bone differential dx Flashcards
location of bone dx is dependent on
localized/generalized
position of jaws
single or multifocal
if a lesion is generalized
it effects all of the osseous structures of the maxilliofacial region
localized lesions can be
unilateral or bilateral
position in the jaws aids diagnostic process by
determining the center of the location and they tend to be found in specific locaitons
if the origin center is coronal or above the IA nerve canal, it is likely to have what origin
odontogenic origin
if the origin is below the IAC, it doesn’t have what origin
odontogenic
if the origin is within the IAC, the lesion has what origin
neural or vascular
if the origin of the lesion is within condylar areas, it is likely to have what origin
cartilagenous lesions
t/f if the origin of the lesion is within the max sinus, the origin is likely to have odonogenic
false
t/f most lesions can grow to any size
true
what type of lesions can stop growing
odontomas
hydraulic shape
somewhat circular, appears to be fluid filled or inflated balloon
scalloped shape
deals with the outside shape, series of contiguous arcs or semicircles
poor defined borders usually indicate
cancer
corticated border
uniform radiopaque line at periphery of lesion, well defined
cysts and tumors
punched out/non corticated
sharp boundary with narrow transition; no bone reaction seen/ no radiopaque line; well defined
soft tissue capsule
radiolucent line at periphery; may be seen in conjunction with corticated periphery
sclerotic borders
wider zone of transition with thick radiopaque border of reactive bone; brushed look
sign of inflammation
t/f. all cysts are radiolucent except for 1
true
abnormal trabecular patterns
variation of number, length, width, and orientation of trabeculae
internal sepatation
long strands of bone or walls within a lesion
multilocular
internal structure divided into different compartments
tumor leaves empty bubbles, don’t get it messed up with mixed
t/f tumors and cysts are space occupying lesions
true
odontogenic lesions tend to push teeth
apically
bone lesions and hematopoetic lesions tend to push teeth
coronally
benign tumors and cysts resorb the tooth how
directional resorption
malignant tumors tend to resorb the tooth how
non-directional resorption
orthodontic movement in pdl
uniform widening with lamina dura intact
malignant lesions in pdl
irregular widening and destruction of lamina dura
IA canal/mental foramen displacement is indicative of what type of process
benign (its pushing things, not invading them like a malignancy), then it will resorb it
what type of lesions have expanded borders of the outer cortex
slowly growing lesions
cysts and tumors
what type of lesions have perforated borders of the outer cortex
rapidly growing lesions
malignancies
reactive lesions
lift off the cortical bone and stimulate osteoblasts to lay down new bone
2 types of periosteal reactions
reactive and inflammatory
characteristics of slowly growing lesions
sharply defined borders corticated borders displaces normal anatomical structures expands rather than perforated normal mucosa pain/paresthesia is uncommon
characteristics of rapidly growing lesions
poorly defined borders destroys normal anatomical structures perforation of the cortical plate more common crepitus ulceration pain/paresthesia
mixed lesion
some lesions can make a mineralized product
radiograph depends on the amount and distribution of the mineralized product
radiolucent lesions
some lesions consistently appear radiolucent because they do not make a mineralized product
inflammatory lesions mimic
malignancies
characteristic of inflammatory lesions
pooly defined borders
variable pain
sometimes associated with fever, malaise, leukocytosis, tender lymphadenopathy
malignant neoplasms of the bone
poorly defined. destroys anatomical stucture
metastatic
t/f. most common malignancy of the jaw did not start in the jaw and started from somewhere else
true (metastatic carcinoma)
primary disease of the bone involve
multiple areas of the skeleton
characteristics of cysts
corticated borders common
hydraulic appearance on radiographs
may arise from odontogenic or non-odontoogenic epithelium
appearance of odontogenic cyst may also be an odontogenic tumor
characteristics of benign odonntogenic tumor
arise in the tooth forming areas of the jaw
slowly growing
can be present before pt seeks tx
malignancies are rare
what benign non odonto tumor is not slowly growing
central giant cell granuloma
what benign non-donto tumor doesn’t have sharply demarcated borders
fibrous dysplasia
definitive dx of bone lesions requires correlation of
radiographs, clinical info, and microscopic examination
gold standard of biopsies
full tissue
why submit a biopsy
make a definitive dx confirm provisional clinical dx establish surgical margins get info to help disease management know more about clinical behavior and px substantiate pt records in legal context
enucleation
removal of lesion only
curettage
removal of lesion and some surrounding bone with hand instrument
peripheral ostectomy
removal of lesion and some surrounding bone with rotary insturment
en bloc resection/segmental resection
resection of lesion and bone with clear margin
decompression/marsupializaiton
used to decrease the size of cysts; pop a hole and put a stent inside
infiltrating cancers
the fingers/tenticles of a tumor beyond its main mass
this is why you’d resect a cancer
