Bone Pathology Flashcards
what is bone remodelling driven by
mechanical stimuli
systemic hormones
cytokines
what systemic hormones are involved in remodelling
PTH
vit D3
oestrogen
what special tests are done for bone biochemistry
blood calcium
osteoblast activity
osteoclast activity
PTH
vit D assays
what type of abnormality is a tori
developmental
what is osteogenesis imperfecta
type 1 collagen defect
what is the clinical features of osteogenesis imperfecta
weak bones
multiple fractures
what is achondroplasia
poor endochondral ossification
dwarfism
what is osteopetrosis
lack of osteoclast activity
failure of resorption
marrow obliteration
what is fibrous dysplasia
slow growing asymptomatic bony swelling due to gene defect
what are the different clinical phenotypes of fibrous dysplasia
monostotic - asymmetry
polyostotic
what is the radiographic appearance of fibrous dysplasia
margins blend into adjacent bone
bone maintains approximate shape becomes more radiopaque as lesions mature
what is the histology of fibrous dysplasia
fibrous replacement of bone
cellular fibrous tissue
metaplastic or woven bone but remodels and increases in density
what is rarefying osteitis
localised loss of bone in response to inflammation
occurs secondary to another form of pathology
what is sclerosing osteitis
localised increase in bone density in response to low-grade inflammation
where would sclerosing osteitis occur
around apex of tooth with necrotic pulp
what does sclerosing osteitis look like on radiographs
poorly defined periapical radiopacity
what is idiopathic osteosclerosis
localised increase in bone density of unknown cause
where would idiopathic osteosclerosis occur
premolar-molar region of mandible
what does idiopathic osteosclerosis look like on radiographs
dense bone island
no bony expansion
no effect on adjacent teeth/structures
how do you determine between idiopathic osteosclerosis and sclerosing osteitis
sensibility testing
what is alveolar osteitis
dry socket
why does alveolar osteitis occur
complication of extraction
what are the clinical features of alveolar osteitis
severe pain
loss of clot
bone sequestra
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
