Bone Pathology Flashcards
What is rarefying osteitis
Localised loss of bone in response to inflammation.
Always occurring secondary to another form of pathology
Where is sclerosing osteitis most commonly found
Around the apex of a tooth with a necrotic pulp
What is sclerosing osteitis
Localised increase in bone density in response to low grade inflammation
Need to address this
What might sclerosing osteitis lead to if not addressed
External root resorption
What is idiopathic osteosclerosis
Localised increase in bone density of an unknown cause
Where is idiopathic osteosclerosis most commonly seen
In the premolar-molar region of the mandible
How would you tell between sclerosing osteitis and idiopathic osteosclerosis if you were unsure
Sensibility test the teeth - sclerosing osteitis occurs around around apex of a non vital tooth
What are 4 things that are thought to be predisposing factors related to dry socket
Female
Contraceptive pill
Lower jaw, further back in the mouth
Smokers
What is osteomyelitis
Inflammation of the medullary cavity of a bone casued by infection - rare but serous condition that required urgent specialist Managment
What is garres sclerosing osteomyelitis ?
This is a chronic sclerosing osteomyelitis with a proliferative
This is a rare condition that is usually associated with a chronic periapical periodontitis or sometimes a chronic periocoronitis
What is the principle clincal feature in garres osteomyelitis
Swelling
Radiographically what would we see in garres osteomyelitis
Area of sclerosing osteitis in the mandible and there would be evidence of new periosteal bone at the periphery of the mandible
What is osteoporosis
Bone atrophy ; the bone resorption exceeds formation
What are three clincal features of osteoporosis
Symptomless
Week bone
Antrum enlarged
Name 3 conditions that may result in secondary osteoporosis
Hyperthyroidism
Cushing syndrome
Diabetes mellitus
If a paitent has a giant cell granuloma what condition would you want to test for
HYPERTHYROIDUSM
What would a serum biochemistry show for someone with pagers disease
Raised alkaline phosphate
What are three dental changes that would be seen in a patient with pagers disease of the bone
Loss of lamina dura
Hypercementosis of multiple teeth
Migration due to bone enlargement
Why does hyperthyroidism cause osteoporosis
Because it caused the calcium to be mobilised from the bones
For a patient with a osteoma what syndrome would we consider
Gardner Syndrome - multiple polyps in the colon which are a high risk of malignant change
If a patient has florid cemento-osseous dysplasia why would we be worried about extraciting this
Because there is not a proper vascularity or ability to heal
Osteosarcoma is a rare malgnant tumour of the jaw - what might be the patients presenting complaint
Unexplained mobility of teeth
What is fibrous dysplasia
Slow growing apsymtopatic bone swelling
Bone is being replaced by fibrous tissue
Will stop once patient stops growing
What are the two clincal phenotypes of fibrous dysplasai
Monostotic ; single bone ( more common)
Polyostotic ; many bones
What is Albrights syndrome ,what age group foes it affect , what will be sene on the skin
Polyostotic fibrous dysplasia
Early puberty
Melanin pigment
What is osteomyelitis
Invasion of bacteria into cancellous bone causes soft tissue inflammation and oedema in the closed bone marrow space.
Oedema in the enclosed space leads to increased hydrostatic pressure higher than the BP of the feeding arteries.
Comprised blood supply then results in soft tissue necrosis
Bacteria proliferate as normal bone defences are not able to reach tissue
Osteomyelitis is rare but if it does occur it is more likely in the mandible than the maxilla - why is this
This is because the maxilla has a much richer blood supply , the sole blood supply of the mandible is the inferior alveolar nerve
Osteomyelitis rarely occurs when the host defences are intact - what are some instances that they may not be
Odontogenic infection and fractures of the mandible
Diabetes - poor nutrition- cancer etc
Osteomyelitis takes around 10-12 days to present on a radiograph - when it does what may it look like
Moth eaten appearnce
Increased radioluceny
What is the management of osteomyelitis
Swabs must be taken to get a culture sensitivity
Antibiotic - penicillin from 6- 12 weeks
Surgical - drain pus if Posisble, remove any n vital teeth in the area of infection, debridement the area
Excision of necrotic bone until you reach actively bleeding bone tissue
