Chisturi oase Flashcards

1
Q

Keratochistul odontogen primordial

A
  • se dezvolta in locul unui dinte
  • deriva din resturi Serres/celule bazale epiteliu oral
  • caracter mai recidivant decat KOD
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2
Q

Keratochistul odontogen dentiger

A
  • in jurul unui dinte
  • deriva din epiteliu adamantin redus
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3
Q

Sindrom nevic bazocelular(Gorlin)

A
  • la copii
  • keratochisturi multiple
  • prezente simultan sau avand diferite localizari, la intervale diferite in timp, timp de cativa ani
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4
Q

Unde apar cel mai frecvent keraochisturile?

A
  • la mandibula, in dr M3
  • la maxilar, in dr M3 sau C
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5
Q

Cum arata clinic Keratochisturile?

A
  • Forme mici/uniloculare, mari/multiloculare
  • asimptomatice→mob dd adiacenti si resorbtie progresiva os
  • imping mvn-fara tulburari senzitive
  • extindere m-d>extindere v-o
  • liza corticale subtiri: vest la maxilar; mandibular-lingual lateral si vestibular in zona F si premolara
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6
Q

RX keratochist:

A
  • limite nete
  • corticalizare perilezionala
  • dinte neerupt intralezional (KOD)
  • lipsa dinte (KOP)
  • frecvent-resorbtie radacina (nu patognomonica)
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7
Q

Tratament pt Keratochist:

A
  1. Chistectomie
  2. Marsupialiazare
  3. Rezectia osoasa marginala/segmentara
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8
Q

Risc recidiva keratochisturi

A
  • >50%
  • dupa chistectomie/marsupializare
  • Factori de risc:x4
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9
Q

Ce este Chistul Folicular(Dentiger)?

A

O transformare chistica a folicului dentar, ce inconjoara dintele neerupt, mereu atasat de JS-C

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10
Q

Teorii asupra formarii chistului folicualr:

A
  • Acumulare continut chistic intre coroana si epiteliu adamantin redus
  • Acumulare lichid intre strat ext si int al epiteliului adamntin redus
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11
Q

Din ce cauze mai poate aparea chistul folicular?

A

Este chist de dezvoltare dar mai poate aparea si din cauza fenomenelor inflamatorii locale:

  • inflamatii periapicale cronice dinte decidual supraiacent
  • pericoronarita repetata dinte semiinclus-M3 mand
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12
Q

Frecventa chist folicular:

A
  • 75%- la unghi mandibula-In legatura cu M3 semiinclus
  • la nivel Cs inclus
  • orice alt dinte neerupt
  • adolescenti/tineri
  • B>F
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13
Q

Variatii rx ale chistului folicular:

A
  • cu extensie laterala
  • cu extensie vestibulara
  • circumferentiala
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14
Q

Recidive chist folicular:

A
  • rare
  • risc moderat de transformare in ameloblastom
  • rar- transformare epiteliu chistic in carcinom spinocelular
  • rer- cel. glandulare mucoase in carcinom mucoepidermoid
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15
Q

Chisturi inflamatorii

A

Chist radicular:

  • periapical
  • radicular lateral
  • rezidual
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16
Q

Semnul Dupuytren

A
  • la chist periapical
  • la palpare in vestibulul bucal, o consistenta de “minge de celuloid” sau “coaja de ou spart”
17
Q

Evolutie chist periapical

A
  • suprainfectare: abces V/P sau de spatiu fascial I
  • extindere 3D-interesare radacini dd vecini
  • evolutie indelungata- fistulizare in cavitatea orala, la tegument sau in sinusul maxilar
18
Q

Generalitati ameloblastom

A
  • cea mai frecventa tumora odontogena
  • Tumora a epiteliului odontogen
  • cu crestere lenta- dar foarte invazive
19
Q

Origini ameloblastom

A
  1. Resturi lama dentara-Serres
  2. organ adamantin
  3. epiteliu chist odontogen-derivat din rr Malsassez
  4. strat bazal mucoasa orala
20
Q

TIpuri de ameloblastom

A
  • Ameloblastom intraosos solid sau multichistic
  • Ameloblastom unichistic
  • Ameloblastom extraosos
21
Q

Frecventa Ameloblastom intraosos solid/multichistic

A
  • orice varsta, dar RAR- la 10-19 ani, si f rar sub 10 ani
  • B=F
  • Mandibula(zona M3, ram mand)>Maxilar (post)
    *
22
Q

Aspect Rx ameloblastom intraosos solid/multichistic

A
  • leziuni mici→ fagure miere
  • leziuni mari→ baloane sapun
  • frecv.-dinte intraosos(M3 mandibular)
  • RR dd adiacenti
  • uneori- pt forma multichistica→aspect RX unilocular
23
Q

Tratament Ameloblastom intraosos solid sau multichistic:

A
  • Chiuretaj tumora (recidiva 50-90%, chiar si dupa 5 ani)
  • Rezectie marginala (electie, recidiva 15-20%)
  • Rezectie segmentara si hemirezectie de mandibula cu sau fara dezarticulare (
24
Q

Recidiva si evolutie ameloblastom intraosos solid sau unichistic

A
  • recidive chiar si dupa 10 ani
  • cazuri de metastazare (fara transformare maligna)→ in ggl loco-regionali sai la distanta in alte structuri osoase
  • daca radioterapi→risc malignizare→carcinom ameloblastic
25
Q

Mecanisme patogenice pt Ameloblastom unichistic:

A
  • De novo
  • trasformare tumorala benigna a unui chist odontogen (ex: folicular)
25
Q

Mecanisme patogenice pt Ameloblastom unichistic:

A
  • De novo
  • trasformare tumorala benigna a unui chist odontogen (ex: folicular)
26
Q

Aspecte Rx Ameloblastom unichistic:

A
  • radiotransparenta uniloculara
  • asemanator cu KOD, KOP, chist radicular/rezidual
27
Q

TRatament ameloblastom unichistic:

A
  1. In situ→ chistectomie+ dispensarizare
  2. Forme microninvazive→ Rezectie mg si trat profilactic
  3. Forme invazive→ ca la ameloblastom solid sau multichistic

Recidiva de 10-20%

28
Q

Origine Ameloblastom extraosos:

A
  • rr LD-Serres
  • epiteliu bazal mucoasa orala
29
Q

CUm arata clinic ameloblastomul extraosos?

A
  • mica tumora gingivala sesila sau pediculata
  • rar peste 1,5 cm
  • nedureroasa
  • pe mucoasa gingivala vestibulara dinti laterali
  • mandibula>maxilar