Oral Pathologies and Dental Anomalies: A Comprehensive Clinical Reference
Craniofacial and Dental Development Anomalies
Developmental Anomalies: Abnormalities within normal developmental patterns can vary. Some cases present mild and superficial alterations that barely affect normal appearance, while others are severe and devastating.
Soft Tissue Anomalies
- Cleft Lip: Can be lateral, central, unilateral left, bilateral, or complete (commonly known as harelip).
- Cleft Palate: Resulting from a lack of fusion, it can affect the soft palate, uvula, or the entire posterior palate.
- Macroglossia: The existence of an excessively large tongue that presses against the teeth and adopts the shape of their borders (scalloped tongue).
- Microglossia: The appearance of a very small tongue affecting all or only the first half, depending on whether one or both hypoglossal nerves are affected.
Mandibular Development Anomalies
- Macrognathia: Refers to an abnormally large jaw, causing a very prominent chin (prognathism).
- Micrognathia: An abnormally small jaw that leads to the retraction of the chin (retrognathism) or even the complete absence of the same.
Dental Development Anomalies
- Anodontia: Dental germs are missing from their expected site and cannot develop dentition.
- Supernumerary (Accessory) Teeth: Additional teeth that appear with greater frequency in the upper and lower maxillae. They may erupt, remain impacted in the gum, or stay embedded.
- Dilaceration: Occurs when the root forms an angle close to 90 degrees with the longitudinal axis of the crown.
- Amelogenesis Imperfecta: A hereditary disease characterized by alterations such as enamel hypocalcification or hypoplasia, while the dentin and pulp remain normal.
- Dentinogenesis Imperfecta: Gives rise to teeth presenting an opalescent dentin with blue, gray, or violet hues and translucent opalescences.
Tooth Wear and Surface Alterations
- Attrition: Physiological wear of the occlusal surfaces caused by continuous tooth-to-tooth contact.
- Abrasion: Pathological wear of dental surfaces caused by external mechanical factors such as improper brushing.
- Erosion: Loss of dental structure caused by chemical agents, acids, or abnormal internal/external physical forces.
Oral Mucosa Infections
Viruses, bacteria, and fungi are the microorganisms that most frequently colonize the oral cavity.
Viral Infections of the Mouth
- Primary Herpetic Stomatitis: Appears as edema of the labial mucosa with the formation of vesicles upon contact with the virus from an infected individual.
- Recurrent Herpes Labialis: Caused by the reactivation of HSV-1 due to common triggers such as cold exposure, fever, or stress.
- Other Viral Pathologies: Affecting the skin and oral mucosa, these include Herpes Zoster (caused by the varicella-zoster virus), Varicella and Measles (common childhood exanthematous viral diseases), and Mumps (a viral glandular infection affecting the parotid duct with edema of Stensen's duct, high fever, and painful sub-auricular swelling).
Fungal Infections of the Mouth
The most well-known and frequent fungal infection is Candidiasis, which is caused by a fungal agent overgrowth.
Maxillary Cysts
A cyst is a pathological cavity lined by epithelium containing liquid or semi-solid material, such as cellular debris.
Epithelial Cysts
- Odontogenic Cysts:
- Inflammatory and Developmental: Radicular, periapical, follicular, eruption, and periodontal cysts.
- Non-Odontogenic Cysts:
- Idiopathic cavities
- Solitary bone cysts
- Aneurysmal bone cysts
Ulcers of the Oral Cavity
Oral ulcers represent a breach in the continuity of the skin or mucosa accompanied by the loss of underlying tissue:
Recurrent Aphthous Stomatitis
Characterized by small, painful ulcers on the oral buccal mucosa. Treatment typically involves antimicrobial rinses, topical corticosteroids, and anesthetics.
Traumatic and Chemical Injuries
Ulcers may appear due to trauma from sharp or carious teeth, as well as chemical agents such as aspirin or cleaning products applied directly to the mucosa.