin 460 dysfunctions 483
Fordyce’s granules 7, 8, 598 odontogenic cyst 268, 289
Facial Foreign body reaction 323 Globulomaxillary cyst 246, 268, 293
hemiatrophy 15 Formation of Glomus tumor 66, 147
hemihypertrophy 13, 34 dental papilla 235 Glossopharyngeal neuralgia 572
nerve paralysis 572 fibrous callus 452 Glucocorticoids 473
primary bone callus 452 Glutamic acid 373
Factitious injury 431 root 236 Glycogen rich adenoma 220
False secondary bone callus 452 Goldenhar syndrome 18, 591
Forward caries 381 Gonorrhea 328, 329, 584
anodontia 34 Fracture callus 157, 411 Gorham syndrome 591
pulp stones 316 Fractures of teeth 426 Gorlin-Goltz syndrome 489, 591
Familial Fragile X syndrome 590 Grades of osteoradionecrosis 439
gigantiform cementoma 262 Fraser’s syndrome 22 Gram-negative rods 397
mucocutaneous candidiasis 361 Free pulp stones 316 Gram-positive
dysautonomia 27 Frenal tag 2 cocci 396, 397
Fanconi’s syndrome 590 Frey’s syndrome 572, 590 rods 396, 397
Favre-Racouchot syndrome 590 Frictional keratosis 182 Granular cell
Fessas bodies 514 Frozen section biopsy 445, 446 myoblastoma 25, 66, 86, 132, 133
Fetal-alcohol syndrome 590 Functions of pattern of ameloblastoma 241
Fibroblastic type of osteosarcoma 153 glucocorticoids 473 Granulation tissue 399
Fibroepithelial polyp 107, 109, 113, phosphorus in body 457 Granulocytopenia 521
vitamin Granuloma inguinale 584
137 Granulomatous diseases 581
Fibroma 104, 109, 113, 134, 137, 219 C 462
Fibromatosis 119 D 459
Fungal infection 358
gingivae 10 Fusion of teeth 34

618 Essentials of Oral Pathology

Green stains 541 Herpetiform ulcers 355, 356 Hypoplasia of
Grinspan syndrome 591 Herring bone 106 mandibular condyle 502
Gumma of tertiary syphilis 25 salivary glands 199
Gummy smile 13 pattern 142
Gunn’s syndrome 591 Hetch-Beals-Wilson syndrome 592 Hypothyroidism 469, 511
Histoplasmal ulcers 343 Hypovolemic shock 585
H HIV
I
Habitual abrasion 308 anti-retroviral treatment 344
Hailey-Hailey disease 600 associated salivary gland disease Idiopathic
Hairy anodontia 34
199 delayed eruption 39
leukoplakia 342, 344, 598 Hodgkin’s lymphoma 66, 164 enamel opacities 49
tongue 27, 598, 599 Homocystinuria 495 external resorption 313
Hajadu-Cheney syndrome 591 Homogenous leukoplakia 598
Hallermann-Streiff syndrome 11, 592 osteomyelitis 402
Hand-Schuller-Christian disease 464 erythroplakia 186
Hanhart syndrome 592 leukoplakia 178 Imbalance of sex hormones 477, 581
Happy puppet syndrome 592 Homologous transplantation 453 Immune-mediated diseases 198, 209
Hay-Wells syndrome 592 Hormone disorder 473 Immunological tests 344
Healing of Horner’s syndrome 591 Immunology of oral cancer 91
biopsy wound 449 Horton’s syndrome 591 Immunosuppression 68, 92, 347
extraction wound 450 Hperthyroidism 470 Impacted tooth 38
fractured jawbone 451 Hpopituitarism 467 Impaired intrinsic tissue function 17
gingivectomy wound 450 Human In vitro testing of living tissue 182
oral wounds 448 cytomegalovirus 344 Incisional biopsy 445
Heavy metal poisoning 580 Incisive canal cyst 295
Heck’s disease 8, 598 diseases 344 Incontinentia pigmenti 35, 36, 545,
Heerfordt’s syndrome 198, 213, 591, immunodeficiency virus 73, 76,
598
603 148 Individual cell keratinization 89, 250
Helminthic diseases 583 papilloma virus 73, 76 Indomethacin 523
Hemangioendothelioma 66, 145 Infantile cortical hyperostosis 496
Hemangioma 66, 102, 120, 126, 148, infection 68, 343, 352 Infectious mononucleosis 340, 344,
Hunter syndrome 591
199 Hurler’s syndrome 463579, 591 351
Hemangiomas of skin and mucous Hutchinson’s Inflammatory

membrane 120 Freckle type 101 diseases 390
Hemangiopericytoma 66, 145, 153 triad 327, 584 disorders 505
Hematoma 102 Hutchinson-Gilford syndrome 591 gingival hyperplasia 109
Hemochromotosis 458 Hyalinosis cutis mucosae 35, 36 hyperplasia of tissue 124
Hemolytic anemia 512 Hydatid cyst 583 Infratemporal space infection 415
Hemophilia 579 Insulin-dependent diabetes mellitus
Hemophilus influenzae 342 Hyoid syndrome 592
Hepatitis 340 Hypercementosis 62, 316 475
Hereditary Hyperfunction of adrenocortical Interstitial pulp stones 316
Intestinal polyposis 3
anodontia 35 hormone 474 Intradermal nevus 70
disturbance of enamel formation Hypergammaglobulinemia 191, 344 Intraepithelial dyskeratosis 598
Hyperorthokeratinization 179 Intraluminal unicystic
51
ectodermal dysplasia 33, 543 Hyperparakeratinization 179 ameloblastoma 243
fructose intolerance 370 Hyperparathyroidism 261, 470, 486, Intramuscular hemangioma 121
gingival hyperplasia 537 Investigations in Sjogren’s syndrome
hemorrhagic telangiectasia 102 489, 581
intraepithelial dyskeratosis 10 Hyperphosphatemia 457 212
Herpangina 353 Hyperpituitarism 467 Ionizing radiation 76
Herpes Hyperplasia of mandibular condyle Iron deficiency anemia 510, 578, 599
labialis 344 Irregular
simplex 342 502
Hypertension 584 epithelial stratifications 180
virus 73, 76, 344, 345 Hyperthyroidism 469, 581 reactionary dentin 384
virus infections 344 Hypervitaminosis A 577 Irritation fibroma 107
zoster 342, 344 Hypocalcemia 51 Isosporiasis 342
Hypocementosis 62
virus infection 343 J
Herpetic Hypodontia 34
Hypoparathyroidism 48, 472, 580 Jaffe-Lichtenstein syndrome 592
eczema 344, 347 Hypophosphatasia 58, 62, 458 Jaffey’s type 482
ulcers 356 Hypophosphatemia 58, 457, 579 Jamestown canyon virus 342
Hypophyseal fibrosis 466
Hypopituitarism 466

Index 619

Jaundice 579 Leukoedema 182, 183, 598 odontogenic neoplasms 264
Jaw winking syndrome 592 Leukoplakia 9, 10, 74, 175, 178, 362 oral tumors 586
Jugular foramen syndrome 592 Lichen planus 10, 28, 74, 182, 183, 191, osteoblast cells 156
Jugulo-digastric and jugulo- reticulosis 600
195, 362, 582, 598 salivary gland neoplasms 225
omohyoid nodes 93 Lichenoid reactions 27 transformation in leukoplakia 182
Junctional nevus 70, 71 Linear gingival erythema 343 Mallory’s phosphotungstic acid-
Juvenile Lingual
hematoxylin stain 132
angiofibroma 66 mandibular salivary glands Mandibular
hypoparathyroidism 58 depression 201
periodontitis 534 cleft 16
thyroid nodule 25, 28, 30 protrusion 13
K varices 25 Mandibulofacial dysostosis 497
Lip Mandibulo-oculofacial dyscephaly
Kaposi’s sarcoma 102, 124, 147, 160, deformities 434
186, 342, 599 lesions 322 35
pits 2 Marble bone disease 492
Kelstadt’s cyst 294 pits and fistulas 1 Marfan’s syndrome 11, 18, 494, 585,
Keratin pearls 89 Lipid reticuloendotheliosis 464
Keratinization pattern 276 Lipoma 66, 119, 126, 199, 219, 225 592
Keratoacanthoma 9, 68, 69, 86 Liposarcoma 66, 143, 144 Marin-Amat syndrome 593
Keratoconjunctivitis 333, 344, 347 Lipstick sign 215 Massive osteolysis 498
Keratosis follicularis 549, 582, 598 Liver Mature cementoma 409
Kidney transplantation 584 biopsy 161 Maxillary
Kimura’s disease 66 scan 161
Klinefelter’s syndrome 495, 592 Localized mucocutaneous canine tooth 414
Koebner phenomenon 192 sinusitis 422
Koplik spots of measles 598 candidiasis 361 Measles 352
Loss of teeth 586 Median
L Low-grade tumor 231 cleft face syndrome 18, 593
Ludwig’s angina 420, 421 rhomboid glossitis 23
Lactic acid 373 Lumbar puncture 521 Medullary osteosarcoma 153
Lactobacillus Lupus Melanocytes 99
Melanoma 199
acidophilus 371, 372 erythematosus 342, 559, 598 Melanotic neuroectodermal tumor of
catenaforme 396 vulgaris 322
minutus 396 Lymphadenopathy 578 infancy 139
Langhan’s type of giant cells 320 Lymphangiogram 521 Melnick-needles syndrome 593
Laparotomy 161 Lymphangioma 21, 66, 124 Meniere’s syndrome 593
Larsen syndrome 18, 592 Lymphatic abnormalities 14 Meningitis 340, 342, 424, 583
Laser Lymphocyte like cells 71 Meningoencephalitis 340, 342, 344,
biopsy 445 Lymphocytes depletion 165
radiation 440 Lymphoepithelial cyst 30, 269 347
Late stage of fibrous dysplasia 410 Lymphoma 7, 86, 150, 199, 342 Menopause 581
Latent tuberculosis 320 Lymphopenia 343 Menstrual cycle 347
Lateral Menstruation 581
dentigerous cyst 293 M Mental space infections 416
periodontal abscess 539 Mesenchymal
periodontal cyst 246, 251, 268, 272, Macrodontia 34
Macroglossia 20 chondrosarcoma 150, 152
287, 293 Macrognathia 13 neoplasms 30
pharyngeal space infection 417 Macroscopic appearance 140 tissue 140
radicular cysts 283 Mesioangular impaction 40
Laugier-Hunziker syndrome 592 of sialolith 203 Metal poisoning 441
Leiomyoma 66, 133, 137 Maffucci’s syndrome 594 Metastatic
Leiomyosarcoma 66, 103, 169 Magenta glossitis 461 carcinoma 104, 150, 232
Leishmaniasis 363, 583 Magic syndrome 594 small cell carcinoma. 153
Lentigo maligna melanoma 100 Magnetic resonance imaging 87, 172 tumor 409
Leontasis ossea 13 Major aphthous ulcers 343, 355, 356
Lepra cells 334 Malignant of jaw bone 411
Lepromatous leprosy 333 Microdontia 32
Leprosy 7, 333 ameloblastoma 236, 237, 264 Microglossia 20
Leptotrichia buccalis 538 diseases of plasma cells 166 Micrognathia 11, 13, 39
Lesch-Nyhan syndrome 592 fibrous histiocytoma 143 Microstomia 434
Letterer-Siwe disease 465 lymphoid cells 165 Midcervical lymph nodes 93
Leukemia 150, 167, 342, 578 lymphoma 210, 225 Middle fossa syndrome 593
melanoma 65, 99 Midline lethal granuloma 335, 600
neoplasms 64, 65, 140 Midpalatal raphe cyst of infants 268
Miescher’s syndrome 593

620 Essentials of Oral Pathology

Migraine syndrome 593 Mumps 209, 353 Neurogenic sarcoma 143, 171,
Mikulicz’s Munchausen syndrome 594 Neurologic diseases 342
Mural unicystic ameloblastoma 244 Neurological pain 569
disease 198, 209, 210, 603 Mxedema 469 Nevoid basal cell carcinoma
syndrome 593 Myasthenia gravis 575
Mild epithelial dysplasia 180 Mycobacterium syndrome 271
Miliary tuberculosis 321 Nevus
Miller ’s bovis 320
chemico-parasitic theory 369 tuberculosis 320 cells 70
syndrome 594 Mycosis fungoides 66 unius lateris 67
Mineralocorticoids 473, 474 Myelodysplastic syndrome 594 Niacin 460
Minor aphthous ulcer 355 Myeloma 150 deficiency 577
Mitotic index 436 Myofacial pain dysfunction Nicotinamide deficiency 577
Mixed Nicotinic acid 460
cellularity 165 syndrome 507 Niemann-Pick disease 466
radiolucent-radiopaque lesions Myositis ossificans 575 Night blindness 460
Myxedema 469, 581 Nikolsky’sign 553
611 Myxoma 106, 111, 116, 117, 132, 219, Nodular
Mobility of wound 449 fascitis 143
Mobius syndrome 593 236 melanoma 100
Mode of transmission of HIV 340 syndrome 593 sclerosis 165
Moderate Non-nucleoside reverse transcriptase
N
burns 435 inhibitor 344
epithelial dysplasia 180 Nagar syndrome 18, 594 Non-Hodgkin’s lymphoma 66, 159,
Mohr syndrome 593 Nasolabial cyst 268, 294
Molluscum contagiosum infection Nasopalatine duct 268 343
Non-insulin-dependent diabetes
343 cyst 295, 296
Mona lisa face 564 Nasopharyngeal mellitus 475
Monomorphic adenoma 199, 220, 229 Non-neoplastic
Monostotic fibrous dysplasia 482 carcinoma 344
Moon’s molars 327 cysts 269 disorders 198
Morphea 96 Natal teeth 38 inflammatory cells 165
Morphology of tooth 376 Natural Non-odontogenic
Morquio’s syndrome 54, 592 history of disease 479 cysts 293
Moth-eaten’ killer cells 92 neoplasms 65
Nature of tumors or cysts 40
appearance 163 cyst lining 276 Non-pigmented cells 140
radiolucency 439 tissue 436 Noonan syndrome 594
Mottling of enamel 51 Neck-tongue syndrome 594 North American blastomycosis 364
Mucoceles 105, 124 Necrotizing Nuclear hyperchromatism 89, 180
Mucocutaneous infections 342 sialometaplasia 206 Nucleoside reverse transcriptase
Mucoepidermoid ulcerative mucositis 336
carcinoma 207, 229 Neisseria gonorrhoeae 328, 329 inhibitor 344
tumor 199, 225, 230 Neonatal Numb chin syndrome 172
Mucormycosis 342, 364 herpes 344, 348 Nursing bottle caries 380
Mucosal lentiginous melanoma 100 teeth 38 Nutritional
Mucous Neoplasia of temporomandibular
extravasation cyst 198, 302 deficiency 49, 188
membrane pemphigoid 195 joint 508 factors 354
patches of syphilis 598 Neoplasms of
retention cyst 198, 225, 302 O
Muir-Torre syndrome 593 debatable origin 236
Mulberry molars 327 epithelial tissue 65 Obligatory intracellular parasite 339
Multicentric Oblique facial cleft 16
cancer 80 origin 65 Occipital condyle syndrome 594
ameloblastoma 237 mesenchymal tissue origin 65 Ocular diseases 424, 473
Multiple minor salivary gland 31 Oculodento-osseous dysplasia 54
cancer 80 salivary glands 215 Oculoglandular syndrome 594
multinucleated giant cells 107 Neural diseases 584 Odontoameloblastoma 236, 255
myeloma 66, 166, 578 Neuralgia 569 Odontogenic
neurofibromatosis 137 Neurilemmoma 134, 135, 199
sclerosis 584 Neuroblastoma 66, 86, 150 carcinoma 236, 265
separate radiopaque lesions of Neuroectodermal cyst 39, 270
in origin 70 epithelium 236
jaw 611 tumor of infancy 150 fibroma 236, 257
Neurofibroma 105, 119, 133, 134, 137 keratocyst 116, 240, 268, 270, 279
Neurofibromatosis 15, 483 myxoma 259, 272
neoplasms 65

Index 621

sarcomas 236, 265 Oteogenesis imperfecta 490 Periosteal
tumor 40 Otopalatodigital syndrome 18, 594 osteoma 127
Odontomas 128 Oxyphilic adenoma 222 osteosarcoma 153, 157
Odontome 246, 254
Oligodontia 34 P Peripheral
Olmsted syndrome 594 ameloblastoma 109, 237
Oncocytoma 219, 222, 225 Pachyonychia congenita 598 cells 8
Opisthotonus 334 Paget’s disease of bone 13, 62, 153, cuffing 113
Oral giant cell 111
cancer 73, 80 262, 264, 316, 410, 479, 486, granuloma 105, 107, 109, 111,
complications of scarlet fever 331 582 137
contraceptives 535 nerve dysfunction 15
diseases 585 Pain in odontogenic fibroma 109, 257
facial digital syndrome 18, 594 abdomen 329 ossifying fibroma 108, 113
foci of infection 586 jaws 569 osteoma 409
hairy leukoplakia 28, 183 teeth and supporting structures trigeminal neuritis 15
lesions of lichen planus 192 569
leukoplakia 78 Pernicious anemia 509, 578, 599
lichen planus 78, 175 Palatal Persistent generalized
melanotic macule 3, 102 lesions 322
mucosal lesions 547 space infection 415 lymphadenopathy 164
soft tissues 1 Peutz-Jegher’s syndrome 3, 4, 595,
squamous cell carcinoma 78 Pancreatic hormone diabetes mellitus
submucous fibrosis 74, 175, 187, 475 599
Pfeiffer syndrome 595
598 Papanicolaou stain 90 Phenol 443
Orbital syndrome 594 Paper electrophoresis 273 Phenylbutazone 523
Organ Papillary hyperplasia 99 Phycomycosis 364
Physico-chemical phenomena 368
of Chievitz 86 of palate 433 Pierre Robin syndrome 11, 18, 494,
transplants 73 Papilloma 66
Organized hematoma 157 Papillon-Lefevre syndrome 595 585, 595
Orofacial Papulosquamous dermatosis 607 Pigmented
angiomatosis 537 Paradental cyst 292
digital syndrome 22 Parakeratin-plugging 98 basal cell carcinoma 102
Oromandibular-limb 594 Paramyxovirus infection 352 cells 140
Orthopantomogram of jaw 87 Paraneoplastic syndrome 594 cellular nevus 70
Osmolarity of cyst fluid 275 Parasellar syndrome 594 lesions of oral cavity 599
Osseous metaplasia 486 Parasitic infections 578 lichen planus 599
Ossifying Paratrigeminal syndrome 595 Pindborg’s tumor 240
fibroma 486 Paray-Romberg syndrome 595 Pituitary
hematoma 131 Parosteal osteosarcoma 66, 153, 157 dwarfism 580
Osteitis deformans 479 Parotid space infection 416 gigantism 13, 34, 468, 580
Osteoarthritis 505 Partial anodontia 34, 35, 543 insufficiency in adults 467
Osteoblastic Partially impacted tooth 41 Pityriasis rosea 545
osteosarcoma 411 Patau syndrome 594 Plasma cell gingivitis 599
type of osteosarcoma 153 Paterson-Kelly syndrome 595, 598 Plasmacytoid pattern 222
Osteoblastoma 66, 116, 128, 157, 264, Pemphigoid 346, 555, 582, 600 Plasmacytoma 66
Pemphigus 346, 552, 582, 600 Pleomorphic
409 adenoma 199, 216, 222, 224, 229,
Osteochondroma 153 erythematosus 552, 554
Osteoclastoma 66 foliaceus 552, 554 232, 233
Osteogenesis imperfecta 153, 489, 582 vegetans 552, 554 rhabdomyosarcoma 170, 171
Osteogenic sarcoma 131 vulgaris 356, 552 Plexiform
Osteoid osteoma 66, 129, 264 Peptostreptococcus ameloblastoma 240
Osteolytic type of osteosarcoma 153 anaerobius 396 neuroma 66
Osteoma 66, 127, 255 magnus 396 Plummer-Vinson syndrome 74, 78,
Osteomatosis 66 prevotii 396
Osteomyelitis 104, 401-403 Perforation of palate 335 510, 578, 595
Periapical Pneumocystis carinii 344
of jaw 343 abscess 400
Osteopetrosis 410, 492, 582 cementraldysplasia 261 pneumonia 342
Osteoporosis 459 cyst 262 Polycythemia 167, 578
Osteoradionecrosis 600 granuloma 262, 286, 398
Osteosarcoma 66, 104, 153, 156, 264 inflammation 62, 316 vera 516
Pericoronitis 540 Polymerase chain reaction 324, 343
Periodontal Polymyositis 551
disease 530, 531 Polyostotic fibrous dysplasia 482
surgery 313 Poorly differentiated

carcinoma 248
squamous cell carcinoma 90

622 Essentials of Oral Pathology

Porphyria 463 Pulp Rhabdomyosarcoma 66, 143, 169
Porphyromonas gingivalis 528, 529, calcification 315 Rheumatic fever 424
necrosis 395 Rheumatoid arthritis 157, 424, 506
538 polyp 394 Riboflavin 461
Portsmouth syndrome 595 stones 316
Port-wine stain 121, 124 deficiency 577
Position of tooth 376 Pulpal Rickets 459
Posterior supraclavicular nodes 93 diseases 389 Rieger’s syndrome 35, 36, 54, 595
Postextraction tooth care 453 metaplasia. 390 Risus sardonicus 334
Postradiation sialadenitis 198, 205 Ritual abrasions 308
Postsurgical bony defect 131 Pulse granuloma 411 Rodent ulcer 95, 96
Pre-existing oral lesions 78 Punch biopsy 445 Role of
Pregnancy 581 Pushing margin 98
Pyogenic granuloma 109, 113, 124, acids in dental caries 373
and sex hormones 530 bacteria and dental plaque in
Preleukoplakia 175 148, 337
Premature Pyostomatitis vegetans 99, 582 periodontal 528
Pyridoxine deficiency 577 bacterial plaque in dental caries
eruption 38
exfoliation of deciduous teeth 39 Q 374
extraction of teeth 306 carbohydrates in dental caries 369
Prepubertal periodontitis 533 Quinidine 523 fluorides in prevention of dental
Prevention of oral cancer 94 Quinine 523
Prevotella intermedia 336, 528, 538 caries 377
Primary R microorganisms in dental caries
acute
Rabies 358, 583 371
apical periodontitis 398 Radiation tobacco in oral cancer 74
herpetic gingivostomatitis 345 Root
chondrosarcoma 150 caries 381 ankylosis and concrescence 62
hyperaldosteronism 474 injuries 435 canal treatment 393
intra-alveolar carcinoma 103 therapy 157 caries 381
intraosseous carcinoma 236 Radicular cyst 281, 293 fracture 426
Sjogren’s syndrome 211 Radiopacities of jaws 612 Rotation of teeth 39
syphilis 324, 328 Rainbow’s syndrome 22 Roundworm infections 583
tumor 64 Raley-Day syndrome 595 Rubeola 352
vascular disorders 605 Ramon syndrome 595 Rubinstein-Tyabi syndrome 595
Primitive neural crest cells 139 Rampant caries 379 Rushton bodies 286
Primordial cyst 240, 268, 270 Ramsay-Hunt syndrome 595 Rutherford syndrome 595
Progeria 11, 476 Ranula 303
Progressive Rapidly progressive periodontitis S
dementia 342
systemic sclerosis 575 534 Saddle nose 336
Prominent intercellular bridges 249 Rckets 460 Saethre-Chotzen syndrome 596
Propionic acid 373 Recurrent Safety-pin cells 514
Protease inhibitor 344 Salivary
Protein-energy malnutrition 579 abdominal pain 3
Proteolytic caries 381 buffering capacity test 385
chelation theory 375 herpetic infections 347 enzymes 377
theory 375 parotitis 209 gland 201
Protozoal infections 583 Red-blue lesions of oral cavity 599
Pruritus 164 Reed-Sternberg giant cells 165 calculi 209
Pseudoanodontia 34 Regional cysts 201
Pseudoepitheliomatous hyperplasia odontodysplasia 60 disease 344
systematic sclerosis 15 ducts 395
86, 99, 134 Regular reactionary dentin 384 neoplasms 97, 105, 124, 134
Pseudomacrognathia 13 Reiter’s syndrome 27, 357, 595, 600 tumors 304
Pseudomembrane 332 Renal immunoglobulins 377
Pseudomicrognathia 12 diseases 583 lymphoma 31
Pseudomonas aeruginosa 342 failure 583 reductase test 385
Psoriasis 9, 27, 544, 582 osteodystrophy 48, 583 Sanfilippo’s syndrome 54
Psychological pain 569 Replantation of tooth 452 Sarcoidosis 7, 323, 581
Pterygomandibular space infection Resorption of teeth 311 Sarcomatoid carcinoma 102
Retained deciduous tooth 39 Satellite cysts 274
415 Reticular atrophy 390 Scanning electron microscopy 274
Ptylosis syndrome 598 Retro-pharyngeal space infection 418 Scarlet fever 331
Pulmonary actinomycosis 329 Rhabdomyoma 66, 133 Schaumann bodies 333
Scheie syndrome 595

Index 623

Schenthaner-Marie-Sainton Southern blot analysis 91 Submerged tooth 40
syndrome 18 Spacing of teeth 42 Submucosal cleft palate 16
Specific bacterial infections 320 Sucrose chelation theory 375
Schilling’s test 510 Specified secondary neoplasms 342 Sulphur granules 330
Schirmer test 212 Speckled leukoplakia 178, 598 Sunburst appearance 155
Schwann cells 135 Speckled erythroplakia 186 Sun-ray appearance 140
Scintigram 225 Sphenopalatine neuralgia 571 Superficial
Scleroderma 563, 582 Spindle cell
Sclerosteosis 493 melanoma 4
Sclerotic cemental masses 128 carcinoma 65, 102 spreading melanoma 100
Scrotal tongue 23 cell pattern 222 Superior deep cervical nodes 93
Sebaceous adenoma 220 Spindle type cells 148 Supernumerary tooth 39, 48
Seborrheic Squamous Suppurative encephalitis 424
cell carcinoma 6, 25, 70, 80, 88-90, Supracellar cyst 466
dermatitis 342 Surgical ciliated cyst of maxilla 304
keratitis 102 99, 232, 251, 323, 363, 598, Sweat retention syndrome 596
Secondary 599 Sweet’s syndrome 596
chondrosarcomas 150 of mouth, anus 342 Swelling of lip and buccal mucosa
hyperaldosteronism 474 metaplasia 219
polycythemia 516 odontogenic tumor 250 608
Sjogren’s syndrome 211 papilloma 107 Swiss cheese 228
syphilis 324, 325, 328 Stafine bone cyst 272 Syndrome of crocodile tears 596
Selenomonas sputigena 396, 538 Stage of Synovial sarcoma 103
Senear-Usher syndrome 596 cell cycle 436 Syphilis 73, 77, 175, 176, 323, 324, 581,
Septicemia 585 formation of dental lamina 235
Sequelae 400 periodontal disease 531 584
of odontogenic infections 419 Staining of teeth 541 Syphilitic
Severe Staphylococcus aureus 207, 342, 403
burn 435 Starry-sky appearance 164 patches 182
epithelial dysplasia 180 Stephen’s curves 370 ulcer 207
Sexual transmission 340 Stereological techniques 182 Systemic
Sexually transmitted diseases 328, Steroid crisis 473 allergy 585
Stevens-Johnson’s syndrome 547, candidiasis 361
584 596 complications of scarlet fever 332
Sialography 201, 203, 225 Stimulate salivary flow 386 diseases 431
Sialolithiasis 201, 208 Stomatitis lupus erythematosus 559, 575
Sialo-odontogenic cysts 289 nicotina 175, 186
Sialosis 198, 213 nicotina palati 598 T
Sicca syndrome 211 Strawberry gingiva 336
Sickle cell anemia 495, 515, 579 Streptococcus Talon cusp 47, 48
Sideropenic dysphagia 175, 191 constellatus 396 Tapeworm infections 583
Signet ring 144 intermedius 396 Taurodontism 45
Silver milleri 371, 397 Tuberculosis 322
morbillorum 396 Technique of exfoliative cytology 448
amalgam 580 mutans 371, 372, 386, 387, 397 Telangiectatic type of osteosarcoma
nitrate 443 pneumoniae 342
Simple pyogenes 207 153
pericoronitis 293 salivarius 371 Temporal pouch infection 415
surgical excision. 120 sanguis 371, 397 Teratoma 66
Sinus histocytosis 126 Stricture of ducts 209 Tertiary syphilis 324, 328
Sipple’s syndrome 595 Stromal tumor 233 Tetanolysin 334, 335
Sjogren’s syndrome 157, 198, 208-210, Sturge-Weber syndrome 122, 596 Tetanospasmin 334, 335
Subacute bacterial endocarditis 424 Tetanus 334, 583
575, 596 Subdural empyema 424 Tetracycline staining 442
Skin lesions 357, 557 Sublingual space infection 417 Thalassemias 513
Small Submandibular Therapeutic effects of radiation 435
cellulitis 343 Thermal burns in mouth 435
cell osteosarcoma 150 lymph nodes 93 Thiamine 460
depression over lip 2 space infection 416 Thiazide 523
Smoker’s keratosis 186 Submasseteric space infection 419 Thickness of epithelium 180
Smooth surface caries 379 Submental Thrombocyte disorders 599
Snow-capped teeth 53 nodes 93 Thrombocytopenia 342
Snyder test 385 space infection 416 Thymic cyst 269
Soft tissue osteosarcoma 153 Thyroglossal
Solitary
bone cyst 297 duct cyst 269
plasmacytoma 168 tract cyst 29

624 Essentials of Oral Pathology

Thyroid gland tissue 28 Tubular sclerosis 384 Verrucous
Tobacco associated leukoplakia 598 Tularemia 323 carcinoma 68, 97, 182, 598
Toluidine blue test 90 Tumor suppressor genes 74, 78 leukoplakia 99, 183
Tooth Turner’s
Vertical impaction 40
abfraction 309 syndrome 11, 596 Veruciform xanthoma 9
malposition 42 tooth 48 Viral
repair 317 Types of
Toothbrush ameloblastoma 237 culture 344
abrasion 308 ankylosis 504 disease 600
injury 429 attrition 306 infections 73, 176, 339
Toothpick injury 430 bruxism 427 sialadenitis 198, 209
Torus Burkitt’s lymphoma 162 Vitamin A 460
mandibularis 66 carbohydrate and caries risk 370 Vitamin A deficiency 577
palatinus 66 dysplasia 180 Vitamin B
Total eruption abnormalities 38 complex 460
anodontia 34, 35 internal resorptions 314 deficiency 599
hemogram 172 lymphangioma 124 Vitamin C 461
skeletal survey 172 macrodontia 34 deficiency 577, 599
Tourniquet test 524 macrognathia 13 Vitamin D 458
Toxoplasmosis 342, 583 microdontia 33 deficiency 577
Transitory bacteremia 586 micrognathia 12 dependent rickets 58
Translucent zone 382 monomorphic adenomas 220 resistant rickets 48, 58
Transmission of electron microscopy osteogenesis imperfecta 490 toxicity 459
osteosarcoma 153 Vitamin K 462
274 pemphigus 552 deficiency 577
Transparent dentin 390 pulp stones 316 von-Hippel-Lindau syndrome 597
Transplantation of teeth 453 supernumerary teeth 37
Traumatic therapeutic radiations 435 W
transplantation 453
atrophic glossitis 430 Waber-Cockayne syndrome 597
bone cyst 286 U Waddling gait 480
disorders 502 Warmin bones 491
injury 7 Ulcerative Warthin’s tumor 31, 199, 222
neuroma 66, 113 colitis 582 Waterhouse-Friderichsen syndrome
ulcer 207, 323, 356, 362 leukoplakia 178, 598
Treacher-Collins syndrome 18, 497, 474
Ultraviolet radiation 76 Wegner’s granulomatosis 323, 600
596 Unicystic ameloblastoma 237, 242, Western blot analysis 343
Treatment of Wharton’s duct 83
246 Whistling face syndrome 597
AIDS 344 Unilocular ameloblastoma 279 White sponge nevus 9, 182, 183, 550,
leukoplakia 182 Upper respiratory tract disease 424
Treponema 528 Urbach-Wiethe syndrome 596 598
Trichloroacetic acid 443 Uremic stomatitis 580 Wolf-Hirschhorn syndrome 597
Trichodentoosseous syndrome 54 Uterocervical cancer 344 Wolinela recta 396
Trigeminal neuralgia 569 Uveoparotitis 210 Woolen textile workers 74
Tripanosomiasis 583 Uvula elongata 4 X
Trisomy-13 syndrome 585 Xenoderma pigmentosum 78
Trotter’s syndrome 596 V Xerophthalmia 460
True pulp stones 316 Xerostomia 343, 543
Tuberculoid leprosy 333 Vaginal discharge 329 Xerostomic mucositis 599
Tuberculosis 126, 320, 342, 363, 581 Van Buchem XXXXY syndrome 597
of lymph nodes 322
of salivary glands 322 disease 493 Y
Tuberculous syndrome 596
gingivitis 322 Vander Woude’s syndrome 22, 597 Yellow-brown stains 541
granuloma 25 van-Gieson staining 132
lesions of Vanishing bone disease 498 Z
Varicella zoster virus
jaw bone 323 diseases 344 Zidovudine 344
salivary gland 322 infections 348 Ziehl-Neilsen stain 324
nodules 322 Veillonella parvula 396 Zimmerman-Laband syndrome 597
osteomyelitis 322 Velocardiofacial syndrome 597 Zinc 458
patches 322 Verruca vulgaris 68, 343
tonsillitis 322 Verruciform xanthoma 68, 598 deficiency syndrome 597
ulcers 207322 Zinssner syndrome 597