Exam 1 - RO Flashcards
Name the lesion:
Focal bone sclerosis (dense bone) associated with the apex of a tooth exhibiting pulpal inflammation or necrosis.
Condensing Osteitis
How would you differentiate between Condensing Osteitis and Idiopathic Osteosclerosis?
Condensing Osteitis- Uniform RO, Widened PDL, Non-vital tooth, Sclerotic bone, Not a uniform homogenous look you should see RL in between
Idiopathic Osteosclerosis - VItal teeth, Dense RO, well-defined borders, Usually more homogeneous, “smooth quality”, and NO apical RL, not inflammatory in nature
T/F Idiopathic Osteosclerosis 50% of the time is located in the mandible, usually in the anterior region.
False - Idiopathic Osteosclerosis 90% of the time is located in the mandible, usually in the posterior premolar region.
T/F Both condensing osteitis and idiopathic osteosclerosis have sclerotic bone.
True
For idiopathic osteosclerosis you can sometimes see spicule into surrounding normal bone.
T/F Idiopathic osteosclerosis has symtpomatic teeth.
False usually they don’t
What age does idiopathic osteosclerosis often arise?
Children / Adolescence
T/F Idiopathic osteosclerosis remains static or slow increase until maturity.
True
How do you treat condensing osteitis? What is the regression percent with tx?
EXT or RCT with 85% partial or total regression
What is another name for bone scar?
Residual condensing osteitis
All RO lesions we talked about are vital except for _______ ________.
Condensing Osteitis
Antral pseudocyst vs Chronic Sinusitis. How would you differentiate?
Chronic sinusitis usually presents with Headache, fever, and pain from several teeth due to nasal congestion/discharge.
Radiographically - chronic sinusitis is cloudy sinus, not a well defined uniform dome-shape like antral pseudocyst.
What is the etiology of antral pseudocyst?
Not precisely known, possible adjacent odontogenic infection or sinus lining irritation from sinus infections or allergies
T/F Antral pseudocyst are not common.
False
Antral Pseudocyst are a dome shaped ___ filled sac. Radiographically they are Homogenous RO that is seen arising from the floor of the _____ sinus due to accumulation of inflammatory (serous) ________ underneath the sinus mucosa.
Antral Pseudocyst are a dome shaped fluid filled sac. Radiographically they are Homogenous RO that is seen arising from the floor of the Mx sinus due to accumulation of inflammatory (serous) exudate underneath the sinus mucosa.
When would you treat a antral pseudocyst?
only treat if there are significant symptoms (expansion, pain)
Tonsillar Concretions (Tonsillothiasis):
Bacteria, foreign material and ________ _____________ accumulation in the tonsillar crypts forms compacted, foul smelling tonsillar concretion. If it calcifies it’s called a ___________.
Bacteria, foreign material and desquamated keratin accumulation in the tonsillar crypts forms compacted, foul smelling tonsillar concretion. If it calcified it’s called a tonsillolith.
While Tonsillar Concretions are not acutely painful, they can predispose to……
recurrent tonsillar infection leading to pain/abscess
What are ways to tx symptomatic cases of Tonsillar Concretions?
Remove with salt water gargling or waterpik
Enucleation/curettage
Laser cryptolysis
Tonsillectomy
Name that lesion: Benign Osseous tumor, usually affecting membranous bone
Osteoma
T/F Osteomas are painful and grow fast.
False painless and slow growth
What is common to occur with osteomas?
Paranasal sinus involvement - not along lower border of sinus like antral pseudocyst it would be like actually in the sinus
What region are osteoma jaw lesions usually found in?
Condylar area and Lingual posterior mandible
How can you tell the difference of osteoma and tori?
They are both exophytic masses on bone (periosteal) but osteomas grow overtime where as tori don’t.
T/F: Osteoma can sometimes happen intramedullary (endosteal or central) similar to end stage inflammatory process (Condensing osteitis) or scelerotic bone (Idiopathic osteosclerosis) .
True
Histologically tori, condensing osteitis, idiopathic osteosclerosis, and osteomas are identical.
True but osteoma has continual growth
What should you always rule out before diagnosing jaw osteomas?
Gardner syndrome
Name that lesion: Autosomal dominant. There is a mutation in adenomatous polyposis coli (APC) tumor suppressor gene (means there is growth promotion).
Gardner syndrome
Gardner syndrome is one of the multiple ________ __________.
polyposis syndromes
What is gardner syndrome characterized by (3 things)?
- Osteomas of facial bone
- Skin lesions - epidermoid cyst and desmoid tumors (aggressive fibrous lesion)
- Impacted supernumerary teeth or less commonly odontomas
Development of precancerous polyps in the colon is a major concern for gardner syndrome. What percentage develop colon cancer and by what age usually?
50% develop colon cancer by age 30
Nearly 100% affected later in life
Particularly in women it is important to diagnose gardner syndrome because there’s an increase risk in ________ ________ also.
Thyroid carcinoma
How do you tx gardner syndrome?
Prophylactic colectomy
removal of cosmetically problematic cysts and osteomas
genetic counseling
