Fibro-osseous Lesions of the Jaws

Question 1

Fibro-osseous lesions are a diverse group of diseases characterised by:

Answer 1

The replacement of normal bone by fibrous tissue, containing newly formed, mineralized produced.

Question 2

How are Fibro-osseous lesions usualy diagnosed?

Answer 2

Combination of clinical and radiographic features, supported by histology.

NOT histology alone.

Question 3

Benign, fibro-osseous neoplasms affecting the jaw and craniofacial bones.

Answer 3

Ossifying fibromas

Question 4

What is the main clinico-pathologic ossifying fibroma variant

Answer 4

Cemento-ossifying fibroma

Question 5

Cemento-ossifying fibromas are true neoplasms.

True or false

Answer 5

TRUE

Question 6

Describe the radiographic appearance of a cemento-ossifying fibroma

Answer 6

• Well defined
• Uniloculuar
• Completely radiolucent to radiopaque, depending on the amount of calcified material
• Root divergence
• Root resorption

Question 7

Fibrous dysplasia lesions are neoplasms

True or false

Answer 7

FALSE

Question 8

Developmental, tumour like condition (but not a neoplasm) where normal bone is replaced and distorted by poorly organised and inadequately mineralised immature bone

Answer 8

Fibrous Dysplasia

Question 9

Which has a genetic basis:

a) Cemento-ossifying fibroma
b) Fibrous Dysplasia

Answer 9

b) Fibrous Dysplasia

GNAS1 mutation - sporadic.

Question 10

Clinical and Radiographic appearance of Fibrous Dysplasia:

Answer 10

• Painless swelling and asymmetry
• Slow growth
• Possible tooth displacement
• Possible pigmentation
• Ground glass appearance on radiograph
• Margins blend imperceptibly to adjacent normal bone

Question 11

Clinical appearance of COF

Answer 11

• Slow, painless, bucco-lingual expansion of bone
• May be incidental discovery
• Larger may have asymmetry

Question 12

Tx of Fibrous Dysplasia

Answer 12

Usually self limiting - stabilises with skeletal maturation

Question 13

Tx of COF

Answer 13

Enucleation

Question 15

What is the most common type of fibro-osseous lesion in the jaw?

Answer 15

Cemento-osseous DYSPLASIA

Question 16

Non-neoplastic fibro-osseous lesion of the jaw, found exclusively in he tooth bearing areas, usually in middle aged females.

Answer 16

Cemento-osseous Dysplasia

Question 17

Tx of Cemento-osseous Dysplasia

Answer 17

Most do not require tx unless infection of bone or facial deformity

Question 18

Which is the most common:

a) Cemento-ossifying Fibroma
b) Fibrous Dysplasia
c) Cemento-osseous Dysplasia

Answer 18

c) Cemeno-osseus dysplasia

Question 20

Describe the radiographic appearnce of Cemento-osseous Dysplasia

Answer 20

• Initially radiolucent
• With time, matures to radiopacity
• Peripheral rim of radiopacity
• Intact PDL and vital teeth
• No root resorption

Question 22

What are the key differences between the radiographic appearance of COF and COD

Answer 22

COF - root divergence and resorption

COD - none

Question 23

Which has a ground glass appearance and blends into the adjacent bone

Answer 23

Fibrous Dysplasia

Question 25

Expansile osteolytic lesion which may arise as a primary or secondary lesion. Histologically - multiple blood filled spaces. Clinically - malocclusion, pain, mobility, vital teeh. Rapid boy expansion.

Answer 25

Anerysmal bone cyst

Question 26

What is the radiographic appearance of an aneurysmal bone cyst?

Answer 26

* Well defined uni or multilocular radiolucency * Root resorption

Question 27

Simple bone cysts are also called:

Answer 27

Solitary bone cyst, or Traumatic bone cyst

Question 28

Describe the radiographic appearance of simple bone cyst

Answer 28

* Well defined uni or multilocular radiolucency * Radiolucency extends between the tooth roots with no root resorption or displacement

Question 29

Localised benign but sometimes aggressive osteolytic proliferation consisting of fibrous tissue with haemorrhage and presence of osteoclast like giant cells, and reactive bone formation.

Answer 29

Central Giant Cell Granuloma

Question 30

Patients with central giant cell granuloma should be screened for:

Answer 30

Hyperparathyroidism

Question 31

Radiographic appearance of a central giant cell granuloma

Answer 31

Usually well defined uni/multilocular radiolucency without root resorption