Causes
Why buccal exostoses form is unclear, but it may involve bruxism (tooth clenching and grinding), and genetic factors. Typically they first appear in early adulthood. Diagnosis
The presence of buccal exostosis can be diagnosed by both clinical examination and radiological interpretation of the oral cavity. Clinically, buccal exostoses appear as single, broad-based masses, usually situated bilaterally in the premolar and molar region on the facial surface of the maxillary alveolar bone. The mass is generally smooth although in some cases a sharp, bony prominence may be present resulting in tenderness beneath the mucosa. Initial presentation usually occurs in early adolescence and the lesions may slowly enlarge up to 3–4 cm in diameter with time, however there is no malignant potential. Despite buccal exostoses being generally painless and self-limiting, they may cause patient concern regarding poor aesthetics, food lodgement and compromised oral hygiene. Their tendency to grow in size may also contribute to periodontal disease as a result of food build up in the area of the lesion.Radiographically, buccal exostoses can be identified as round, well-defined structures which superimpose the roots of the teeth, normally in the premolar and molar region. Dental panoramic tomography and cone beam tomography can be used to confirm diagnosis.An additional biopsy for diagnosis of buccal exostosis is not usually recommended, however it is important to rule out the possibility of early osseosarcomas and chondrosarcomas. In addition, it is recommended that patients who present with multiple growths showing similar characteristics but not in the classic exostoses locations should be evaluated for Gardner syndrome.
Collins bodies form in cortical and subcortical neurons where they disrupt the cells normal functioning and ultimately lead to cell death. Progressive dementia results from this gradual loss of nerve cells in certain parts of the brain. Researchers believe that a buildup of related, potentially toxic substances in nerve cells may also contribute to the signs and symptoms of this condition.This condition is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. In many cases, an affected person has a parent with the condition. References

National Library of Medicine. Genetics Home Reference - Familial encephalopathy with neuroserpin inclusion bodies


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