Exam 1 - Radiolucencies Flashcards
Radiolucencies Only
Most common odontogenic cyst
Periapical granuloma / cyst
Periapical granuloma / cyst :
Unilocular or multilocular
Always unilocular
Apex of a non vital tooth; cant distinguish by size or radiographic appearance
Periapical granuloma / cyst
Periapical granuloma / cyst between teeth
lateral radicular cyst
When a tooth is extracted without taking care of a Periapical granuloma / cyst what is left behind
residual periapical cyst
Point of drainage for sinus tract of a necrotic tooth
Parulis
Lined by epithelium, can be developmental or inflammatory
Cyst
Second most common odontogenic cyst
Dentigerous cyst
Dentigerous cyst arises from
reduced enamel epithelium
Unilocular around the crown of a tooth
Dentigerous cyst
what is the most common mimc of a dentigerous cyst
OKC (then unicystic ameloblastoma)
A small dentigerous cyst lesion is virtually identical to
hyperplastic dental follicle
In the soft tissue overlying the crown; can be bluish because of blood
eruption cyst
Usually unilocular, but can look multilocular. In the mandible, canine / premolar area between teeth
Lateral periodontal cyst
Where does the lateral periodontal cyst derive from
dental lamina rests
With a lateral periodontal cyst are teeth vital or non vital?
Teeth are vital (different from lateral radicular cyst)
Identical to lateral periodontal cyst but in soft tissue not bone
gingival cyst of the adult
Teeth are vital, radiolucency between apices of #8-9
Nasopalatine Duct cyst (incisive canal cyst)
When is a Nasopalatine Duct cyst (incisive canal cyst) abnormal / too big to have this diagnosis
> 6mm = abnormal because the canal cant get bigger than that
Unilocular or multilocular, looks like many other lesions
Odontogenic keratocyst (OKC)
Tunnels through bone instead of expanding
Odontogenic keratocyst (OKC)
Odontogenic keratocyst (OKC) is derived from
Dental lamina rests
In this syndrome OKC’s in the jaw are characteristic (More than 2 lesions = syndrome)
Nevoid basal cell carcinoma syndrome (Gorlin syndrome)
What is another name for Nevoid basal cell carcinoma syndrome
Gorlin syndrome
What are 5 characteristic features of Nevoid basal cell carcinoma syndrome besides OKCs
Bifid ribs
Basal cell carcinoma
Calcified falx cerebri
palmar / plantar pitting
increased cranial circumference
Big hole in bone with no lining
Simple bone cyst (traumatic bone cyst)
Who usually gets simple bone cysts
young patients (10-20 years old)
Teeth are painless and vital, lesion is in the mandible only and scallops up between the roots, unilocular
Simple bone cyst (traumatic bone cyst)
Benign odontogenic epithelial tumor
Ameloblastoma
Found in the mandible, most often the posterior, unilocular or multilocular, soap bubble or honeycomb
Ameloblastoma
More round and expansive than OKC
Ameloblastoma
Unilocular, pericoronal to un-erupted 3rd molar
Unicystic ameloblastoma
Visual intraorally, any odontogenic cyst or tumor can do this
Peripheral ameloblastoma
What are 2 “other” benign odontogenic tumors
Ameloblastic fibroma
Odontogenic fibroma
Ameloblastic fibroma (4 things)
Posterior Jaw
<20 years
Unilocular
Impacted tooth
Odontogenic fibroma is found
in both jaws
<30 years
Mandible, anterior, can cross midline
Expansile, unilocular or multilocular
Central giant cell granuloma
What do you have to rule out when you suspect central giant cell granuloma
Rule out brown tumor (hyperparathyroidism)
Developmental in bone due to normal salivary gland tissue (thinning of bone)
Stafne Defect (stafne bone cyst: not a cyst)
Found below inferior alveolar canal
Stafne defect (stafne bone cyst: not a cyst)
Found within the mandibular canal
Schwannoma / Neurofibroma in bone
AV malformations
Bony vascular malformations
Multilocular, trabeculation
Pulsation, bruit, warm, bright red blood
Bony vascular malformations
What needs to be taken if a Bony vascular malformations is suspected
An angiogram
Found in the mandible at an old extraction site
Focal osteoporotic marrow defect
Pain, tooth mobility, numb chin
Radiolucent malignancies involving bone
Radiolucent malignancies involving bone
Children vs adults
In children
leukemia/lymphoma, rhabdomyosarcoma, Ewing sarcoma
In adults
Metastatic carcinoma (most often mandible), lymphoma, multiple myeloma (multiple punched out radiolucencies)
In soft tissue or in the jaw (with time perforation into soft tissue)
Non-hodgkin lymphoma
Ill defined, pain, numb chin but the teeth are not effected
Non-hodgkin lymphoma
Punched out
70 years
Multiple areas
Multiple Myeloma
What is associated with a multiple myeloma
renal insufficiency
recurrent bacterial infections
What are the 6 developmental cysts
Dentigerous cyst
Eruption cyst
Lateral periodontal cyst
Gingival cyst of the adult
Nasopalatine duct cyst
Odontogenic Keratocyst
If you see a multilocular lesion what 5 things could it be
Lateral periodontal cyst
Odontogenic keratocyst
Ameloblastoma
Central giant cell granuloma
Bony vascular malformations
Which radiolucencies have pain
Periapical granuloma/ cyst (acute= pain)
Central Giant Cell Granuloma (Can have pain but doesn’t have to)
Schwannoma/ Neurofibroma in bone
Radiolucent malignancies involving bone
Non- Hodgkin Lymphoma (Vague pain)
Multiple Myeloma
How can you tell the difference between a residual periapical cyst and a focal osteoporotic marrow defect
Histology tells you the difference
focal osteoporotic marrow defect = fatty and hematopoietic marrow
(also only in the mandible)
Residual periapical cyst= thick, non-keratinized epithelial lining
