Diseases of Bone - BFOL Flashcards
describe the benign fibro osseous lesion
- altered condition of bone
- normal bone replaced
- proliferation of fibrous connective tisuse
- new mineralized component
- developmental lesions
- reactive or dysplastic processes
- neoplasms
what are the 3 benign fibro osseous lesions
- fibrous dysplasia
- osseous dysplasia
- ossifying fibroma
what are the 3 types of osseous dysplasia
- periapical cemento osseous dysplasia
- florid cemento osseous dysplasia
- focal cemento osseous dysplasia
what are the 2 types of fibrous dysplasia
monostotic
- polyostotic
describe monostotic fibrous dysplasia
- common
- craniofacial
what are the two types of polyostotic fibrous dysplasia and describe each
- mcCune albright sydrome: severe, bone, skin and endocrine lesions
- Jaffe- Lichetenstein syndrome: mild, bone and skin lesions only
how does fibrous dysplasia appear on radiographs
- ground glass appearance
- shepards hook femur bone
- expansion of bone
what are the histology features of fibrous dysplasia
looks like chinese characters
what is the gene involved in fibrous dysplasia
- postzygotic GNAS 1 mutation- codes for a g protein and results in hyperfunction of cells in the involved tissues
the clinical severity of fibrous dysplasia depends on:
the point in time the mutation occurs
what cells and features are involved with early embryonic life in undifferentiated stem cell fibrous dysplasia
- osteoblasts: multiple bone lesions
- melanocytes: cutaneous pigmentation
- endocrine cells: endocrine distrubances
what cells and features are involved in later emryonic life in skeletal progenitor cell fibrous dysplasia
- osteoblasts
- multiple bone lesions, cutaneous pigmentation
what are the cells and features involved in postnatal life fibrous dysplasia
- osteoblasts
- single bone lesion
describe cemento osseous dysplasia
- benign fibro osseous process
- abnormal reaction of bone
- the most common benign fibro osseous lesion of the jaws
- probably arises from elements of the PDL
describe periapical cemento osseous dysplasia
- a benign fibro osseous lesion located in the periapical region of the anterior mandible
- females 10:1
- blacks 70%
- ages 30-50 years
- aasymtpmatic associated with vital teeth
- solitary or multiple
- early lesions lucent
what are the radiographic stages of periapical cemento osseous dysplasia
RL (osteoclastic stage) -> mixed -> RO (osteoblastic stage)
are the teeth in periapical cemento osseous dysplasia vital
yes
what is seen in the histo of PA cemento osseous dysplasia
bone and fibrous CT
describe florid cemento osseous dysplasia
- middle aged adults, strong racial predominance for african americans, strong female gender predominance
- multifocal involvement, often bilateral and symmetric four quadrant involvement not unusual
- lucent - mixed - opaque with thin peripheral RL rim
- usually asymptomatic, possiblly dull pain, expansion rare
- associated with simple bone cysts
what is the predilection for focal cemento osseous dysplasia
- middle aged adults mean 38 years
- strong female gender predominance
- possible racial predominance but not really
- posterior mandible commonly
- frequently in extractio nsite
- thin peripheral radiolucent rim
describe the cemento ossifying fibroma and its predilection
- benign neoplasm
- age 20-40 years old
- female predilection
- molar and pre molar region of mandible most common
- radiolucent to mixed
- expansion may displace teeth
- may arise from elements of the periodontal ligement
what is the biopsy feature of cemento ossifying fibroma
all comes out in one piece
what is the histo for cemento ossifying fibroma
fibrous CT and bone
how should you differentiate ossifying fibroma and fibrous dysplasia since both histo look the same
clinical and radiographic dx
