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Oral Pathology - NEETMDS- courses
NEET MDS Lessons
Oral Pathology

Disease Serum Marker Changes
Paget’s Disease ↑ Alkaline phosphatase
Caffey’s Disease Fibrous dysplasia; may show ↑ alkaline phosphatase
Hyperparathyroidism ↑ Alkaline phosphatase
Osteopetrosis (Marble Bone Disease) ↑ Acid phosphatase
Osteogenesis Imperfecta Normal calcium & phosphate; ↑ bone fragility due to collagen defect
Chondrodysplasia Normal alkaline phosphatase
Odontogenic Myxoma ↑ Acid phosphatase
Thalassemia Prominent premaxilla; marrow expansion may affect jaw bones

Exception Alert: Serum alkaline phosphatase is raised in all of the following except: ➡️ Osteogenesis Imperfecta

Condition

Key Features

Paget's Disease

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

Osteopetrosis

- Rugger jersey spine
- Chalk-stick fractures

Fibrous Dysplasia

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

Cemento-Ossifying Fibroma

- Leontiasis ossea
- Chinese script trabeculae

Hyperparathyroidism

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

Cherubism

- Giant cells + vascular stroma + hemosiderin

Central Giant Cell Granuloma

- Giant cells + vascular stroma + hemosiderin

Juvenile Ossifying Fibroma

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

Mnemonics Flashcards

Mnemonic

Meaning

Paget's Patients Prefer Tight Dentures

Paget's → Denture tightening due to arch expansion

Fibrous Faces Feel Funny

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

Giant Cells Have Three Homes

Seen in: Hyperparathyroidism, Cherubism, CGCG

  • Actinomycosis (Sulfur Granules):

    • Yellow sulfur granules: Are actually bacterial colonies.

    • Histopathology: Colonies appear "cotton wool" shaped. (Note: "Cotton wool appearance" is seen radiographically in Paget's disease).

  • Tuberculosis (TB):

    • Diagnosis (Gold Standard): Presence of acid-fast bacilli in sputum.

    • Staining Method: Ziehl-Neelsen staining method is used to identify acid-fast bacilli.

    • Scrofula: TB of cervical lymph nodes.

    • Lupus Vulgaris: TB of skin.

  • Tongue & Gingival Appearance in Systemic Conditions:

    • Strawberry tongue and Raspberry tongue: Seen in stomatitis of Scarlet Fever.

    • Strawberry Gingivitis: Seen in Wegener's Granulomatosis.

Nasopalatine cyst

Radiology

The nasopalatine cyst appears as a well-defined, round radiolucency in the midline of the anterior maxilla . Sometimes it appears to be 'heart-shaped' because of super-imposition of the anterior nasal spine.

Radiological assessment should include examination of the lamina dura of the central incisors (to exclude a radicular cyst) and assessment of size (the nasopalatine foramen may reach a width of as much as 10 mm).

Pathology

The cyst is lined by a layer of pseudostratified ciliated columnar epithelium and/or stratified squamous epithelium. The capsule of the cyst is fibrous and may include the incisive canal neurovascular bundle.


Nasolabial cyst

Radiology

'Bowing' inwards of the anterolateral margin of the nasal cavity has been recorded

Pathology

The nasolabial cyst is lined by non-ciliated pseudostratified columnar epithelium, which is often rich in mucous cells.

  • Mosaic / Cotton Wool Bone → Paget’s Disease
  • Orange Peel / Ground Glass → Monostotic Fibrous Dysplasia
  • Salt & Pepper Bone → Thalassemia
  • Phantom Bone / Massive Osteolysis → Bone disappearance
  • Drill / Rider’s / Exercise Bone → Myositis Ossificans
  • Brittle Bone → Osteogenesis Imperfecta
  • Wormian Bones → Cleidocranial Dysplasia
  • Coarse Woven Bone → Fibrous Dysplasia

  • Inverted Pear-shaped Radiolucency: Globulomaxillary cyst.

    • Associated teeth need not be non-vital.

    • Klestadts’s cyst: Soft tissue variant of Globulomaxillary cyst.

  • Tear Drop-shaped Radiolucency: Lateral Periodontal Cyst.

    • Associated teeth are vital.

  • Cluster of Similar Cysts / Cluster of Grapes: Botryoid Odontogenic Cyst.

 General Features

  • Caused by mutation in DSPP gene (dentin sialophosphoprotein).

  • Teeth appear translucent or opalescent.

  • Enamel fractures easily due to poor dentin support.

  • Pulp chambers are obliterated or enlarged depending on type.

  • Also called Hereditary Opalescent Dentin or Shell Teeth.

Type II DI

  • Pulp chambers are normal but rapidly obliterate.

  • Associated with progressive hearing loss.

Type III DI

  • Pulp chambers are large and shell-like.

  • Seen in Brandywine isolate population.

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