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)

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

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

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

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

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

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)

Exam 3 Flashcards by Mitchell Scher

Uncommon neoplasm that probably arises from PDL fibroblasts

Central Ossifying Fibroma

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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)

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Benign osseous tumor that primarily affects paranasal sinuses (and other craniofacial bones)?
-Painful?

Osteoma

-No

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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

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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

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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

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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

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Hyperplastic response to bone in patients with poorly controlled secondary hyperparathyroidism related to end-stage renal disease:

Renal Osteodystrophy

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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

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Most common primary bone malignancy:

-What is the most common form of cancer to involve bone?

Osteosarcoma

-Metastatic Disease

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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

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Which is twice as common as the other (osteo/chondrosarcoma)

OSTEOsarcome is twice as common

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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)

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Chondrosarcoma tx:

5yr survival:
Death is usually due to:

Radical surgery

87%
Direct extension of tumor, involving vital structures

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How can metastatic deposits from malignancies below the neck affect the jaws?

Through Batson’s paravertebral plexus of veins which lack valves

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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

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Most common cyst of the jaws

Periapical cyst

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Periapical cyst develops due to inflammatory stimulation of:

-Inflammation through lateral canals may lead to:

epithelial rests of Malassez

-lateral radicular cyst

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Most common DEVELOPMENTAL odontogenic cyst:

Dentigerous Cyst

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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)

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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