3 - More radiographic interpretation Flashcards
What can be included under the term “jaw lesions”?
- cysts
- benign neoplasms
- cancers
- developmental abnormalities and genetic conditions
- reactive lesions
What is the first step in the differential diagnosis of any lesion?
Is it…
- anatomical
- artefactual
- pathological
What can be used to describe a lesion?
- site
- size
- shape
- margins
- internal structure
- effect on adjacent anatomy
- number
What should be include in the description of the site of a lesion?
- where it is, what type of bone
- relationship and position relative to other structures
What should be include in the description of the size of a lesion?
- measure with dimensions
- describe the boundaries
What should be include in the description of the shape of a lesion?
- general (rounded, scalloped, irregular)
- locularity (unilocular, pseudolocular, multilocular)
Define unilocular.
One smooth shape, one clear border
Define multilocular.
Appears as many small shapes together
Define pseudolocular.
Cloud appearance
How can you describe the margins of a lesion?
- well defined and corticated
- well defined and non-corticated
- poorly defined and blending into surrounding anatomy
- poorly defined and moth eaten appearance
What type of margin indicates a malignancy?
Poorly defined and moth eaten appearance
What type of margin indicates a benign lesion?
Corticated
How can you describe the internal structure of a lesion?
- entirely radiolucent
- radiolucent with some internal radiopacity
- radiopaque (homogenous or heterogeneous)
- describe the amount of radiopacity, bony septae, if there is tooth structure or similar
What causes radiolucency?
- resorption of bone
- decreased mineralisation of bone
- decreased thickness of bone
- replacement of bone with abnormal, less mineralised tissue
What causes radiopacity?
- increased thickness of bone
- osteosclerosis of bone
- presence of abnormal tissues
- mineralisation of normally non-mineralised tissue
How do you describe the effect on adjacent anatomy?
- aggressive pathologies tend to grow quickly and be more destructive
- slower growing lesions tend to displace structures
How can a lesion affect the bone?
- displacement of cortices
- perforation of cortices
- sclerosis of trabecular bone
How can a lesion affect the ID canal?
- displacement
- erosion
- compression
How can a lesion affect the teeth?
- displacement/impaction
- resorption
- loss of lamina dura
- widening of PDL
- hypercementosis
How does the number of lesions aid diagnosis?
- majority occur alone
- few pathologies are bilateral
- suspect a syndrome if >2 lesions
What are common radiopacities seen on radiographs?
- idiopathic osteosclerosis
- scelorising osteitis
- hypercementosis
- buried retained roots
- supernumeraries
What is idiopathic osteosclerosis?
- localised area of increased bone density of unknown cause
- asymptomatic
- typically presents in adolescents, can impact orthodontics
- most common in premolar area
Describe the appearance of idiopathic osteosclerosis.
- well defined radiopacity, usually homogenous
- no radiolucent margin
- variable shape, usually <2cm
- not associated with any structures
What is sclerosing osteitis?
- localised area of increased bone density in response to low grade, chronic inflammation
- also known as condensing osteitis
Describe the appearance of sclerosing osteitis.
- well defined or poorly defined radiopacity
- variable shape
- directly associated with source of inflammation
- no expansion or displacement of adjacent structures
What is hypercementosis?
- excessive deposition of cementum around root
- cause is unknown but associated with certain conditions
- can make extractions more difficult
What conditions are associated with hypercementosis?
- Paget’s disease
- acromegaly
Describe the appearance of hypercementosis.
- multiple teeth can be involved
- homogenous radiopacity continuous with root surface
- PDL space extends around periphery
- margins are well defined and smooth
