Oral Pathology - INFLammation And Repair

When the body is injured, the initial response is inflammation. Inflammation is a protective response by the immune system to remove harmful stimuli and initiate the healing process. It involves increased blood flow to the affected area, resulting in redness, swelling, heat, and pain. Inflammation helps to isolate the injured area, destroy pathogens, and recruit immune cells to facilitate tissue repair. This process is essential for the body's defense against infection and to initiate the subsequent stages of healing.

Acute inflammation occurs when there is minimal and brief injury to the tissue, and the source of the injury is removed. This type of inflammation is characterized by a rapid onset and short duration. It is typically caused by infection, injury, or trauma, and is a normal response of the immune system to protect the body and promote healing. Acute inflammation is usually localized to the site of injury and is characterized by symptoms such as redness, swelling, heat, and pain.

The correct answer is the ingestion of foreign substance by white blood cells (WBCs). Phagocytosis is a process where WBCs engulf and digest foreign particles such as bacteria or dead cells. This mechanism helps in removing harmful substances and maintaining the immune system's functionality.

Erosion refers to the loss of tooth structure caused by chemical action. This can occur due to factors such as acidic foods or drinks, certain medications, or gastric acid reflux. Unlike abrasion, which is caused by mechanical actions like toothbrushing, erosion specifically involves the breakdown of tooth enamel and dentin through chemical processes. Drug allergy and attrition are not related to the chemical action that characterizes erosion.

An amalgam tattoo is a pigmented lesion that occurs when particles of dental amalgam (a material used for dental fillings) become embedded in the oral tissues. This can happen during dental procedures or as a result of accidental injury. The pigmentation appears as a bluish-gray or black spot on the gums or inner cheeks. In contrast, traumatic ulcer, frictional keratosis, and aspirin burn are not pigmented lesions but rather represent different types of oral mucosal injuries caused by trauma, friction, or chemical irritation respectively.

Erosion is the correct answer because it refers to the gradual loss of tooth structure caused by the chemical action of acid on the teeth. In the case of bulimia, frequent vomiting exposes the teeth to stomach acid, which can erode the enamel and lead to tooth damage. Attrition refers to the natural wear and tear of teeth, bruxism refers to teeth grinding, and abrasion refers to the mechanical wearing away of tooth structure, none of which are directly associated with bulimia.

Erosion is the correct answer because it refers to the generalized loss of tooth structure primarily on the lingual surfaces of teeth. Erosion occurs when the tooth enamel is dissolved by acids, which can be caused by factors such as acidic foods and drinks, gastric reflux, or excessive consumption of citrus fruits. This leads to the wearing away of the tooth surface, particularly on the lingual (inner) side. Attrition, abrasion, and bruxism are all different causes of tooth wear, but they do not specifically involve the lingual surfaces as mentioned in the question.

Macrophages are immune cells that play a crucial role in the body's defense against pathogens. They are known for their ability to perform phagocytosis, which involves engulfing and destroying foreign particles. Macrophages also aid in the removal of large foreign matter and inhaled particles from the body. However, the formation of antibodies is not a function of macrophages. Antibodies are produced by B cells, another type of immune cell. Macrophages primarily focus on engulfing and destroying pathogens rather than producing antibodies.

Exudate is the correct answer because it refers to the fluid and proteins that escape from blood vessels and accumulate in the surrounding tissues. This process occurs in response to inflammation or injury, and the exudate helps to nourish and protect the tissues as well as remove waste products. Hyperemia refers to an increased blood flow to a specific area, margination is the process of white blood cells sticking to the walls of blood vessels, and erythema refers to redness of the skin caused by increased blood flow.

Neutrophils, also known as PMN leukocytes, are a type of white blood cell that plays a crucial role in the immune response. They are not derived from precursor red blood cells (rbcs), but rather from precursor cells in the bone marrow. Neutrophils contain lysosomal enzymes, which are responsible for breaking down and destroying foreign substances, such as bacteria and viruses. Unlike other leukocytes, neutrophils have granules in their cytoplasm, hence they are not agranular. Additionally, neutrophils are produced throughout life, not just in infancy.

Bruxism is not the same as mastication. Mastication refers to the process of chewing food, while bruxism refers to the habit of grinding or clenching teeth, often unconsciously. Bruxism can occur during the day or at night during sleep, and it can cause damage to the teeth, jaw, and surrounding structures. Mastication, on the other hand, is a normal and necessary function for breaking down food before swallowing.

Macrophages and lymphocytes are the most common cells in chronic inflammation. Macrophages play a crucial role in the immune response by engulfing and digesting pathogens and cellular debris. They also release inflammatory mediators that recruit other immune cells to the site of inflammation. Lymphocytes, on the other hand, are responsible for adaptive immune responses and produce antibodies to target specific antigens. In chronic inflammation, these cells are often present in higher numbers as the immune system continues to respond to persistent or recurring stimuli.

Hyperplasia refers to an increase in the size of an organ or tissue due to an increase in the number of cells. This can occur in response to various stimuli such as hormonal changes or tissue damage. Unlike hypertrophy, which involves an increase in cell size, hyperplasia involves an actual increase in the number of cells. Hyperemia refers to an increased blood flow to an area, while inflammation is a response to tissue injury characterized by redness, swelling, and pain.

Healing by secondary intention refers to the healing process of an injury when there is increased formulation of granulation tissue. Granulation tissue is formed when the body responds to an injury by producing new blood vessels, fibroblasts, and extracellular matrix. This tissue helps to fill the wound and promote healing. In contrast, healing by primary intention occurs when there is an incision with clean edges joined by sutures, resulting in minimal granulation tissue formation. Therefore, the increased formulation of granulation tissue is the correct answer in this context.

A sialolith is a salivary gland stone. This means that it is a hard, calcified deposit that forms within the salivary gland. It can block the flow of saliva and cause pain and swelling. Chronic inflammation of a salivary gland refers to long-term inflammation, while acute inflammation refers to sudden and severe inflammation. A pooling of saliva in the connective tissue is not a recognized medical term or condition. Therefore, the correct answer is a salivary gland stone.

A periapical granuloma is an example of chronic inflammation. It is a localized inflammatory lesion that forms at the apex of a tooth root due to chronic infection or irritation. The body's immune response tries to contain the infection, leading to the formation of a granuloma. This process can persist for a long time, causing chronic inflammation.

Chemotaxis refers to the directed movement of white blood cells (WBCs) towards the site of injury. When there is tissue damage or infection, certain chemicals are released by damaged cells or pathogens, creating a concentration gradient. WBCs detect these chemicals and move towards the higher concentration, allowing them to reach the site of injury and initiate an immune response. This process is essential for the body's defense mechanism and helps in the removal of harmful substances and pathogens from the body.

The presence of active wear facets during examination of the dentition suggests that the patient is a bruxer. Bruxism refers to the habit of grinding or clenching the teeth, which can lead to the formation of wear facets on the teeth. This can be caused by various factors such as stress, anxiety, misalignment of the teeth, or an abnormal bite. The wear facets indicate that the patient is experiencing excessive forces on their teeth, which can result in tooth damage and other dental issues.

Abrasion refers to the wearing away of tooth structure due to abnormal mechanical actions, such as excessive tooth brushing or chewing on hard objects. This can lead to the loss of tooth enamel and dentin, causing tooth sensitivity and increasing the risk of tooth decay. Attrition, on the other hand, refers to the natural wearing down of tooth structure due to normal use and chewing. Erosion refers to the loss of tooth structure caused by chemical actions, such as acid erosion from acidic foods or gastric acid reflux. Gemination is a dental anomaly where a single tooth splits into two, resulting in a larger than normal tooth count.

Residual cyst is the correct answer because it is a type of cyst that remains after the extraction of a tooth without removing the cystic sac. This type of cyst can develop from the remnants of the dental follicle or from the remains of the epithelial lining of a previously existing cyst. It is important to remove the entire cystic sac during tooth extraction to prevent the formation of residual cysts.

Granulation tissue is a type of tissue that forms during the healing process of a wound. It is characterized by the presence of newly formed blood vessels and fibroblasts, which produce collagen. This tissue is considered immature because it is still in the early stages of development and lacks the organization and structure of normal connective tissue. It is rich in inflammatory cells and has a granular appearance, hence the name "granulation tissue."

Radicular cysts are characteristically associated with a tooth that is nonvital upon pulp testing. This means that the tooth does not respond to pulp testing, indicating that the pulp tissue inside the tooth is no longer alive. Radicular cysts occur as a result of inflammation or infection in the root canal system of the tooth, leading to the formation of a cyst around the root. In contrast, residual, dentigerous, and dermoid cysts are not specifically associated with nonvital teeth.

During the repair process, the clot serves as a guide for migrating epithelial cells. These cells move along the clot, helping to close the wound and promote healing. The clot provides a scaffold for the cells to follow and ensures that they migrate in the correct direction. Without the clot, the epithelial cells may not be able to effectively navigate the wound site, leading to delayed or improper healing.

The correct answer is gingiva. The peripheral giant cell granuloma is a benign oral lesion that typically occurs on the gingiva, which is the gum tissue surrounding the teeth. It is characterized by the presence of giant cells and can cause localized swelling and ulceration. While it is possible for oral lesions to occur on other areas such as the hard palate, buccal mucosa, or floor of the mouth, the peripheral giant cell granuloma specifically refers to the gingiva.

The given etiologic factors, such as heavy plaque and calculus, mouth breathing, orthodontic appliance, and overhang restorations, are commonly associated with irritation fibromatosis. This condition is characterized by the formation of fibrous tissue due to chronic irritation or trauma. These factors can cause chronic irritation to the oral tissues, leading to the development of fibrous nodules or growths. Phenytoin hyperplasia is a side effect of the medication phenytoin, not related to these etiologic factors. Nifedipine (Procardia) does not cause a reaction, and chemical fibromatosis is not a recognized condition.

The correct answer is posterior gingiva and edentulous ridge. An amalgam tattoo is a bluish-gray discoloration of the oral tissues caused by the deposition of amalgam particles. It occurs when small particles of amalgam, a dental filling material, become embedded in the soft tissues of the mouth. The posterior gingiva and edentulous ridge, which refers to the gum tissue behind the last teeth and the area where teeth are missing, are common sites for amalgam tattoos to be observed.

During the initial stage of the inflammatory response, constriction of the microcirculation occurs. This constriction is known as vasoconstriction and it helps to limit blood flow to the affected area. This response is triggered by various factors including the release of vasoconstrictor substances and neural signals. The constriction of blood vessels helps to reduce the amount of blood reaching the site of injury or infection, which is important in preventing the spread of harmful agents. Additionally, constriction also helps to minimize tissue damage and control the inflammatory process.

The correct answer is severing of or trauma to a minor salivary gland duct. A mucocele is a type of cyst that forms when saliva accumulates in a blocked or damaged salivary gland duct. The most common cause of a mucocele is the severing or trauma to a minor salivary gland duct, which disrupts the normal flow of saliva and leads to its accumulation. Inflammation and obstruction of a salivary gland duct can also contribute to the development of a mucocele, but they are not the primary or most common cause. Tumor formation is not typically associated with the development of a mucocele.

The lower lip is the most common site for a mucocele to occur. A mucocele is a harmless cyst that forms when a salivary gland duct is damaged or blocked, leading to the accumulation of saliva. The lower lip is more prone to injury and trauma, such as biting or sucking, which can cause damage to the salivary ducts and result in the formation of a mucocele. Additionally, the lower lip has a higher number of minor salivary glands compared to other areas of the mouth, making it more susceptible to mucocele development.

Epulis fissuratum is a condition that occurs due to irritation caused by a denture flange. A denture flange is the extension of a denture that extends beyond the teeth and comes into contact with the soft tissues of the mouth. Continuous irritation from the denture flange can lead to the development of epulis fissuratum, which is characterized by the formation of fibrous hyperplasia in the affected area. Therefore, the presence of a denture flange is the most likely cause of epulis fissuratum.

Gingival hyperplasia may be caused by medication. This is because certain medications, such as anticonvulsants, immunosuppressants, and calcium channel blockers, can cause an overgrowth of gum tissue. This condition is known as drug-induced gingival hyperplasia. It is important to note that gingival hyperplasia can also be caused by other factors such as poor oral hygiene, hormonal changes, and certain systemic diseases.

During inflammation, monocytes are the second type of immune cells to migrate from the blood vessel into the injured tissue. Neutrophils are typically the first immune cells to respond to inflammation, followed by monocytes. Monocytes play a crucial role in the immune response by differentiating into macrophages, which help in phagocytosis and the clearance of pathogens and cellular debris. Therefore, monocytes are the correct answer as they are actively involved in the inflammatory response and tissue repair.

The correct answer is "due to changes in their lymphocytes." When there is systemic involvement with inflammation, the lymphocytes, which are a type of white blood cell, undergo changes. These changes can cause the lymph nodes to become enlarged and palpable along the routes of blood vessel drainage. The hypothalamus does not directly regulate lymph nodes, and leukocytes are a general term for white blood cells, not specifically lymphocytes.

Repair is the body's final defense mechanism because it is a process that occurs after injury or damage to restore the structure and function of tissues. It is a protective response that aims to prevent further damage and promote healing. Repair involves various cellular and molecular processes, such as inflammation, tissue regeneration, and scar formation. It is not a perfect process as functioning cells and tissue components may be replaced by scar tissue, which may not fully restore the original function. However, repair is essential for the body's survival and to maintain homeostasis.

Epulis fissuratum is a benign hyperplastic fibrous tumor that occurs as a reaction to ill-fitting dentures or other oral appliances. It typically forms in the vestibular sulcus, which is the space between the alveolar ridge and the cheeks or lips. The gingiva, also known as the gum tissue, does not extend into this area. Therefore, epulis fissuratum would not occur on the gingiva.

The most common cause of a radicular cyst is caries. Caries, also known as tooth decay, is a microbial disease that leads to the destruction of tooth structure. When caries reaches the pulp of the tooth, it can cause inflammation and infection, leading to the development of a radicular cyst. This cyst forms at the root of the tooth and is filled with fluid. It is important to address caries promptly to prevent the development of complications such as radicular cysts.

A periapical abscess does not always cause radiographic periapical changes. While a periapical abscess is an infection at the root tip of a tooth, it may not always result in visible changes on a radiograph. In some cases, the infection may be localized and not spread to the surrounding bone, leading to no radiographic changes. Therefore, the statement that a periapical abscess always causes radiographic periapical changes is false.

Maintenance of osteoblast-producing tissues can delay normal bone tissue repair. Osteoblasts are responsible for the formation of new bone tissue. If the tissues that produce osteoblasts are not properly maintained, it can hinder the production of these cells and slow down the repair process. This can result in delayed healing of bone fractures or other bone injuries.

Chronic inflammation can lead to external tooth resorption. Inflammation is the body's response to injury or infection, and when it becomes chronic, it can cause damage to the tissues surrounding the tooth. This can result in the breakdown of the tooth's structure, leading to resorption. Chronic inflammation can be caused by various factors such as gum disease, trauma, or autoimmune disorders.

Necrotizing sialometaplasia is a condition characterized by the death of tissue in the salivary glands. The most likely cause of this condition is the loss of blood supply to the affected area. When blood supply is compromised, the tissues do not receive enough oxygen and nutrients, leading to tissue death. This can occur due to trauma, infection, or other factors that disrupt the blood flow. Blocked salivary gland ducts, radiation therapy, and a sialolith (salivary gland stone) may cause inflammation or damage to the salivary glands, but they are not typically associated with necrotizing sialometaplasia.

The components of the complement system mediate the inflammatory process by causing cytolysis. Cytolysis refers to the destruction or lysis of cells, which can occur as a result of complement activation. When the complement system is activated, it forms a membrane attack complex (MAC) that inserts into the cell membrane of target cells, leading to their destruction. This process helps to eliminate pathogens and damaged cells, contributing to the inflammatory response.

The given correct answer suggests that one of the characteristics of the giant cell granuloma is that it may present as a multiocular radiolucency. This means that on radiographic images, the lesion appears as multiple cavities or holes with a radiolucent (dark) appearance. This characteristic is important to note as it can help in the diagnosis and differentiation of the giant cell granuloma from other similar conditions.

A ranula is a type of cyst that forms on the floor of the mouth. It is typically found near the base of the tongue, specifically in the area known as the retromolar pad. This area is located behind the last molar teeth on the lower jaw. Therefore, the correct answer is retromolar pad, floor of the mouth.