Cemento-osseous dysplasia Flashcards
What hx if mobile teeth and bleeding gums?
Duration and type of symptoms - pain/ bleeding/ numbness
Hx of periodontal disease
If had braces - wearing retainer
MH
What MH would be worried about if presentation of mobility/ bleeding?
MH exacerbate periodontal - diabetes
Any medications - anticoagulants
What MH would you be more concerned about identifying because of this?
Leukaemia
Bone disease - Paget’s
What IO exam carry out if mobility/ bleeding gums?
Teeth: TTP, mobility, caries
Periodontal - pocketing/ recession
Vitality testing
Palpating for mass
What radiograph would you want if mobile teeth/ bleeding gums?
PA or OPT
What are possible differentials of radiopaque mass seen between 4/5s on PA?
Cementoma
Scelorsing osteomyelitis
Fibrous dysplasia
Paget’s
Cementoblastoma
Hypercementosis
Ossifying fibroma
PA abscess
What is feature often seen with a cementoma?
Resorption of roots / fusion with lesion
What is most ideal radiographic view if see lesion?
OPT to rule out any other lesions and show full extent of lesions
Is memento-osseous dysplasia focal or generalised?
Can be focal - but can be a florid variety which is multifocal
What to do if see opaque mass on radiograph?
Referral maxfax
Patient has opaque mass (likey osseous- dysplasia) and concerned cancer what should tell her?
Reassure that while neoplastic process it is not representative of cancer
Likely to be a chronic process
How to answer pt if asked why not seen before?
Explain in initial stage of lesion can be radiolucent which may have can be misdiagnosed as infection
What are sinister features that would make you worry?
Loss of sensation
Root resoprtion
Palpable mass
What are possible complications of cemnto-osseous dysplasia?
Infection and abscess formation
Delayed healing after XLA
Secondary pulp infection and necrosis
Secondary periodontal infection
Failure of implants to oesseo-integrate
