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By D22 & D24



x (
(3)Concrescence cementum
(4)Talon cusp (Eagles cusp) incisors cingulum
(5)Dens evaginatus(central cusp) IEE cusp
(6)Dens invaginatus(dens in dente)
(8)Turners tooth(Turners hypoplasia)

(9)Syphilitic hypoplasia Hutchinsons incisors(

1/3 ) mulberry molars( 1 st molar)(!)
(10)Enamel pearl 2nd molar(!)
(1)Micrognathia (anchondroplasia)(Cleidocranial)
(2)Macrognathia Pagets diseaseAcromegaly(
)Leontiasis ossea(fibrous dysplasia )
3. Fordyces granules 80%
(1)Orofacial cleft (!) 1/1000()1/500()CL(cleft lip)
+CP(cleft palate) 45% CL 80%
Pierre Robin syndrome cleft syndromeCPMd
micrognathia glossoptosis ()
(2)Double lipAscher syndrome
Ascher syndromedouble lipblepharochalasis()nontoxic thyroid
enlargement(50%)Ascher syndrome
mucopolysaccharidoses( )neurofibromatosis MEN2B( 2B
)amyloidosis()angioedema tumors
Cretinism() myxoedema()
(2)Median rhomboid glossitis() filiform papilla
(3)Fissure tongue(Scrotal tongue) Melkersson-Rosenthal syndrome

(4)Hairly tongue(Black hairy tongue)filiform papilla


Hairly leukoplakia hairly leukoplakia EBV-induced HIV
AIDS 30% hairly leukoplakia
(5)Geographic tongue (erythema migrans) filiform papilla
fungiform papilla lesion
Vit. B2
(1)Eagles syndromeStyloid process stylohyoid ligment

(2)Stafnes defectSublingual gland submandibular gland X

(1)Palatal cyst of the newborn Epsteins pearls Bohns
(2)Nasolabial(Nasoalveolar) cyst
(3)Globulomaxillary cyst ( reverse teardropshaped) vital
(4)Nasopalatine duct cyst(Incisive canal cyst) 1/100 non-odontogenic
cyst ( odontogenic cyst radicular cyst)X
(5)Gardner syndrome(osteomas) ()
epidermoid cyst fibroma
(6)Thyroglossal duct cystforamen cecum() suprasternal notch
(7)Branchial cleft cyst(Cervical lymphoepithelial cyst) SCM
cervical fistulaConnect tissue wall lymphoid ()(!)
8. syndromes
(1)Crouzon syndrome() cranial suture

(2)Apert syndromeCrouzon syndrome ()

(3)Mandibulofacial dysostosis (Treacher Collins syndrome)

(4)Cleidocranial dysplasia(10%)

(1)8> 2> 5> 5> 1> 2>7
(2)Ectodermal dysplasiaDowns syndromeCrouzon syndromeEhlers-Danlos
syndromeEllis-van Creveld syndromeGorlin syndromeHurler syndrome ( p.69)
(3)Cleidocranial dysplasiaGardner syndromeDowns syndromeEhlersDanlos syndromeCrouzon syndromeApert syndromeTurner syndrome( p.70)
(4)Cleidocranial dysplasia()RicketCretinismDowns
(5)Cushings syndromehyperthyroidism

diseasedentinal dysplasia

1. Abfraction() enamel cervical enamel
2. / pulp ( pink spot) PDL
intracoronal bleachingPagets disease
4. Dentinogenesis imperfecta()()
Enamel dentin osteogenesis imperfecta Crown
cervical cervical construction bulbous()
chamber Shell teethenamel
dentin pulp
Type I osteogenesis imperfecta with opalescent teeth
Type II dentin
Type IIIX-ray finding type II
5. Dentin dysplasia()()
I Radicular type(rootless tooth) canalpulp chamber
Type IICoronal typepulp chamber pulp stone( Dentinogenesis imperfecta )
6. Regional odontodysplasia() (Ghost teeth)Enameldentinpulp

1. NUG BF(Bacillus fusiform)BV(Bacillus vincentii)Treponema Selenomona
Vencent`s infection Trench() mouthPapilla punched-out

2. (phenytoin)(cyclosporine)
3. Papillon-Lefvre syndrome periodontal attachment and bone
loss 2~3 neutrophil dysfunction dipeptidyl
aminopeptidase I (Peri !)

1. Scarlet fever -hemolytic streptococcus
( soft palate) fungiform papilla white strawberry
tongue red strawberry tongue

Pastias line
2. Congenital Syphilis() mulberry molars Hutchinsons triadHutchinsons
incisorsocular interstitial keratiitis()CN VIII

3. Actinomycosis()G(+)(sulfur granules
) 1st molar actinomycotic osteomyelitis
Botryomycosis () (!)
4. Candidiasis
2)Erythematous 3)filliform papilla
4)Chronic multifocal 5)Angular cheilitis 6)Denture stomatitis
7)Hyperplastic 8)Mucocutaneous 9)Endocrine-candidiasis syndrome
5. Blastomycosis() pseudoepitheliomatous hyperplasia(
) SCC(!)
6. Cryptococcosis()AIDS 90
7. Impetigo() Streptococcus pyogenes()
Staphylococcus aureus(!)
8. Cat-scratch disease() Bartonella henselae

1. HHV(Human Herpesviridae )
1)HHV-1(HSV-1Herpes simplex virus) 2~3
(acute herpetic gingivostomatitis)
ulcer(Herpetic labialis)(cold sore)
(fever blister) (!) Herpetic withlow()
2)HHV-2(HSV-2)(genital zone)
3)HHV-3(VZVVaricella-zoster virus)(Vericella)(Herpes zoster)
Herpes zoster
(self-limitating) Herpes zoster
Ramsay Hunt syndrome(tinnitus)(!)
4)HHV-4(EBVEpstein-Barr virus)kissing diseaseEBV
B cell B cell B cell
EBV (1)Infectious mononucleosis(kissing disease)
(2)AIDS (3)Hairy leukoplakia (4)Endemic Burkutts lymphoma (5)NPC (!)
5)HHV-5(CMVCytomegalovirus )AIDS Owl eye cell
6)HHV-8(Kaposis sarcoma associated virus)
2. Enterovirus RNA
1)Herpangina() Coxsackievirus A() Enterovirus 71 3~10
2)Hand-Foot-Mouth disease Coxsackievirus A() Enterovirus 71
3)Acute lymphonodular pharyngitis Coxsackievirus A
Herpangina Enterovirus 71

3. Rubeola measles paramyxovirus 1~2

Kopliks spot
4. Rubella Togavirus Forchheimers sign
(Pedo !)
5. Munps paramyxovirus Whartons and Stensens duct
6. AIDS CD4 T AIDS Kaposis
sarcoma() Non-Hodgkins lymphoma( 60 )
1)70% HIV 1/3 AIDS
3)NUG(interdental papilla bone loss)NUP
5) Kaposis sarcoma AIDS

1. Riga-Fede disease 1 1
2. Xerostomia Serous gland() mucous gland
1)Lead plumbism() marginal gingival (

2) marginal gingival
acrodynia() pink disease( pink disease)Swift
diseaseAmalgam (Pedo !)
3)Argyria() marginal gingival
4. (exfoliative cheilitis)
5. Myospherulosis()
bag of marbles ()( p.281)

1. (Erythema multiforme)
2~6 targetbulls-eye
Stevens-Johnson syndrome
2. Pemphigus vulgaris desmosome
Nikolsky sign()
Tzanck cell()

3. Cicatricial () pemphigoid benign mucous membrane pemphigoid
() hemidesmosome( IgG )
) Nikolsky sign Tzanck cell

4. Linchen planus palatereticular type

(Wickhams striae)Erosive type
orthokeratosis parakeratosis rete ridge
( Civatte bodiescolliod bodiescytoid bodies hyaline
bodies) T cell bandlike infiltrate
5. Stomatitis medicamentosaoral mucosa
6. Wegners granulomatosis(strawberry gingivitis)(!)
7.(recurrent aphthous ulceration) major > minor >
8. Behets syndrome = Mouth and genital ulcer with inflamed cartilage (MAGIC syndrome)
multisystem disorder
9. Reiters disease

10. (Sarcoidosis)()
( TB )

(epithelioid histiocytes)
Langhans giant cells(!)Kveim test(

Heerfordts syndrome(anterior
uveitis)( P.293) (!)
11. Graft versus host disease (GVHD) GVHD 100
lichen planus exprednisolon(!)

1. Squamous papillomaHPV() 6 11 30~50
finger-like 5mm Koilocytes()
2. Verruca vulgaris()HPV 24640 lip papillary
3. Condyloma acuminatum()HPV 26115354
4. Focal epithelial hyperplasia HPV 13 32 HIV

5. Verruciform xanthoma
SLE lipid-laden() histiocytes

alveolar mucosa
PAS ()rete ridge SCC (!)
6. Lentigo maligna Melanoma()
7. Oral melanotic maculesmacules
Peutz-Jeghers syndromeMcCune-Albright syndromeAddison diseaseNeurofibromatosis

8. Cafe-au-lait spots McCune-Albright syndrome

9. Nevus cell (epitheliod) type Atype B type C spindle
10. Blue nevus type C(spindle)
11. Leukoplakia

Proliferative verrucous leukoplakia(PVL) verrucous

carcinoma SCC
12. Erythroplakia 40% 28%
13. Oral submucous fibrosis(OSF) 7.6% HLA type I
14. Actinic() cheilosis Actinic keratosis farmers lip sailors lip
15. SCC 57%
Grading (!) ( N1 stage III )
(3)StageT3N0M0 T1~3N1M0
(4)StageT4 N2N3 M1
16.Verrucous carcinoma() HPV 1618 20% SCC
90% 5 (OS !) SCC
17.Nasopharyngeal carcinoma EBV Vit. C < 40
18.BCC()2 clear zone 95%
Nevoid basal cell carcinoma syndrome(Gorlin syndrome) BCCOKC

19. Melanoma skin cancer(No1BCCNo2SCC)

1)Asymmetry 2)Border irregularity 3)Color variegation
4)Diameter 6mm1)() 2)
3) 4) Acral lentiginous melanoma()() S100(+)HMB-45MART-1 (!)
20. Merkel cell carcinoma cytokeratin 20(CK20) cribriform

appearance (Swiss cheese)


CH 11
1. Parotid g. serous( salivary gland tumor ) Submandibular g.serous
mucus Sublingual g.mucus serous
2. Myoepithelial cell(MEC) epithelial cell
3. Major salivary gland tumorMixed tumorMucoepidermoid carcinoma
Adenoid cystic carcinoma
Minor salivary gland tumorpalate(50%)lip(21%)
Adenoma ()
1. Pleomorphic adenoma() (Mixed tumor) parotid gland
2. Papillary cystadenoma lymphomatosum (Warthins tumor) parotid gland 2

Carcinoma ()
1. Acinic cell carcinoma (ACA)Parotid gland
(facial n.)
Warthins tumor() ACA()
2. Mucoepidermoid carcinoma(MEC) 1st 2nd (1st mixed tumor)
1st Degree of cytologic atypia() Amount of cyst formation Mucus,
epidermoid, intermediate cells (!)
3. Adenoid cystic carcinoma(ACC) (50%) Swiss cheese
appearance facial paralysis 12-17%
Chest PA (!)
4. Polymorphous low grade adenocarcinoma (PLGA) minor glandpalate
Non-neoplastic lesions
1. Mucocele( minor duct)(75%)
2. RanulaSublingual gland mucin swelling

3. Plunging ranulaFluid mylohyoid m. submandibular space

4. Sialolithiasis() submandibular gland (80%) (duct serous )
5. Sialadenitis()Sjgren syndrome sialography
sialadenitis ()(surgical
mumps)(NPO)Staphylococcus aureus(!)
6. Sialodochitis ()
Sausage-link pattern(OS!)
7. Xerostomia RT BLLSjgren syndrome HIV
Drug---antihistamoinereserpine(antihypertension)atropineRampant caries cervical root

8. Benign Lymphoepithelial Lesion(BLL)() parotid gland

---Triad ---parenchymatous atrophyinterstitial lymphocytic infiltationepi-myoepithelial island
9 Sjgren syndromePrimary Sjgren syndrome(sicca
(antinuclear antibody) SS-A SS-B Secondary Sjgren syndromesicca syndrome+
(exRAscleradermapolymyositis)IgG Sialography fruit-laden,
branchless tree() duct
10. Necrotizing sialometaplasia ()
cancer > 2-3 wks crater-like ulceration56wks
psedoepitheliomatous hyperplasia() SCC or MEC(!)

1. Fibroma
2. Giant cell fibroma 1 cm

3. Epulis fissuratum rete ridge

4. Inflammatory papillary hyperplasia
Epulis fissuratumInflammatory papillary hyperplasiaNorth
American blastomycosisGranular cell tumorNecrotizing sialometaplasia
5. Pyogenic granuloma
()( pregnancy tumor granuloma
6. Peripheral giant cell granuloma(Giant cell epulis) 50~60
tumor-like Pyogenic granuloma
cupping() resorption10%
7. Peripheral ossifying fibroma() interdental papilla
2 cm 10-19
8. Schwannoma capsule
() Antoni A(Schwann cell
Verocay bodies ) Antoni B()S-100 protein(+)
9. Neurofibroma Schwann cell
perineural fibroblast capsule spindle
tumor cellwavy nuclei S-100 protein scattered

10.Neurofibromatosis 1/3000type I ( 17 )
tumors ()()(lisch
nodules)5% schwannoma

11.Multiple endocrine neoplasia (MEN)

Type I
Type II (MEN2ASipple syndrome)
Type III(MEN 2B)
(phenochromocytoma)( VMA )
12. Melanotic neuroectodermal tumor of infancy(MNETI)
VMA (p.s.Neuroblastoma VMA )
13. Granular cell tumor() Schwann cell neuroendocrine cell
S-100 protein(+)()(!)
14. Hemangioma and Vascular malformation(!)
1) Hemangioma ()
strawberry hemagioma(!)
2)Kasabach-Merritt syndrome 30~40%
3)Vascular malformation4)
5) (Intraosseous = cental hemagioma)
X honeycomb soap bubble

15. Sturge-Weber angiomatosis port-wine stain(

)() (!)
16. Rhabdomyoma
CT scan

18. Lymphagioma() 2 (10 y/o )Oral lymphagioma



1. Hemophilia()Hemophilia A Hemophilia B
Hemophilia A clotting factor 8 Hemophilia B ( Christmas disease)
clotting factor 9 (Pedo !)
AB won Willebrands disease () aPTT (!)
2. Anemia
1)-globin chain (adenine thymine)
hair-on end(!)
2)Thalassemia() hair-on end()

(hydrops fetalis) (!)

3)Aplastic anemia()
3. Agranulocytosis()punched-out
4. Cyclic neutropenia 21

5. Langerhans cell diease(histiocytosis X)Langerhans cell T cell

Eosinophilic granulomaHand-Schuller-Christian disease(
punched out)Letterer-Siwe disease 10-20%X
punched out() floating in air S-100 protein(+)
Birbeck granules(!)
punched out
6. Leukemia (HTLV1Non-Hodgkin lymphoma)
7. Hodgkins lymphoma cervical and supraclavicular nodes
RS cells(Reed-Sternberg cells)
8. Non-Hodgkins lymphoma -lymphocyte series lymphocyte
syndromeAIDS)(SLERASjgren syndrome)(EBVHHV8 HTLV-1)
9. Burkitts lymphoma -lymphocyte series EBV
starry-sky pattern(macrophages )
10. Multiple myeloma light chain proteins (Bence
Jones proteins)amyloid ()
X punched-out 60-70 leukopenia()
thrombocytopenia( )hyperglobulinemia() x-ray
radioleucency (!)
11. Thrombocytopenia()<10 /mm3(!)

1. Fibrous dysplasiaosteoblast fibrous GNAS 1

1)Monostotic fibrous dysplasia (!)

2)Polyostotic fibrous dysplasia
X lesion ground glass(
) Chinese characters()
remodeling woven bone()
McCune-Albright syndrome(Albrights syndromePolyostotic fibrous dysplasia)

Jeffys syndrome
2. Periapical cementosseous dysplasia
X radiolucency radiopaque

3. Focal Cemento-ossous dysplasia 40

4. Ossifying fibroma tooth-bearing area Md body region

true tumorlamina dura PDL spaceX
(!)radiopacity ( Fibrous dysplasia )
5 .Pagets disease

denture ridge
black beard Lincons sign hydroxypoline
X-ray cotton wool (!)
6. Hypophosphatasiacementum
pulpenamel hypoplasiadentin
7. Central giant cell granuloma
lamina dura
8. Brown tumor (
central giant cell granunoma lesion)
9. Cherubism 78
Md angle
10. Osteosarcoma()30~40
X sun ray effect Codman triangle(
jaw bone osteosarcoma 20~40 long bone osteosarcoma
<20 >50 Chondroblastic()osteoblasticfibroblastic(!)
11. Ewing sarcoma(Primitive neuroectodermal tumorPNET)Ewing
MIC 2 X motheaten onion-skin()radioleucent75%
(glycogen granules)(!)
12. Hypercementosis
1)Local factorAbnormal occlusal traumaAdjecent inflammationUnopposed teeth()
2)Systemic factor
Acromegaly() and Gigantism()ArthritisCalcinosis()Pagets
diseaseRheumatic fever()Thyroid goiter()Vit A deficiency()
13. Osteogenesis imperfecta()(!)
type I collagen
(1) 30

opalescent() dentin(Type I dentinogenesis


(4) 50%
14. Aneurysmal bone cyst ()soap bubble honeycomb x-ray

15. Simple bone cyst ( p.549)(<20 )()>

(! ) long bone
16. Osteopetrosis () osteoclast
remodeling marrow space delay eruption

1. (Tumors of odontogenic epithelium)
1)Ameloblastoma (tumor) local invasive
capsule(50~90%) 40 ascending ramus
cyst50% X
multilocular radiolucency ( radiolucency ) soap bubble honey
comb PsNo1 Odontoma
Unicystic Ameloblastoma(X radiolucency ) 10~15%
( 23 ) mural type()
Ameloblastic carcinoma
Malignant Ameloblastom
2)SOT(Squamous odontogenic tumor) PDL
3)Calcifying epithelial odontogenic tumor(Pindborg tumor)
Ameloblastoma REE amyloid()50%
X irregular multilocular radiolucency with radiopacity
Liesegang sings()
Pindborg tumorBCC
4)AOT(Adenomatoid odontogenic tumor2/3 tumor) capsule2/3
(10~20 )()X well defined radiolucency
(spot) cyst spindle shape cell
(whorled appearance)tumor(ductlike) dentinoid( dentin dentinal tubeles)
2. Mix odontogenic tumor()
1)Ameloblastic fibroma 21 75%
2)Ameloblastic fibrosarcoma Ameloblastic fibroma
3)Ameloblastic fibro-dentinoma Ameloblastic fibroma

4)Ameloblastic fibro-odontoma 11.5 dentin enamel
5)OdontomaWell-encapsuled hamartomas(
neoplasmsNeoplasma odontoma )

Compound odontoma
Complex odontoma tooth substance
1)Odontogenic myxoma Ameloblastoma30~40
local invasionpoor encapsuledX multilocular radiolucency
tennis racket septum(Ameloblastoma soap bubble honey
2)Odontogenic fibroma inactive
Ameloblastic fibroma active
Benign cementoblastoma(true Cementoma) cementoblast cementum
20 Well-encapsule
vitalX sunburst appearance
Periapical cemental dysplasia tumorX
radiolucent radiopcity
Frorid cemento-osseous dysplasia tumor

Cemento-ossifynig fibroma tumor capsule

Odntogenic cystcyst fluidfibro-capsulelining epithelium

1. Primodial cyst cyst(psresidual cyst )
2. Dentigerous cystdental follicle REE cyst
cyst cervical>>Dentigerous cyst
ameloblastoma SCC low cuboid cell mucous cell
3. Eruption cyst Dentigerous cyst soft tissue
4. Lateral periodontal cyst PDL Malassez dental lamina dental follicle
5. Gingival cyst dental lamina Gingival cyst free
gingival attached gingiva Gingival cyst
6. Odontogenic keratocyst(OKC) OKC
1)Lining epithelium keratinosis parakeratin orthokeratin
2) 6~8 rete pegs
3) palisaded() basal cell layer

OKC 30% epithelium budding daughter cyst

OKC Basal cell nervous(Bifid Rib
syndrome) BCC()
7. Kerating and calcifying odontogenic cyst (COCGorlins cyst)
AOT dental lamina enamel
organ Ghost cell (!)(reverse from basal layer
8. Radicular cyst cyst Malassez
periapical granuloma radicular cyst
9. Glandular odontogenic cyst ciliated epithelial cell(
) cyst invasion
10. Paradental cyst cervical area
buccal bifurcation cyst () 1st molar

CH 17Oral Manifestation of Systemic Disease

1. Hyperthyroidism(ThyrotoxicosisGraves disease)
--- 60 90% Graves disease( TSH )
(glycosaminoglycan retro-orbital )free T4
Tx. 131I
2. Hyperparathyroidism()
Brown tumorLamina dura
3. AmyloidosisAmyloid -pleated sheet Amyloid Conco red
Organ-limited amyloidosis
Systemic amyloidosis(1)Primary (2)Myeloma-associated
(4)Hemodialysis-associated -2 microglobin

4. Crohns disease

CH 18Facial Pain and Neuromuscular Disease

1. Bells palsyCN7 ()()
2.Trigeminal neuralgia 40 >6T=Trigger
point( nasolabial fold)Twinge()Time( 2min)Truce(
(refractory period) trigger point )Track()
Tegretol(=carbamazepine )
3. Frey syndromeAuriculotemporal n.()(40%
parotidectomy()) Minors starch-iodine test

Addisons disease ACTHMSH

Apert syndromefibroblast crowding crossbite
Ascher syndrome(p.1)
Behets syndrome (p.6)
Crouzon syndrome()(p.2)
Cushings syndrome (Hypercortisolism)Buffalo humpmoon faceosteoporosis(p.12)
Cleidocranial dysplasia(p.2)
Eagles syndrome (p.2)
Frey syndrome(p.15)
Gardner syndrome()
epidermoid cyst fibroma(!) (p.2)
Gorlin syndrome Nevoid basal cell carcinoma syndrome BCCOKC
(+OS !) (p.7)
Gorlins cyst = Calcifying odontogenic cyst (p.14)
Garres Osteomyelitis periapical abscess

Heerfordts syndrome (p.6)
Hunters glossitis (Moellers glossitis)
Herlers syndrome()
Klinefelter syndrome (p.1)
Kasabach-Merritt syndrome(p.10)
Jaffe-Lichtenstein syndrome()+polystotic fibrous dysplasia

Melkersson-Rosenthal syndrome(!)(p.1)
Maffucci syndrome chondroma
McCune-Albright syndrome= Albrights syndrome()
Peutz- Jeghers syndrome(hereditary intestinal polyposis syndrome)
(labial and buccal mucosaand the
keratinocyte melanocyte LKB1 (serine/threonine kinase)
Pierre-Robin syndrome cleft syndrome(p.1)
Plummer-Vinson syndrome

Papillon-Lefvre syndrome (p.11)


Ramsay Hunt syndromeHerpes zoster

Reiters syndrome(p.6)
Steven-johnson syndrome
Static (Stafnes) bone cyst cystx

Sjgren syndrome()
15% RA 30% SLE Sjgren syndrome
Sipple syndrome(p.9)
Treacher Collins syndrome(p.2)
Von Recklinghausens diseaseNeurofibroma ()
()()() lesion x
10Crowes sign
Lisch spots
Van der Woude syndrome( p.5)Paramedian lip pits()

1. Strawberry tongue -
2. Strawberry gingivitis - Wegeners granulomatosis
3. Strawberry hemangioma infant, superficial hemangioma
4. Strawberry nevus congenital hemangioma


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