Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Oral Pathology > Chapter 14 > Flashcards

Chapter 14 Flashcards

1
Q

Benign bone neoplasia

A

Asymptomatic

Slow growth – displaces teeth and expands the cortex of bone

Symmetrical

Does not metastasize

Corticated rim

(Expanded cortex –> slow pressure: osteoclasts remove bone and signal to osteoblasts to lay down new bone)

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

Benign lesion

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

Malignant bone neoplasia

A

Symptomatic

Grows RAPIDLY - bone resorption

Asymmetrical

Ragged or poorly defined margins

Destroys cortex

Lay bone down outside of the cortex

Capable of metastasis

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

Osteogenesis Imperfecta

A

Defect in COLLAGEN TYPE I maturation

(most common type of inherited bone disease)

Bone has –>

Thin cortex

Fine trabeculation

Diffuse osteoporosis

Bone healing may occur – but may be inappropriate healing

Signs and symptoms:

Bone fragility

Blue sclera

Altered teeth – blue/brown opalescent teeth, premature pulpal obliteration, Class III malocclussion (simmilar to dentinogenesis imperfecta)

Hearing loss

Long bone and spine deformitites

Joint hyperextensibility

Xrays: Osteopenia (low bone density), Bowing, Wormian bone of skull

patients may be on BISPHOSPHONATES

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

Xray features of osteogenesis imperfecta

A

Osteopenia (low bone density)

Bowing

Wormian bones in the skull

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

Oral cavity findings in osteogenesis imperfecta

A

Teeth - blue to brown translucence

Premature pulpal obliteration

class II malocclusion

Similar tooth look to dentinogenesis imperfecta

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

What is defective in osteogeneis imperfecta?

A

Type I collagen maturation

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

Blue sclera!

Unique to osteogenesis imperfecta

( Bowing of bones – another symtom)

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

Osteopetrosis

A

Marble bone disease

Skeletal disorder with a marked increase in BONE DENSITY (no bone is broken down)

** Defect in remodeling caused by FAILURE of normal OSTEOCLAST function **

VERY radio-opaque radiographs

Loss of marrow space – loss of nutrients (blood supply) –> may becoe osteomyelitits

Usually class III

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

Osteopetrosis

Failure of normal osteoclast function

May develp osteomyelitis

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

Cleidocranial Dysplasia

A

Characterized by clavicle and dental abnormatlities

Clavicles – varying degress of hypoplasia (unusual mobility of shoulders)

Appearance (DIAGNOSTIC): Short stature, big head. Pronounced frontal bossing, Occular hypertelorism, broad base of nose

Oral ->

HIGH arched palates.

increased prevalance of cleft palate

Prolonged retention of deciduous teeth

Delay or failure of eruption or permanent teeth

Abnormally shaped teeth

**Numerous unerrupted permanent teeth and supernumerary teeth **

No treatment

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

Moveable shoulders

A

Cleidocranial Dysplasia

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

Oral complications of cleidocranial dysplasia

A

High arched palate

INCREASED prevalence of cleft palate

Prolonged retention of deciduous teeth

Delayed or failure of eruption of permanent teeth

Abnormally shaped teeth

Numerous unerupted permanent and supernumerary teeth

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

Focal osteoporotic marrow defect

A

Area of hematopoietic marrow – producing a radiography lucency (varies in size)

Marrow has pushed the bone away creating a defect

NOT PATHOLOGY - asymptomatic and incidental finding on radiograph

Radiolucency - ill defined borders with fine central trabeculations (multilocular)

Occurs in posterior mandible typically

NO jaw expansion

Biopsy is required for diagnosis – will just have bone marrow

No treatment necessary

No association with any hematologic disorder

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

Focal osteoporotic marrow defect

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

Idiopathic osteosclerosis

A

Focal area of increased radiodensity

UNKOWN cause

Typically associated with a healthy tooth

Can be present with NO teeth – after extraction

ASYMPTOMATIC

No cortical expansion

Diagnosis – history, clinical findings, radiographic findings

Biopsy is considered if symptomatic

If found in adolescence – periodic XRAYS are prudent until the area stabilizes. No treatment necessary.

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

Idiopathic osteosclerosis XRAY manifestations

A

Well defined - Round or Elliptical

Radiopaque

Usually associated with root apex

NO radiolucent rim

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

Idiopathic osteosclerosis

Healthy tooth

Radioopaque

Well defined

NO radiolucent rim

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

Condensing osteitis vs idiopathic osteosclerosis

A

Condensing osteitis –> associated with infection

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

Cemento-osseous dysplasia vs idiopathic osteosclerosis

A

Cemento-osseeous dysplasia –> Radiolucent rim

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

Cementoblastoma vs idiopathic osteoscelerosis

A

Cementoblastoma –> fused with the tooth

NO PDL SPACE

bulges out

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

Massive osteolysis

A

Gorham Disease

spontaneous and progressive destruction of one or more bones - affected area does not regenerate or repair

Destroyed bone is initially replaced by vascular proliferation

Eventually filled with dense fibrous tissue

No known cause

Mandible affected more than maxilla

Treatment: Surgical and bisphosphonates

Surgical + bone graft –> bone graft will undergo osteolysis (not a successful treatment)

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

Massive osteolysis signs and symptoms

A

Mobile teeth

Pain

Malocclusion - movement of teeth

Deviation of the mandible

Clinically obvious deformity

Pathologic fracture

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

Massive osteolysis xray manifestation

A

Radiolucent foci of varying size with indistinct margins

Coalesce to become larger - involve cortical bone

Large prortions of invovled bone disappear

Loss of lamina dura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Paget's Disease
***_Abnormal resorption and deposition of bone_*** Relatively common Distortion and weakening of affected bones UNKOWN cause Affects older adults Affects **more than one bone - _Polyostotic_** Symptoms: **_bone pain_****_, bone distortion, and weakening of bones, bowing deformity, increase circumference of head_** \* enlargment of midde 1/3 of face -- resulting in *_Leontiasis ossea_* (lionlike facial deformity)\* Most common bones affected --\> vertebrae, pelvis, skull, femur. Maxilla \> mandible ***Generalized hypercementosis*** *_Slow and chronically progressive_ -- rarely leads to death* Treatment - NSAIDS for pain, ***Bisphosphonates*** INCREASED risk of developing a **_malignant bone tummor -- *OSTEOSARCOMA*_**
26
Head and neck symptoms of Paget's Disease
Increased circumference of head Enlargement of middle 1/3 face -- ***_Leontiasis ossea_*** (lionlik facial deformity) Alveolar ridges are symmetrical -- grossly enlarged (dentures no longer fit) Hypercementosis
27
Diagnostic of Paget's Disease
Cotton wool appearance on xray Generlized hyper cementosis ***_HIGH serum alkaline phosphatase levels_*** ***_NORMAL calcium and phosphorus levels_***
28
What medications are Paget disease patients typically taking?
**BISPHOSPHONATES** *NSAIDS*
29
Paget disease patients have an increased risk of developing?
Malignant bone tumors - ***_Osteosarcoma_***
30
Xray manifestatsion of Paget's Disease
Cotton wool bone appearance Generalized hypercementosis
31
Generalized hyper cementosis
**Paget's Disease**
32
Dentures don't fit anymore Hat has seemed a little tight lately
**Paget's Disease** Increased head circumference - ill fitting hat Gross bone expansion -- ill fitting dentures
33
**Lentiasis ossea** Lionlike facial deformity ***_SEVERE case of Paget's disease_*** of the jaw - enlargement of middle 1/3 of face.
34
Giant Cell Granuloma
**_Painless bone expansion_** Non-neoplastic lesion Some -- aggresive behavior (associated with pain, paresthesia, and perforation of cortical plate) Discoverd during xrays or painless bone expansion ***_More common in ANTERIOR jaw - frequently cross the midline_***
35
Central Giant Cell Granuloma - XRAY manifestations
Not diagnositc!! Radiolucent lesion -- **_multilocular OR unilocular_** Well delineated Noncorticated margins Histo -- similar to brown tumor of hyperparathyroidism and lesions of cherubism (patients must be evaluated for hyperparathyroidism) **Cellular, vascular stroma, prominent multinucleated giant cells** Treatment: Curettage with recurrence (20% of the time) No risk of metastasis
36
Central Giant Cell Granuloma
***_NONNEOPLASTIC lesion_*** *_(no unlimited growth)_* Some may demonstrate aggressive behavior -- and act like a neoplastic lesion ***_ANTERIOR JAW -- CROSSES MIDLINE_*** (Most things tend to NOT cross the midline) Young adults Painless bone expansion -- some can cause pain (minority) _Xray:_ RL lesion with multilocular or unilocular Well delineated Noncorticated margins _Histo:_ Identical to brown tumor of *_hyperparathyroidism_* and lesions of *_cherubism_* Giant cell _Treatment:_ Curettage -- liklihood of recurrence Good long term prognosis
37
What lesions most commonly crosses the midline?
Central giant cell granuloma
38
What are the xray features of _Central Giant Cell Granuloma (4)_
Not diagnostic RL lesion -- multilocular or unilocular Well delineated Noncorticated margins (aggressive growth)
39
What is the histology of central giant cell granuloma similar to?
Brown tumor of hyperparathyroidism Lesions of cherubism
40
Nonneoplastic
Central Giant Cell Granuloma
41
Cherubism
AD inherited condition **Bilateral involvement of _posterior_ mandible that produces chubby cheeks.** Due to overgrowth of GIANT CELLS -- will displace bone. Will regress after puberty. Symptoms: Eyes turned to heaven - wide rim of exposed sclera below iris (due to **_infraorbital rim_** involvment) Enlarged cheeks - due to displace bone in posterior mandible Stretching of upper facial skin May lead to failure of toot eruption **_Mandibular lesions_** -- painless, bilateral, posterior, expansile **_Maxillary_** -- posterior involvemed ***_Marked widening and distortion of the alveolar ridges_***
42
Cherubism Xray features:
Multilocular Expansile Radiolucent (Identical to those in central giant cell granuloma)
43
Cherubism treatment
Typically regresses after puberty BUT... Early surgical curretage may lead to good results or rapid regrowth with worsening deformaty NO radiation indicated --\> due to postirradation sarcoma
44
Cherubism
45
Cherubism
46
Traumatic Bone Cyst
"simple bone cyst" ***_benign, EMPTY or fluid filled cavity within bone_*** NOT a true cyst -- *_lesion does not have an epithelial lining_* Trauma hemorrhage theory Young patients _Xray:_ Well delineated RL Margins ill or well defined ***Dome like projections - SCALLOP between roots*** **_teeth are VITAL_** Treatment: surgical exploration is necessary. Typically curative. Cause bleeding and new bone will form to fill in the void
47
Traumatic Bone Cyst -- Trauma hemorrhage theory
48
49
Traumatic Bone Cyst EMPTY cavity when surgically explored
50
Aneurysmal Bone Cyst
Intraosseus accumulation of ***_blood filled spaces surrounded by CT_*** \*\* ***_NOT a true cyst_*** -- no epithelial lining\*\* Posterior Mandible Clinical manifestation --\> Swelling that develops rapidly, Painful _Xray:_ RL lesion -- marked cortical expansion and thinning (ballooning) **Uniloculuar** - can be multilocular Variable borders Described as "BLOW OUT" -- ballooning distention of affected bone Surgical exploration: **_Surgical soaked sponge_** Treatment: Curretage or enucleation No need for bone graft - new bone formation Good prognosis
51
Blood soaked Sponge
Aneurysmal bone cyst
52
Ballooning distention of cortical bone
Aneurysmal Bone Cyst
53
Ballooning distention **Aneurysmal Bone Cyst**
54
Fibrous osseous lesions
Replacement of NORMAL bone by fibrous tissue containing mineralized product (No fibrous CT in bone normally) Clinical and radiographic findings are necessary to establish a diagnosis. **_Benign Fibro-osseus lesions:_** Fibrous dysplasia Cemento-osseus dysplasia Ossifying fibroma
55
Examples of Benign Fibro-osseus lesion
Fibrous dysplasia Cemento-osseus dysplasia Ossifying fibroma
56
Fibrous Dysplasia
Tumor like condition **Fibrous CT intermixed with bone** ***_POST ZYGOTIC MUTATION_*** Depending on when the mutation takes place the process involve: 1 bone --\>monostotic multople bones --\> polyostotic Skin Endocrine system Two types: Monostotic, polyostotic
57
Fibrous Dysplasia -- MONOSTOTIC
**Majority of fibrous dysplasia cases** JAW --\> mx \>mn Teenage years Painless, slow growing swelling Involvement of MANDIBLE --\> leads to expansion of both BUCCAL and LINGUAL plates Involvement of MAXILLA -- can lead to maxillary sinus _Xray:_ ***Ground Glass Opacification*** Poorly calcified bone in a disorganize fashion Not well demarcated --\> margins blend into adjacent normal bone
58
What type of fibrous dysplasia accounts for the majority of cases?
Monostotic
59
Radiographic appearance of **_Ground Glass_**
Monostotic Fibrous Dysplasia
60
Fibrous Dysplasia -- Monostotic Ground Glass Appearance
61
Fibrous Dysplasia -- Polystotic
Involvement of two or more bones Two Disease: Jaffe-Lichtenstein and McCune - Albright Syndrome Clinical management - challenging Disease tends to stabilize and stop growing at skeletal maturity No radiation therapy Surgical removal - best option
62
Cemento Osseeous Dysplasia
Tooth bearing areas of the jaw MOST COMMON - fibrous osseous lesion encounterd in practice Three types: Focal Periapical Florid
63
Three types of Cemento osseous dysplasia
Focal Peripheral Florid
64
Jeffe-Lichtenstein Syndrome
Type of fibrous dysplasia POLYSTOTIC Cafe au lait spots (coast of main - rough)
65
McCune- Albright Syndrome
Polystotic fibrous dysplasia Cafe au late (coast of maine) **multiple endocrinopathies** _Multiple endocrinopathies:_ Sexual percocity Pituitary adenoma hyperthyroid
66
Multiple endocrinopathies of McCune Albright Syndrome
Sexual precocity -- early onset puberty Pituitary adenoa Hyperparathyroidism
67
Focal Cemento Osseous Dysplasia
**SINGLE site of involvement** Females, 40, caucasians **_POSTERIOR mandible_** Asymptomatic _Xray:_ Completely radiolucent -- Densely radiopaque (depends on calcification: less -- RL, more --RO) Radiolucent rim Commonly mixed RL and RO pattern Lession is usually well defined
68
Focal Cemento osseous dysplasia posterior mandible -- common RL rim, RO or RL lesion
69
Periapical Cemento - Osseous Dysplasia
_Periapical region of_ ***_ANTERIOR MANDIBLE_*** **MULTIPLE foci** 40, female, AA Teeth are vital Asymptomatic Early lesions --\> circumscribed areas of RL involving apex of tooth End stage lesion --\> densely RO with RL rim PDL will be intact -- the lesion will not fuse to the tooth (FUSION to tooth -- cementoblastoma) ***Self limiting-- NO progressive growth***
70
Periapical Cemento osseuos dysplasia
71
Also associated with a ground glass appearance
Fibrous dysplasia monostotic Involvment o mandible --\> leads to expansion of buccal and lingual cortical plates
72
Florid Cemento - osseous dysplasia
**MULTIPLE focal involvment** -- ***_NOT limited to anterior mandible_*** Female, AA Bilateral and symmetrical Asymptomatic Xray: Lesions demonstrate identical patterns of maturation Initial lesion -- RL Overtime become RO -RL mixed End stage -- predominately RO DON'T extract the tooth -- don't want to open bone to cause further infection
73
Florrid Cemento-Osseous Dysplasia Mutlifocal Bilateral and symmetrical
74
Ossifying Fibroma
**NEOPLASM** with significant growth potential **_fibrous CT containing variable mixture of bone and cementum_** Wide range of age *_Female Mandibular_* Small lesions -- do not cause symptoms and are detected by xray LARGE TUMORS -- painless swelling _Xray:_ Well defined Unilocular Completely RL or more commonly RL-RO mix ***Root divergence or resorption of roots occur*** ***_DOWNWARD bowing of the INFERIOR CORTEX of mandible_*** Treatment --\> enucleation Prognosis good, recurrnece rare DO NOT undergo malignant transformation
75
Ossifying Fibroma Mandible Downward bowing of inferior cortex of mandible Root divergence Unilocular LARGE tumor
76
Juvenile (active) ossifying fibroma Distinguised from ossifying fibroma because of.. (3)
Distinguished from ossifying fibroma: Age Common sites Clinical behavior
77
Juvenile (acitve) ossifying fibroma
Slowly progressive growth -- some exhibit Rapid growth Well circumscribed Lesions are typically --\> ***_RL with central RO_*** Two types: TRABECULAR and PSAMMOMATOID (more common) *_MALE MAXILLARY_* The younger the pt --\> MORE aggressive the tumor Treatment -- curettage (small lesions), wide resectio (rapid large lesions) ***_NO malignant transformation_*** Recurrence may occur (30-60%)
78
Two types of Juvinille Ossifying Fibroma
Psammomatoid Trabecular BOTH occur in *_MALES in the MAXILLA_*
79
Juvinille Ossifying Fibroma MAXILLARY - large and aggressive RL with RO center
80
Osteoma
**Benign tumors of mature bone** _ARISE on the surface of bone or withing medullary bone_ Head and Neck --\> Inferior border of mandible, forehead. Somewhere on the head and skull. More commonly in the SINUS (looks radiographically the same as antral pseudocyst Attached mucosa --\> tori *_May cause pain, swelling, sinusitis, or nasal discharge_* **Can continue to GROW** Treatmet --\> conservative excision Rarely reoccur ***_ASSOCIATED WITH GARDNER'S SYNDROME_***
81
Gardner Syndrome
**Bowel Polyps** -- will transform into adenocarcinoma (around 30yrs) **Osteomas** (skull, sinus, and mandible), multiple **Supernumerary teeth** **Impacted teeth** **Odontomas** Prophylacticlly --\> will REMOVE the colon
82
Osteoma
83
What 2 syndromes have supernumerary teeth?
Cleidocranial Dysplasia Gardner Syndrome
84
Osteoblastoma vs Osteoid Osteoma
Closely related **BENIGN bone tumors** *_arise from OSTEOBLASTS_* Histo --\> identical Produce prostaglandins --\> **_OSTEOID OSTEOMA is smaller and produces less therfore pain can be relieved by ASPIRIN_** Osteoid osteoma --\> smaller than 2 cm Osteoblastoma --\> larger than 2 cm Treatment --\> local excision or curretage Malignant transformation is rare
85
Osteoblastoma
RARE, occurs in the jaws MD\>MX Posterior\>anterior **_2-4 cm_** **Pain, tenderness, and swelling** ***_pain is NOT relieved by aspirin_***
86
Osteoid Osteoma
Rare in the jaw ***_PAIN_*** -- nocturnal and relieved by aspiring Xray: Well circuscribed RL Less than 1 cm Small RO nidus --\> TARGET LIKE APPEARANCE
87
Osteoid Osteoma Nocturnal pain relieved by aspirin
88
89
Cementoblastoma
Odontogenic neoplasm of cementoblasts **_MANDIBLE - molar and premolar region_** Typically on permanent teeth Xray: RO mass fused to tooth root -- NO PDL Outline of root is obscured Surrounded by RL rim Treatment --\> surgical extraction of the tooth with calcified mass
90
Cementoblastoma
91
Chondroma
Benign tumor of cartilage Diagnosis of jaw with skepticism -- most examples occur in condyle or anterior maxilla **RL with a central RO** *_May be a potential CHONDROSARCOMA_*
92
Synovial Chonromatosis
Rare Benign Nonneoplastic **Develpment of cartilaginous nodules within the synovial membrane** _Can affect the TMJ_ middle aged xray: **loose bodies seen (joint mice)** Treatment --\> removal of synovium and loose bodies Low recurrance
93
Synovial Chondromatosis Loose bodies -- joint mice
94
Osteosarcoma
**MESENCHYMAL malignancy** Production of osteiod or immature bone through uncontrolled growth One of the most common malignancy to originate in the bone (besides leukemia and langerhans histocytosis) **Intramedullary** **Juxtacortical** **Extraskeletal** Extragnathic osteosarcomas -- 10-20 years old, 50 years old Jaw osteosarcoma --\> 7% of all osteosarcomas Mandibular -- posterior jaw Maxillary -- inferiorly ( alveolar ridge, sinus floor, palate) Symptoms: **Pain and Swelling** *_Jaw lesions--\> less likely to metastasize_*
95
Osteosarcoma Radiographic Appearance
**Spiking resorption** of roots -- Tappered narrowing of root **SUNBURST APPEARANCE** - best seen withan occlusal xray **Codman's Triangle** -- triangular elevation of periosteum Early finding --\> SYMMETRICAL widening of the PDL or one or more teeth
96
Most common location for osteosarcoma in young adults
Distal femur Proximal Tibia
97
Osteosarcoma SUNBURST appearance Spikin resorption
98
Postirradiation Bone Sarcoma
Sarcoma arising in the bone that has been previously subjected to radiation therapy Well recognized phenomenon _*May develop **3 years -- 15 years***_ *_following radiation_*
99
Chondrosarcoma
**MALIGNANT bone tumor of _Cartilage_** MAXILLARY\>mandibular Painless mass or swelling May be associated with separation or loosening of teeth RL poorly defined borders Variable amounts of RO foci +/- root resorption, symmetrical PDL widening **_Demonstrate extensive infiltration between osseous trabeculae or preexisting bone without causing significant resorption_** - tumor is difficult to determine the extent radiographically Death -- due to direct extension into vital structures rather than metastases. Best treatment -- tumor resection
100
Ewing Sarcoma
Primary MALIGNANT tumor of bone 3rd most common osseous neoplasm -- osteosarc and chondrosarc **_Translocation in chromosome 11 and 12_** Long bones - Jaws affect 2% of the time *_PAIN, swelling_* *_Parasthesia and loosening of teeth are common findings in oral_* Xray: Irregular RL with ill-defined margins Onionskin periosteal reaction **Frequently metastasize**
101
Metastaic Tumors to the Jaws
Metastatic carcinoma is the MOST COMMON form of cancer involving bone Most common origin of gnathic mets: Breast Lung Thyroid Prostate Kidney _Affects older patients_ Majority occurs in the MANDIBLE Symptoms: Pain Swelling Loosening of teeth Parasthesia Numb-chin syndrome Mets may be discoverd in a nonhealing ext site **MOTH EATEN -- worrisome category of bone lesions** **POOR prognosis - stage IV disease** 5 year survival is exceedling rare succumb to cancer within a new year
102
Moth-eaten: Worrisome Category of bone lesions
Metastatic Tumors of the jaw
103
Codman Triangle Osteosarcoma

Oral Pathology (17 decks)

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