Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Oral Pathology, Stephen > ch 14 Bone Pathology > Flashcards

ch 14 Bone Pathology Flashcards

1
Q

Most common type of inherited bone disorder

A

Osteogenesis imperfect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Osteogenesis imperfecta is an impairment of what tissue maturation

A

type I collagen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What parts of the body are affected by OI

A

bone Dentin

Sclera Ligaments Skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the bone character in O.I.

A

thin cortex, fine trabeculations, diffuse osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How will bone heal in O.I.

A

heal, but with abundant callus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the radiographic hallmarks of O.I.

A

osteopenia Bowing
Angulation/deformed long bones Multiple fractures
Wormian skull bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are wormian bones

A

10 or more sutural bones that are 6X4mm in diameter or larger and mosaic patterned, but not specific to O.I.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

O.I. can appear dentally identical to what other disorder

A

Dentinogenesis imperfect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How will the dentition look in both Osteogenesis Imperfecta and Dentinogenesis Imperfecta

A

blue to brown opalescent teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What should you call teeth that have the characteristic brown or blue opalescence? Should it be D.I. or O.I outright

A

No, just opalescent teeth until determined if only D.I.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the characteristic malocclusion in O.I. and why

A

1.) Class III due to maxillary hypoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most common, mildest form of O.I.

A

Type I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the most severe form of O.I.

A

Type II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Other physical characteristics of O.I.

A

Blue sclera
Hypoacusis(hearing loss)
Long bone & spine deformaties Joint hyperextensibility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Most severe form of O.I. noted in patients beyond

the perinatal period and has moderately severe to severe bone fragility

A

Type III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Type III O.I. patients die from cardiopulmonary complications from what

A

kyphoscoliosis = abnormal spin curvature in coronal and sagittal plane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

O.I. type associated with mild to moderate bone fragility

A

Type IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What happens to bone throughout life in O.I.

A

Cortical bone is attenuated
Reduced bone matrix production
Bone immature throughout life
Woven bone never transforms to lamellar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the primary goal of O.I. treatment

A

No cure, goal to improve symptoms (bisphosphonates later in life)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

rare hereditary skeletal disorder characterized by marked increase in bone density

A

Osteopetrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Osteopetrosis cause

A

defect in osteoclast function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What causes the thickening of cortical bone and sclerosis of cancellous bone

A

defective osteoclast function + continued osteoblast function + endochondral bone formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

2 types of osteopetrosis

A

Infantile/Malignant Adult/Benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Character of Infantile/Malignant Osteopetrosis

A

diffusely sclerotic skeleton Marrow failure
Frequent fracture (accusations of child abuse)
Cranial nerve compression (blind/deaf/facial paralysis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Facial character of Infantile/Malignant Osteopetrosis

A

broad face Hypertelorism
Snub nose
Frontal bossing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Tooth eruption in Infantile/Malignant Osteopetrosis

A

Delayed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Common complication of tooth extraction in Infantile/Malignant Osteopetrosis

A

osteomyelitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are common in Infantile/Malignant Osteopetrosis even though bone is dense

A

pathologic fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How will bone look radiographically in Osteopetrosis

A

increased radiographic density with loss of distinction between cortical and cancellous bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

O.I with opalescent teeth normally show what

A

severe attrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Which part of skeleton has significant sclerosis in Adult/Benign Osteopetrosis

A

axial skeleton, long bones not as sclerotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

When is Adult/Benign Osteopetrosis diagnosed and how

A

dental radiographs by increased radiopacity of medullary portions of bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How do patients that are symptomatic with Adult/Benign Osteopetrosis present

A

with pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Most common treatment with best prognosis for Infantile Osteopetrosis

A

bone marrow transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Secondary treatment for Osteopetrosis that decreases bone mass, decrease infection prevalence, and lower frequency of cranial nerve compression

A

Interferon gamma 1b with calcitriol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Cleidocranial dysplasia affects what type of bone formation

A

endochondral ossification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Most prominent abnormalities of Cleidocranial dysplasia affect what bones

A

clavicles and skull

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Absent/hypoplastic clavicles with underdeveloped neck muscles allowing shoulders to be approximated in front of the chest is characteristic of

A

cleidocranial dyplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Physiologic appearance of pt with Cleidocranial dysplasia

A

short stature
Large head
Prominent frontal and parietal bossing Hypertelorism
Broad nasal base and depressed nose bridge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Skull bone character in Cleidocranial dysplasia

A

delayed or never closed fontanels with sutures featuring wormian bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Palate character in Cleidocranial dysplasia patient

A

narrow, high arched palate

Increased prevalence cleft palate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Teeth character of Cleidocranial dysplasia

A

prolonged deciduous retention, permanent eruption failure, numerous unerupted supernumand permanent teeth with dilacerated roots or abnormal crowns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What do Cleidocranial dysplasia teeth lack that may be associated with eruption failure

A

Lack of secondary cementum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Cleidocranial dysplasia mandible character on radiograph

A

coarse trabeculation
Narrow ascending rami
Narrow pointed coronoid process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Cleidocranial dysplasia maxilla character on radiograph

A

Thin zygomatic arch

Hypoplastic maxillary sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Profile of Cleidocranial dysplasia patient as they age

A

short lower face height
Acute gonial angle
Anterior incline of mandible
Prognathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Treatment of choice for Cleidocranial dysplasia dentally

A

removal of primary and supernum teeth followed by exposure of permanent teeth to be extruded orthodontically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

An area of hematopoietic marrow that is sufficient in size to produce an area of radiolucency that may be confused with an intraosseous neoplasm (i.e. it is not a pathologic process)

A

Focal Osteoporotic Marrow Defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Demographics of Focal Osteoporotic Marrow Defect

A

Post menopausal females, posterior mandible, endentulous areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Is there expansion in the mandible from Focal Osteoporotic Marrow Defect

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

How treat Focal Osteoporotic Marrow Defect

A

incisional biopsy for diagnosis, if it is FOMD, then no further treatment required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Focal area of increased radiodensity that is of unknown cause and cannot be attributed to any inflammatory, dysplastic, neoplastic, or systemic disorder

A

Focal Idiopathic Osteosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What must do to the tooth if see a radiopaque lesion at the root apex

A

Test Tooth vitality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

If teeth are nonvital with testing then what should be the diagnosis of the radiopacity at the root apex

A

condensing osteitis or focal chronic sclerosis osteomyelitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

When does Focal Idiopathic Osteosclerosis begin and end

A

begins 1st to 2nd decade and ceases with bone maturity ~ 4th decade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Where does Focal Idiopathic Osteosclerosis normally appear

A

90% mandible, most common near 1st molar, but also common in 2nd PM and 2nd Molar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What should be included in the differential diagnosis if more than one area of osteosclerosis is noted

A

multiple osteomas associated with Gardner’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Radiographic character of Focal Idiopathic Osteosclerosis (size, shape, rim)

A

radiopaque 3mm-2cm, well-defined round to irregular with no rim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Is root resorption common in Focal Idiopathic Osteosclerosis

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Radiographic character of Focal Idiopathic Osteosclerosis

A

dense lamellar bone with scant fibrofatty marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Treatment for Focal Idiopathic Osteosclerosis

A

serial radiographs until growth stops, then no treatment required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What would be an indication for biopsy with focal idiopathic osteosclerosis

A

if cortical expansion occurs (indicates a neoplasm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Abnormal and anarchic resportion and deposition of bone resulting in distortion and weakening of the affected bones

A

Paget’s Disease (Osteitis Deformans)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Paget’s disease demographics

A

more common in Britain, after 4th decade, Males > women, Whites > blacks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Most commonly affected bones in Paget’s

A

lumbar vertebrae
Pelvis
Skull
Femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Can Paget’s jump a joint space to a previously unaffected bone

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Can just the mandible be affected in Paget’s

A

No, maxilla must be involvd if mandible involved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Paget affected bone character

A

thickened, enlarged, weakened

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Characteristic stance of Paget’s disease and why

A

weight bearing bones bow, resulting in Simian stance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Paget’s disease head circumference

A

Large head circumference

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Term for extreme cases of maxillary expansion in Paget’s disease

A

leotiasis ossea (gross expansion of midface)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Phase I of Paget’s Disease is osteolytic or osteoblastic

A

Osteolytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is osteoporosis circumscripta

A

waves or fronts of progressive demineralization occur in skull in Paget’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What is the cause of the increased cranial circumference in Paget’s disease

A

expansion of diploic table of skull

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Phase II of Paget’s Disease is osteolytic or osteoblastic

A

osteoblastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Descriptive term of the radiographic appearance of Phase II Paget’s Disease with patchy areas of sclerotic bone

A

cotton wool appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Character of Phase III Paget’s Disease

A

mixed osteolytic/osteoblastic, but no coordination between the two

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is pathognomonic for Paget’s Disease

A

Generalized hypercementosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What type of root resorption is seen in Paget’s Disease

A

external root resorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Change in teeth due to Osteoblastic (Phase II) of Paget’s disease

A

diastema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What other pathology is included in the differential when diagnosing Paget’s Disease

A

cement-osseous dysplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Consideration of Pagetoid bone

A

hypervascular, therefore poor hemostasis, sensitive to inflammation, high output cardiac failure (?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Malignant bone tumor associated with Paget’s disease (because it is rare to find in someone older than 40)

A

Osteosarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What is required for diagnosis of Paget’s disease

A

clinical, radiographs, lab tests (high alkaline phosphatase among other things)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What should patient be sent for once diagnosed with Paget’s disease

A

Bone scintography to detect skeletal involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What is histologically characteristic of Paget’s disease

A

numerous basophilic reversal lines forming mosaic or jigsaw pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What replaces marrow in Pagetoid bone

A

highly vascular fibrous connective tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Common treatment for the bone pain common in Paget’s disease

A

NSAID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What can result due to compression of cranial nerves during Phase II (osteoblastic) Paget’s

A

deafness, blindness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What can be prescribed to reduce bone resorption

A

parathyroid hormone antagonist (calcitonin or bisphosphonates)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What pagetoid bone is an osteosarcoma likely to occur in

A

pelvis or lower extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What tumors normally develop in Pagetoid bone in the craniofacial skeleton

A

benign and malignant giant cell tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Character of anterior Mandibular Central Giant Cell Granuloma

A

anterior can cross midline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Central Giant Cell Granuloma commonly found before what age and in what gender

A

before age 30, females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

majority presentation of Central Giant Cell Granuloma

A

asymptomatic, but have swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Are central giant cell granulomas aggressive, fast growing, perforate cortical plate, and do they cause root resorption

A

No, nonaggressive slow growing with no cortical expansion and no root resoprtion (Nonaggressive Central Giant Cell Granuloma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Can Central giant cell granulomas be aggressive and grow quickly causing perforation of the cortical plant and root resorption

A

Yes (Aggressive Central Giant Cell Granuloma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Central Giant Cell Granulomas can be what flavor (unilocular or multilocular)

A

Either unilocular or multilocular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Central Giant Cell Granulomas are radiopaque or radiolucent

A

radiolucent with well-defined rim, but rim is not corticated (does not have a definite white line)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

What is a differential diagnosis for a multilocular radiolucent lesion of the jaw

A

Central Giant Cell Granuloma

Ameloblastoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Unilocular radiolucent lesion of the jaw differential diagnosis

A

Central Giant Cell Granuloma
Periapical Granuloma
Cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Giant Cell Granulomas are histopathologically identical to what tumor associated with hyperparathyroidism

A

brown tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Common histology in all Central Giant Cell Granulomas

A

multinucleated giant cells in background of ovoid to spindle mesenchymal cells & round Macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Before preceeding with treatment of Central Giant Cell Granuloma, what disease must be first ruled out

A

hyperparathyroidism (because brown tumor of hyperparathyroidism is histologically identical to Central Giant Cell Granuloma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

What disease should be investigated in a child that has multiple foci of apparent central giant cell granuloma and why

A

Cherubism. Because Central Giant Cell Granuloma normally occurs as 1 lesion while Cherubism is bilateral lesions presenting commonly at age 2-5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Treatment of nonaggressive Central Giant Cell Granuloma

A

Curettage (has 15%-20% recurrence)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

3 alternatives to surgery for Aggressive Central Giant Cell Granuloma

A

Corticosteroids
Calcitonin
Interferon alpha-2a

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Where do giant cell tumors normally occur in the body

A

epiphysis of long tubular bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

Rare developmental condition of painless bilateral expansion of the posterior mandible involving the angles and ascending rami

A

Cherubism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Cherubism: genetic or random mutation

A

can be autosomal dominant genetic transfer or spontaneouls mutation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Cherubism usually manifests at what age range

A

2-5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Besides the chubby cheeks, what is the other physiologic feature that leads to the naming of Cherubism

A

“eyes upturned to heaven) appearance due to infraorbital rim and orbital floor involvement tilting eye up while pulling lower lid down exposing more sclera below iris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

When will the lesion regress

A

stabilize and slowly regress at puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

What is the diagnostic (pathognomonic) radiography for Cherubism

A

multilocular expansile radiolucency with a bilateral symmetrical presentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Side effects of the bilateral symmetrical jaw expansion of cherubism

A

displaced teeth, delayed eruption, impaired mastication and speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

What is contraindicated for Cherubism treatment and why

A

No radiation therapy, rick of post irradiation sarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Benign empty or fluid-filled cavity within bone that is devoid of epithelial lining

A

simple bone cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

Where do Simple Bone Cysts commonly occur in the body

A

long bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

Where do simple bone cysts commonly occur in the head and in what age range

A

mandible, between 10-20 years

120
Q

What is the radiographic appearance of Simple bone cyst (radiolucent or opaque, uniloc or multiloc)

A

unilocular well-defined radiolucency

121
Q

What is highly suggestive of simple bone cysts radiographically

A

superior border of cyst scallops up and down between adjacent tooth roots

122
Q

Are teeth adjacent to Simple bone cysts vital or non-vital

A

vital

123
Q

Is there root resorption with simple bone cyst

A

no root resorption

124
Q

Does a simple bone cyst have an epithelial lining

A

no, may have a thin vascular connective tissue membrane adjacent to the bone

125
Q

Treatment for Simple bone cyst

A

curettage and enucleation with submission of any recovered tissue to pathology

126
Q

How will the walls of the simple bone cyst appear on surgical exploration

A

smooth and shiny

127
Q

What will happen to simple bone cyst after curettage and enucleation

A

bony fill within 6 months

128
Q

Intraosseous accumulation of variable-sized, blood-filled spaces surrounded by cellular fibrous connective tissue that is often admixed with trabeculae of reactive woven bone

A

Aneurysmal bone cyst

129
Q

Aneurysmal bone cysts commonly located

A

shaft of long bone

Vertebral column

130
Q

Patient age normal for aneurysmal bone cyst in long bones and vertebral column

A

<30

131
Q

Patient age for aneurysmal bone cyst in jaw

A

children and young adults, mean age 20

132
Q

Aneurysmal bone cyst in head normally occur in what region of what bone

A

posterior segments of mandible (mandibular molar region)

133
Q

Most common clinical symptom of aneurysmal bone cyst

A

rapid facial swelling

134
Q

What is the radiographic appearance of an aneurysmal bone cyst

A

unilocular or multilocular, radiolucent, marked cortical expansion and thinning

135
Q

Treatment of aneurysmal bone cyst

A

enucleation and curettage, can look like a blood soaked sponge

136
Q

What does the aneurysmal bone cyst do to the surrounding bone

A

blow out or balloon

137
Q

Does the aneurysmal bone cyst have an epithelial lining

A

No, just spaces filled with clotted blood surrounded by fibroblastic tissue with gian cells and trabeculae of osteoid

138
Q

Odontogenic neoplasm of cementoblasts

A

cementoblastoma

139
Q

Most common area for cementoblastoma

A

mandibular molar and mandibular premolar region

140
Q

What age is cementoblastoma commonly found

A

late teens to 30’s

141
Q

What has occurred in a cementoblastoma that does not allow you to follow the root outline to the apex

A

root resorption has occurred and lesion is fused with tooth

142
Q

What is fused onto the root surface

A

sheets or thick trabeculae of mineralized cementum or osteocementum

143
Q

what is the cell type that lines the trabeculated sheets attached to the tooth root in cementoblastoma

A

blast cells

144
Q

Radiographic appearance of cementoblastoma

A

radiopaque mass fused to one or more tooth roots surrounded by thin radiolucent rim

145
Q

Treatment of Cementoblastoma

A

surgical extraction of tooth and attached mass, does not recur

146
Q

Primary malignant tumor of bone composed of small undifferentiated round cells of questionable etiology

A

Ewing’s sarcoma

147
Q

What is thought to be the origin of the round cells of Ewing’s sarcoma

A

neuroectodermal

148
Q

what are the top three most common osseous malignancies (in order)

A
  1. Osteosarcoma
  2. Chondrosarcoma
  3. Ewing’s Sarcoma
149
Q

Demographics of Ewing’s sarcoma

A

20’s, white, male

150
Q

Most common symptom of Ewing’s sarcoma

A

pain and swelling

151
Q

What does the tumor or Ewing’s sarcoma do to the cortical bone and what results

A

perforates cortical bone and soft tissue mass lies over the affected bone

152
Q

Majorityu of the cases contain what in the cytoplasm of the Ewing’s sarcoma tumor cells

A

glycogen

153
Q

Treatment for Ewing’s sarcoma

A

chemotherapy, multidrup chemotherapy to address micrometastasis, surgery. No radiation due to post irradiation sarcoma risk

154
Q

Most common form of cancer involving bone

A

Metastatic Carcinoma

155
Q

Carcinomas of what organs or tissues give rise to the majority of gnathic metases

A

Breast, Lung, Prostate, Colon, Thyroid, Renal

156
Q

How do the primary carcinomas metastasize to the jaw

A

hematogenous route

157
Q

Majority of metastatic tumors of the jaw are what type and occure where and in what age

A

intraosseous, posterior body of mandible, condyle, anterior maxilla, 5th – 7th decade

158
Q

In general, metastatic tumors of the jaw are found in areas of what (think of the route of transmission)

A

areas of red marrow

159
Q

Symptoms found in metastatic tumors of the jaw

A

pain, swelling, mass, tooth mobility, paresthesia, numb chin syndrome

160
Q

In general, the metastatic lesion in the jaw appears how radiographically

A

radiolucent with moth eaten appearance and possible PDL widening

161
Q

Metastatic process in jaw particular to breast and prostate cancer as primary site

A

osteoblastic

162
Q

If the metastasis is osteoblastic, how will it appear radiographically

A

radiopaque or mixed density

163
Q

In the 25% of the metastases to the oral cavity that don’t go to bone, where do they go

A

soft tissue: gingival or dorsal tongue

164
Q

2 things a metastatic tumor to the Oral cavity can be confused for

A

pyogenic granuloma
PGCG
Fibroma

165
Q

Why is the prognosis dismal if it is a metastatic tumor or the jaw

A

because metastasis automatically places pt in Stage IV, survival generally 1 yr

166
Q

diverse group of processes that are characterized by replacement of normal bone by fibrous tissue containing a newly formed mineralized product

A

Fibro-osseous lesions

167
Q

Developmental tumorlike condition characterized by replacement of normal bone by an excessive proliferation of cellular fibrous connective tissue intermixed with irregular bony trabeculae

A

Fibrous dysplasia

168
Q

What is the character of the abnormal fibro- osseous tissue

A

poorly formed

Functionally inadequate

169
Q

By what process does the abnormal fibro-osseous tissue arise in Fibrous dysplasia

A

Metaplasia

170
Q

when Fibrous dysplasia is confined to 1 bone

A

Monostotic (80% all cases)

171
Q

Most common symptom of Monostatic fibrous dysplasia

A

painless swelling at site

172
Q

Part of oral cavity most affected by Fibrous dysplasia

A

Maxilla

173
Q

Fibrous dysplasia that involves 2 or more bones

A

polyostotic

174
Q

Polyostotic fibrous dysplasia associated with café au lait pigmentation

A

Jaffe-Lichtenstein Syndrome

175
Q

Maxillary fibrous dysplasia normally involves more bones than just the maxilla, so it is commonly called

A

Craniofacial fibrous dysplasia

176
Q

Polyostotic fibrous dysplasia with café-au lait and multiple endocrinopathies (e.g. sexual precocity, pituitary adenoma, hyperthyroidism)

A

McCune-Albright Syndrome

177
Q

This fibrous dysplasia syndrome also has affectation or effeacement of various neural foramina at base of skull in CT

A

McCune-Albright Syndrome

178
Q

What is the character of the café au lait pigmentation in McCune Albright syndrome

A

uniform pigment with irregular border

179
Q

What is the radiographic character of Fibrous dysplasia

A

highly variable from radiolucent to radiopaque

180
Q

2 radiographic clues for Fibrous dysplasia

A

1) cortical persistence of inferior border mandible with bone enlargement
2) Superior displacement of IAN canal

181
Q

What is the most common radiographic appearance of Fibrous dysplasia and what does it indicate

A

ground glass pattern(end of slide or decanter stopper). Indicates lesion is hard & will be difficult to remove surgically

182
Q

2 pathognomonic radiographic returns for Fibrous dysplasia

A

peau d’orange

Fingerprint

183
Q

Fibrous dysplasia lesions in youth versus adult

A

Youth: Hypervascular
Adult: avascular

184
Q

Concern with surgery in youth fibrous dysplasia

A

Hemostasis due to hypervascularity

185
Q

Concern with adult fibrous dysplasia

A

avascular bone so more susceptible to infection

186
Q

Only fibrous dysplasia type that has risk of malignant transformation

A

polyostotic

187
Q

dysplastic condition at apices of anterior mandible teeth

A

periapical cement-osseous dysplasia

188
Q

What demographic does periapical cement- osseous dysplasia have a marked predilection for

A

middle aged African American females

189
Q

What is the status of the teeth associated with Periapical Cemento-Osseous dysplasia

A

vital(key for endo)

190
Q

Stage I periapical cement-osseous dysplasia radiographic appearance

A

periapical radiolucency (do vitality testing so don’t do unnecessary endo)

191
Q

Stage II periapical cement-osseous dysplasia radiographic appearance

A

mixed radiolucent/radiopaque lesion as woven and lamellar bone and cementum mineralize

192
Q

Stage III periapical cement-osseous dysplasia radiographic appearance

A

large radiopaque mass due to masses coalescing to form acellular disorganized cement-osseous material

193
Q

Is there any treatment indicated for periapical cement-osseous dysplasia

A

No, don’t want to biopsy or extract because exposing to oral environment could superimpose osteomyelitis on dysplastic bone

194
Q

a subset of Periapical Cemento-osseous dysplasia that has extensive periapical cement-osseous dysplasia in multiple posterior quadrants

A

Florid Cemento-osseous dysplasia

195
Q

Does Florid cemento-osseous dysplasia have 3 developmental stages like Periapical cement-osseous dysplasia

A

Yes

196
Q

What is the danger with Periapical or Florid cement-osseous dysplasia

A

Exposing it to oral environment which can cause osteomyelitis

197
Q

What is the characteristic Florid Cemento-osseous dysplasia histologically

A

ginger root curvilinear trabeculae

198
Q

Benign, well-circumscribed, slow-growing neoplasm of craniofacial bones, predominantly in the mandibular molar and premolar region, with a predilection for Females in their 3rd – 4th decade

A

cement-ossifying fibroma

199
Q

What radiographic feature is key for cement- ossifying fibroma

A

well-circumscribed, sharply defined border

200
Q

How does cement-ossifying fibroma grow

A

equidirection expansion with centrifugal growth pattern that can thin cortical bone

201
Q

What is composition of Cemento-ossifying fibroma

A

uniform fibroblasts and small irregular masses resembling cementum

202
Q

What is a differentiating characteristic between cement-ossifying firbrom and fibrous dysplasia

A

cement-ossifying fibroma does not arrest at skeletal maturity like fibrous dysplasia does

203
Q

Cemento-ossifying fibroma treatment

A

complete enucleation with larger possibly requiring surgical resection and bone grafting

204
Q

Ossifying fibrom that is rapidly growing, well- circumscribed lacking continuity with adjacent bone

A

Juvenile aggressive ossifying fibroma

205
Q

Major pattern of Juvenile/Aggressive Ossifying Fibroma that occurs in the craniofacial skeleton

A

psammomatoid

206
Q

What part of the craniofacial skeleton does Juvenile/Aggressive Ossifying Fibroma occur most often

A

maxilla, psammomatoid. 70/5 in orbital, frontal bones and paranasal sinuses

207
Q

Symptoms of Juvenile/Aggressive Ossifying Fibroma

A

nasal obstruction, pain, sinusitis, headache, proptosis (eye bulging)

208
Q

Juvenile/Aggressive Ossifying Fibroma histology

A

psammomatoid bodies embedded in cellular stroma of stellate cells w/ hyperchromatic nuclei, no mitotic bodies. Osteoid and woven bone when mature

209
Q

Treatment and recurrence of Juvenile/Aggressive Ossifying Fibroma

A

surgical excision and curettage, 30-58% recurrence but no malignant transformation

210
Q

Most common osseous tumor of the jaw

A

Osteoma (benign neoplasm of bone)

211
Q

Does an osteoma occur in immature or mature bone

A

mature lamellar bone

212
Q

Do palatal tori, mandibular tori, and buccal exostoses represent osteomas

A

No

213
Q

2 ways osteomas can arise

A

1) on bone surface = periosteal/peripheral/exophytic osteoma

2) In medullary bone = endosteal or central osteoma

214
Q

Most common osteoma location

A

body of mandible or condyle

215
Q

When osteoma found in the body of the mandible, where will it most likely occur

A

posterior to premolars, lingual side

216
Q

How would one differentiate between and osteoma in the condyle and condylar hyperplasia

A

condylar osteoma would be lobulated, condylar hyperplasia the condyle retains its shape

217
Q

How will an osteoma look histologically

A

lots of dense bone w/ little marrow and prominent osteoblastic activity

218
Q

What is the demographic for osteomas

A

6th decade, females

219
Q

How do osteomas appear radiographically

A

well circumscribed sclerotic mass attached by a broad base to underlying bone. Radiopaque

220
Q

Can an osteoma cause root resorption

A

yes

221
Q

Where are the two most common sinus locations for maxillary osteomas

A

Frontal osteoma, 80%. # 2 is ethmoid sinus

222
Q

what is the problem with sinus osteomas

A

they are aggressive, cause obstructions and recur after initial attempts to remove

223
Q

how treat an osteoma

A

surgical removal to secure diagnosis and treat cosmetic or functional defects

224
Q

What is osteoma is small, asymptomatic, and located endosteal, how treat

A

observed periodically

225
Q

Autosomal inherited trait with 100% penetrance or the result of spontaneous mutation on Chromosome 5 characterized gnathically by multiple osteomas and multiple supernumerary teeth

A

Gardner syndrome

226
Q

What is another systemic manifestation of Gardner syndrome

A

colorectal polyps that will become malignant

227
Q

What does Chromosome 5 have to do with Gardner syndrome

A

it is the adenomatous polyposis coli (APC) tumor suppressor gene (think colon polyps)

228
Q

What will all patients with Gardner Syndrome develop in their life, 50% by age 30

A

aggressive colon adenocarcinoma

229
Q

2 prophylactic treatments in Gardners

A

prophylactic colectomy

Screen other family members

230
Q

when do the multiple osteomas of Gardners syndrome usually present

A

during puberty and precede colon polyps

231
Q

Can the multiple osteomas of Gardners be treated

A

yes, for cosmetic reasons, but long term prognosis depends on bowel adenocarcinomas

232
Q

Benign tumors composed of mature hyaline cartilage

A

Chondroma

233
Q

Where are chondromas normally located

A

short tubular bones of hands and feet

234
Q

) If a chondroma is going to occur in the head and neck, what is the embryonic origin of its location

A

where embryonic cartilaginous remnants located

235
Q

Where are the embryonic cartilaginous remnants that are conducive to chondromas located in the head and neck

A
  • Mandible: premolar area(Meckel’s cartilage), condyle, coronoid process, symphysis
  • Maxilla: nasal septum, ehtmoid sinus
236
Q

When are chondromas normally diagnosed

A

Before age 60

237
Q

How do chondromas look radiographically

A

localized irregular radiolucent defect with punctuate or stippled calcifications

238
Q

What will chondromas do to small bones

A

expansion and cortical thinning

239
Q

If chondroma in the jaw, is there root resorption

A

yes

240
Q

What is the dilemma with chondromas in the jaw

A

Some believe they are chondrosarcomas meaning they are malignant

241
Q

What indicates a chondroma versus a chondrosarcoma in the jaw

A

Chondroma will have absence of pain, lack of disturbed cortex and surrounding bone architecture and no cytologic atypia

242
Q

What does an osteochondroma consist of

A

cancellous bone surrounded by compact bone with a cartilaginous cap

243
Q

If patient has multiple osteochondromas what will be the physical character of their bone and what are they at risk for

A

deformed bone

Propensity to develop chondrosarcoma

244
Q

What will an osteochondroma look radiographically

A

radiopaque extraosseous projection

245
Q

where do osteochondromas occure most frequently

A

condyle and coronoid process

246
Q

Benign bone tumor arising from osteoblasts that is rare in the jaw

A

Osteoid osteoma

247
Q

Demographic for Osteoid Osteoma

A

Males (3:1), 2nd decade

248
Q

Pathonomonic clinical symptoms for Osteoid Ostemoa

A
  • pain of increasing severity
  • Worse at night
  • Relieved w/in 20-30 min of aspirin/NSAID dose
249
Q

How does and osteoid osteoma appear radiographically

A

well demarcated radiopaque nidus, round to ovoid wit h a peripheral radiolucent rim surrounded by zone of reactive host sclerosis

250
Q

Is the sclerosis surrounding an Osteoid Osteoma a part of the lesion or a host response

A

host response that resolves once nidus is gone

251
Q

When the nidus is well ossified, how can the Osteoid Osteoma look radiographically

A

targetoid or bulls-eye appearance (what is other pathology that has targetoid appearance?)

252
Q

What is the histopathology of Osteoid Osteoma

A

irregular randomly ordered trabeculae of osteoid and woven bone

253
Q

What is the character of the nidus in Osteoid Osteoma

A

well vascularized, clearly separate from reactive bone

254
Q

what is the growth potential of Osteoid Osteoma

A

limited growth, nidus < 2 cmdiameter

255
Q

What is responsible for reactive host sclerosis, inflammatory changes in soft tissue and pain in Osteoid Osteoma

A

large amounts of prostaglandin E2 and prostacyclin

256
Q

Treatment of Osteoid Osteoma

A

surgical excision of nidus and surrounding bone and curettage

257
Q

Also a benign bone tumor arising from osteoblasts that occurs in Males(3:1) in 2nd decade

A

Osteoblastoma

258
Q

Differences of osteoblastoma from Osteoid Osteoma

A

Osteoblastoma will grow >2cm, does not have nocturnal pain relieved by aspirin/NSAID, lacks secondary peripheral sclerosis

259
Q

Where will an osteoblastoma appear in mandible radiographically

A

in vicinity of tooth root with a central opacity surrounded by peripheral radiolucent halo

260
Q

How treat osteoblastoma

A

surgical en bloc excision (as a unit, all together). Nidus is well demarcated and can be removed easily from surrounding bone

261
Q

Histology of Osteoblastoma (same as Osteoid Osteoma)

A

interlacing network of bone trabeculae evenly distributed in loose fibroblastic stroma with prominent vasculature and osteoblastic rimming

262
Q

Aggressive Osteoblastoma character

A

occur in older patients (>30) larger than normal osteoblastoma (>4cm) severe pain, locally destructive w/ high recurrence after surgery

263
Q

The most common primary malignancy of bone (excluding hematopoietic tumors)

A

osteosarcoma

264
Q

What must an osteosarcoma be able to do

A

produce osteoid and immature bone

265
Q

What is demographic for osteosarcoma

A

males, during periods of highest growth. 10-20 years and >50 years

266
Q

What bones does osteosarcoma arise in normally

A

skeletal areas with highest growth rate: distal femur, proximal tibia, proximal humerus

267
Q

At what age does an osteosarcoma in the mandible or maxilla normally occur

A

3rd and 4th decade

268
Q

What disease and treatment can predispose for osteosarcoma

A

Paget’s disease

Previous irradiation

269
Q

Osteosarcoma clinical symptoms

A

pain (weeks to months) of increasing intensity, swelling, skin warm to touch

270
Q

Weight loss associated with osteosarcoma indicates metastasis to what area

A

Lungs

271
Q

What are the radiographic features of jaw osteosarcoma

A

ill defined border/indistinct, spiking of teeth due to root resorption, sunburst/sunray appearance, Codman’s triangle

272
Q

What causes the sunburst/sunray appearance on an osteosarcoma

A

osteophytic bone production on surface of lesion

273
Q

What is an important early radiographic sign of a jaw osteoma

A

symmetrical widening of PDL around 1 or several teeth

274
Q

What will be elevated in patient with osteosarcoma

A

alkaline phosphotase

275
Q

Treatment for osteosarcoma

A

Neodjuvant (preop) chemo and radiation
Surgical excision
Adjuvant (postop) chemo

276
Q

What is Codman’s Triangle

A

Tumor growing on bone surface can elevate periosteum and cause periosteal reaction of open triangle showing radiographically

277
Q

What will happen to the teeth along with the external root resorption in osteosarcoma jaw lesions

A

mobility

278
Q

Essential microscopic criterion for osteosarcoma

A

direct production of tumor osteoid by malignant mesenchymal cells

279
Q

Secondary Osteosarcoma can arise from where

A 
Paget’s disease 
Fibrous dysplasia
Ionizing radiation >3000 Gys 
Bone infarcts
Chronic osteomyelitis 
Metallic prosthetic implants
280
Q

What are the clinical symptoms associated with sarcomatous transformation

A

sudden onset of pain
Rapid worsening of previous pain
Increased deformity

281
Q

Character of Secondary Osteosarcomas

A

high grade
Aggressive
Poor prognosis

282
Q

Malignant tumor characterized by the formation of cartilage, but not bone, by tumor cells. Can arise de novo or within a preexisting benign chondroma

A

chondrosarcoma

283
Q

Second most frequent bone sarcoma

A

chondrosarcoma

284
Q

where do chondrosarcomas occur gnathically

A

Maxillary anterior alveolus, orbit, nose, condyle or skull base

285
Q

Can there be a periosteal reaction with chondrosarcoma

A

yes

286
Q

Cortical disruption with significant extension into soft tissues signifies what type of chondrosarcoma

A

advanced lesion

287
Q

What can be seen with the teeth in chondrosarcoma that was seen with osteosarcoma

A

widening of PDL with root divergence or resorption

288
Q

Most common type of chondrosarcoma

A

Mesenchymal

289
Q

How are chondrosarcomas graded

A

by histologic features

290
Q

Chondrosarcoma with lobular architecture, rarely metastasizes

A

Grade I

291
Q

Chondrosarcoma with myxoid stromaand mitotic figures, 10% metastasis rate

A

Grade II

292
Q

Chondrosarcoma with markedly cellular, spindleform, abundant mitosis, 71% metastasis rate

A

Grade III

293
Q

treatment for chrondrosarcoma and where contraindicated

A

Wide local or radical surgical excision. May not be possible in base of skull

294
Q

Is radiotherapy or chemotherapy useful in chondrosarcoma treatment

A

No

295
Q

When is prognosis for Chrondosarcoma worse

A

Jaws. Maxilla worse prognosis than mandible

296
Q

What can a chondrosarcoma be confused for

A

Chondroblastic osteosarcom which would have some bone in it (radiograph would have some more opacity and greater change of periosteal reaction)

297
Q

Why is it important to differentiate between a chondrosarcoma and a chondroblastic osteosarcoma

A

because treatment and prognosis is different. Osteosarcomas are slower growing with a reduced metastasis rate which increases their prognosis. As well osteosarcomas have other therapy options beyond surgical excision.

Oral Pathology, Stephen (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions