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Oral Pathology - My deck > Chapter 14 > Flashcards

Chapter 14 Flashcards

1
Q

What are some signs that bone lesions are benign?

A

Asymptomatic, grows slowly (corticated rim) and by expansion (displaces teeth and expands cortex), symmetrical, and does not metastasize

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2
Q

What are some signs that bone lesions are malignant?

A

Symptomatic, grows rapidly, invades and destroys adjacent structures, asymmetrical, ragged/poorly defined margins (destroys cortex), capable of metastases

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3
Q

What term describes a group of heritable disorders that has defective type I collagen maturation?

A

Osteogenesis Imperfecta

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4
Q

What are the characteristics of bone in osteogenesis imperfecta?

A

Thin cortex, fine trabeculation, diffuse osteoporosis, and fractures heal inappropriately

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5
Q

When is osteogenesis imperfecta usually noticed?

A

At birth, as infants are born with multiple bone fractures

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6
Q

How many people are affected with osteogenesis imperfecta?

A

About 1 in 8000

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7
Q

What are some signs and symptoms of osteogenesis imperfecta?

A

Bone fragility, blue sclera, altered teeth, hearing loss, long bone and spine deformation, joint hyperextensibility

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8
Q

What are some radiographic features of osteogenesis imperfecta?

A

Osteopenia (low bone density), bowing/angulation/deformity or long bones, multiple fractures, wormian bones in the skull

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9
Q

What are some oral manifestations of osteogenesis impefecta?

A

Teeth with a blue to brown translucency (opalescent), premature pulpal obliteration, class III malocclusion

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10
Q

What is the goal of therapy for osteogenesis imperfecta?

A

Manage symptoms, manage fractures (so patients may be on bisphosphonates)

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11
Q

What term describes a skeletal disorder with a marked increase in bone density?

A

Osteopetrosis (marble bone disease)

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12
Q

What is the cause of osteopetrosis?

A

A defect in remodeling caused by a failure of normal osteoclast function

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13
Q

What are the 2 major clinical patterns of osteopetrosis?

A

Infantile and Adult osteopetrosis

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14
Q

What is the difference between infantile and adult osteopetrosis?

A

Infantile is discovered early on and has severe manifestations with a poor prognosis. Adult osteopetrosis is discovered later in life is has less severe manifestations, with a long term survival

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15
Q

What are some of the manifestations of infantile osteopetrosis?

A

Widespread increase in skeletal density, marrow failure, frequent fractures, cranial nerve compression, facial deformities, delayed tooth eruption, osteomyleitis in post tooth infraction

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16
Q

What is another name for adult osteopetrosis?

A

Benign osteopetrosis

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17
Q

What are some significant oral complications that are a result from osteopetrosis?

A

Fracture and osteomyelitis after tooth extraction

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18
Q

What term describes a syndrome characterized by dental and clavicle abnormalities?

A

Cleidocranial dysplasia

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19
Q

How many people are affected by cleidocranial dysplasia?

A

1 in 1,000,000

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20
Q

Are the clavicles usually present in cleidocranial dysplasia?

A

Yes, but they show varying degrees of hypoplasia (they are absent in 10% of cases)

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21
Q

What are some characteristics of people with cleidocranial dysplasia?

A

Short stature, big head with pronounce frontal bossing, ocular hypertelorism, broad base of nose, unusual mobility of shoulders

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22
Q

What are some oral manifestations associated with cleidocranial dysplasia?

A

High arched palate, increased prevalence of cleft palate, retention of deciduous teeth, delayed eruption of permanent teeth, and supernumerary teeth

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23
Q

What is the treatment for cleidocranial dysplasia?

A

No treatment exists for bone anomalies, and treatment of dental problems is difficult

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24
Q

What term describes an area of hematopoietic marrow that produces a radiolucency?

A

Focal osteoporotic marrow defect

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25
Q

What is the clinical presentation of a focal osteoporotic marrow defect?

A

A lesion of variable size with ill defined borders and no jaw expansion, typically asymptomatic

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26
Q

Where and in what population do focal osteoporotic marrow defects usually occur?

A

75% in woman in the posterior mandible

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27
Q

How is a focal osteoporotic marrow defect diagnosed?

A

Incisional biopsy, but once dx is confirmed no tx is necessary

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28
Q

What term describes a focal area of increased radiodensity that is of unknown causes and cannot be attributed to anything else?

A

Idiopathic osteoscleorosis

29
Q

What are some other conditions that may be confused with idiopathic osteosclerosis, and why are they different from idiopathic osteosclerosis?

A

Condensing osteitis - infection; focal cemento-osseous dysplasia, has radiolucent rim; cementoblastoma - is fused with the tooth

30
Q

How many Americans have idiopathic osteosclerosis?

A

About 5% of Americans

31
Q

When does idiopathic osteosclerosis usually occur?

A

Cases arise in teenage years, then remain static

32
Q

What are the clinical characteristics of idiopathic osteosclerosis?

A

Asymptomatic, no cortical expansion, well defined

33
Q

Where does idiopathic osteosclerosis usually occur?

A

In the mandible, and about 80% are associated with the root apex

34
Q

When should idiopathic osteoscerosis be biopsied?

A

If there are symptoms, continued growth or cortical expansion

35
Q

What term describes a disease characterized by abnormal resorption and deposition of bone, and is of unknown cause?

A

Paget’s disease of bone

36
Q

What does Paget’s disease cause?

A

Distortion and weakening of affected bones = bowing, simian stance (monkey like stance)

37
Q

What population is most commonly affected by Paget’s disease of bone?

A

Older adults, males, caucasians

38
Q

What is a common complaint of Paget’s disease of bone?

A

Bone pain, osteoarthritis, joint pain and limited mobility

39
Q

What bones are most commonly affected by Paget’s disease of bone?

A

Vertebrae, pelvis, skull and femur

40
Q

In how many cases does jaw involvement occur in Paget’s disease of bone?

A

About 20%

41
Q

What does jaw involvement in Paget’s disease of bone result in?

A

Maxillary disease is more common than mandibular, resulting in an enlargement of the middle 1/3 of the face = leontiasis ossea (lionlike face); alveolar ridges are symmetrical and grossly enlarged

42
Q

What are some radiographic characteristics of Paget’s disease of bone?

A

Patchy or sclerotic areas (cotton wool appearance), general hypercementosis (premolars usually affected)

43
Q

What diagnostic test can be done to confirm Paget’s disease of bone?

A

A blood test = high elevations of alkaline phosphatase levels with normal calcium and phosphorous levels

44
Q

How is Paget’s disease of bone treated?

A

NSAIDs for pain, antiresorption agents for those with phosphatase levels above normal (bisphosphonates)

45
Q

What is a recognized complication of Paget’s disease of bone?

A

Development of a malignant bone tumor (osteosarcoma) in up to 10% of cases = poor prognosis

46
Q

What term describes a non-neoplastic lesion of bone, that causes painless bone expansion from medullary bone?

A

Central giant cell granuloma

47
Q

At what age and in what population are central giant cell granulomas more common?

A

Before 30, and in females

48
Q

Where are central giant cell granulomas most common?

A

In the mandible, anterior and they frequently cross the midline!

49
Q

What are some radiographic features of a central giant cell granuloma?

A

Radiolucent lesion which may be unilocular or multilocular, typically well defined with noncorticated margins

50
Q

What must patients be evaluated for if they have a central giant cell granuloma?

A

Hyperarathyroidism – histopathology identical to brown tumor of hyperparathyroidism and lesions of cherubism

51
Q

How is a central giant cell granuloma treated?

A

Currettage

52
Q

How likely is a central giant cell granuloma to recur?

A

About 20% recur

53
Q

What is cherubism?

A

A developmental, autosomal dominant jaw condition that involves the bilateral posterior mandible, and the infraorbital rim/orbital floor = chubby cheeks, wide rim of exposed sclera

54
Q

When does cherubism occur?

A

Between the ages of 2-5

55
Q

What is unique about the progression of cherubism?

A

The disease will progress until puberty then stabilize and slowly regress

56
Q

What are some oral manifestations of cherubism?

A

Widening and distortion of the alveolar ridges, and failure of tooth eruption

57
Q

What are some radiographic characteristics of cherubism?

A

Multilocular, expansile and radiolucent lesions

58
Q

What term describes a benign, empty or fluid filled cavity within bone?

A

Traumatic bone cyst, aka simple bone cyst

59
Q

Why is the name “traumatic bone cyst” a misnomer?

A

Because the lesion does not have an epithelial lining

60
Q

What is the cause of a traumatic bone cyst?

A

Trauma-hemorrhage theory is the most widely accepted etiology – clot forms and dissoves but never triggers bone formation

61
Q

What is the most common location of tramautic bone cysts?

A

Long bones, but some are found in the mandible of patients aged between 10 and 20

62
Q

What are some clinical and radiograhic characteristics of a traumatic bone cyst?

A

Asymptomatic, vital teeth, with a well defined, radiolucent defect with scalloping around teeth

63
Q

How is a traumatic bone cyst treated?

A

Surgical exploration to confirm diagnosis and is usually curative

64
Q

What term describes a blood filled cavity within bone?

A

Aneurysmal bone cyst

65
Q

Why is the term “aneurysmal bone cyst” a misnomer?

A

Because it is not a true cyst because it has no epithelial lining

66
Q

Where do aneurysmal bone cysts usually occur?

A

In long bones, but rarely in the posterior mandible of patients around 20

67
Q

What are some clinical and radiographic findings of an aneurysmal bone cyst?

A

Painful, rapid swelling with a well defined, radiolucent lesion with cortical expansion, usually unilocular = “blow out” or ballooning distention of the affected bone (BLOOD SOAKED SPONGE)

68
Q

How is an aneurysmal bone cyst treated?

A

Curretage or enucleation

69
Q

How likely is an aneurysmal bone cyst to recur?

A

About 10-60%, usually due to inadequate removal of the first lesion

Oral Pathology - My deck (22 decks)

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