ORAL PATHOLOGY COMPREHENSIVE EXAM 2025/2026
QUESTIOS AND SOLUTIONS GRADED A+
✔✔ankyloglossia - ✔✔tongue-tie; lingual frenum is too short or attached too anteriorly
✔✔lingual varices - ✔✔enlarged tortuous veins on ventral surface of tongue
✔✔fissured - ✔✔deep dorsal surface grooves; usually developmental on adults
✔✔hairy tongue - ✔✔proliferation of filiform papillae; color varies due to chromogenic
bacteria
✔✔central papillary atrophy (median thromboid glossitis) - ✔✔erythematous area
located in midline of tongue, anterior to circumvallate papillae and devoid of filiform
papillae
✔✔geographic tongue (migratory glossitis) - ✔✔erythematous areas devoid of filiform
papillae usually with a yellowish-white border; areas appear to migrate, but in reality one
area heals and another appears
✔✔fordyce granules - ✔✔yellowish clusters of submucosal sebaceous glands
✔✔leukoedema - ✔✔opalescent (milky) hue of the buccal mucosa resulting from
increased intracellular edema
✔✔lip pits - ✔✔blind sacs found in the vermillion zone or commisures, cause is usually
congenital
✔✔melanin pigmentations - ✔✔focal brownish areas that may be racial in origin or
indicative of a systemic disease (Addison's disease or Peutz-Jeghers syndrome)
✔✔retrocuspid papilla - ✔✔fibrous elevation lingual to mandibular canines (pt at the VA)
✔✔leukoplakia - ✔✔not a diagnosis, but a clinical description of a white lesion that does
not rub off
Etiology: usually resulting from chronic irritation with hyperkeratosis
Clinical manifestations: may be pre-malignant with use of high-risk factors like tobacco
and alcohol
✔✔lichen planus - ✔✔skin disease, etiology unknown
Oral manifestations:
1. white or gray thread-like papules in a linear or reticular arrangement (Wickham's
striae)
2. plaque-like form (more common on the dorsum of the tongue)
, 3. bulbous and/or erosive form (see vesiculoerosive diseases)
Clinical manifestations: more commonly seen in nervous, high-strung individuals
Treatment: none unless symptomatic (erosive), then corticosteroids
✔✔concresence - ✔✔joining of adjacent teeth by cementum only
✔✔dens in dente (Dens invaginatus) - ✔✔tooth within a tooth; enamel is deposited
within the pulp chamber due to the invagination of enamel organ
✔✔dilaceration - ✔✔abnormal root curvature caused by trauma during tooth formation
✔✔enamel pearl - ✔✔development of excess enamel on root due to misplaced
ameloblasts
✔✔macrodont - ✔✔denotes large tooth; relative or absolute
✔✔microdont - ✔✔denotes a small tooth; relative or absolute (peg lateral is most
common)
✔✔regional odontodysplasia (odontogenesis imperfecta (ghost teeth on x-ray)) -
✔✔ectodermal and mesodermal tooth components are affected; evidence of thin
enamel and dentin with large pulp chambers
✔✔talon cusp - ✔✔accessory cusp found on the maxillary and mandibular anteriors
✔✔taurodontism - ✔✔elongated pulp chamber with short roots
✔✔anodontia - ✔✔missing teeth; total, partial, congenital (ectodermal dysplasia),
acquired (extraction)
✔✔fusion - ✔✔two teeth are fused into one, resulting in a macrodont; therfore, fewer
than normal complement of teeth are present
✔✔supernumerary - ✔✔extra teeth; mesiodens is most common; usually microdont in
size, and may be a result of a syndrome (cleidocranial dysplasia or dysostosis -no
clavicles or collarbones)
✔✔gemination - ✔✔two clinical crowns are evident with usually one root; results in
greater than normal number of teeth; usually macrodont in size; result of tooth bud
attempting to split
✔✔enamel hypoplasia - ✔✔defect in enamel mineralization
Etiology-possible factors include: genetic (amelogenesis imperfecta), environmental
(drug ingestion, fever), metabolic (vitamin deficiency), disease (congenital syphilis)
QUESTIOS AND SOLUTIONS GRADED A+
✔✔ankyloglossia - ✔✔tongue-tie; lingual frenum is too short or attached too anteriorly
✔✔lingual varices - ✔✔enlarged tortuous veins on ventral surface of tongue
✔✔fissured - ✔✔deep dorsal surface grooves; usually developmental on adults
✔✔hairy tongue - ✔✔proliferation of filiform papillae; color varies due to chromogenic
bacteria
✔✔central papillary atrophy (median thromboid glossitis) - ✔✔erythematous area
located in midline of tongue, anterior to circumvallate papillae and devoid of filiform
papillae
✔✔geographic tongue (migratory glossitis) - ✔✔erythematous areas devoid of filiform
papillae usually with a yellowish-white border; areas appear to migrate, but in reality one
area heals and another appears
✔✔fordyce granules - ✔✔yellowish clusters of submucosal sebaceous glands
✔✔leukoedema - ✔✔opalescent (milky) hue of the buccal mucosa resulting from
increased intracellular edema
✔✔lip pits - ✔✔blind sacs found in the vermillion zone or commisures, cause is usually
congenital
✔✔melanin pigmentations - ✔✔focal brownish areas that may be racial in origin or
indicative of a systemic disease (Addison's disease or Peutz-Jeghers syndrome)
✔✔retrocuspid papilla - ✔✔fibrous elevation lingual to mandibular canines (pt at the VA)
✔✔leukoplakia - ✔✔not a diagnosis, but a clinical description of a white lesion that does
not rub off
Etiology: usually resulting from chronic irritation with hyperkeratosis
Clinical manifestations: may be pre-malignant with use of high-risk factors like tobacco
and alcohol
✔✔lichen planus - ✔✔skin disease, etiology unknown
Oral manifestations:
1. white or gray thread-like papules in a linear or reticular arrangement (Wickham's
striae)
2. plaque-like form (more common on the dorsum of the tongue)
, 3. bulbous and/or erosive form (see vesiculoerosive diseases)
Clinical manifestations: more commonly seen in nervous, high-strung individuals
Treatment: none unless symptomatic (erosive), then corticosteroids
✔✔concresence - ✔✔joining of adjacent teeth by cementum only
✔✔dens in dente (Dens invaginatus) - ✔✔tooth within a tooth; enamel is deposited
within the pulp chamber due to the invagination of enamel organ
✔✔dilaceration - ✔✔abnormal root curvature caused by trauma during tooth formation
✔✔enamel pearl - ✔✔development of excess enamel on root due to misplaced
ameloblasts
✔✔macrodont - ✔✔denotes large tooth; relative or absolute
✔✔microdont - ✔✔denotes a small tooth; relative or absolute (peg lateral is most
common)
✔✔regional odontodysplasia (odontogenesis imperfecta (ghost teeth on x-ray)) -
✔✔ectodermal and mesodermal tooth components are affected; evidence of thin
enamel and dentin with large pulp chambers
✔✔talon cusp - ✔✔accessory cusp found on the maxillary and mandibular anteriors
✔✔taurodontism - ✔✔elongated pulp chamber with short roots
✔✔anodontia - ✔✔missing teeth; total, partial, congenital (ectodermal dysplasia),
acquired (extraction)
✔✔fusion - ✔✔two teeth are fused into one, resulting in a macrodont; therfore, fewer
than normal complement of teeth are present
✔✔supernumerary - ✔✔extra teeth; mesiodens is most common; usually microdont in
size, and may be a result of a syndrome (cleidocranial dysplasia or dysostosis -no
clavicles or collarbones)
✔✔gemination - ✔✔two clinical crowns are evident with usually one root; results in
greater than normal number of teeth; usually macrodont in size; result of tooth bud
attempting to split
✔✔enamel hypoplasia - ✔✔defect in enamel mineralization
Etiology-possible factors include: genetic (amelogenesis imperfecta), environmental
(drug ingestion, fever), metabolic (vitamin deficiency), disease (congenital syphilis)
