All Flashcards
Adenomatoid Odontogenic Tumor
Chapter 2
Well- defined, single, uni,
Patient: Females 2:1
Age: 10-19
Site: Anterior maxilla but can occur in post mand
Appearance: Unilocular RL with or with out radio-opaque flecks, 74% associated with impacted teeth-canine common. Can displace teeth although not normally aggressive. Resembles dentigerous cyst
TX- Curettage
Ameloblastoma Solid
Chapter 2
Well-Defined-Single
Patient: No gender
Age: Average 33 30-70 rare under 12
Site: 85% in posterior mandible by molars or ramus
Appearance: multilocular, expansile with septa, resorbs and displaces teeth and can perforate the jaw.
TX- curretage or resection
Recurrence high with out resection
Desmoplastic ameloblastoma
Chapter 2
Ill-defined Patient: Any Age: 30-60 Site: Anterior maxilla and mandible Appearance: Poorly demarcated borders with mixed RL and RO patterns that are often mistaken for other benign lesions. Can appear like SOT, a triangle between teeth that displaced the roots. TX- curretage or resection
Unicystic Ameloblastoma
Chapter 2
Well-defined Single Patient: No gender Age: 10-20 Site: 90 % in the posterior mandible Appearance: Well circumscribed, locally aggressive, thinly corticated and expansile with some association with impacted teeth and can displace teeth. Can resemble a dentigerous cyst. TX- Curettage Can recur just not as much as solid
Ameloblastic Fibroma
Chapter 2
Well-defined Single Patient: Any gender Age: Young first and second decade Site: Molar area of the mandible Appearance: Unilocular or multilocular RL often associated with an impacted tooth with smooth borders that are sometimes sclerotic. Can be expansile and push teeth. Slow growing but can get big. Can reoccur TX: Curettage
Ameloblastic Fibro-odontoma
Chapter 2
Well-defined, single, mixed
Patient: No gender preference
Age: Children around 10
Site: Equal distribution between maxilla and mandible- Often associated with unerupted tooth
Appearance: Well circumscribed, expansile, RL containing RO material- potentially a precursor to Odontoma but not proven can get big
TX surgical curretage
ABC/ Aneurysmal Bone Cyst
Defined-Single RL Patient: Slight female Age: Before the age of 20 Site: Mandible Appearance: Unilocular or multilocular expansile balloning RL, honeycombing or whispy septa, pain TX: Curretage
Benign cementoblastoma
Chapter 2
Defined-single, RO/mixed
Patient: Males
Age: Under 25
Site: Mandible, often 1st molars
Appearance: Mixed lesion consisting of an RO mass fused to a tooth root that is surrounded by a RL rim, they have been known to be expansive. Vital tooth
TX- Surgical removal and extraction of tooth
CCOT/Calcifying cystic odontogenic tumor aka COC Gorlins Cyst
Chapter 1
Well-defined-Single
Patient: Any gender
Age: 2nd or 3rd decade, so the patient is the right age- average 33
Site: Anterior/Canine area more common, equal on maxilla and mandible, < 50% around impact teeth
Appearance: Well circumscribed corticated radiolucency with flecks or masses of radio-opaque material inside. Can be expansile and displace teeth and resorb roots.
CEOT/Calcifying Epithelial Odontogenic Tumor/Pindborg Tumor
Chapter 2
Well-defined, single, Multi or uni RL w/slight RO
Patient: Any gender
Age: Any age but more often between 30-50
Site: Posterior mandible but can be anterior, 50% associated with impacted teeth
Appearance: They are unilocular, expansive, well defined, and can have flecks of RO material like driven snow or a multilocular honeycomb appearance, and can be mixed but they are uncommon. Make amyloid
TX- resection
Central Giant Cell Granuloma/CGCG
Ill-defined, single, multi
Patient: Females
Age: Young 60% children and adults below 30
Site: Mandible often anterior and cross midline
Appearance: Multilocular expansile RL with wispy septa, can be aggressive, ballooning
TX: Curettage, possible resection, steroids
Central Odontogenic Fibroma
Chapter 2
Well- defined- single, multi or uni, usually RL
Patient: Females 7 to 1
Age: Average age of 40 or children depend on the resource
Site: More in the anterior maxilla 60% but has been seen in posterior mandible 40%
Appearance: Unilocular or multilocular expansile RL or rarely 12% R with flecks of RO material.
TX: Curettage
COF/Central Ossifying or Cementifying Fibroma
Chapter 2
Defined, single, multi or uni
Patient: Females 5:1
Age: Average 35
Site: 90% in mandible
Appearance: Fast, Expansive in all directions, can displace teeth, resort, corticated border with RL or RL with RO in it. Go through 3 stages starting out RL and moving into mixed then turning RO. Characteristically cause a dip in inferior border of the mandible.
TX- Surgical excision or curettage and enucleation
Chondroma
Ill-defined
Patient: Any- rare
Age: Any- rare
Site: Condyle of anterior maxilla midline only
Appearance: Irregular RL or mottled RD, non-painful, firm, smooth or lobulated submucosal mass
TX: Surgery/Excision
Chondrosarcoma:
Ill-defined Patient: Males Age: Older average 60s Site: More in the maxilla Appearance: Unilocular or multilocular expansile buccal lingually, RL mixed snowflake or punctate calcified foci. Can cause teeth to be non-vital. TX: Curretage
Dentigerous Cyst
Chapter one
Defined, single
Patient: No gender preference
Age: Most common 20-30
Site: Posterior mandible is most common- Often associated with impacted 3rd molar- associated with the crowns of teeth or max canines
Appearance: Unilocular or multilocular radiolucency often with corticated borders. Can be aggressive, expansile and displace teeth and resorb roots or not and they are pretty common- 20% of odontogenic cysts. Like unerupted teeth.
TX: curettage to marsupialization
Recurrence is rare
Exostosis
Well-defined, multiple or single
Patient: Any gender
Age: Any age- associated with mechanical irritation
Site: Maxilla more common- often bilateral, molar area buccal and posterior alveolar ridge
Appearance: Radiopaque mass- this could be superimposed and not internal in the bone.
Fibrous Dysplasia
Ill-defined, can be multiple
Patient: No gender
Age: Starts at puberty and completes growth by 30
Site: More common in maxilla, but can also occur in mandible
Appearance: Asymptomatic swellings that can displace teeth sometimes and can vary from ground glass, cotton wool, orange peal to cystic RLs. Can be multilocular, expansile, and displace, and resorb teeth, often appears more RO than this lesion though, can be aggressive if it is the craniofacial variant.
TX- surgical
Gingival Cyst of the adult
Chapter 1
Patient: No gender
Age: 40-50
Site: On attached or free facial gingiva, 75% mandibular canine to premolar area
Appearance: Bluish or pinkish nodule, vital tooth
Glandular Odontogenic Cyst/GOC
Chapter 1
Well-defined, single, RL,
Patient: Slight Males
Age: Average age of 49 but can occur in all ages
Site: Mandible- 3x more common than maxilla- Anterior more common
Appearance: Can be large, uni or multilocular, expansile, perforate bone, tip teeth, corticated with areas of septa and uneven appearance.
Hyperparathyroidism
Ill-defined unless Brown tumor that looks like CGCG
Patient: Females
Age: Middle age
Site: More in the anterior maxilla 60% but has been seen in posterior mandible 40%
Appearance: Loss of density/ground glass from loss of Ca++ in bone. Can cause bone pain- jaws and fingers most common bones involved
TX: Underlying disease
Juvenile Ossifying Fibroma
Well-defined, mixed, single
Patient: No gender preference
Age: 11-20
Site: Maxilla most common but occurs in mandible too
Appearance: Well-defined, mixed, RL to RO, can be expansile, aggressive and fast growing, can displace and resorb teeth.
Lateral Periodontal Cyst
Chapter one
Well-defined single
Patient: Males
Age: 30-50,
Site: More in the mandible cuspid or bicuspids usually
Appearance: Small round, unilocular radiolucency (don’t re-occur) not aggressive, or multilocular is botryoid odontogenic cyst (re-occur) which can push ad resorb teeth
TX- surgical removal and curettage
Lateral Radicular Cyst
Chapter 1
Well defined, RL, single Patient: No gender preference Age: Any Site: Next to a tooth that is non-vital Appearance: Often large restorations or decay on teeth. It can be ruled out by testing for vitality. Not always corticated
Mandibular buccal Infected Cyst
Chapter 1
Well-defined,
Patient: More in males
Age: 8-13,
Site: Mandible around 1st and 2nd molars most common, from cervix to root bifurcation on tooth.
Appearance: They occur with mandibular buccal swelling and inflammation, suppuration and pain. Can displace tooth lingually., often bilateral
DDX Langerhans
TX: Enucleation
Metastatic Carcinoma
Ill-defined
Patient: No gender preference- depends on original cancer for females- breast, prostate male
Age: Again depends on original cancer usually older but sometimes in the 40s
Site: Rare in oral cavity 1-2% of all lesions and more unlikely to both mandible and maxilla
Appearance: More often RL than mixed or RO and usually in one area. Prostate makes mixed sometimes
Odontogenic Myxoma
Chapter 2
Well-defined multilocular RL Patient: No gender Age: 23-30 rare over 50 or under 10 Site: Posterior Mandible Appearance: Expansile multilocular or destructive mottled RL so appearance varies and can show septa and expansion, resorption and perforation such as this case. Margins can be corticated and scalloped. TX: resection or curettage Tendency to recur
Odontoma
Chapter 2
Well-define, Mix
Patient: No gender
Age: Average 14 but any
Site: Compound more in anterior- More common in maxilla, usually associated with unerrupted teeth. Complex more common in posterior.
Appearance: Well circumscribed, RL with mottled appearance from radio-opaque pieces of undeveloped tooth structure.
TX: Surgical excision
No reccurance
OKC
Chapter 1
Well-defined RL single
Patient: Males
Age: Most common 10-40 but can occur at any age
Site: 70-80% posterior ramus- Molar area most common but can happen anywhere,
Appearance: Unilocular or multilocular (can have satelite or daughter cysts)- Can be well defined and corticated and scalloped or smooth between teeth, displaces teeth; can be mildly expansile-rarely and, grow anterior posteriorly. Like to reoccur, parasthesia if involves nerves
TX- surgical removal and carnoys cauterization
High recurrence rate
Assoc with bifid rib basal cell Nevus syndrome
OOC
Chapter 1
Well-defined, single
Patient: 70% male
Age: Average 38,
Site: 2 to 1 mandible- more common in posterior, most associated with impacted teeth- over 50%
Appearance: Less aggressive than OKC but can get big, not as common as OKC though and histology could rule it out. 50% associated with impacted teeth. Close cousin to OKC-Dont use on same DDX
TX Curretage
Osteoma
Well defined, single, RO
Patient: 2:1 males
Age: Any- but average age is 30
Site: Common bone neoplasm but not as common in the mouth
Appearance: Central osteomas are all RO and composed of dense bone and not separated from surrounding bone by a capsule. They have been known to displace teeth and can push up and grow out of the alveolar ridge. Peripheral like inferior mandible border. Gardner’s syndrome is auto dominant= multiple osteomas and intestinal polyps
TX: Surgical, no recurrence
Osteomyelitis
Ill-defined, mixed
Focal chronic sclerosing osteomyelitis: Maybe but:
Patient: Any gender
Age: Before the age of 20 usually
Site: Apex of a tooth with previous deep caries or restoration
Appearance: Mixed lesion at apex of tooth of dense bone
Chronic sclerosing osteomyelitis: Ill defined, pain
Patient: Any gender
Age: Mostly adults to older patients -acute any age don’t use on ddx
Site: Apex of a teeth in the jaw bones- mostly mandible
Appearance: Mixed lesion at apex of tooth of dense bone and ill defined RL, irregular and moth eaten bony sequestra appearance often in reaction to an infection or inflamation. There does appear to potentially be some bone loss so this could be in response to periodontal problems.
Chronic diffuse sclerosing osteomyelitis: Maybe but:
Patient: No gender or race- some say 2 to 1 female
Age: Adults to older patients
Site: Mostly mandible, unusual to be in both maxilla and mandible, but perhaps it is in reaction to periodontitis which would occur on both arches.
Appearance: Diffuse bone sclerosis, cotton wool, a mosaic pattern of RO and RL
Juvenile mandibular osteomyelitis: Possible but:
Patient: Females mostly
Age: 6-12, so the patient is a little old
Site: Mainly mandible
Appearance: Bone and soft tissue swelling, diffuse bone sclerosis, ground glass or cotton wool
TX- treat cause, steroids antibiotics
Osteosclerosis/Condensing osteitis-can be after infection in tooth
Ill-defined, multi or single RO Patient: No gender Age: Any age Site: Any site Appearance: Dense thickened bone lesions that can go between teeth but rarely fuse or push teeth- usually less vascular. Ideopathic, inflamatory, developmental
Osteosarcoma
Ill-defined
Patient: Males
Age: Average 30-33 so patient is a little old
Site: Equal distribution between mandible and maxilla
Appearance: Expansive in all directions, range of appearances from RL, mixed, and RO with dense sclerosis and ill-defined. It can have a sunburst appearance and is malignant. It also ranges from painless to pain if nerves are involved. Most common malignant tumor of bone.
Can displace teeth.
PARL/Periapical Radicular Cyst
Chapter 1
Well-defined
Patient: Any
Age: Any, adults
Site: Apices of teeth where the nerve is necrotic, often there are large fillings or decay
Appearance: Round area of radiolucency at apex of tooth, size, exact shape and cortication is variable, tooth must be non-vital. Can cause resorption. Teeth often have large fillings, decay or history of trauma.
Periapical Cemental dyplasia
Chapter 2
Ill-defined, mixed
Patient: Females 14:1- black
Age: Adults
Site: Most often apices of mandibular incisors, vital teeth
Appearance: Diffuse to corticated depending on stage, Starts RL then gets flecks of RO, progressing to an RO ball with thin RL rim. Teeth are vital
TX- None
Peripheral Odontogenic Fibroma
Chapter 2
Patient: No gender Age: Any age Site: Gingiva of Mandible Appearance: Firm or hard small, well circumscribed, slow growing nodule on the gingiva, can displace teeth, TX surgical good prognosis
Primordial Cyst
Chapter 1
Well-defined- but don’t use on DDX
Patient: Any
Age: Any
Site: Where a tooth never was- common in 3rd molar areas
Appearance: Develop at a spot where a tooth never developed. Don’t use on DDX on test. Unilocular or multilocular, well-defined but can have a sclerotic border, can be expansile. Given the still has #16, he may have never had his other 3rds come in and never had his wisdom teeth removed. These appear very similar to OKC and could be ruled out by knowing his dental history.
TX Curettage
Pyogenic Granuloma
Patient: Any gender
Age: Any age
Site: Gingiva most common orally
Appearance: Rapidly growing, well demarcated, nodule can be blueish, pink or white, Also can be ulcerated or hemorrhagic. Knowing the history could rule this out or not.
SOT/Squamous Odontogenic Tumor
Well-defined, RL, Unilocular but can have multiples
Patient: No gender preference
Age: 11-67
Site: No preference
Appearance: Presents as a RL triangle narrower at occlusal area and wider at roots. Can displace teeth. Can present in multiples- rarely get big. Usually not corticated.
Pain
TX: Curettage
Traumatic Bone Cyst/Solitary Bone Cyst
Chapter 1
Well-defined, single
Patient: Males
Age: 10-20
Site: Posterior Mandible but anterior is a good location too
Appearance: Well circumscribed with defined border that is sometimes sclerotic and scalloped that squeezes in between teeth, often asymptomatic, sometimes can displace teeth and while not consistently this large, they can get big. Above IA and below teeth. Etiology trauma.
TX: Exploratory Surgery
Eruption Cyst
Chapter 1
No gender, kids around erupting teeth crowns.
Well circumscribed, fluctuant, translucent or purple red (hematoma)
RL around crown of erupting teeth which disappears when tooth erupts
Bifib rib basal cell nevus syndrome
Chapter 1
Auto dom
Starts at puberty to early 30s sometimes early as 7 and late as after 40
Assoc with multiple OKC
Basal Carcinomas
Intracranial Calcifications
Hypertelorism/frontal bulging/ sunken eyes heavy fused eyebrows and jaws
Dental lamina cysts of newborn
Epstein’s pearls
Bohns nodules
Chapter 1
White nodules on alveolar ridge, filled with keratin, go away with eruption
Similar nodules-
Epstein’s pearls- mid palatine raphe
Bohns nodules- palate especially at junction of hard and soft palate
Nasopalatine Duct Cyst
Chapter 1
Common 30-50 but any age and gender Usually asymptomatic unless infected Bilateral round ovoid or heart shaped well defined RL, can push roots of incisors tipping the teeth. TX Curettage when symptomatic
Palatal Cyst of Newborn
Chapter 1
Epstein’s pearls
Bohns nodules
Filled with keratin go away on their own
Thyroglossal Tract Cyst
Chapter 1
Any age but 50% under 20 80% below hyoid Firm cystic mass under chin on midline Asymptomatic unless pressing on throat, slow, maybe fistula TX surgery Low recurrence
Nasolabial/Nasoalveolar Cyst
Chapter 1
Swelling of upper lip and gingiva by lateral and canine that can elevate ala of nose
Asymptomatic unless infected and an drain to nose
TX surgical
Low recurrence
Benign Lymphoepithelial Cyst
Chapter 1
Any gender and age
Floor of mouth, ventral tongue, tonsil area most common
Small yellowish/whitish raise lesion can be side of neck too
Epidermal Cyst/Dermoid Cyst
Chapter 1
Common on skin, rare in oral cavity
Lips and tongue
Midline floor of mouth is dermoid cyst
Nodular fluctuant subcutaneous swelling , white or yellow in color
TX surgical
Focal Osteoporotic Bone-marrow defect
Chapter 1
Adult often edentulous
Females 75%
Posterior Mandible 70%
Ill-defined RO of variable size
Salivary Gland Depression
Chapter 1
Any age
Males
Lower mandible, below ia round to oval, bilateral or unilateral RL well defined filled with normal tissue
No tx
Peripheral Ameloblastoma
Chapter 2
Middle age Mainly mandible Small firm well define nodule on gingiva TX surgical excision Recurrence rare
Ameloblastic Carcinoma
Chapter 2
Adults Ave 36 30-70
Posterior mandible
Aggressive, transformation and metastasis
Ill defined destructive and irregular RL
Focal cemento-osseous dysplasia
Chapter 2
Middle age females like peri apical osseous dysplasia just around one tooth in the back….
3 stages
Florid osseous dysplasia
Chapter 2
Like the other just more diffuse 2 to 1 mandible
