Disease of Bone/ Systemic Disease Flashcards
What is fibrous dysplasia?
A benign developmental abnormality
Bone is replaced by calcified fibrous tissue
How does early FD appear radiographically?
Early lesions tend to be radiolucent with well-defined border
What happens as lesion matures?
More bone is laid down = mottled radiopacity ‘orange peel’
How does mature FD appear radiographically?
Ill-defined margins, orange peel look
What are complications of FD?
Bony expansion
Lesions maxilla can occlude sinus
Teeth displaced
Root resorprtion
What does FD resemble?
Paget’s
How to differentiate FD and Pagets?
FD is uncommon middle/ old age
FD unilateral unlike Paget
What is cherubism?
Rare inherited fibro-osseous disease of jaw which develops in infancy
How does cherubism present?
Painless bilateral expansion of the lower face - followed expansion maxilla
What would you see radiographically in cherubism?
Cyst-like radiolucent lesions at posterior aspect of mandible bilaterally, expand into rami and body
Well defined causing bony expansion not cortical perforation
Consequence of cherubism?
Bony expansion
Tooth buds displaced/ destroyed
Primary teeth exfoliated early
What is Paget’s disease?
Abnormal resorption and disposition of osseous tissue in bones
Affects middle and old age
Where is Paget’s commonly seen
Skull
How does Paget affect oral cavity?
Affect maxilla > mandible
Enlargement - space between teeth/ dentures not fitting
Can cause hypercementosis
What does Paget cause?
Enlargement of bones = COMPRESSION OF NERVES
How does Paget’s appear radiographically?
Bony expansion and ‘cotton wool’ appearance
Bone deposition - hyperostosis - thickening and expansion
What is osteoporosis?
Persistence of calcified cartilage and marrow spaces obliterated = issue haemopoiesis
Bones become very fragile
Oral consequences of osteoporosis?
Delayed eruption and early loss of teeth- children
Cortical structures - lamina dura/ mandible canal walls can be obscured dense bone
What causes hyperparathyroidism?
Excess circulation PTH which activates osteoclasts causing Ca to be mobilised from skeleton
What happens in hyperparathyroidism?
Ca leached from bones - bones look ‘radiolucent’
What radiolucent lesions can be associated w/ hyperparathyroidism?
Brown cell tumour - expansile radiolucent lesion w/ honeycomb pattern
What is hyperpituitarism?
Excessive production of growth hormone
In childhood = gigantism
In adults = acromegaly
What are the characteristics of acromegaly?
Increased length of ramps and body of mandible
Enlargement paranasal sinus
Prognathic chin - class III
Large hand
What would you see on lateral skull radiograph in acromegaly?
Ballooning of sella turcica
Expanded pituitary fossa
What is sickle cell anaemia?
Chronic haemolytic blood disorder- red blood cells rapidly destroyed = hyperplasia of bone marrow
What happens to bone marrow is sickle cell anaemia?
Expansion of the bone marrow - marrow hyperplasia = thinning cancellous trabeculae
What do you see in-between the teeth of sickle cell anaemia pt?
Bony trabeculae coarse = step ladder pattern
