Congenital lip and
commissural pits and fistula
It is malformation of the lips ,often following
a hereditary pattern.
It may occur alone or in association with other
developmental anomalies such as various oral
75-80% of all cases of congenital labial fistulas
,there is an associated cleft lip or cleft palate.
Many theories have put up but none has been
Notching of the lip.
Fixation of the tissue at the base of the notch.
However it is harmless and seldom
VAN DER WOUDE SYNDROME
It is an autosomal dominant syndrome
typically consisting of cleft lip or cleft palate
and distinctive pits of the lower lip
The most prominent feature is orofacial
Caused due to abnormal fusion of palate
and lip , at days 30-50 postconception
• Occurences: affects about 1 in 100,000-
• Sex: no sex prediliction
• Lesion: isolated ,usually medial
• Site : on the vermilion portion of lower lip
Examination and genetic counseling by a
Surgical repair of clept lip and palate
CLEFT LIP AND CLEFT PALATE
It is a common congenital malformation.
Failure in the fusion of the nasal and
maxillary prosses leads to cleft of
primary palate ,can be unilateral or
Incidence of cleft of the lip and palate
varies from 1 in 500 to 1 in 2500
depends on geographic origin.
Insufficent nutrition to pregnant women
o Defective vascular supply
o Size of the tongue prevent union of affected
o Infections , certain alcohol ,drugs and toxins
o Lack of inherent developmental force
• Sex : male predilection
• Lesion: unilateral or bilateral anomaly
i. The cleft anterior to the incisive foramen is
defined as cleft of primary palate.
ii. The cleft posterior to the incisive foramen is
defined as a cleft of secondary palate.
Most cases can be surgically repaired
with excellent cosmetic and functional
Eating and drinking are difficult because
of regurgitation of food and liquid
through the nose.
Characterized by progressive enlargement
and eversion of the lower labial mucosa that
results in obliteration of the mucosal-
Lip enlargement is attributable to
inflammation , hyperemia , edema and
Surface keratosis , erosion,self-inflicted
biting , factitial trauma , excessive wetting
from compulsive licking , drying
Chronic aggravating factor.
• Lesion :enlargement of lip and loss of
elasticty , asymptomatic lip swelling ,
burning discomfort, sensation of rawness
• Sex :male predilection.
• Age :4th -6th decade.
• Secretion: Mucopurulent exudates from
ductal orifices of labial minor salivary
o Chronic inflammatory cell infiltrate
o Shows peri and para vascular aggregations
of lymphocytes ,plasma cells and
o Formation with epitheloid cells and
Langhan’s type giant cells.
Intra lesional corticosteriods injections.
Non steroidal anti-inflammatory agents .
Mast cell stabilizers .
Surgery and radiation.
Hereditory intestinal polyposis
It is an autosomal dominantly inheritant disorder
characterized by intestinal hamaratomaous polyps
in association with muco-cutaneous melanocytic
The cause of the Peutz-Jeghers syndrome
appears to be a germline mutation of the
STK11 gene in most cases, located on band
>Races: all races
>Signs and symptoms: intestinal bleeding, menstrual
irregularities, cutaneous pigmentation
>Extensive smooth muscle arborization throughout
Labial and oral melanotic
It shows a focal area of melanin deposition
• Sex:2:1 female predilection
• Age :23years
• Site: vermilion border of lip , buccal mucosa,
gingiva and palate
• Lesion: well demarcated, uniformly tan to
dark brown, asymptomatic ,round shaped
o Normal stratified squamous epithelium with
abundant melanin deposits within the
keratinicytes of basal and parabasal layers.
No treatment is
It is a developmental anomaly characterized by
heterotropic collections of sebaceous glands at
various sites in the oral cavity
• Lesion :Small yellow spots.
• Sex/race: No gender and races predilection.
• Site: Tongue ,gingiva , frenum and palate
o Heterotopic collections of sebaceous
o The gland are usually superficial and may
consist of only a few or a great many
o Shows keratin plugging.
Requires no treatment.
FOCAL EPITHELIAL HYPERPLASIA
It is one of the most contagious of the oral
It is able to produce extreme acantosis or
hyperplasia of the prickle cell layer of
• Age :children ,young and middle-aged.
• Sex : no predilection
• Site: labial , buccal and lingual mucosa ,
• Lesion: papillary in nature , smooth
surfaced, flat-topped ,pale or rarely white.
o Focal acantosis of oral epithelium
o Spinous layer show both cytoplasm and
nuclei in cell
Treatment is unnecessary.
Conservative excisional biopsy for proper