Oral Medicine and Pathology Flashcards

Oral lichen planus (OLP) is a chronic immune-mediated condition. Which clinical form of OLP carries the greatest risk of malignant transformation?

Answer: Erosive/atrophic OLP

Erosive (atrophic/ulcerative) lichen planus has the highest malignant transformation risk among OLP subtypes — the chronic mucosal breakdown may promote DNA damage in the dysregulated immune environment.

A patient is referred with jaw pain, clicking, and limited mouth opening. Examination reveals pain in the preauricular region and deviation of the mandible on opening. What is the most likely diagnosis?

Answer: Temporomandibular joint disorder (TMJD/TMD)

The combination of preauricular pain, joint sounds (clicking), limited mouth opening, and mandibular deviation on opening is classic for temporomandibular disorder, a common musculoskeletal pain condition affecting the TMJ and masticatory muscles.

Sjögren's syndrome is a systemic autoimmune condition affecting exocrine glands. What is the PRIMARY oral manifestation?

Answer: Xerostomia (dry mouth) due to destruction of salivary gland tissue

Sjögren's syndrome is characterised by lymphocytic infiltration and destruction of exocrine glands, primarily the salivary and lacrimal glands — causing xerostomia (dry mouth) and xerophthalmia (dry eyes).

In the World Health Organisation (WHO) classification of odontogenic tumours, which is the most common malignant odontogenic tumour?

Answer: Ameloblastic carcinoma

Ameloblastic carcinoma, while rare, is classified as the most common malignant odontogenic tumour in the WHO classification. It combines the histological features of ameloblastoma with cytological atypia indicating malignancy.

A biopsy report describes 'moderate epithelial dysplasia.' What does this finding mean clinically?

Answer: The lesion shows premalignant cellular changes in the middle layer of the epithelium and requires active management with close follow-up and possible excision

Moderate dysplasia represents significant premalignant change involving the middle third of the epithelium. It carries increased malignant transformation risk and typically warrants excision or close monitoring depending on clinical context.

A patient is taking alendronate (a bisphosphonate) for osteoporosis and requires a tooth extraction. What is the main concern regarding their oral management?

Answer: Bisphosphonates may cause medication-related osteonecrosis of the jaw (MRONJ), particularly after dento-alveolar surgery

Bisphosphonates suppress osteoclast-mediated bone remodelling. Dental extractions and other dento-alveolar surgery can trigger medication-related osteonecrosis of the jaw (MRONJ), a potentially serious and difficult-to-treat complication.