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DENT 322 - Image Interpretation > Inflammatory lesions of the jaw > Flashcards

Inflammatory lesions of the jaw Flashcards

1
Q

Describe the pathogenesis of periapical lesions

A
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2
Q

7 symptoms of periapical lesions

A
  • Asymptomatic
  • Occasional toothache
  • Severe pain with or without swelling
  • Mobility, elevation of the involved tooth
  • Sensitive to percussion
  • Pain with periapical palpation
  • Spontaneous drainage with fistula
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3
Q

Radiographic aspect of early periapical lesion

A

Any radiographic change

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4
Q

Radiographic aspect of chronic lesions

A

Lytic (radiolucent) or sclerotic (radiopaque) changes

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5
Q

Location of periapical lesions

A
  • At the apex of the involved tooth
  • Laterally to the apex
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6
Q

2 possible peripheral findings of periapical lesions

A
  • Ill-defined periphery with a gradual transition from normal to abnormal bone pattern of the lesion
  • Well-defined periphery with a sharp transition, appearance of cortical boundary
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7
Q

5 possible appearances of internal structure of periapical lesions

A
  • Earliest change = widening of the PDL space
  • Later stage = radiolucent appearance/ radiopacities (sclerosis)
  • Periapical rarefying osteitis (bone resorption)
  • Periapical sclerosing osteitis (bone formation)
  • Osteosclerosis
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8
Q

3 characteristics of osteosclerosis

A
  • Thicker trabeculae
  • Increased number of trabeculae per unit area
  • Sclerotic pattern located at the periphery
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9
Q

4 effects of periapical lesions on surrounding structures

A
  • Lamina dura around apex is lost
  • External resorption of the apical region of the root
  • Sclerotic reaction
  • Destruction of expansion of the cortical boundaries
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10
Q

3 effects of periapical lesions on the maxillary sinus

A
  • Periosteal reaction in the floor of the maxillary sinus
  • Thin layer of new bone produced by the infalmed periosteum
  • Ragional mucositis of the adjacent segment of the maxillary sinus
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11
Q

2 differential diagnoses for periapical lesions

A
  • Radicular cyst
  • Periapical cemental dysplasia
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12
Q

How to differentiate a radicular cyst from a periapical lesion

A

Lesions are larger than 1 cm in diameter

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13
Q

3 characteristics of early radiolucent phase of periapical cemental dysplasia

A
  • Diagnosis relies on clinical examination
  • Test of tooth vitality
  • Associated with the apical region of the mandibular anterior teeth
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14
Q

Describe mature periapical cemental dysplasia

A

Evidence of a dense, radiopaque structure within the radiolucency

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15
Q

Define pericoronitis

A

Inflammation of the soft tissues surrounding the crown of a partially erupted tooth

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16
Q

Usual location of pericoronitis

A

Often seen in association with the third mandibular molars

Bone changes centered on the follicular space

17
Q

Describe the periphery of pericoronitis

A

Ill-defined with a gradual transition of the normal trabecular pattern into a sclerotic region

18
Q

Describe the internal structure of pericoronitis

A
  • Area of radiolucency imemdiately adjacent to the crown
  • Sclerotic aspect of bone adjacent to the pericoronitis
19
Q

Describe the effects of pericoronitis on surrounding structures

A
  • Sclerosis and rarefaction of the surrounding bone
  • Extensive case –> evidence of periosteal new bone formation
20
Q

Define osteomyelitis

A

Inflammation of bone that spreads through the bone to inbolbe the marrow, cortex, and periosteum

21
Q

Cause of osteomyelitis

A

Pyogenic organisms reaching the bone from abscessed teeth or postsurgical infection

22
Q

2 principal categories of osteomyelitis

A
  • Acute osteomyelitis
  • Chronic osteomyelitis
23
Q

Time frame of acute osteomyelitis

A

4 weeks after onset of disease

24
Q

Which jaw most commonly experiences acute osteomyelitis?

A

Mandible

25
Q

7 symptoms of acute osteomyelitis

A
  • Rapid onset
  • Pain
  • Swelling of adjacent soft tissues
  • Fever
  • Lymphadenopathy
  • Associated teeth may be mobile and sensitive to percussion
  • Paresthesia of the lower lip
26
Q

Describe the radiographic appearance of the early stages of acute osteomyelitis (within 2 weeks)

A

No radiographic changes

27
Q

6 radiographic characteristics of acute osteomyelitis (later stages)

A
  • Slight decrease in the density of the involved bone
  • Replacement of marrow fat by inflammation (hypointense signal on CT/MRI)
  • Sclerotic regions become apparent
  • Cancellous bone osteolysis
  • Cortical plate perforation
  • Periosteal reaction
28
Q

5 radiographic characteristics of chronic osteomyelitis

A
  • Increased bone density (diffuse sclerosis)
  • Areas of osteolysis
  • Defects of cortical bone
  • Cortical plate thickening
  • Fistula, sequestra
29
Q

4 differential diagnoses of chronic osteomyelitis

A
  • Firbous dysplasia
  • Osteosarcoma
  • Oral epidermoid carcinoma
  • Bisphosphonate-related osteonecrosis of the jaws
30
Q

3 ways to differentiate fibrous dysplasia from chronic osteomyelitis

A
  • No signs of acute infection
  • Outer cortex may be thinned
  • COrtical bone is not destroyed

DENT 322 - Image Interpretation (12 decks)

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