Developmental Disturbances of Oral & Paraoral structures/ dental crown & bridge courses

Developmental Disturbances
of Oral & Paraoral structures-2
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com

OBJECTIVES
 At the end of the lecture student should be able to understand
the
– Developmental disturbances associated with:
•Buccal mucosa
•Gingiva
•Salivary gland

BUCCAL MUCOSA

Fordyce’s Granules
• Heterotopic collection of sebaceous glands
• Due to inclusion of ectoderm having some potentialities
of skin
• Small yellow spots
• Bilaterally symmetrical
• Commonly involved areas- Buccal mucosa, lips, tongue,
gingiva, frenum
• Adults > Children
• Males=Females

Histopathology
• Resembles normal
sebaceous glands
• A hair shaft may be
present
• Few to many lobules
• Grouped around ducts
opening onto surface
• Keratin plugging
Treatment
• No treatment required
• Benign sebaceous
adenoma may develop
sebaceous glands

Focal Epithelial hyperplasia
Heck’s Disease
• Multiple nodular lesion with sessile base
• Common seen on lips, buccal mucosa, commisure,
tongue,
• 1-5 mm in diameter
• Same color as adjacent mucosa
• Seen commonly in children 3-18 yrs
• Undergo spontaneous regression in 4-6 months

• Histopathology
– Nodular elevations
– Acanthosis
– Fusion of rete pegs
– Mild hyperkeratosis
– Clumps of lymphocytes,
PMN’s
– Liquefaction degeneration
of basal layer
Treatment
– No treatment required
Acanthosis

GINGIVA

Fibromatosis Gingivae
• Dense, diffuse, smooth, nodular overgrowth of gingival tissues
of one or both arches
• Appears at the time of eruption of incisors
• Normal color, not painful, non hemorrhagic
• H/F
– Thick epithelium
– Elongated rete pegs
– Dense fibrous connective tissue
– Few interspersed fibroblasts
– Inflammation may or may not be present
• Treatment
– Surgical resection

Narrow,slender elongated rete pegs

Retrocuspid papillae
• Small elevated nodule on lingual mucosa of mandibular
cuspids
• Sessile, bilateral, regresses with age
• Lies between free gingival margin and mucogingival
junction
• Hyperparakertatinized/ Hyperorthokeratinized
• No treatment required

Salivary Glands
DEPARTMENT OF ORAL PATHOLOGY AND MICROBIOOGY
SHARAD PAWAR DENTAL COLLEGE

• Aplasia
– Congenital absence of salivary glands
– Xerostomia – Dry mouth
– Oral mucosa appears dry, smooth, pebbly
– Lips are crackled and fissures at corner of mouth
– Rampant caries and early loss of teeth
– No specific treatment

• Atresia
– Congenital occlusion or absence of salivary gland duct
– Retention cysts
– Severe Xerostomia
• Aberrancy
– Presence of salivary glands in abnormal locations
– Lead to formation of retention cyst
– Neoplasm like Central mucoeidermoid carcinoma

Xerostomia
• Dry or burning sensation of mucosa
• Mucosa may become atrophic, inflamed, pale & translucent
• Atrophy of lingual papillae
• Fissuring, cracking, areas of denudation
• Rampant caries
• Lack of tolerance of appliances

Etiology
• Temporary / Transient xerostomia due to emotional reaction,
blockage of ducts, drugs,
• Salivary gland aplasia
• X Ray radiation
• Vitamin deficiency
• Sjogren’s syndrome
• Miscellaneous causes
• Treatment.-
• Correction of cause
• Saliva substitutes

Hyperplasia of Palatal Glands
• Hyperplasia of minor salivary glands
• Etiology
– Endocrinal disorders, Gout, Diabetes mellitus, menopause, hepatic
disease, starvation, alcoholism, inflammation, benign
lymphoepithelial lesion, sjogren’s syndrome, aglossia-adactylia
syndrome, uveoparotid fever etc.

• C/F
– Small localized swelling, usually on hard palate or junction of
hard and soft palate,
– Intact surface, sessile, normal color, asymptomatic
• H/F
– Closely packed collection of normal mucous acini, normal ducts,
• Treatment
– Surgical excision

STAFNE CYST
• Due to inclusion of glandular tissue adjacent to lingual surface
of the body of mandible
• R/F
– Ovoid radiolucency between mandibular canal and inferior
border of mandible in the molar region
– Should be differentiated from traumatic bone cyst

Anterior lingual depression
– Poorly defined radiolucency in anterior region between central
incisor and premolar
– Due to sublingual gland

SUMMARY
 By the end of the lecture student should be able to conclude the
– Developmental disturbances associated with:
•Buccal mucosa
•Gingiva
• Salivary gland

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