Oral Pathology
Disorders and Tumors of the Oral Cavity and Jaws
The mouth and jaws are comprised of many different types of tissues, such as bone, muscle, glands, and mucosa (the tissue that covers the cheeks, lips, and gums). For various reasons, any of these tissues can develop abnormal growth. This may be caused by heredity, an irritating factor, an injury, an impacted tooth, or a systemic process. Many types of disorders and tumors can develop in these tissues. Some of the more common lesions are shown below.
Lichen planus is a skin disorder which can affect the oral tissues.
The name was given to the disorder in 1869 due to its resemblance to a flat fungus growing on a rock. It is caused by an autoimmune mechanism, and has either a fine, lace-like or an ulcerated appearance.
It is seen most commonly in adult women, and approximately 1% of patients may have skin lesions.
The disorder can be painless or painful. It is usually treated by a topically-applied cortisone ointment, or in severe cases, with cortisone pills. It appears in cycles, and may eventually resolve on its own.
Rare cases can develop into oral cancer, so evaluation by an oral surgeon is recommended. |
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There are many different lumps and bumps that can appear in the mouth and face. Fortunately, a great majority of these are benign and require fairly minor surgery, most of which can be performed in the surgeon's office.
Every type of tissue in the body has the potential to develop abnormal growth. Here are a few examples of the more common lesions, and their treatment.
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Case 1
This 16 year old girl had a benign tumor of nerve tissue (Schwannoma) which developed under her tongue. It was removed in the office.
It was a hard, shiny mass, about 11 x 6 mm in size. After 3 years, there has been no recurrence. |
Case 2
This 52 year old man developed this swelling on his palate. A biopsy showed this to be a benign mixed tumor (pleomorphic adenoma) of a minor salivary gland. It was treated in the hospital under anesthesia by removal of the tumor and reconstruction with a tissue graft. Two years after surgery, it is healed well, with no recurrence.
Case 3
This 19 year old had a 3 month history of swelling and pain of his right jaw, along with numbness of his right lower lip and teeth.
X-Rays showed a large cyst associated with an impacted 3rd molar (wisdom tooth). The cyst was large, pushing the tooth to the lower border of the jaw and destroying a significant amount of bone. A biopsy showed that this was an aggressive type of benign jaw tumor, known as an ameloblastoma.
These three radiographs show the size of the jaw tumor and the thinning of the jaw bone. |
It was treated by removal of the tumor and surrounding jaw bone (mandible). Immediate reconstruction was done, using a bone graft from the patient's hip.
It healed well, and the reconstruction was completed two years later by the placement of dental implants into the bone graft.
The bone graft was held in place by a large reconstruction plate and two smaller bone plates. Notice on the right, the restoration of the patient's facial form and his tooth relationships. |
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