Gateway exam Flashcards
What is a sialolith?
a salivary gland calcification
Where do the majority of sialoliths occurs?
Submandibular gland - 83-94%
50% in the distal third of the duct
20% in the proximal third
30% within the gland
Is a sialolith always symptomatic?
No
What symptoms may you get?
meal time syndrome. Sudden onset recurrent swelling associated with eating.
RECURRENT SIALADENITITS
What is the peak incidence of a sialolith?
30-50 with males twice as likely to be affected
Radiopacity of salivary stones
40% of parotid salivary stones are radiolucent
20% of submandibular stones are radiolucent
How can you detect radiolucent stone?
Ultasound
What other methods of imaging are there?
2 radiological views at 90 degrees to one another
sialography
What may cause cervical lymph node calcification?
Previous chronic infection eg. TB, Cat scratch, radiotherapy
Why do lymph nodes calcify?
Inflammation leads to fibrosis and dystrophic calcification.
What do calcified lymph nodes look like radiographically?
> 1.5 cm
irregular outline
variable densities
What is a tonsillith?
Tonsillar calcifiaction
Where and when do you find tonsilliths?
Normally an incidental finding in >40
Overlies the air shadow of the oropharynx as it corsses over the posterior body/ramus of the mandible. SMALL RADIOPAQUE
What is the normal length of the stylohyoid muscle?
0.5-2.5cm
When is the stylohyoid ligament considered elongated?
> 28 mm on a DPT
What is Eagles syndrome?
Elongation of the stylohoid process along with symptoms of pain on turning the head and swallowing
What is the most common sight for arterial carotid calcification?
C4, the sight of carotid calcification, adjacent to the upper border of the thyroid cartilage
What is a phlebolith?
A venous calcification. it is a calcified thrombus associated with vascular lesions eg, haemangioma
Describe the radiological appearance of a phelbolith
Well defined round or ovoid opacity
often centric deposits with central radiolucency
rarely solitary
What imaging modality would you suggest if a patient has been suffering from chronic sinusitis for >3 months
CT
What is an antrolith?
A calcification in the antrum with an inflammatory aetiology
What other conditions can cause calcification of the antrum?
Thalasseamia sickle cell anaemis fibrous dysplasia Pagets disease osteopetrosis
Differentials for odontogenic, unilocular cyts
Radicular cyst
Residual cysts
Lateral periodontal cyst
Dentigerous cyst
Differentials for non-odontogenic, unilocular cysts
Nasopalantine cyst
Nasolabial cyst
Bone cyst - solitary/aneurysmal
What is the origin of radicular and residual cysts?
Cell rests of Malassez from the epithelial remnants of the Hertwigs epithelial root sheath
What is a lesion below the ID canal?
NON-ODONTOGENIC
What is the origin of a lateral periodontal cyst?
reduced enamel epithelium
What is a botyroid cysts?
A mulitlocular variant of the lateral periodontal cyst. It is rare and seen more commonly in middle age to older adults
What is the origin of a dentigerous cyst?
Remenants of the reduced enamel epithelium after tooth formation
Usually affecting the crowns of unerrupting teeth such as 3’s and 8’s
What is an eruption cyst?
A term used to describe a dentigerous cyst when it is in the soft tissues overlying the unerupted tooth
What is commonly seen in Gorlin-Goltz syndrome?
Odontogenic keratocyst
What is an odontogenic keratocyst?
A multilocular odontogenic tumour most commonly seen in the anterior maxilla or posterior mandible
What is known as the great mimicer?
Ameloblastoma
What is an ameloblastoma?
An multilocular odontogenic tumour. It is rare but very disfiguring.
SOAP BUBBLE EFFECT
affect the posterior mandible (anterior mandible in black africans)
Unicystic ameloblastoma
accounts for ~15% of ameloblastomas. Usually associated with the crown of an unerupted tooth
What is the appearance of an odontogenic myxoma?
Mutlilocular - soap bubble/honeycomb
Affects the posterior mandible or maxilla and is of odontogenic origin
Cortical expansion of neoplastic lesions
lingual and buccal expansion may be uneven.
Malignant periosteal reactions have what effect?
Suburst
Differentials for well defined, non-corticated, punched out lesions
Mutiple myeloma
Langerhans cell histiocytosis
primary malignancy
metastasis (breast, bronchus, kidney, thyroid, prostate)
What is multiple myeloma?
Multifocal proliferation of the plasma cell series within the bone marrow which leads to the overproduction of immunoglobulins
Lamellar type periosteal reaction is common in that?
Osteomyelitis
What is osteomyeletis
Infection and inflammation of the bone marrow. It is usually caused by bacteria
What is a supplemental tooth?
A supernumerary tooth , where the tooth has a normal shape for a tooth in that series
What is the dental relevance of cleidocranial dysplasia?
Multiple supernumerary teeth
Failure of eruption of secondary teeth
Prgnathic mandible due to hypoplasia of the maxilla
