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Soft tissue lesions - Coggle Diagram
Soft tissue lesions
Lymph angioma
Characteristics: superficial lymph angioma‘s present as painless nodules that may be trans lucent or bluish and have a pebbly or bubbly surface that looks somewhat like cooked tapoica
Dental implications: patients who have had surgical removal may have damage to facial, lingual or hypoglossal nerves. The dental hygienist is in an excellent position to help the patient learn how to manage complications associated with damage
Transmission genetic tendency related to its congenital presentation but otherwise it is nontransmissible
Treatment and prognosis: depends on the size location and composition of this malformation. Small lesions may not need to be treated unless they create a cosmetic problem. Surgical removal is the treatment of choice for other lesions. The prognosis for small isolated lesions is excellent
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Dermoid cyst
Characteristics: painless, slow growing, soft, doughy, midline mass primarily in the floor of the mouth.
Dental implications: is this lesion is located in the floor of the mouth it can impair chewing, swallowing, and speaking. Patient may present with this as a reason for seeking dental care.
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Etiology: results from entrapment of epithelial cells along the lines of embryonic closure or fusion
Acinic Cell carcinoma
Characteristics: these tumors may be present as slow growing hard masses. Parotid tumor’s facial nerve paralyzes occurs in frequently but indicates a less than favorable prognosis.
Dental implication the tumors are slow growing and the dental hygienist may be the first person to detect this neoplasm
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Treatment and prognosis: prognosis is generally good.Surgical removal of the tumor is needed for treatment
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Fibrosarcoma
Characteristics: most of these lesions present as gradually enlarging, painless masses. Ulceration of the surface, secondary to trauma, may occur as the lesion in larges. With enlargement the patient may complain of pain, swelling, paresthesia and loosening of teeth
Dental implications: early identification of the enlarging soft tissue mass is is of the most importance in obtaining a favorable treatment outcome
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Treatment and prognosis: the treatment of choice is surgical excision with wide margins. The prognosis is guarded
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Sjögren Syndrome
Characteristics: the most significant oral manifestation is there Estonia. The severity varies from individual to individual. Patient complaining of difficulty swallowing, altered taste, difficulty wearing prosthetic device such as dentures. The parotid and submandibular gland’s become enlarged
Dental implications: zero stoma increases the patient’s dental caries risk, Para Donald disease and infections such as candidiasis
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Treatment and prognosis: normally treated by managing the symptoms of the disease the prognosis is normally good with strict adherence to modifications
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Rhabdomyosarcoma
Characteristics: hard and soft pallets are the most frequent areas found. Symptoms of pain and paresthesia may be present especially if the job is involved. Lesions located within the jars appear radio graphically as ill defined radiolucencies
Dental implications: soft tissue enlargements that have not been identified and does not resolve over a two-week period should be biopsied.
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Treatment and prognosis: the standard treatment is surgical removal combine with chemotherapy and radiation therapy. The prognosis varies widely according to the location of the tumor, histologic characteristics and where there has been metastasis
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Fibroma
Characteristics: nodular and exophytic and may be pedunculated. They have a smooth surface texture and firm consistency normally the same color or lighter in color than surrounding tissues
Dental implications: determining the cause of the irritation or trauma and removing it is the most important. Patients who wear dentures should be educated on how to take care of them
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Treatment and prognosis surgical removal of the fibroma is the treatment of choice. The prognosis for both forms of this lesion is excellent if the source of irritation is removed
Etiology: not considered true neoplasms but rather reactive responses to chronic trauma or irritation.
Neurofibromatosis
Characteristics: Well defined, painless sub mucosal nodules. Lesions of the tongue can appear as Macroglossia
Dental implications:Problems associated with the development of this lesion includes impaired mastication, swallowing and speaking. Growths may complicate the patients attempts to maintain good oral hygiene
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Treatment and prognosis: it is a genetic disorder so it cannot be treated in the strict sense of the word. Management includes frequent examination of the skin for new lesions and assessment of already present lesions. This decreases life expectancy by about 15 years
Etiology: an inherited disorder that is associated with the mutation of the NF1 GeneOn chromosome 17
Thyroglossal tract cyst
Characteristics: 2% of these lesions develop within the tongue it’s self. Rarely will these appear in the suprahyoid position as swelling of the floor of the mouth.
Dental implications: lesions located on the posterior dorsal surface of the tongue should not be removed until it is known what they are.
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Treatment and prognosis: complete surgical excision using Sistrunk procedure is the treatment of choice. Prognosis is normally excellent if the cyst is completely excised
Etiology: remnants of epithelial cells that line the thyroid glossal tracked during embryonic development
Mucoepidermoid carcinoma
Characteristics: this malignant neoplasm is most often found in the parotid gland where it manifests as an asymptomatic swelling.The minor salivary gland can appear as asymptomatic swelling’s that can be fluctuant and slightly blue in color.
Dental implications: these tumors can’t be present for several years before they are noticed by the patient. Oral cancer screening examinations should include palpation of all major salivary gland’s to identify at an early stage
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Treatment and prognosis: the tumor is treated by surgical removal. The prognosis depends primarily on the grade of the tumor. Patients with low-grade tumors have a very good prognosis 95% of patients surviving five years
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Adenoid cystic carcinoma
Characteristics: present as firm, well-defined masses with in the gland. They are slow growing and may be tender on palpation
Dental implications: radiation therapy is almost always recommend it. All dental procedures need to be accomplished prior to the radiation therapy
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Treatment and prognosis: surgical excision of the carcinoma is the treatment of choice. The tumor has a good five-year prognosis and a poor 20 year prognosis
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Pleomorphic adenoma
Characteristics painless slow growing for mass that usually is found in the Superficial lobe of the parotid near the angle of the mandible.
Dental implicationn: These are difficult to remove completely therefore it is essential to monitor the patient’s periodically for reoccurrences
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Treatment and prognosis: complete surgical removal is recommended with enough adjacent tissue removed to ensure there are no remaining nests of cells. The prognosis is excellent if they have been completely removed
Etiology: a benign neoplasm that arises from the proliferation of two different types of salivary gland cells
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Bacterial sialadenitis
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Dental implications: zero Estonia is one of the major risk factors for developing this infection. Patients who have xerostomia should be monitored closely.
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Treatment and prognosis: this infection may be difficult to treat analgesics are used to help decrease the pain, moist compress, rehydration and stimulation of salivary flow are helpful. The prognosis is good in most cases
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NeurilEmoma
Characteristics: smooth surface submucosal masses. They can occur anywhere in the mouth but most frequently on the tongue. They can appear as well defined radiolucencies. Bone lesions are often associated with pain and paresthesia
Dental implications: accurate interpretation of radiographic findings in areas where the patient reports pain may be essential to detect this neoplasm
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Treatment and prognosis the treatment is surgical excision. There is little chance of reoccurrence and the prognosis is excellent
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Sarcoidosis
Characteristics: salivary gland enlargement especially the parotid gland and xerostomia are possible. Other lesions present as either firm or spongy papular or nodular growths found on the gingiva lips palette tongue or buccal mucosa
Dental implications: the patient should be encouraged to adhere a good oral hygiene regimen because of the potential for involvement of gingival tissues.
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Treatment and prognosis: patients often experience spontaneous resolution of the disease. Topical steroids may help manage oral lesions. The prognosis is good for those affected
Etiology a multi system Inflammatory disease of unknown etiology that results in the formation of granulomas within affective organs or tissues
Neurofibroma
Characteristics: the tumor manifests as I slow growing, smooth surface, asymptomatic mass. Located commonly on the tongue or buccal mucosa.
Dental implications: the dental hygienist may be in a unique position to detect these lesions and request referral
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Treatment and prognosis: surgical excision is the treatment. Prognosis is excellent due to little chance of reoccurrence
Etiology: a benign neoplasm that originates from Schwann cells or connective tissue cells that support the peripheral nerves
Fibromatosis
Dental implications: early diagnosis of any enlarging mass is crucial to obtaining a favorable treatment outcome.
Treatment and prognosis: the treatment of choice is aggressive surgical excision. Chemotherapeutic agents are sometimes used in addition to the surgery because there is a higher rate of reoccurrence with these tumors.Deaths have been reported due to reoccurrence and locally aggressive invasion of vital tissues
Characteristics slowly enlarging soft tissue mass when I observed in the oral cavity. Facial asymmetry can be expected as the lesions in large. Soft tissue surrounding the mandible are affected. If the bone of the mandible is affective the lesions appear as ill defined radiolucencies. Expansion of the cortical bone may occur
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Traumatic neuroma‘s
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Characteristics: small firm nodules covered by normal mucosa. The nodules are normally painful when palpated but no other symptoms.
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Treatment and prognosis: surgical removal of the neuroma is the usual treatment. The prognosis is excellent
Mumps
Characteristics: swelling can occur in any of the major salivary gland’s but the parotid gland is the most effective. There may be erythema surrounding the salivary ducks. Pain when chewing or eating foods that stimulate the salivary glands And also pain can occur in the ear due to pressure
Dental implications: it is important to recognize the manifestation of this infection so the patient can be referred for medical evaluation
Treatment and prognosis: treatment is focused on relieving the general symptoms associated with this infection. Includes bed rest, fluids and analgesics for the pain and fever: prognosis is excellent
Transmission: months is transmitted by direct contact with the saliva or droplets of an infected person
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Lymphoid hyperplasia
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Characteristics: clinically varying enlargements of lymphoid tissue which appear bulbous papillary or smooth surface: same color or slightly lighter than the surrounding tissue.
Etiology: reactive response of the immune system caused by infectious agents or foreign substances that invade the body
Dental implications: identification of the hyper plastic tissue is important to rule out more serious conditions such as cancer. The tonsillar region should always be included in the oral cancer examination.
Treatment and prognosis: treatment is not necessary unless the tissue becomes large enough to impede oral functions such as eating or is chronically traumatized. Prognosis is good
References
Langlais, R, Miller, C., & Gehrig, J. (2017). Color Atlas of Common Oral Diseases. Fifth Edition. Philadelphia: Wolter Kluwer.
Delong, L & Burkhart, N. (2019). General and Oral Pathology for the Dental Hygienist. Third Edition. Philadelphia: Wolter Kluwer.