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Oral Surgery BDS4 > Bone Pathology > Flashcards

Bone Pathology Flashcards

1
Q

what is bone remodelling driven by

A

mechanical stimuli
systemic hormones
cytokines

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2
Q

what systemic hormones are involved in remodelling

A

PTH
vit D3
oestrogen

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3
Q

what special tests are done for bone biochemistry

A

blood calcium
osteoblast activity
osteoclast activity
PTH
vit D assays

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4
Q

what type of abnormality is a tori

A

developmental

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5
Q

what is osteogenesis imperfecta

A

type 1 collagen defect

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6
Q

what is the clinical features of osteogenesis imperfecta

A

weak bones
multiple fractures

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7
Q

what is achondroplasia

A

poor endochondral ossification
dwarfism

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8
Q

what is osteopetrosis

A

lack of osteoclast activity
failure of resorption
marrow obliteration

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9
Q

what is fibrous dysplasia

A

slow growing asymptomatic bony swelling due to gene defect

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10
Q

what are the different clinical phenotypes of fibrous dysplasia

A

monostotic - asymmetry
polyostotic

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11
Q

what is the radiographic appearance of fibrous dysplasia

A

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

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12
Q

what is the histology of fibrous dysplasia

A

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

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13
Q

what is rarefying osteitis

A

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

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14
Q

what is sclerosing osteitis

A

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

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15
Q

where would sclerosing osteitis occur

A

around apex of tooth with necrotic pulp

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16
Q

what does sclerosing osteitis look like on radiographs

A

poorly defined periapical radiopacity

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17
Q

what is idiopathic osteosclerosis

A

localised increase in bone density of unknown cause

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18
Q

where would idiopathic osteosclerosis occur

A

premolar-molar region of mandible

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19
Q

what does idiopathic osteosclerosis look like on radiographs

A

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

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20
Q

how do you determine between idiopathic osteosclerosis and sclerosing osteitis

A

sensibility testing

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21
Q

what is alveolar osteitis

A

dry socket

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22
Q

why does alveolar osteitis occur

A

complication of extraction

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23
Q

what are the clinical features of alveolar osteitis

A

severe pain
loss of clot
bone sequestra

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24
Q

what is osteomyelitis

A

rare endogenous infection

25
Q

what is the aetiology of bone necrosis

A

osteomyelitis
avascular necrosis
irradiation (ORN)

26
Q

what are osteoclast inhibitors used for

A

osteoporosis
pagets disease
bone metastases

27
Q

where is osteonecrosis usually seen

A

mandible

28
Q

what guidelines are available for MRONJ

A

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

29
Q

name 3 metabolic bone diseases

A

osteoporosis
rickets and osteomalacia
hyperthyroidism

30
Q

what is osteoporosis

A

bone atrophy - resorption exceeds formation

31
Q

what are the clinical features of osteoporosis

A

symptomless
weak bone
antrum enlarged

32
Q

what are the radiographic features of osteoporosis

A

loss of normal bone markings

33
Q

what is the aetiology of osteoporosis

A

sex hormone status
age
calcium status and physical activity
secondary osteoporosis

34
Q

what is rickets and osteomalacia

A

vitamin D deficiency
osteoid forms but fails to calcify

35
Q

what is rickets caused by

A

low calcium
raised alkaline phosphatase

36
Q

how can you be deficient in vitamin D

A

lack of sunlight
diet
malabsorption
renal causes

37
Q

what happens to bones with hyperparathyroidism

A

calcium mobilised from bones
generalised osteoporosis
osteitis fibrosa cystica

38
Q

what are the types of hyperparathyroidism

A

primary
secondary
tertiary

39
Q

what is primary hyperparathyroidism

A

neoplasia/hyperplasia

40
Q

what is secondary hyperparathyroidism

A

hypocalcaemia

41
Q

what is tertiary hyperparathyroidism

A

hyperplasia as a result of prolonged secondary

42
Q

name 2 giant cell lesions of the jaw

A

peripheral giant cell epulis
central giant cell granuloma

43
Q

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

A

osteitis fibrosa cystica
aneurysmal bone cyst
giant cell tumours

44
Q

what is cherubism

A

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

45
Q

what is the clinical presentation of pagets disease

A

bone swelling
pain
nerve compression

46
Q

what is the bone pattern with pagets disease

A

changes with disease progression

47
Q

what are the dental changes with pagets disease

A

loss of lamina dura
hypercementosis
migration

48
Q

what is the histology of pagets disease

A

increased bone turnover
osteoclastic and blastic activity

49
Q

what are the complications of pagets disease

A

infection
tumour

50
Q

name 2 bone tumours

A

osteoma
osteoblastoma

51
Q

what is an osteoma

A

solitary, slow growing cortical bone tumour

52
Q

what is the clinical features of ossifying fibroma

A

slow growing
wide age range
mainly mandible
radiologically well-defined

53
Q

what is the histology of ossifying fibroma

A

cellular fibrous tissue
immature bone
acellular calcifications

54
Q

name 2 cementum lesions

A

cementoblastoma
cemento-osseous dysplasias

55
Q

what is a cementoblastoma

A

neoplasm attached to root

56
Q

what is a cemento-osseous dysplasia

A

nomenclature problem
not neoplastic

57
Q

what are the types of cemento-osseous dysplasia

A

periapical
focal
florid

58
Q

what is an osteosarcoma

A

bone cancer

Oral Surgery BDS4 (21 decks)

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