Exam 3 longer Flashcards
1
Q
Uncommon neoplasm that probably arise from PDL fibroblasts
A
Central Ossifying Fibroma
2
Q
Central Ossifying Fibroma…
- Most common in what area?
- Most common in which people?
A
- Lower premolar/molar region
- adult female
3
Q
Central Ossifying Fibroma..
- Radiographic Appearance?
- Affect on teeth?
- Tx?
A
- Well circumscribed radiolucency with central opacity
- root diveregence
- Enucleation (separates from bone easily in one piece)
4
Q
Benign osseous tumor that primarily affects paranasal sinuses (and other craniofacial bones)
A
Osteoma
5
Q
Gardner Syndrome…
- 1: ____-____ live births
- One of the ___ syndromes
- __gene, chromosome ___
A
- 8000-16000
- FAP (familial adenomatous polyposis)
- APC, 5
6
Q
What is characterized by osteomas of facial bones, epidermoid cysts, and desmoid tumors
A
Gardner Syndrome
7
Q
Most significant aspect of Gardners Syndrome is the development of:
-__% of patients develop adenocarcinoma of the colon by 30 years of age
A
Precancerous polyps of the colon
-50
8
Q
Central Giant Cell Granuloma…
- Most pts are under what age?
- Sex?
- tx
- prog
A
- 30
- female 2:1
- curettage
- good
9
Q
What is most common in ANTERIOR MANDIBLE and CROSSES midline
A
Central Giant Cell Granuloma
10
Q
Hyperplastic response to bone in patients with poorly controlled secondary hyperparathyroidism related to end-stage renal disease:
A
Renal Osteodystrophy
11
Q
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
A
-Osteoid by tumor cells
-1000
-teens
35
12
Q
Which bone malignancy causes PAIN and a symmetrically widened PDL
A
Osteosarcoma
13
Q
Most common primary bone malignancy:
-What is the most common form of cancer to involve bone?
A
Osteosarcoma
-Metastatic Disease
14
Q
Osteosarcoma tx:
- 5 yr survival:
- Death is more often due to _______ than _____
A
Radical surgery, together with chemo in some cases
- 60-70%
- Uncontrolled local disease than metastasis
15
Q
Which is twice as common as the other (osteo/chondrosarcoma)
A
OSTEOsarcome is twice as common
16
Q
Chondrosarcoma group of people:
A
Adult MALES
17
Q
What causes PAIN in femur/pelvis/ribs and rarely in head/neck (unless it’s LOW grade)
A
Chondrosarcoma
18
Q
Chondrosarcoma tx:
- 5yr survival:
- Death is usually due to:
A
Radical surgery
- 87%
- Direct extension of tumor, involving vital structures
19
Q
How can metastatic deposits from malignancies below the neck affect the jaws?
A
Through Batson’s paravertebral plexus of veins which lack valves
20
Q
Socket in POSTERIOR MANDIBLE (tooth 30) is NOT healing, they might have:
A
Metastatic Disease
21
Q
__% of jaw metastases represent initial manifestation of the malignant process of Metastatic Disease
A
22
22
Q
Metastatic Disease…
- tx:
- prog
A
- Palliation, usually with radiation therapy, anti-resorptves
- VERY POOR (most die within 1 year)
23
Q
Most common cyst of the jaws
A
Periapical Cyst
24
Q
Periapical cyst develops due to inflammatory stimulation of:
-Inflammation through lateral canals may lead to:
A
epithelial rests of Malassez
-lateral radicular cyst
25
Most common DEVELOPMENTAL odontogenic cyst
Dentigerous Cyst
26
When fluid accumulates between crown and REE (reduced enamel epithelium) of an UNERUPTED tooth, it causes:
Dentigerous Cyst
27
When lucent space around crown of unerupted crown is greater than 3-4mm, it's considered a:
Dentigerous Cyst
28
Most common site for DENTIGEROUS CYST:
| -Most common age
Mandibular 3rd molar, followed by max canines
| -2nd-3rd decade (3rd molars erupting)
29
Dentigerous cyst that forms in soft tissue
Eruption Cyst
30
Rare lesion thought to be derived from degenerating tooth bud epithelium
Primoridal Cyst
31
Which cyst develops in place of a tooth, before any mineralized material is deposited
Primordial Cyst
32
Usually detected as a unilocular radiolucency in the area of a missing 3rd molar (that was NOT surgically removed...naturally missing)
Primordial Cyst
33
Locally aggressive cyst associated with nevoid basal cell carcinoma syndrome is:
-This specific association is suspected in pts under __ yrs old
Odontogenic Keratocyst
| -15
34
Odontogenic Keratocyst peak age:
- More common in mandible or maxilla?
- At what age is anterior maxilla more favored?
3rd decade
- Mandible twice as common
- Over 60
35
Odontogenic Keratocyst..
- Present as __locular radio___
- Tx depends on:
- Prognosis:
- UNIlocular radioLUCENCY
- Size
- guarded (3-62% recurrence)
36
Complex mix of malformations and neoplams exhibiting over 100 different features related to skin, CNS, and skeleton:
Nevoid Basal Cell Carcinoma Syndroma
37
What deals with PTCH gene, chromosome 9
Nevoid Basal Cell Carcinoma Syndrome
38
__% of mutations are new from Nevoid Basal Cell Carcinoma Sydnrome
40%
39
Nevoid Basal Cell Carcinoma Syndrome...
- Craniofacial features:
- Affect on skin
- Radiographic findings
- Which cysts develop in jaws
- Enlarged cranial circumference, heavy brow ridges
- 1-2mm shallow pits on palms and soles
- Lamellar calcification of falx cerebri
- Odontogenic Keratocysts
40
Presents as 1-2mm yellow-white papules on maxillary ridge of newborn
Gingival Cyst of newborn
41
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
42
Gingival Cyst of Adult...
- Related to ______ cyst
- Arises from:
- lateral periodontal cyst
| - dental lamina rests in the gingival connective tissue (rests of Serres)
43
Gingival Cyst of Adult...
- Area
- __ on Palpation
- Predilection?
- Tx
- Attached gingiva of Canine/premolar
- tense
- None
- Conservative excision
44
What mimics mucocele (blue) but on ATTACHED gingiva
Gingival Cyst of Adult
45
Lateral Periodontal Cyst..
- Are adjacent teeth vital?
- Area
- Tx:
- yes
- mandibular premolar, maxillary lateral incisor
- Curettage
46
Calcifying Odontogenic Cyst...
- Aka _____ cyst
- Maxilla/mandible predilection?
- Mean age
- Gorlin
- Nope
- 33 yrs old
47
Calcifying Odontogenic Cyst...
- Scattered radiopacities in __% of cases
- __% of COC's are associated with impacted tooth, __% with odontoma
- Resorption of adjacent roots happens in __% of cases
- 50%
- impacted 30%, odontoma 20%
- resorption 80%
48
Most common odontogenic neoplasm
Ameloblastoma
49
Ameloblastoma..
- Sex predilection?
- Age range
- No sex pred
| - Very wide 3rd-7th
50
Ameloblastoma...
- __% occur in mandible (posterior)
- __% are associated with impacted tooth
- 80%
| - 20%
51
Ameloblastoma...
- Growth rate?
- Does it perforate bone?
- Symptoms?
- Slow
- no, it expands
- none except swelling
52
Desmoplastic Variant of Ameloblastoma radiographic finding:
POORLY demarcated radiolucency with numerous radiopaque flecks
53
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
54
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)
55
Calcidying Epithelial Odontogenic Tumor (CEOT)..
- aka
- mean age
- Sex predilection
- area
- Pindborg Tumor
- 40
- none
- posterior mandible
56
Calcidying Epithelial Odontogenic Tumor (CEOT)..
- __% associated w impacted tooth
- Radiographically
- tx
- __% recurrence rate
- 50%
- well-circumscribed radiolucency. Can have radiopaque flecks
- Conservative excision with peripheral ostectomy
- 15%
57
Adenomatoid Odontogenic Tumor (AOT)...
- Mean age:
- Sex predilection?
- Maxilla/mandible predilection?
- Tx:
- Prog
- 18yrs
- female 2:1
- maxilla 2:1
- Enucleation
- Excellent
58
Adenomatoid Odontogenic Tumor (AOT)..
- 75% occur in anterior/posterior
- __% are associated with impacted tooth
- Anterior
| - 75%
59
Adenomatoid Odontogenic Tumor (AOT)..
- Symptoms?
- Radiographically
- Affect on adjacent teeth?
- Asymptomatic
- Well-circumscribed radiolucency w radiopaque flecks
- Separation of roots/teeth
60
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
61
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
62
Odontogenic tumor with features of ameloblastic fibroma as well as odontoma
Ameloblastic Fibro-Odontoma
63
Ameloblastic Fibro-Odontoma..
| -mean age
-10
64
Ameloblastic Fibro-Odontoma..
- Radiographically it has varying amounts of calcified material having the density of:
- often associated with:
- tx:
- prog
- tooth structure
- impacted tooth
- Conservative curettage
- excellent
65
Odontoma...
- What are the 2 different forms?
- Mean age
- Usually associated with:
- compound or complex
- 14
- unerupted tooth
66
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)
67
Odontogenic Myxoma ONLY affects which part of body:
Jaw bones
68
Odontogenic Myxoma...
- Average age:
- Symptoms:
- 25
| - Asymptomatic expansion of the bone
69
Odontogenic Myxoma...
- Radiographically may have "____" appearance
- Tx depends on
- Recurrence rate:
- "soap-bubble"
- size (small=curettage...large=en bloc or segmental resection)
- 25%
70
Cementoblastoma...
- Area
- Age
- Mandibular molar region
| - Under 25
71
Cementoblastoma...
- Rate of growth
- Tx
- Prog
- slow (can produce expansion or pain)
- Surgical extraction of involved tooth
- Excellent
72
What is a well-circumscribed radiOPAQUE mass with a fine radiolucent border. Fused to the resorbed root of the mandibular first molar
Cementoblastoma
