Bone Differential Diagnosis

Question 1

Location: Origin of Lesion

Coronal to tooth

Above IAC

Below IAC

Answer 1

• coronal to tooth- Odontogenic
• Above IAC- Odontogenic
• Below IAC- Not odontogenic

Question 2

Location Origin

Within IAC

Condylar Areas

Max sinus

Answer 2

• Within IAC- Neural or vascular
• Condylar areas- Cartilaginous
• Max sinus- Epithelial origin

Question 3

Internal Structures

Totally RL

Totally RO

Mixed RL/RO

Answer 3

• Totally RL
  
  • Cyst
• Totally RO
  
  • Certain bone lesions
• Mixed
  
  • Tumor or cyst produces calcified material

Question 4

Teeth displacement

Odontogenic lesions

Bone and hematopoietic

Answer 4

• Odontogenic
  
  • Push teeth apically
• Bone hematopoietic
  
  • Push teeth coronally

Question 5

Teeth Resorption

Benign tumors/cysts

Malignant tumors

Answer 5

• Benign tumors/cysts
  
  • More common
  • Will try to displace tooth first
  • Directional resorption- smooth following contour of hydraulic app, slowly growing
• Malignant
  
  • Non-directional resorption- resorbs in all directions quickly, thinning roots, loss of PDL

Question 6

Outer Cortex

Expansion

Perforation

Growth and type of lesions

Answer 6

• Expansion
  
  • Slow, cysts and tumors
• Perforation
  
  • Fast, malignancies

Question 7

Periosteal reaction

Reactive lesions

Inflammatory lesions

Answer 7

• Reactive lesions
  
  • lift periosteum off of the cortical bone and stimulate osteoblasts to lay down new bone
• Inflammatory lesions bt also lesions

Question 8

Impressions of bone disease

3 categorie to look at

Answer 8

• Growth
  
  • Slow
  • Rapid
• Tissue of origin
  
  • Odontogenic
  • Non-odontogenic
    
    • Bone/fibrous tissue
    • Sinus
    • Other
• Category of disease
  
  • Inflamatory
  • Cyst
  • Tumor
  • Systemic
    
    • Genetic
    • Metabolic
  • Other

Question 9

Slow growth

Xray feat 4

Clinical 2

Answer 9

• Sharply demarcated borders
• Corticated (sometimes)
• Displaces normal anatomical structures
• Expands rather than perforate
• Overlying mucosa normal
• Pain or paresthesia uncommon

Question 10

Rapid Growth

Xray 3

Clinical 2

Answer 10

• Poorly demarcated borders
• Destroys normal anatomical structures
• Perforation
• Ulceration of overlying mucosa common
• Pain or paresthesia common

Question 11

Cysts

Xray4

Origin

Resemble

Answer 11

• Usually well defined
• Corticated common
• Hydraulic app
• Can cause expansion
• May arise from odonto or non-odonto epithelium
• May resemble tumor

Question 12

Benign Tumors

Xray4

Answer 12

• Well defined
• Usually corticated
• Displaces structures
• Can cause expansion

Question 13

Inflammatory Focal

Xray 2

Clinical 2

Answer 13

• Often poorly defined borders
• Pain is variable
• Often surrounded by sclerotic bone
• Sometimes assoc with systemic manifestations

Question 14

Inflammatory Widespread

Xray 4

Answer 14

• Often pooly defined
• Pain variable
• Often surrounded by sclerotic bone
• May appear moth eaten