Brainscape's Knowledge GenomeTM

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


See full index

Neville and Damm > Ch14 Bone Path (Part IV) > Flashcards

Ch14 Bone Path (Part IV) Flashcards

1
Q

What are the 3 theories for the etiology of cemento-osseous dysplasia?

A

1) PDL 2) remodling caused by trauma 3) hormonal imbalance

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

What are the 3 variants of COD?

A
  1. focal 2. periapical 3. florid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Focal COD: gender

A

90% in females

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

Focal COD: mean age, typical age range

A

41 years, 3rd-6th decades

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

Focal COD: top three races effected, in order

A
  1. blacks 2.east asians 3.whites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Focal COD: site

A

posterior mandible

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

Periapical COD: site

A

periapical region of anterior mandible

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

Periapical COD: gender / race

A

female (10:1 to 14:1)..70% blacks

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

Periapical COD: typical age, never under what age?

A

30-50…almost never under 20 years

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

Periapical COD: expansile?

A

NO, periapical COD is non-expansile

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

Florid COD: site of most cases

A

posterior mandible/maxilla, synchronous with anterior MANDIBLE as well..bilateral / symmetrical…all 4 quadrants

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

Florid COD: gender? race? age?

A

black females (90%)…middle aged to older..intermediate freq in east asians

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

Florid COD: patients may have DULL PAIN, alveolar sinus tracts, and exposure of yellowish, avascular _____to the oral cavity. Although rarely prominent, some jaw ________ may be evident.

A

BONE..EXPANSION

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

Florid COD: does it have to be a dentulous area?

A

nope, edentulous and dentulous areas have been found

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

Florid COD: coexistence with what other type of cyst is common?

A

simple bone cyst (instersitial fluid obstruction by the fibro-osseous proliferation

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

COD histo: as lesions mature the ratio of fibrous connective tissue to mineralized material _______

A

decreases

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

COD histo: OVER TIME, the bony trabeculae become thick and curvilinear, with shapes likened to _______

A

GINGER ROOTS

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

COD histo: the FINAL RO stage, the individual trabeculae FUSE to form sheetlike or globular masses of _______, disorganized cemento-osseous material

A

SCLEROTIC

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

Which one has MORE DELICATE bony trabeculae-ossifying fibroma or florid COD?

A

ossifying fibroma

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

Which one has more prominent OSTEOBLASTIC RIMMING…ossifying fibroma or florid COD?

A

ossifying fibroma

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

ossifying fibroma or florid COD? hemorrhage

A

COD

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

ossifying fibroma or florid COD? cementum-like particles that are ovoid, brush borders in intimate association with the adjacent stroma

A

ossifying fibroma

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

COD: in the _______ phase, the lesions tend to be hypovascular and prone to necrosis and secondary infection with minimal provocation.

A

sclerotic

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

Because the onset of symptoms usually is associated with exposure of the sclerotic masses to the oral cavity, surgical procedures like ________ SHOULD BE AVOIDED.

A

elective tooth extraction, BIOPSIES

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

Dental implant placement in an area of cemento-osseous generally is _________

A

NOT recommended

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

In some instances, symptoms of COD begin after lesion exposure resulting from progressive alveolar atrophy under a ______.

A

DENTURE

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

What is the typical treatment for florid COD that develops secondary osteomyelitis?

A

antibiotics (often not effective)

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

What other type of cyst likes to develop in florid COD?

A

simple bone cysts…usually curetted out, heal slower, and retain abnormal radiographic appearance

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

What is the name for the RARE SUBSET of PROGRESSIVE GROWTH, but otherwise typical featrues of COD? What location and demograhic is it found in and what is the treatment?

A

Expansive osseous dysplasia…black females, anterior mandible, surgical excision

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

What type of malignancy has been reported to arise from a COD?

A

sarcoma (why is this called dysplasia if its not considered pre-malignant?)

31
Q

FAMILIAL GIGANTIFORM CEMENTOMA: what type of inheritance pattern? Penetrance? Expressivity?

A

Autosomal Dominant…HIGH penetrance, VARIABLE expressivity

32
Q

__________ is characterized by a cemento-osseous proliferation involving MULTIPLE quadrants of the jaws and often resulting in MASSIVE expansion.

A

Familial Gigantiform Cementoma

33
Q

Based on microscopic similarities, some authors consider familial gigantiform cementoma to be a variant of __________…HOWEVER, a tendency for progressive
lesion growth suggests a truly neoplastic process and many authors prefer to regard this as a distinct neoplasm OR a subtype of _________.

A

cemento-osseous dysplasia…OSSIFYING FIBROMA

34
Q

FAMILIAL GIGANTIFORM CEMENTOMA: race? gender? WHEN does it show up?

A

no predilection for blacks or gender…MOST reported families are white or asian…radiographic changes in FIRST decade of life

35
Q

In a few reported cases of FAMILIAL GIGANTIFORM CEMENTOMA: especially rapid growth has been noted during WHAT LIFE EVENT?

A

PREGNANCY

36
Q

If FAMILIAL GIGANTIFORM CEMENTOMA is left UNTREATED, when does osseous enlargement typically cease?

A

fifth decade

37
Q

FAMILIAL GIGANTIFORM CEMENTOMA behaves much like COD radiographically in that it becomes more _______ over time and inflammatory stimuli can cause necrosis with minimal provocation

A

radiopaque

38
Q

FAMILIAL GIGANTIFORM CEMENTOMA: What serum level is said to be altered after removal? What other blood dyscrasia is associated?

A

alkaline phosphatase decreased post resection…anemia

39
Q

________ is a heritable AUTOSOMAL DOMINANT condition characterized by GDD1 [or TMEM16E] mutations, diffuse fibro-osseous lesions of the jaws with a prominent psammomatoid body component, bone fragility, and bowing/cortical sclerosis of long bones

A

gnatho-diaphyseal dysplasia

40
Q

FAMILIAL GIGANTIFORM CEMENTOMA cannot be distinguished histologically from __________

A

florid cemento-osseous dysplasia

41
Q

(Based on one fucking case) familial gigantiform cementoma might be associated with ___________, gynecologic evaluation is prudent for female patients–especially those with ANEMIA

A

polypoid adenomas of the uterus

42
Q

Which neoplasm is composed of FIBROUS TISSUE with a variable mixture of bony trabeculae and cementum-like spherules?

A

Ossifying fiboma

43
Q

The ________ material in ossifying fibromas is regarded as a variation of bone.

A

cementum-like

44
Q

Bone and cementum are essentially THE SAME mineralized product and only can be distinguished based on _______

A

ANATOMIC LOCATION

45
Q

What are the 4 manifestations of hyperparathyroidism-jaw tumor syndrome? What is the genetic mutation?

A

1) parathyroid adenoma/carcinoma 2)ossifying fibromas of the jaw 3)renal cysts 4)wilms tumors…HRPT2 gene

46
Q

Ossifying fibroma: age, gender, most common site…more specific site for mandible and maxilla (each have a common site)

A

broad age range, with a peak in the third and fourth decades of life..female predilection…mandible…The mandibular premolar and molar area is the most common site. Maxillary lesions tend to involve the antrum.

47
Q

Larger _________ can produce PAINLESS jaw swelling and facial deformity..WHICH DIRECTION is the swelling MOST COMMON??

A

Ossifying fibromas….buccolingually

48
Q

Ossifying fibromas characteristic _________ of the inferior cortex. The adjacent teeth may exhibit root divergence OR root resorption.

A

DOWNWARD BOWING

49
Q

Ossifying fibroma: At surgery, the lesion tends to separate ______ from the surrounding bone..Grossly and microscopically, most lesions are well demarcated but __________.

A

easily…unencapsulated

50
Q

Microscopic examination of a _________ shows cellular fibrous tissue with mineralized product

A

Ossifying fibroma

51
Q

Ossifying fibsomas histologically show a variable admixture of what 3 substances?

A

1) osteoid, 2) bone, and 3) basophilic acellular (or “cementum-like”) spherules

52
Q

The bony trabeculae of ossifying fibromas vary in size and frequently demonstrate both ______ and ______ patterns.

A

woven and lamellar

53
Q

ossifying fibromas: Peripheral osteoid and osteoblastic _______ are usually present.

A

rimming

54
Q

Ossifying fibroma histo: The cementum-like spherules often demonstrate ________ that blend into the adjacent connective tissue

A

brush borders

55
Q

Ossifying fibroma VS Fibrous dysplasia: WHICH one is histologically MORE UNIFORM?

A

Fibrous dysplaisa…..The heterogeneous mineralized product characteristic of ossifying fibroma differs from the more uniform osseous pattern of fibrous dysplasia.

56
Q

Rarely, a lesion may exhibit combined features of ossifying fibroma and ___________.

A

central giant cell granuloma

57
Q

Recurrence after complete removal of an ossifying fibroma is uncommon; BUT one systematic review of the literature has reported a ___% recurrence rate.

A

12%

58
Q

The _________ is a controversial lesion that has been distinguished from conventional ossifying fibroma on the basis of patient age, site predilection, and clinical behavior.

A

juvenile ossifying fibroma

59
Q

What are the two varients of juvenile ossifying fibroma? Which is more common in the craniofacial region?

A

1) trabecular 2) psammomatoid….psammomatoid is more common in the craniofacial region

60
Q

juvenile ossifying fibroma, psammomatoid variant age range? avg age at diagnosis?

A

3 months to 72 years….8.5-12 years

61
Q

juvenile ossifying fibroma, trabecular variant age range: average age at diagnosis?

A

2 to 33 years…16 to 33 years

62
Q

juvenile ossifying fibroma gender predilection?

A

slight male (or none)

63
Q

Juvenile ossifying fibroma: tabecular vs psammomatoid…location for each

A

trabecular: in jaws (maxilla especially)…psammomatoid: paranasal sinuses and orbital

64
Q

Uhoh. “ground glass” and honeycomb” radiographic pattern are seen in ________

A

juvenile ossifying fibroma (as well as fibrous dysplasia and ameloblastoma, respectively lol)

65
Q

Similar to conventional ossifying fibromas, juvenile
ossifying fibromas may produce ________ of
the inferior cortex of the mandible.

A

downward bowing

66
Q

Juvenile ossifying fibromas can cause tooth displacement, root resorption, and failure of tooth development. Sinus involvement may appear radiographically as cloudy opacification mimicking ______

A

sinusitis

67
Q

Name that tumor: well demarcated but unencapsulated.
The fibrous stromal component exhibits variable
degrees of cellularity and collagenization. Some zones may be so hypercellular that the cytoplasm of individual cells is hard to discern. Other areas may appear myxomatous with pseudocystic degeneration. Hemorrhage and small clusters of multinucleated giant cells are common.

A

Juvenile ossifying fibroma

68
Q

Juvenile ossifying fibroma: In the _______variant, microscopic zones of hemorrhage, giant cells, and pseudocystic degeneration may correlate with grossly evident BROWN, curvilinear strands on the tumor’s cut surface

A

TRABECULAR

69
Q

Which histological component varies in the two forms of Juvenile ossifying fibroma?

A

the mineralized component

70
Q

Which variant of juvenile ossifying fibroma? irregular strands of highly cellular osteoid encasing plump and irregular osteocytes

A

Trabecular

71
Q

Which variant of juvenile ossifying fibroma? concentric lamellated OSSICLES that vary in size and may be round, ovoid, or crescentic in shape. The ossicles typically appear basophilic with peripheral eosinophilic osteoid rims and brush borders that blend into the surrounding stroma

A

psammomatoid

72
Q

Juvenile ossifying fibromas can have secondary formation of a ________ OR a ________ also is possible. The latter may manifest clinically with rapid, aggressive growth.

A

simple bone cyst OR aneurysmal bone cyst

73
Q

IN CONTRAST to the negelable recurrence rate of an ossifying fibroma, the JUVENILE ossifying fibroma has had a range of __% to __% recurrence rates reported

A

30-58%

Neville and Damm (72 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions