Bone Pathology Flashcards
what are the general principles of bone remodelling?
- Mechanical stimuli
- Systemic hormones (PTH, Vit D3, Oestrogen)
- Cytokines
- Complex interactions promoting cell & bone matrix growth
special tests to assess bone health?
- blood calcium levels
- osteoblast & clast activity
- Parathyroid hormone
- Vit D assays
what type of bone developmental abnormalities can you get, where can you find them?
Torus (Developmental, exostosis)
Torus Palatinus (middle of palate)
Torus/Tori Mandibularis (Lingual aspect of mandible
what are some BONE DEVELOPMENTAL ABNORMALITIES?
- osteogenesis imperfecta
- achondroplasia
- osteopetrosis
What is osteogenesis imperfecta?
- collagen defect
- inherited
- weak bones, multiple fractures
what is achondroplasia?
- inherited
- dwarfism
- poor endochondral ossification (cartilage not properly replaced by bone)
what is osteopetrosis?
- lack of osteoclast activity
- failure of resorption
- marrow obliteration
what is fibrous dysplasia?
bone disorder characterized by abnormal growth and replacement of normal bone tissue with fibrous connective tissue, leading to weakened and deformed bones
what is the histology of active fibrous dysplasia?
“fibro-osseous”
fibrous replacement of bone
- cellular fibrous tissue
- bone (metaplastic or woven)
what is rarefying osteitis?
localised loss of bone in response to inflammation
- occurring secondary to another form of pathology
- if at apex, consider apical periodontitis/granuloma/abscess
what is sclerosing osteitis?
localised increase in bone density in response to low-grade inflammation,
most common around apex of tooth with necrotic pulp
what is idiopathic osteosclerosis?
localised increase in bone density of unknown cause
what is alveolar osteitis?
dry socket, delayed healing
- complication of extraction
- difficult lower molar XLA
- severe pain, loss of clot, bone sequestra
- varied aetiology
what is osteomyelitis?
rare endogenous infection
acute or chronic (suppuration is rare)
aetiology of bone necrosis?
- osteomyelitis (acute or chronic)
- avascular necrosis (age related/anti-resorptive medication)
- radiation (osteoradionecrosis)
anti-resorptive meds affecting bone?
- osteoclast inhibitors (osteoporosis, paget’s, bone metastases)
- osteonecrosis (mandible>maxilla)
- Management (conservative - XLA last resort)
what are examples of metabolic bone diseases?
- osteoporosis
- rickets & osteomalacia
- hyperparathyroidism
what is osteoporosis?
bone atrophy: resorption>formation
clinical features:
- symptomless
- weak bone
radiographic features:
- loss of normal bone markings
aetiology of osteoporosis?
- sex hormone status
- age
- calcium & physical activity
what is rickets & osteomalacia?
Vit D deficiency
- lack of sun
- diet
- malabsorption
- renal cause
Osteoid forms but fails to calcify
Rickets
- poor endochondral bone
- low calcium
- raised alkaline phosphatase
what is hyperparathyroidism?
an abnormally high concentration of parathyroid hormone in the blood, resulting in weakening of the bones through loss of calcium.
giant cell lesions of the jaws?
- peripheral giant cell epulis
- central giant cell granuloma
what is cherubism?
Cherubism is a disorder characterized by abnormal bone tissue in the jaw.
what is paget’s disease of bone?
a chronic (long-lasting) disorder that causes bones to grow larger and become weaker than normal.
what are DENTAL CHANGES in pts with pagets disease of bone?
- loss of lamina dura
- hypercementosis
- migration (due to bone enlargement)
what are types of bone tumours?
- osteoma (bone growing on other bone, small usually benign)
- osteoblastoma (usually larger and more aggressive, can become malignant)
what is it, and clinical and histology features of ossifying fibroma?
substitution of bone by fibrous tissue
Clinical:
- slow growing
- mainly mandible
- radiologically well-defined
Histology:
- cellular fibrous tissue
- immature bone
- acellular calcifications
what are types of cementum lesions?
- cementoblastoma (neoplasm attached to root)
- cemento-osseous dysplasia
what is and characteristics of osteosarcoma?
highly aggressive bone cancer that arises from osteoblasts,
age 30s
Characteristics:
- mandible > maxilla
- local destruction
- recurrence & metastasis (secondary growth)
