Differential Diagnosis: Radiolucent Lesions Flashcards
What is the Differential Diagnosis of a Periapical RL? (2)
-
PA Granuloma/Cyst
- __Non-vital tooth
- Lamina dura is gone
- From Rests of Malassez
-
Apical Scar
- __Area where bone was destroyed and didn’t fill in
What tooth is most likely to have an Apical Scar?
Maxillary lateral incisor
What lesions can fool us into thinking they are Perapical RL? (5)
- Lateral Periodontal Cyst
- Odontogenic Keratocyst
- Langerhans Cell Disease (Eosinophilic Granuloma)
- Central Giant Cell Granuloma
- Cementoma (Periapical COD)
Which false PARL are seen in vital teeth?
-
Lateral Periodontal Cyst
- Diagnostic histo: epithelial plaques = swirled squamous cells
-
CGCG
- Mandibular Anteriors
- Young Females
-
Cementoma - Early Lesion
- Mandibular Anteriors
- Black Females > 40 yrs
- Can see root outline
How do you differentiate a PARL that appears in the posterior mandible, that erodes bone/”scoops it out”?
- Adult = OKC
- Not epicentered, resorbs roots and teeth
- Young Persons = Eosinophilic Granuloma
- ”teeth floating in air”
What is the Differential Diagnosis for Unilocular Pericoronal RL? (8)
“The HOA doesn’t like is when my dad drinks CORONA(L) in the garage with the AUDIO loud.”
- Hyperplastic Dental Folicle
- Odontogenic Keratocyst
- Ameloblastic Fibroma
- Adenoid Odontogenic Tumor
- Unicystic Ameloblastoma
- Dentigerous Cyst
- Intraosseous SCC
- Odontogenic Mxyoma
What is the Differential Diagnosis for a Unilocular Pericoronal RL, that is acting aggressive and resorbing the root?
- OKC
- Unicystic AB
- Odontogenic Myxoma
What is the diagnosis for a Unilocular Pericoronal RL if it is < 4mm?
Hyperplastic Dental Follicle
What is the diagnosis for a Unilocular Pericoronal RL if it is > 5mm?
Dentingerous Cyst
Which Unilocular Pericoronal RL is a mixed tumor (2 germ layers), that recurs and can transform?
Ameloblastic Fibroma
Which Unilocular Pericoronal RL’s most commonly occur in the posterior mandible, around an unerupted 3rd molar? (4)
- Dentingerous Cyst
-
OKC
- Adult
-
Unicystic Ameloblastoma
- Young
-
Ameloblastic Fibroma
- Young
What are the other Unilocular RL’s? (10)
“The OTHER UNIformed SHORTIES get BJ’s”
- Surgical Ciliated Cyst
- Hematopoietic Bone Marrow Defect
- Ossifying Fibroma
- Residual Cyst
- Traumatic Bone Cyst
- Incisive Canal Cyst
- Early, Focal COD
- Schwannoma
- Buccal Bifurcation Cyst/Paradental Cyst
- Juvenille Ossifying Fibroma
What is the Differential Diagnosis for a Globulomaxillary RL in a young person? (2)
Young Females
-
Central Giant Cell Granuloma
- Typically in the anterior mandible assoc with vital teeth
-
Adenomatoid Odontogenic Tumor
- Anterior maxillar - impacted canine
What is the Differential Diagnosis for a Globulomaxillary RL in an adult? (4)
“GOLD”
-
Glandular Odontogenic Cyst
- No keratin
- Prefers anterior
- VITAL
-
Odontogenic Keratocyst
- Rare
-
Lateral Periodontal Cyst
- Males >40 yrs
- 25% max incisor area
- VITAL
-
Desmoplastic Ameloblastoma
- Ground glass RO, not pure RL
What is the Differential Diagnosis for Lytic Destruction of Alveolar Bone (moth-eaten, destroying the crest of the ridge - must biopsy)? (8)
“CLOMPing around will DESTROY your BONES”
- CGCG
- Lipid Granuloma
- Langerhan Cell Ds
- OKC
- Osteomyelitis
- Malignancy
- SCC
- Osteo/Chondrosarcoma
- Lymphoma
- Metastatic Lesion
- Perio Ds
- Pulse Granuloma
