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AU'18 Oral Path II > Bone Disorders - part II > Flashcards

Bone Disorders - part II Flashcards

1
Q

cemento-osseous dysplasia (COD) is malignant

A

false, benign

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2
Q

T/F: COD may be a reactive process

A

true

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3
Q

where may COD originate from?

A

fibroblasts of PDL vs. defect in bone remodeling

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4
Q

what is the most common fibro-osseous lesion encountered in clinical practice of dentistry?

A

COD

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5
Q

what are the 3 different types of COD?

A
  1. periapical COD
  2. focal COD
  3. florid osseous dysplasia
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6
Q

what is obtained at the time of surgery for COD?

A

multiple small gritty fragments

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7
Q

COD is commonly seen in who?

A
  1. black females
  2. east Asian females
  3. white females
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8
Q

focal type COD is reported to be more common in who?

A

white females

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9
Q

T/F: COD can affect both genders and any ethnic group

A

true

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10
Q

T/F: COD is usualyl found incidentally on x-ray

A

true

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11
Q

where does COD affect?

A

tooth-bearing areas of jaws

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12
Q

clinical features of COD

A
  1. asymptomatic

2. swelling, discomfort unusual

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13
Q

T/F: COD teeth test NON-vital

A

false, vital

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14
Q

COD ranges radiographically from?

A

from completely radiolucent to densely radiopaque with a thin radiolucent rim (PDL remains intact)

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15
Q

what does the florid osseous dysplasia show radiographically?

A

multiple “cotton wool” type radiopacities in at least 2 quadrants of the jaws

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16
Q

what might the florid osseous dysplasia seen radiographically be associated with?

A

simple bone cyst

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17
Q

severity of periapical COD

A

mild

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18
Q

severity of focal COD

A

moderate

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19
Q

severity of florid osseous dysplasia

A

severe

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20
Q

where does periapical COD typically affect?

A

mandibular anterior region usually, but maxillary anterior as well

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21
Q

who is especially affected by periapical COD?

A

middle-aged black females

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22
Q

how does periapical COD initially appears as?

A

initially unilocular radiolucencies at apices, central opacity develops gradually

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23
Q

T/F: COD is symptomatic

A

false, asymptomatic

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24
Q

what can perioapical COD be confused with?

A
  1. hypercementosis
  2. idiopathic osteosclerosis
  3. benign cementoblastoma
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25
Q

who does focal COD more often affects?

A

white females

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26
Q

where does focal COD affect?

A

body of mandible

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27
Q

how does focal COD appear radiographically?

A

unilocular radiolucency or radiopacity with thin radiolucent rim

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28
Q

T/F: focal COD is asymptomatic

A

true

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29
Q

what can focal COD be confused with?

A
  1. ossifying fibroma

2. a true neoplasm

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30
Q

who is most commonly affected by florid osseous dysplasia?

A

middle-age or older black females

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31
Q

T/F: usually only one quadrant of the jaw is affected by florid osseous dysplasia

A

false, multiple

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32
Q

florid osseous dysplasia is generally asymptomatic unless what?

A

overlying mucosa ulcerates resulting in bony sequestration (e.g. from ill’fitting denture)

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33
Q

T/F: dental implants are NOT recommended for pts with florid osseous dysplasia

A

true

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34
Q

florid osseous dysplasia lesions tend to be what?

A

hypovascular

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35
Q

hypovascular florid osseous dysplasia lesions are prone to what?

A
  1. necrosis
  2. infection
  3. osteomyelitis with minimal provocation
  4. reduced ability to heal
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36
Q

histopathologic features of COD

A
  1. cellular fibrous CT with embedded mineralize tissue resembling either immature (woven) bone or cellular cementum
  2. fragmented specimen
    3.
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37
Q

what does the mineralized product of COD resemble histopathologically?

A

ginger root

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38
Q

T/F: mature COD lesions have more mineralized product than cellular stroma histopathologically

A

true

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39
Q

florid osseous dysplasia can show densely mineralized tissue with what histopathologically ?

A

necrotic debris and inflammation

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40
Q

diagnosis of COD is based on what?

A

clinical and radiographic features

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41
Q

what can be used to confirm the diagnosis of COD?

A

by bx if indicated

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42
Q

tx for periapical COD

A

none indicated

43
Q

why might biopsy be indicated for focal COD?

A

to rule out other disease processes

44
Q

T/F: bx is NOT necessary for florid osseous dysplasia

A

true

45
Q

regular visits for dental prophylaxis and OHI is indicated to prevent what in COD pts?

A

to prevent perio disease and need for endo

46
Q

T/F: COD pts should be encouraged to retain their teeth

A

true

47
Q

ideally, why should surgical procedures should be avoided in COD pts?

A

onset of sysmptoms associated with exposure of sclerotic bone to oral cavity

48
Q

T/F: management of symptomatic COD pts with secondary osteomyelitis is difficult

A

true

49
Q

tx for management of symptomatic COD pts

A
  1. debridement
  2. abx (often not efffective)
  3. chlorhexidine rinse
50
Q

prognosis for periapical and focal COD

A

excellent

51
Q

T/F: the initial appearance of focal COD may be the first sign of florid OD

A

true

52
Q

prognosis for florid osseous dysplasia

A

good

53
Q

when would prognosis of COD be guarded?

A

if secondarily infected requiring debridement and ATB

54
Q

T/F: malignant transformation of COD is rare

A

true

55
Q

osteoporotic bone marrow defect

A

area of hematopoietic bone marrow of sufficient size to cause a radiographic radiolucency

56
Q

what is the pathogenesis of osteoporotic bone marrow defect

A

unknown

57
Q

what may osteoporotic bone marrow defect resemble?

A

metastatic disease

58
Q

where does osteoporotic bone marrow defect usually occur?

A
  1. posterior body of mandible

2. often at old EXT site

59
Q

who is usually affected by osteoporotic bone marrow defect?

A

middle-aged female

60
Q

T/F: osteoporotic bone marrow defect is often found incidentally on radiographs

A

true

61
Q

T/F: osteoporotic bone marrow defect is symptomatic

A

false, asymptomatic

62
Q

radiolucency of osteoporotic bone marrow defect can appear circumscribed but may show what on closer inspection?

A

may show ill-defined borders and a fine trabecular pattern

63
Q

histopathologic features of osteoporotic bone marrow defect

A
  1. fatty and hematopoietic marrow

2. no abnormal osteoblastic or osteoclastic activity

64
Q

what is often indicated to establish diagnosis of osteoporotic bone marrow defect?

A

biopsy

65
Q

prognosis of osteoporotic bone marrow defect

A

excellent

66
Q

once osteoporotic bone marrow defect is diagnosed, what is needed?

A

no further tx needed

67
Q

other terms for idiopathic osteosclerosis

A
  1. dense bone island
  2. enostosis
  3. bone whorl
  4. focal periapical osteopetrosis
  5. bone scar
68
Q

idiopathic osteosclerosis

A

focally increased area of dense bone

69
Q

what causes idiopathic osteosclerosis?

A

unknown

70
Q

T/F: idiopathic osteosclerosis is usually found incidentally on radigraphs

A

true

71
Q

T/F: idiopathic osteosclerosis has a male predilection

A

false, NO gender predilection

72
Q

when does most idiopathic osteosclerosis arise?

A

most arise late 1st to early 2nd decade, peak prevalence in 3rd decade

73
Q

T/F: idiopathic osteosclerosis occasionally regresses

A

true

74
Q

when does idiopathic osteosclerosis usually stabilize?

A

at skeletal maturity

75
Q

clinical features of idiopathic osteosclerosis

A
  1. asymptomatic
  2. no expansion
  3. remain static or slow enlarge
76
Q

radiographic features of idiopathic osteosclerosis

A
  1. radiopaque

2. borders blend with surrounding trabeculae, but occasionally may be sharp

77
Q

where is the most common site for idiopathic osteosclerosis

A

mandibular pre-molar/molar area

78
Q

T/F: in the past, idiopathic osteosclerosis was not distinguished from inflammatory or other lesions

A

true

79
Q

what may idiopathic osteosclerosis be confused with?

A
  1. condensing osteitis
  2. hypercementosis
  3. cementoblastoma
80
Q

histopathologic features of idiopathic osteosclerosis

A
  1. dense vital bone

2. may see fibrofatty marrow

81
Q

tx for idiopathic osteosclerosis

A

none indicated unless symptoms or cortical expansion

82
Q

if idiopathic osteosclerosis is noted in childhood, what should be done?

A

periodic radiographs until lesion stabilized

83
Q

what is needed in order to establish diagnosis of idiopathic osteosclerosis?

A

biopsy

84
Q

prognosis of idiopathic osteosclerosis

A

excellent

85
Q

other terms for simple bone cyst

A
  1. traumatic bone cyst

2. hemorrhagic bone cyst

86
Q

simple bone cyst

A

empty or fluid-filled bone cavity

87
Q

why is simple bone cyst not a true cyst?

A

lacks an epithelial lining thus is a pseudocyst

88
Q

T/F: simple bone cyst is usually an incidental finding

A

true

89
Q

etiology of simple bone cyst

A

unknown

90
Q

trauma-hemorrhage theory of simple bone cyst

A

trauma causing hematoma but not fracture and without subsequent organization and repair of hematoma, liquefies instead

91
Q

T/F: simple bone cyst is related to trauma

A

nah, questionable

92
Q

who is affected by simple bone cyst?

A

seen in 1st and 2nd decade

93
Q

what is the gender predilection of simple bone cyst in jaws?

A

no gender predilection

94
Q

what is the gender predilection of simple bone cyst in other bones?

A

male predilection

95
Q

where does simple bone cyst typically occur?

A
  1. posterior mandible

2. symphysis

96
Q

clinical features of simple bone cyst

A
  1. typically painless

2. no expansion, but possible

97
Q

radiographic features of simple bone cyst

A
  1. well-delineated
  2. unilocular but can be multilocular
  3. often scallops between roots
98
Q

T/F: it is difficult to obtain specimen of simple bone cyst

A

true, usually just fragments of bone

99
Q

histopathologic features of simple bone cyst

A
  1. bone fragments are lined by inflamed granulation tissue

2. no epithelial lining

100
Q

tx of simple bone cyst

A

surgical exploration and curettage to induce bleeding (an empty cavity within bone is found at time of surgery)

101
Q

why would hemorrhage be indicated for tx of simple bone cyst?

A

hemorrhage organizes and lesion heals

102
Q

how many months after surgery of simple bone cyst does radiogrpahic findings become normal?

A

~12-17 months

103
Q

when is periodic radiographs of simple bone cyst warranted?

A

until complete resolution

104
Q

T/F: recurrence rate is low for simple bone cyst

A

true

AU'18 Oral Path II (31 decks)

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