Bone Pathology Flashcards by Katie Glass

what is bone remodelling driven by

mechanical stimuli
systemic hormones
cytokines

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what systemic hormones are involved in remodelling

PTH
vit D3
oestrogen

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what special tests are done for bone biochemistry

blood calcium
osteoblast activity
osteoclast activity
PTH
vit D assays

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what type of abnormality is a tori

developmental

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what is osteogenesis imperfecta

type 1 collagen defect

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what is the clinical features of osteogenesis imperfecta

weak bones
multiple fractures

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what is achondroplasia

poor endochondral ossification
dwarfism

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what is osteopetrosis

lack of osteoclast activity
failure of resorption
marrow obliteration

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what is fibrous dysplasia

slow growing asymptomatic bony swelling due to gene defect

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what are the different clinical phenotypes of fibrous dysplasia

monostotic - asymmetry
polyostotic

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what is the radiographic appearance of fibrous dysplasia

margins blend into adjacent bone
bone maintains approximate shape becomes more radiopaque as lesions mature

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what is the histology of fibrous dysplasia

fibrous replacement of bone
cellular fibrous tissue
metaplastic or woven bone but remodels and increases in density

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what is rarefying osteitis

localised loss of bone in response to inflammation
occurs secondary to another form of pathology

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what is sclerosing osteitis

localised increase in bone density in response to low-grade inflammation

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where would sclerosing osteitis occur

around apex of tooth with necrotic pulp

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what does sclerosing osteitis look like on radiographs

poorly defined periapical radiopacity

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what is idiopathic osteosclerosis

localised increase in bone density of unknown cause

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where would idiopathic osteosclerosis occur

premolar-molar region of mandible

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what does idiopathic osteosclerosis look like on radiographs

dense bone island
no bony expansion
no effect on adjacent teeth/structures

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how do you determine between idiopathic osteosclerosis and sclerosing osteitis

sensibility testing

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what is alveolar osteitis

dry socket

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why does alveolar osteitis occur

complication of extraction

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what are the clinical features of alveolar osteitis

severe pain
loss of clot
bone sequestra

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what is osteomyelitis

rare endogenous infection

what is the aetiology of bone necrosis

osteomyelitis avascular necrosis irradiation (ORN)

what are osteoclast inhibitors used for

osteoporosis pagets disease bone metastases

where is osteonecrosis usually seen

mandible

what guidelines are available for MRONJ

SDCEP Oral Health Management of Patients at Risk of Medication Related Osteonecrosis of the Jaw

name 3 metabolic bone diseases

osteoporosis rickets and osteomalacia hyperthyroidism

what is osteoporosis

bone atrophy - resorption exceeds formation

what are the clinical features of osteoporosis

symptomless weak bone antrum enlarged

what are the radiographic features of osteoporosis

loss of normal bone markings

what is the aetiology of osteoporosis

sex hormone status age calcium status and physical activity secondary osteoporosis

what is rickets and osteomalacia

vitamin D deficiency osteoid forms but fails to calcify

what is rickets caused by

low calcium raised alkaline phosphatase

how can you be deficient in vitamin D

lack of sunlight diet malabsorption renal causes

what happens to bones with hyperparathyroidism

calcium mobilised from bones generalised osteoporosis osteitis fibrosa cystica

what are the types of hyperparathyroidism

primary secondary tertiary

what is primary hyperparathyroidism

neoplasia/hyperplasia

what is secondary hyperparathyroidism

hypocalcaemia

what is tertiary hyperparathyroidism

hyperplasia as a result of prolonged secondary

name 2 giant cell lesions of the jaw

peripheral giant cell epulis central giant cell granuloma

what is your differential diagnoses for giant cell lesions of the jaw

osteitis fibrosa cystica aneurysmal bone cyst giant cell tumours

what is cherubism

rare condition where there are multicystic/multilocular lesions in multiple quadrants and grow for about 7 years and then regress after puberty

what is the clinical presentation of pagets disease

bone swelling pain nerve compression

what is the bone pattern with pagets disease

changes with disease progression

what are the dental changes with pagets disease

loss of lamina dura hypercementosis migration

what is the histology of pagets disease

increased bone turnover osteoclastic and blastic activity

what are the complications of pagets disease

infection tumour

name 2 bone tumours

osteoma osteoblastoma

what is an osteoma

solitary, slow growing cortical bone tumour

what is the clinical features of ossifying fibroma

slow growing wide age range mainly mandible radiologically well-defined

what is the histology of ossifying fibroma

cellular fibrous tissue immature bone acellular calcifications

name 2 cementum lesions

cementoblastoma cemento-osseous dysplasias

what is a cementoblastoma

neoplasm attached to root

what is a cemento-osseous dysplasia

nomenclature problem not neoplastic

what are the types of cemento-osseous dysplasia

periapical focal florid

what is an osteosarcoma

bone cancer