Fibro-osseous Lesions of the Jaws Flashcards
Fibro-osseous lesions are a diverse group of diseases characterised by:
The replacement of normal bone by fibrous tissue, containing newly formed, mineralized produced.
How are Fibro-osseous lesions usualy diagnosed?
Combination of clinical and radiographic features, supported by histology.
NOT histology alone.
Benign, fibro-osseous neoplasms affecting the jaw and craniofacial bones.
Ossifying fibromas
What is the main clinico-pathologic ossifying fibroma variant
Cemento-ossifying fibroma
Cemento-ossifying fibromas are true neoplasms.
True or false
TRUE
Describe the radiographic appearance of a cemento-ossifying fibroma
- Well defined
- Uniloculuar
- Completely radiolucent to radiopaque, depending on the amount of calcified material
- Root divergence
- Root resorption
Fibrous dysplasia lesions are neoplasms
True or false
FALSE
Developmental, tumour like condition (but not a neoplasm) where normal bone is replaced and distorted by poorly organised and inadequately mineralised immature bone
Fibrous Dysplasia
Which has a genetic basis:
a) Cemento-ossifying fibroma
b) Fibrous Dysplasia
b) Fibrous Dysplasia
GNAS1 mutation - sporadic.
Clinical and Radiographic appearance of Fibrous Dysplasia:
- Painless swelling and asymmetry
- Slow growth
- Possible tooth displacement
- Possible pigmentation
- Ground glass appearance on radiograph
- Margins blend imperceptibly to adjacent normal bone
Clinical appearance of COF
- Slow, painless, bucco-lingual expansion of bone
- May be incidental discovery
- Larger may have asymmetry
Tx of Fibrous Dysplasia
Usually self limiting - stabilises with skeletal maturation
Tx of COF
Enucleation
What is the most common type of fibro-osseous lesion in the jaw?
Cemento-osseous DYSPLASIA
Non-neoplastic fibro-osseous lesion of the jaw, found exclusively in he tooth bearing areas, usually in middle aged females.
Cemento-osseous Dysplasia
Tx of Cemento-osseous Dysplasia
Most do not require tx unless infection of bone or facial deformity
Which is the most common:
a) Cemento-ossifying Fibroma
b) Fibrous Dysplasia
c) Cemento-osseous Dysplasia
c) Cemeno-osseus dysplasia
Describe the radiographic appearnce of Cemento-osseous Dysplasia
- Initially radiolucent
- With time, matures to radiopacity
- Peripheral rim of radiopacity
- Intact PDL and vital teeth
- No root resorption
What are the key differences between the radiographic appearance of COF and COD
COF - root divergence and resorption
COD - none
Which has a ground glass appearance and blends into the adjacent bone
Fibrous Dysplasia
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.
Anerysmal bone cyst
What is the radiographic appearance of an aneurysmal bone cyst?
- Well defined uni or multilocular radiolucency
- Root resorption
Simple bone cysts are also called:
Solitary bone cyst, or Traumatic bone cyst
Describe the radiographic appearance of simple bone cyst
- Well defined uni or multilocular radiolucency
- Radiolucency extends between the tooth roots with no root resorption or displacement
Localised benign but sometimes aggressive osteolytic proliferation consisting of fibrous tissue with haemorrhage and presence of osteoclast like giant cells, and reactive bone formation.
Central Giant Cell Granuloma
Patients with central giant cell granuloma should be screened for:
Hyperparathyroidism
Radiographic appearance of a central giant cell granuloma
Usually well defined uni/multilocular radiolucency without root resorption
