Exam 3 Flashcards
Uncommon neoplasm that probably arises from PDL fibroblasts
Central Ossifying Fibroma
Central Ossifying Fibroma….
- Most common in what area?
- Most common in which people?
- Radiographic appearance:
- Pain?
- What can it do to teeth?
- Tx:
- Lower premolar/molar region
- Adult female
- Well-circumscribed radiolucency with central opacity
- No pain, asymptomatic swelling
- Cause root divergence
- Enuclueation (usually separates from bone easily in one piece)
Benign osseous tumor that primarily affects paranasal sinuses (and other craniofacial bones)?
-Painful?
Osteoma
-No
Gardner Syndrome…
- Autosomal ______.
- 1:___-___ live births
- It is one of the ____________ syndromes
- ___ gene, chromosome __
- Characterized by:
- Dominant
- 8,000-16,000
- FAP (Familial Adenomatous Polyposis)
- APC, 5
- multiple osteomas of the facial bones, epidermoid cysts, and desmoid tumors
Most significant aspect of Gardners Syndrome is the development of:
-__% of patients develop adenocarcinoma of the colon by 30 years of age
Precancerous polyps of the colon
-50
Central Giant Cell Granuloma…
- 60% of pts are what age range
- What group of people
- Common area
- Does it cross midline?
- Tx
- Prognosis
- under 30
- females (2:1)
- anterior mandible
- yes, crosses midline
- Aggressive curettage
- good
Hyperparathyroidism…
- Causes inappropriate secretion of:
- Primary is due to:
- Secondary is due to:
- Radiographically:
- “______” tumors
- parathormone
- parathryoid hyperplasia, parathyroid adenoma, parathyroid carcinoma
- renal failure (poor calcium retention and altered vitamin D metabolism)
- Loss of lamina dura and “ground glass”
- Brown
Hyperplastic response to bone in patients with poorly controlled secondary hyperparathyroidism related to end-stage renal disease:
Renal Osteodystrophy
Osteosarcoma…
- Shows production of ____ by ____ cells
- ~____ new cases in US annually
- Peak age: _____, but that’s normally long bones. osteosarcoma of the jaws is usually around __ years
- Pain?
- Affect on PDL?
-Osteoid by tumor cells
-1000
-teens
35
-Yes pain
-Symmetrically widened PDL
Most common primary bone malignancy:
-What is the most common form of cancer to involve bone?
Osteosarcoma
-Metastatic Disease
Osteosarcoma tx:
- 5 yr survival:
- Death is more often due to _______ than _____
Radical surgery, together with chemo in some cases
- 60-70%
- Uncontrolled local disease than metastasis
Which is twice as common as the other (osteo/chondrosarcoma)
OSTEOsarcome is twice as common
Chondrosarcoma…
- Group of people:
- Area:
- Common in head/neck?
- Pain?
- Are jaw lesions usually higher or lower grade?
- Adult MALES
- Femur, pelvis, ribs
- NO (only 0.1%)
- Yes
- Low grade (I or II)
Chondrosarcoma tx:
- 5yr survival:
- Death is usually due to:
Radical surgery
- 87%
- Direct extension of tumor, involving vital structures
How can metastatic deposits from malignancies below the neck affect the jaws?
Through Batson’s paravertebral plexus of veins which lack valves
Metastatic Disease…
- Area:
- Affect on tooth socket?
- __% of jaw metastases represent initial manifestation of the malignant process
- Tx:
- Prognosis
- Posterior mandible
- Doesn’t let it heal
- 22%
- Palliation, usually with radiation therapy, anti-resorptives
- VERY POOR…most die within 1 year
Most common cyst of the jaws
Periapical cyst
Periapical cyst develops due to inflammatory stimulation of:
-Inflammation through lateral canals may lead to:
epithelial rests of Malassez
-lateral radicular cyst
Most common DEVELOPMENTAL odontogenic cyst:
Dentigerous Cyst
In a Dentigereous Cyst, fluid accumulates between:
- It’s associated with the crown of an _____ tooth
- When lucent space around crown is greater than __mm, it’s considered a dentigerous cyst
- Most common site
- Most common age
the crown and the REE (reduced enamel epithelium)
- unerupted
- 3-4mm
- mand 3rd molar , followed by max canines
- 2nd-3rd decades (3rd molars erupting)
Adentigerous cyst that forms in the soft tissue
Eruption cyst
Eruption cyst color can be ___ because of ____
Blue b/c of bleeding
Rare lesion thought to be derived from degenerating tooth bud epithelium
Primordial Cyst
Which cyst develops in place of a tooth, before any mineralized material is deposited
Primordial Cyst
Usually detected as a unilocular radiolucency in the area of a missing 3rd molar (NOT surgically removed…naturally missing)
Primordial Cyst
Locally aggressive cyst associated with nevoid basal cell carcinoma syndrome:
-This specific association is suspected in pts under __yrs old
Odontogenic Keratocyst
-15
Odontogenic Keratocyst peak age:
- More common in mandible or maxilla?
- At what age is anterior maxilla more favored?
- Present as __locular radio___
- Tx depends on:
- Prognosis:
3rd decade
- Mandible twice as common
- Over 60
- UNIlocular radioLUCENCY
- Size
- guarded (3-62% recurrence)
Complex mix of malformations and neoplams exhibiting over 100 different features related to skin, CNS, and skeleton:
Nevoid Basal Cell Carcinoma Syndroma
Nevoid Basal Cell Carcinoma Syndrome…
- __ gene, chromosome __
- 40% are __ mutations
- Craniofacial features:
- Affect on skin
- Radiographic findings
- Which cysts develop in jaws
- PTCH gene, chromosome 9
- new
- Enlarged cranial circumference, heavy brow ridges
- 1-2mm shallow pits on palms and soles
- Lamellar calcification of falx cerebri
- Odontogenic Keratocysts
Presents as 1-2mm yellow-white papules on maxillary ridge of newborn
Gingival Cyst of newborn
Similar appearing lesions to gingival cyst of newborn..
- Epstein pearls:
- Bohn’s Nodules
- occur along median palatal raphe and arise from epithelium entrapped along the line of fusion
- scattered over the hard palate, often near the soft palate junction; believed to be derived from the minor salivary glands
Gingival Cyst of Adult…
- Related to ______ cyst
- Arises from:
- Area
- __ on Palpation
- Predilection?
- Tx
- lateral periodontal cyst
- dental lamina rests in the gingival connective tissue (rests of Serres)
- Attached gingiva of Canine/premolar
- tense
- None
- Conservative excision
What mimics mucocele (blue) but on ATTACHED gingiva
Gingival Cyst of Adult
Lateral Periodontal Cyst..
- Are adjacent teeth vital?
- Area
- Tx:
- yes
- mandibular premolar, maxillary lateral incisor
- Curettage
Calcifying Odontogenic Cyst…
- Aka _____ cyst
- Maxilla/mandible predilection?
- Mean age
- Scattered radiopacities in __% of cases
- __% of COC’s are associated with impacted tooth, __% with odontoma
- Resorption of adjacent roots happens in __% of cases
- Gorlin
- Nope
- 33 yrs old
- 50%
- impacted 30%, odontoma 20%
- resorption 80%
Most common odontogenic neoplasm
Ameloblastoma
Ameloblastoma..
- Sex predilection?
- Age range
- __% occur in mandible (posterior)
- __% are associated with impacted tooth
- Growth rate?
- Does it perforate bone?
- Symptoms?
- No sex pred
- Very wide 3rd-7th
- 80%
- 20%
- Slow
- no, it expands
- none except swelling
Radiograph shows poorly demarcated radiolucency with numerous radiopaque flecks
Desmoplastic Variant of Ameloblastoma
Ameloblastoma…
- Small lesion tx:
- Large lesion tx:
- prognosis:
- Does maxilla or mandible require more aggressive surgical removal (due to anatomical location)
- Small: aggressive curettage or small en bloc resection
- Large: large n bloc resection or marginal segmental resection with reconstruction
- Guarded (high recurrence)
- Maxilla
Peripheral Ameloblastoma presents as:
-Prognosis
asymptomatic gingival mass in middle-aged adult, usually mandible
-GOOD (this is an innocuous lesion that can easily be cured by local excision, low recurrence)
Calcidying Epithelial Odontogenic Tumor (CEOT)..
- aka
- mean age
- Sex predilection
- area
- __% associated w impacted tooth
- Radiographically
- tx
- __% recurrence rate
- Pindborg Tumor
- 40
- none
- posterior mandible
- 50%
- well-circumscribed radiolucency. Can have radiopaque flecks
- Conservative excision with peripheral ostectomy
- 15%
Adenomatoid Odontogenic Tumor (AOT)…
- Mean age:
- Sex predilection?
- Maxilla/mandible predilection?
- Tx:
- Prog
- 18yrs
- female 2:1
- maxilla 2:1
- Enucleation
- Excellent
Adenomatoid Odontogenic Tumor (AOT)..
- 75% occur in anterior/posterior
- __% are associated with impacted tooth
- Symptoms?
- Radiographically
- Affect on adjacent teeth?
- Anterior
- 75%
- Asymptomatic
- Well-circumscribed radiolucency w radiopaque flecks
- Separation of roots/teeth
How can you tell the difference of an Adenomatoid Odontogenic Tumor (AOT) from dentigerous cyst
When AOT is associated with impacted tooth, the lesion often extends apically beyond the CEJ
Ameloblastic Fibroma…
- Usually in younger/older
- 70% of cases in what area
- tx:
- Prog
- Malignant transformation common?
- Younger
- Posterior mandible
- aggressive curettage
- good
- NO, NOT common
Odontogenic tumor with features of ameloblastic fibroma as well as odontoma
Ameloblastic Fibro-Odontoma
Ameloblastic Fibro-Odontoma..
- mean age
- Max/mand predilection
- Radiographically it has varying amounts of calcified material having the density of:
- often associated with:
- tx:
- prog
- 10
- nope
- tooth structures
- impacted tooth
- Conservative curettage
- excellent
Odontoma…
- What are the 2 different forms?
- Mean age
- Usually associated with:
- compound or complex
- 14
- unerupted tooth
Difference of compound and complex Odontomas?
-Where are each usually seen
- Compound: collection of small malformed teeth often overlying an impacted tooth (ANTERIOR MAXILLA)
- Complex: calcified mass that has same density of tooth structure also overlying impacted tooth (POSTERIOR MAXILLA OR MANDIBLE)
Odontogenic Myxoma…
- ONLY affects which part of body:
- Average age:
- Symptoms:
- Radiographically may have “____” appearance
- Tx depends on
- Recurrence rate:
- Jaw Bones
- 25
- Asymptomatic expansion of the bone
- “soap-bubble”
- size (small=curettage…large=en bloc or segmental resection)
- 25%
Cementoblastoma…
- Area
- Age
- Sex predilection?
- Rate of growth
- Tx
- Prog
- Mandibular molar region
- Under 25
- none
- slow (can produce expansion or pain)
- Surgical extraction of involved tooth
- Excellent
What is a well-circumscribed radiOPAQUE mass with a fine radiolucent border. Fused to the resorbed root of the mandibular first molar
Cementoblastoma
