Oral Diagnosis and Pathology Flashcards

A 52-year-old female presents for a routine examination. Clinical inspection reveals bilateral, asymptomatic, white, lace-like striations on the buccal mucosa. The patient's medical history is noncontributory, and she is a non-smoker. What is the most likely diagnosis?

Answer: Lichen Planus

The clinical description of bilateral, asymptomatic, white, lace-like (reticular) lesions, often referred to as Wickham's striae, is the classic presentation for oral lichen planus. Leukoplakia is typically a more homogenous white patch, candidiasis can be wiped off, and lupus lesions can appear similar but are less common and often associated with other systemic signs.

A 45-year-old patient complains of a persistently dry mouth and a gritty sensation in their eyes for the past year. Oral examination reveals erythematous mucosa, a fissured tongue, and rampant cervical caries. Which of the following conditions is most consistent with this clinical presentation?

Answer: Sjögren's Syndrome

Sjögren's Syndrome is a chronic autoimmune disorder characterized by lymphocyte-mediated destruction of exocrine glands, primarily the salivary and lacrimal glands. This leads to the hallmark symptoms of xerostomia (dry mouth) and xerophthalmia (dry eyes), which can result in the oral findings described.

A panoramic radiograph of an 18-year-old patient reveals a well-defined, corticated, unilocular radiolucency surrounding the crown of an impacted mandibular right third molar. The radiolucency appears to be attached at the cementoenamel junction. What is the most probable radiographic diagnosis?

Answer: Dentigerous Cyst

A dentigerous (or follicular) cyst is a developmental odontogenic cyst that originates from the separation of the follicle from around the crown of an unerupted tooth. Its characteristic radiographic feature is a unilocular radiolucency attached at the CEJ of an unerupted tooth, which perfectly matches the description.

Which of the following oral premalignant lesions possesses the highest rate of malignant transformation?

Answer: Erythroplakia

Erythroplakia, a red, velvety patch on the oral mucosa, has the highest malignant potential of all oral premalignant lesions. Histological examination often reveals severe dysplasia, carcinoma in situ, or invasive squamous cell carcinoma at the time of initial biopsy. Its risk is significantly higher than that of leukoplakia.

A 38-year-old patient who is HIV-positive presents with non-painful, white, corrugated lesions on the lateral borders of the tongue. The lesions cannot be scraped off. This clinical finding is most commonly associated with an infection by which virus?

Answer: Epstein-Barr Virus (EBV)

The described lesions are characteristic of Oral Hairy Leukoplakia. This condition is caused by the Epstein-Barr Virus (EBV) and is most frequently seen in immunocompromised individuals, serving as a common oral manifestation of HIV infection.

A 60-year-old female patient reports a constant burning sensation on her tongue and lips for the past six months, with no identifiable clinical signs of lesions or inflammation. The sensation is absent upon waking but worsens throughout the day. A complete blood count and tests for nutritional deficiencies are normal. What is the most likely diagnosis?

Answer: Burning Mouth Syndrome (BMS)

Burning Mouth Syndrome is a diagnosis of exclusion characterized by a chronic burning or painful sensation in the mouth without any clinically visible mucosal abnormalities. It typically worsens during the day and often spares sleep. The diagnosis is made after ruling out local and systemic causes like candidiasis, allergies, and nutritional deficiencies.