Lecture 5 - Benign Fibro-osseous Lesions Flashcards
Fibrous Dysplasia
Bone dysplasia
Cancellous bone -> fibrous tissue w/ abnormal-appearing bone
Maxilla > Mandible 2:1
Posterior
Unilateral
Can displace the inferior alveolar nerve canal superiorly
Fibrous Dysplasia Histologic Findings
Chinese Characters
Numerous short, irregularly shaped, randomly oriented trabeculae of woven bone
Fibrous Dysplasia Radiographic Findings
Early lesion:
- radiolucent
- well-defined, corticated border
Mature lesion:
- radio-opaque
- ill-defined periphery
- granular, ground glass, or peau d’orange pattern
Fibrous Dysplasia Epidemiology
Polyostotic form - <10yo
Monostotic - slightly older
McCune-Albright Syndrome - women
Fibrous Dysplasia DDx
Paget’s (Older age group, bilateral)
Periapical Cemental Dysplasia (Older age group, bilateral, periapical epicenter)
Osteomyelitis (Sequestra, OM expands from the outside - new bone laid on surface of outer cortex, FD expands from the inside - displacing and thinning the outer cortex)
Cemento-ossifying fibroma (Tooth displacement from a single epicenter)
Periapical Cemental Dysplasia
Normal cancellous bone -> fibrous tissue and cementum-like material / abnormal
Lesion at tooth apex
Multiple lesions
Bilateral
Anterior mandible most common
Rarely causes root resorption or expansion of the jaw
Periapical Cemental Dysplasia Radiographic Findings
Well-defined border, radiolucent border surrounded by band of sclerotic bone
Early lesion:
Radiolucent lesion at tooth apex with loss of lamina dura
Mixed lesion:
Radiolucent lesion with radiopaque amorphous tissue, swirling pattern
Mature lesion:
Radiopaque, thin radiolucent margin at periphery
Periapical Cemental Dysplasia Epidemiology
Mean age 39yo
F>M 9:1
Blacks and Asians
Periapical Cemental Dysplasia DDx
Early:
Periapical rarefying osteitis (tooth not vital)
Mature:
Benign Cementoblastoma (clinical sx, attached to root surface, root resorption, concentric expansion, mandibular 1st molar)
Odontoma (Prevent tooth eruption, enamel and tooth-like structures)
Dense Bone Island (no radiolucent periphery)
Florid Osseous Dysplasia
Widespread form of Periapical Cemental Dysplasia
3-4 quadrants
Cancellous bone -> dense acellular cemento-osseous tissue w/ background of fibrous connective tissue
Florid Osseous Dysplasia Epidemiology
Similar to PCD Mean age ~39yo F>M Blacks and Asians Sometimes familial pattern
Florid Osseous Dysplasia Location
Bilateral
Mandible more common, but usually in both jaws
Epicenter is apical to teeth, above inferior alveolar canal (mandible)
Posterior to cuspid
Florid Osseous Dysplasia Clinical Findings
Usually no symptoms
Sometimes pain, bony swelling, or secondary infections
Can displace the inferior alveolar nerve canal
Alveolar bone enlargement
Hypercementosis on roots of associated teeth
Florid Osseous Dysplasia Radiographic Findings
Similar to PCD
Well-defined border, radiolucent border surrounded by band of sclerotic bone
Florid Osseous Dysplasia DDx
Paget’s (polyostic, affects entire mandible)
Chronic sclerosing osteomyelitis
