midterm photos Flashcards
what type of PA is this
maxillary PM PA
want to see the contacts of D of C/PM, PM/PM, and 2ndPM/M
what type of pa is this
mx canine
you want to see the mesial contact of canine
what do we have here
an exta tooth lined up with adjacent teeth
we can tell due to a radiopacity in a tooth shape.
what do we see here
superimposed CI
it moves with beam movement so we can tell its palatal.
alveolar crest
floor/wall of mx sinus
zygomatic bone (inf. border)
zygomatic process of the maxilla
floor of nasal fossa
nasolabial fold
becomes more evident with age.
nasolabial fold
alveolar crest
external oblique line
internal oblique line
internal oblique line
inf alveolar canal
inf mandibular border
what do we see here
and is it buccal or lingual, and why:
we can tell its a mesioderm because of location (mx incisor)
Midline view, structure is covering mesial half of apex of LI, as the beam moves away from the midline the position moves to the mid of the root, more further away from midline can tell bc see the cuspid in there, now we see it covering the whole apex
As the beam moves to the right so did the structure, so SLOB, it is lingual/palatal.
what do we have here
- mesioderm
Plaque accumulation an extra probing pocket maybe
Esthetics
Crowding
Phonetics (maybe)
Spacing issues
-
what do we see here
buccal, lingual and why?
- mesiodens- its a tiny tooth, doesnt necesarilly have the shape of a tooth though.
- superimposed at CI and then shift shot see it superimposed with LI, so it has moved to the right
- it is lingual/palatal to the erupting teeth because of SLOB
what do we have here
buccal, lingual and why:
we have a mesiodens
didnt give anothe view so cant tell if it is buccal or lingual lol
what do we see here?
buccal, lingual and why?
we have another mesiodens - on this xray we can kinda see a DEJ, with a change of radiolucencies.
can also see that the follicle is shrunken around the crown of the supernumerary tooth so probably WILL NOT cause a cyst, really is having no problems. If they have no problems, could actually maybe resorb.
no other XR given, cannot tell if B or L
what do we see here
supernumerary tooth
what do we have here?
can see a supernumerary tooth, identified and just monitored because not causing any problems could cause resorbption.
what do we see here?
right behind the 3M so distodens but its also a paramolar technically too.
only one side affected.
what do we have here?
pt has 3 4M.
these can cause probs in pericoronal infections so a good idea to remove these molars.
what do we have here?
we can see the dental follice on the supernumerary tooth
there is a potential for the follicular sacs could become cystic.
what syndrome would you first suspect when seeing this XR
cleidocranial dysplasia
because SO MANy supernumerary teeth associated with it
but also can see a lack of dental development on the maxilla anteriors.
what syndrome would you guess this is?
cleidocranial dysplasia
because SO MANy supernumerary teeth associated with it
but also can see a lack of dental development on the maxilla anteriors.
what syndrome would you guess this is?
cleidocranial dysplasia.
because SO MANy supernumerary teeth associated with it
but also can see a lack of dental development on the maxilla anteriors.
what do we have here?
cystic degeneration of follicular epithelium
is the pt missing 3M?
dont think so.
mx- unable to tell
md- if you were to upright the two molars you can see that there is enough space for a 1M so that means that the two M there are the 2M and 3M. They are tilted in due to drifting.
is the pt missing 3M?
cannot tell. could be congentialy missing or acquired missing.
is the pt missing 3M?
- not missing in mx R quad
- not missing in md R quad can see the outline of where the 3M was.
- mx L quad 2M lining up with zygomatic process so yes missing 3M do not know if acquired or congenital.
- in md L quad not mising 3M.
what do we see here?
a peg lateral. think both of them are pegs.
promixal surfaces are converging which is not what its suppose to be, its suppose to be that proximal surfaces are convex.
what do we see here?
peg lateral.
AMLI
what do we see here?
- could be ectodermal dysplasia bc missing teeth and deformed
but also see pegged laterals.
what do you see?
an impacted cuspid
what do you see?
no cuspid.
a retained decidous tooth because perm is impacted or missing. Here it is missing.
dilaceration
what do we see here
what do you see here
retained deciduous tooth, no erupting perm tooth.
what is this and what problems does it come with
macrodont
tooth has extra grooves- plaque accumulation, incr. caries
marginal ridges do not line up - more susceptible to caries and periodontal probs
extraction is difficult too
what do we see here?
bifurcation at PM
means there is an extra root.
what do you see
abrasion
notice the line on the PM that is a give away that this is from unusual wear.
what do you see
abrasion
notice the line on the PM that is a give away that this is from unusual wear.
what do you see
abrasion
notice the line on the PM that is a give away that this is from unusual wear.
what do you see
erosion
what do you see?
erosion
what do you see?
erosion
what do you see here?
erosion.
balemic pt probably bc you can see the “U” shape of marginal ridges you are loosing the cingulum.
typical finding, smoothing out of marginal ridges.
what do you see here
taurodont
what do you see?
dens in dente
type I - coronal
what is this
dens in dente
type I - coronal
tx: restore coronal pit
what is this?
double dens invagination
tx: restore coronal pit
what is this
dens in dente
type I - coronal
tx: restore coronal pit
what is this
dens in dente
type II - extends apical to CEJ
tx: restore coronal pit
what is this
dens in dente
type III - extends through root perforating to apex
- has the worst prognosis*
tx: restore coronal pit
what is this?
talon cusps
an extra cusp
what is this
talon cups
an extra cusp
what is this?
upside down
an inverted tooth
what is this?
impacted tooth
partly erupted so more suspicious to infection
what is this?
impacted tooh
striaght vertical impacted
what is this?
inverted mesioangle
what is this?
horiztonal impacted tooth
what do we see here and what age
large pulp chamber/canal
young patient
what do you see here and what age
large pulp chamber
young age
what can we see here?
normal follicle
what is this
pericoronitis
If the dental follicle gets infected, the inflammation often spreads along the deep fascial planes which gives cellulitis
what is this
a dental follicle
infected gives pericoronitis
what is this
pericoronitis
Painful due to spread of infection through the fascial pains
Painful in any of the areas
what is this
pericoronitis
Painful due to spread of infection through the fascial pains
Painful in any of the areas
what is this
pericoronitis
Painful due to spread of infection through the fascial pains
Painful in any of the areas
what is the most common cyst in the jaw?
dentigerous cyst
what is the most common cyst in the jaw
periapical cyst
what is this
dentigerous cyst
Cystic lining arise from remnants of dental follicle
Consistently widened follicular space of >3mm
Well-delineated radiolucency with corticated borders
what is this
dentigerous cyst
Cystic lining arise from remnants of dental follicle
Consistently widened follicular space of >3mm
Well-delineated radiolucency with corticated borders
what is this
dentigerous cyst
Cystic lining arise from remnants of dental follicle
Consistently widened follicular space of >3mm
Well-delineated radiolucency with corticated borders
what is this
dentigerous cyst
Cystic lining arise from remnants of dental follicle
Consistently widened follicular space of >3mm
Well-delineated radiolucency with corticated borders
what is this
dentigerous cyst
Cystic lining arise from remnants of dental follicle
Consistently widened follicular space of >3mm can get super large, and this is not painful to the pt
Well-delineated radiolucency with corticated borders
what is this
dentigerous cyst
Cystic lining arise from remnants of dental follicle
Consistently widened follicular space of >3mm
Well-delineated radiolucency with corticated borders
what is this
dentigerous cyst
Cystic lining arise from remnants of dental follicle
Consistently widened follicular space of >3mm
Well-delineated radiolucency with corticated borders
what is this
Eruption cyst
soft, fluid filled swelling of crestal mucosa. Blue-ish coloration to it due to trauma creating blood in cystic fluid.
XR: lack of crestal alveolar bone bc of position of erupting crown and cyst near the area.
age: <10 yo, mixed dentition
site: most common in md M region
what is this
eruption cyst
soft, fluid filled swelling of crestal mucosa. Blue-ish coloration to it due to trauma creating blood in cystic fluid.
XR: lack of crestal alveolar bone bc of position of erupting crown and cyst near the area.
age: <10 yo, mixed dentition
site: most common in md M region
what is this
eruption cyst
soft, fluid filled swelling of crestal mucosa. Blue-ish coloration to it due to trauma creating blood in cystic fluid.
XR: lack of crestal alveolar bone bc of position of erupting crown and cyst near the area.
age: <10 yo, mixed dentition
site: most common in md M region
what is this
ameloblastic fibroma
XR: pericoronal radiolucency associated with a developing tooth
Tooth is displaced and not even well formed
Age: younger individuls 70%
Site: md M/PM region
Tx: enucleation, 20% of recurrence.
what is this
Ameloblastic fibro-odontoma
Clinical: mixed odontogenic tumor, similar to ameloblastic fibroma but has a mineralized stroma
XR: pericoronal radio-lucency associated with a developing tooth. Radiopaque flecks noted in the lumen.
Most are neoplasms so did not develop properly
Age: ~15 years
Site: post md
Must be differentiated from the odontoameloblastoma as the latter is more aggressive.
what is this
Ameloblastic fibro-odontoma
Clinical: mixed odontogenic tumor, similar to ameloblastic fibroma but has a mineralized stroma
XR: pericoronal radio-lucency associated with a developing tooth. Radiopaque flecks noted in the lumen.
Most are neoplasms so did not develop properly
Age: ~15 years
Site: post md
Must be differentiated from the odontoameloblastoma as the latter is more aggressive.
what is this
Ameloblastic fibro-odontoma
Clinical: mixed odontogenic tumor, similar to ameloblastic fibroma but has a mineralized stroma
XR: pericoronal radio-lucency associated with a developing tooth. Radiopaque flecks noted in the lumen.
Most are neoplasms so did not develop properly
Age: ~15 years
Site: post md
Must be differentiated from the odontoameloblastoma as the latter is more aggressive.
what is this
Odontoameloblastoma
Rare, must be differentiated bc this one requires surgical resection while amelobastic fibro-odontoma doesn’t
Clinical: seen mainly in md
Age: teens and children
XR: expansive with destruction of adjacent bone
Also has rudimentary tooth-like structures similar to complex odontoma
what is this
Odontoameloblastoma
Rare, must be differentiated bc this one requires surgical resection while amelobastic fibro-odontoma doesn’t
Clinical: seen mainly in md
Age: teens and children
XR: expansive with destruction of adjacent bone
Also has rudimentary tooth-like structures similar to complex odontoma
what is this
Odontoameloblastoma
Rare, must be differentiated bc this one requires surgical resection while amelobastic fibro-odontoma doesn’t
Clinical: seen mainly in md
Age: teens and children
XR: expansive with destruction of adjacent bone
Also has rudimentary tooth-like structures similar to complex odontoma
what is this
Adenomatoid odontogenic tumor
XR: consistnely widened follicular space of >3mm if associated with crown of impacted tooth (~75%)
Can see radiolucency’s developing within the lumen
Well-defined radiolucency with corticated border usually more than 3cm
Clinical: can have asymmetrical swelling, more common in females (2:1 ratio)
Age: adolescents 10-19 yo
Site: ant jaw. Max:md is 2:1 looks like dentigerous cyst but look at the location!! this gives clues to it.
what is this
Adenomatoid odontogenic tumor
XR: consistnely widened follicular space of >3mm if associated with crown of impacted tooth (~75%)
Can see radiolucency’s developing within the lumen
Well-defined radiolucency with corticated border usually more than 3cm
Clinical: can have asymmetrical swelling, more common in females (2:1 ratio)
Age: adolescents 10-19 yo
Site: ant jaw. Max:md is 2:1
what is this
Adenomatoid odontogenic tumor
XR: consistnely widened follicular space of >3mm if associated with crown of impacted tooth (~75%)
Can see radiolucency’s developing within the lumen
Well-defined radiolucency with corticated border usually more than 3cm
Clinical: can have asymmetrical swelling, more common in females (2:1 ratio)
Age: adolescents 10-19 yo
Site: ant jaw. Max:md is 2:1
what is this
Adenomatoid odontogenic tumor
XR: consistnely widened follicular space of >3mm if associated with crown of impacted tooth (~75%)
Can see radiolucency’s developing within the lumen
Well-defined radiolucency with corticated border usually more than 3cm
Clinical: can have asymmetrical swelling, more common in females (2:1 ratio)
Age: adolescents 10-19 yo
Site: ant jaw. Max:md is 2:1
what is this
Adenomatoid odontogenic tumor
XR: consistnely widened follicular space of >3mm if associated with crown of impacted tooth (~75%)
Can see radiolucency’s developing within the lumen
Well-defined radiolucency with corticated border usually more than 3cm
Clinical: can have asymmetrical swelling, more common in females (2:1 ratio)
Age: adolescents 10-19 yo
Site: ant jaw. Max:md is 2:1
what is this
Adenomatoid odontogenic tumor
XR: consistnely widened follicular space of >3mm if associated with crown of impacted tooth (~75%)
Can see radiolucency’s developing within the lumen
Well-defined radiolucency with corticated border usually more than 3cm
Clinical: can have asymmetrical swelling, more common in females (2:1 ratio)
Age: adolescents 10-19 yo
Site: ant jaw. Max:md is 2:1
what is this
Adenomatoid odontogenic tumor
XR: consistnely widened follicular space of >3mm if associated with crown of impacted tooth (~75%)
Can see radiolucency’s developing within the lumen
Well-defined radiolucency with corticated border usually more than 3cm
Clinical: can have asymmetrical swelling, more common in females (2:1 ratio)
Age: adolescents 10-19 yo
Site: ant jaw. Max:md is 2:1
what is this
Adenomatoid odontogenic tumor
XR: consistnely widened follicular space of >3mm if associated with crown of impacted tooth (~75%)
Can see radiolucency’s developing within the lumen
Well-defined radiolucency with corticated border usually more than 3cm
Clinical: can have asymmetrical swelling, more common in females (2:1 ratio)
Age: adolescents 10-19 yo
Site: ant jaw. Max:md is 2:1
what is this
Adenomatoid odontogenic tumor
XR: consistnely widened follicular space of >3mm if associated with crown of impacted tooth (~75%)
Can see radiolucency’s developing within the lumen
Well-defined radiolucency with corticated border usually more than 3cm
Clinical: can have asymmetrical swelling, more common in females (2:1 ratio)
Age: adolescents 10-19 yo
Site: ant jaw. Max:md is 2:1 but can still be seen in other places
what is this
Adenomatoid odontogenic tumor
XR: consistnely widened follicular space of >3mm if associated with crown of impacted tooth (~75%)
Can see radiolucency’s developing within the lumen
Well-defined radiolucency with corticated border usually more than 3cm
Clinical: can have asymmetrical swelling, more common in females (2:1 ratio)
Age: adolescents 10-19 yo
Site: ant jaw. Max:md is 2:1
what is this
Calcifying epithelial odontogenic tumor
Clinical: ~50% associated with impacted teeth
Aka pindborg tumor
XR: fleck are due to calcified amyloid
Breakdown product of the neoplastic epithelial cells; these mineralization are Leisegang’s rings
Histo: see epithelial cells bridging
Age: mean age of 40
Site: md: mx 2:1
Most likley in post mandible
Tx: larger lesions require en bloc resections
what is this
Calcifying odontogenic cyst
Clinical: aka Gorlin cyst
Extremely variable presentation
About 2-16% behave as neoplasms
2.0 to 4.0 cm diameter, can be as large as 12cm
Half of them are peri coronal and half of them are not
Slow growing cyst
XR: vary from uni to multilocular
50% have radiopacities in the lumen
33% present as pericoronal radiolucencies.
Age: at any age but mostly dx in teens and young adults
Site: 65% in ant maxilla
Tx: simple enucleation with minimal recurrence
what is this
Calcifying odontogenic cyst
Clinical: aka Gorlin cyst
Extremely variable presentation
About 2-16% behave as neoplasms
2.0 to 4.0 cm diameter, can be as large as 12cm
Half of them are peri coronal and half of them are not
Slow growing cyst
XR: vary from uni to multilocular
50% have radiopacities in the lumen
33% present as pericoronal radiolucencies.
Age: at any age but mostly dx in teens and young adults
Site: 65% in ant maxilla
Tx: simple enucleation with minimal recurrence
what is this
Calcifying odontogenic cyst
Clinical: aka Gorlin cyst
Extremely variable presentation
About 2-16% behave as neoplasms
2.0 to 4.0 cm diameter, can be as large as 12cm
Half of them are peri coronal and half of them are not
Slow growing cyst
XR: vary from uni to multilocular
50% have radiopacities in the lumen
33% present as pericoronal radiolucencies.
Age: at any age but mostly dx in teens and young adults
Site: 65% in ant maxilla
Tx: simple enucleation with minimal recurrence
what is this cyst
Incisive canal cyst
The most likely one we will see
Around the midline
Clinical: painless swelling, sinus tract may be present
XR: unilocular radiolucency in vicinity of mx midline, causes alterations to walls of incisive canals, root divergence in cases of large cyst
The wall outline is bowing and corticated, away from the midline.
Age: 4th and 6th decade
Site: ant mx, close to the midline
Gender: M:F (3:1)
Tx: enucleation, ideally remove but need to take in pt consideration and maybe just have to do routine monitoring
what is this
normal incisve canal
Incisive canal cyst this is suspicious bc dn follow continous of incisve foramen
The most likely one we will see
Around the midline
Clinical: painless swelling, sinus tract may be present
XR: unilocular radiolucency in vicinity of mx midline, causes alterations to walls of incisive canals, root divergence in cases of large cyst
The wall outline is bowing and corticated, away from the midline.
Age: 4th and 6th decade
Site: ant mx, close to the midline
Gender: M:F (3:1)
Tx: enucleation, ideally remove but need to take in pt consideration and maybe just have to do routine monitoring
what is this
Incisive canal cyst
The most likely one we will see. Its Around the midline
Clinical: painless swelling, sinus tract may be present
XR: unilocular radiolucency in vicinity of mx midline, causes alterations to walls of incisive canals, root divergence in cases of large cyst
The wall outline is bowing and corticated, away from the midline.
Age: 4th and 6th decade
Site: ant mx, close to the midline
Gender: M:F (3:1)
Tx: enucleation, ideally remove but need to take in pt consideration and maybe just have to do routine monitoring
what is this
Incisive canal cyst
The most likely one we will see. Around the midline
Clinical: painless swelling, sinus tract may be present
XR: unilocular radiolucency in vicinity of mx midline, causes alterations to walls of incisive canals, root divergence in cases of large cyst
The wall outline is bowing and corticated, away from the midline.
Age: 4th and 6th decade
Site: ant mx, close to the midline
Gender: M:F (3:1)
Tx: enucleation, ideally remove but need to take in pt consideration and maybe just have to do routine monitoring
what is this
Incisive canal cyst its not heart shape that is the ant nasal spine in the way, its actually rounded
The most likely one we will see. Around the midline
Clinical: painless swelling, sinus tract may be present
XR: unilocular radiolucency in vicinity of mx midline, causes alterations to walls of incisive canals, root divergence in cases of large cyst
The wall outline is bowing and corticated, away from the midline.
Age: 4th and 6th decade
Site: ant mx, close to the midline
Gender: M:F (3:1)
Tx: enucleation, ideally remove but need to take in pt consideration and maybe just have to do routine monitoring
what is this
Incisive canal cyst
The most likely one we will see. Around the midline
Clinical: painless swelling, sinus tract may be present
XR: unilocular radiolucency in vicinity of mx midline, causes alterations to walls of incisive canals, root divergence in cases of large cyst
The wall outline is bowing and corticated, away from the midline.
Age: 4th and 6th decade
Site: ant mx, close to the midline
Gender: M:F (3:1)
Tx: enucleation, ideally remove but need to take in pt consideration and maybe just have to do routine monitoring
what is this
Incisive canal cyst
The most likely one we will see. Around the midline
Clinical: painless swelling, sinus tract may be present
XR: unilocular radiolucency in vicinity of mx midline, causes alterations to walls of incisive canals, root divergence in cases of large cyst
The wall outline is bowing and corticated, away from the midline.
Age: 4th and 6th decade
Site: ant mx, close to the midline
Gender: M:F (3:1)
Tx: enucleation, ideally remove but need to take in pt consideration and maybe just have to do routine monitoring
what is this
Incisive canal cyst
The most likely one we will see. Around the midline
Clinical: painless swelling, sinus tract may be present
XR: unilocular radiolucency in vicinity of mx midline, causes alterations to walls of incisive canals, root divergence in cases of large cyst
The wall outline is bowing and corticated, away from the midline.
Age: 4th and 6th decade
Site: ant mx, close to the midline
Gender: M:F (3:1)
Tx: enucleation, ideally remove but need to take in pt consideration and maybe just have to do routine monitoring
what is this
Incisive canal cyst
The most likely one we will see. Around the midline
Clinical: painless swelling, sinus tract may be present
XR: unilocular radiolucency in vicinity of mx midline, causes alterations to walls of incisive canals, root divergence in cases of large cyst
The wall outline is bowing and corticated, away from the midline.
Age: 4th and 6th decade
Site: ant mx, close to the midline
Gender: M:F (3:1)
Tx: enucleation, ideally remove but need to take in pt consideration and maybe just have to do routine monitoring
what is this
Incisive canal cyst
The most likely one we will see. Around the midline
Clinical: painless swelling, sinus tract may be present
XR: unilocular radiolucency in vicinity of mx midline, causes alterations to walls of incisive canals, root divergence in cases of large cyst
The wall outline is bowing and corticated, away from the midline.
Age: 4th and 6th decade
Site: ant mx, close to the midline
Gender: M:F (3:1)
Tx: enucleation, ideally remove but need to take in pt consideration and maybe just have to do routine monitoring
what is this
Incisive canal cyst
The most likely one we will see. Around the midline
Clinical: painless swelling, sinus tract may be present
XR: unilocular radiolucency in vicinity of mx midline, causes alterations to walls of incisive canals, root divergence in cases of large cyst
The wall outline is bowing and corticated, away from the midline.
Age: 4th and 6th decade
Site: ant mx, close to the midline
Gender: M:F (3:1)
Tx: enucleation, ideally remove but need to take in pt consideration and maybe just have to do routine monitoring
what is this
Incisive canal cyst
The most likely one we will see. Around the midline
Clinical: painless swelling, sinus tract may be present
XR: unilocular radiolucency in vicinity of mx midline, causes alterations to walls of incisive canals, root divergence in cases of large cyst
The wall outline is bowing and corticated, away from the midline.
Age: 4th and 6th decade
Site: ant mx, close to the midline
Gender: M:F (3:1)
Tx: enucleation, ideally remove but need to take in pt consideration and maybe just have to do routine monitoring
what is this
(Traumatic ) Solitary bone cyst like an empty cavity
Clinical: normally asymptomatic, may have swelling or pain
Other names: theres a lot solitary bone cyst, hemorrahgic bone cyst
XR: unilocular radiolucency with interradicular scalloped superior margins. Usually >10mm and associated with >1 root apex
Aggressive lesions can be expansive
Age: <25 years, but mostly the second decade
Site: body and ramus of the mandible
Gender: none
Tx: initiate bleeding to start the healing process, recurrence is rare
what is this
(Traumatic ) Solitary bone cyst like an empty cavity
Clinical: normally asymptomatic, may have swelling or pain
Other names: theres a lot solitary bone cyst, hemorrahgic bone cyst
XR: unilocular radiolucency with interradicular scalloped superior margins. Usually >10mm and associated with >1 root apex
Aggressive lesions can be expansive
Age: <25 years, but mostly the second decade
Site: body and ramus of the mandible
Gender: none
Tx: initiate bleeding to start the healing process, recurrence is rare
what is this
(Traumatic ) Solitary bone cyst like an empty cavity
Clinical: normally asymptomatic, may have swelling or pain
Other names: theres a lot solitary bone cyst, hemorrahgic bone cyst
XR: unilocular radiolucency with interradicular scalloped superior margins. Usually >10mm and associated with >1 root apex
Aggressive lesions can be expansive
Age: <25 years, but mostly the second decade
Site: body and ramus of the mandible
Gender: none
Tx: initiate bleeding to start the healing process, recurrence is rare
what is this
(Traumatic ) Solitary bone cyst like an empty cavity
Clinical: normally asymptomatic, may have swelling or pain
Other names: theres a lot solitary bone cyst, hemorrahgic bone cyst
XR: unilocular radiolucency with interradicular scalloped superior margins. Usually >10mm and associated with >1 root apex
Aggressive lesions can be expansive
Age: <25 years, but mostly the second decade
Site: body and ramus of the mandible
Gender: none
Tx: initiate bleeding to start the healing process, recurrence is rare
what is this
(Traumatic ) Solitary bone cyst like an empty cavity AGRESSIVE.
Clinical: normally asymptomatic, may have swelling or pain
Other names: theres a lot solitary bone cyst, hemorrahgic bone cyst
XR: unilocular radiolucency with interradicular scalloped superior margins. Usually >10mm and associated with >1 root apex
Aggressive lesions can be expansive
Age: <25 years, but mostly the second decade
Site: body and ramus of the mandible
Gender: none
Tx: initiate bleeding to start the healing process, recurrence is rare
what is this cyst
Posterior lingual mandibular salivary gland depressions
Clinical: asymptomatic, usually found in routine radiographs examinations
Aka stafne cyst
XR: well circumscribed post radiolucency in M region between mand canal and inf border
Posterior lingual mandibular salivary gland depressions
Clinical: asymptomatic, usually found in routine radiographs examinations
Aka stafne cyst
XR: well circumscribed post radiolucency in M region between mand canal and inf border
Posterior lingual mandibular salivary gland depressions
Clinical: asymptomatic, usually found in routine radiographs examinations
Aka stafne cyst
XR: well circumscribed post radiolucency in M region between mand canal and inf border
Lateral periodontal cyst
Clinical: asymptomatic, dome-shaped swellings of the interdental papilla, attached gingiva or alveolar mucosa
This is not necessarily apical cyst, it is not displacing the root but growing B and L and starts to form biconcave and grows around the root
XR: well defined radiolucency’s. It is round to ovid in shape. Normally in interradicular areas between alveolar crest and apices.
May or may not come in contact with the root surface
Age: adults
Site: MD around the C-PM area
Gender: more in Males
Tx: enucleation, this should be removed, the cyst does not recur. But must be differentiated from early stage OKCs and ameloblastomas
Lateral periodontal cyst
Clinical: asymptomatic, dome-shaped swellings of the interdental papilla, attached gingiva or alveolar mucosa
This is not necessarily apical cyst, it is not displacing the root but growing B and L and starts to form biconcave and grows around the root
XR: well defined radiolucency’s. It is round to ovid in shape. Normally in interradicular areas between alveolar crest and apices.
May or may not come in contact with the root surface
Age: adults
Site: MD around the C-PM area
Gender: more in Males
Tx: enucleation, this should be removed, the cyst does not recur. But must be differentiated from early stage OKCs and ameloblastomas
Lateral periodontal cyst
Clinical: asymptomatic, dome-shaped swellings of the interdental papilla, attached gingiva or alveolar mucosa
This is not necessarily apical cyst, it is not displacing the root but growing B and L and starts to form biconcave and grows around the root
XR: well defined radiolucency’s. It is round to ovid in shape. Normally in interradicular areas between alveolar crest and apices.
May or may not come in contact with the root surface
Age: adults
Site: MD around the C-PM area
Gender: more in Males
Tx: enucleation, this should be removed, the cyst does not recur. But must be differentiated from early stage OKCs and ameloblastomas
Lateral periodontal cyst
Clinical: asymptomatic, dome-shaped swellings of the interdental papilla, attached gingiva or alveolar mucosa
This is not necessarily apical cyst, it is not displacing the root but growing B and L and starts to form biconcave and grows around the root
XR: well defined radiolucency’s. It is round to ovid in shape. Normally in interradicular areas between alveolar crest and apices.
May or may not come in contact with the root surface
Age: adults
Site: MD around the C-PM area
Gender: more in Males
Tx: enucleation, this should be removed, the cyst does not recur. But must be differentiated from early stage OKCs and ameloblastomas
Lateral periodontal cyst
Clinical: asymptomatic, dome-shaped swellings of the interdental papilla, attached gingiva or alveolar mucosa
This is not necessarily apical cyst, it is not displacing the root but growing B and L and starts to form biconcave and grows around the root
XR: well defined radiolucency’s. It is round to ovid in shape. Normally in interradicular areas between alveolar crest and apices.
May or may not come in contact with the root surface
Age: adults
Site: MD around the C-PM area
Gender: more in Males
Tx: enucleation, this should be removed, the cyst does not recur. But must be differentiated from early stage OKCs and ameloblastomas
Lateral periodontal cyst
Clinical: asymptomatic, dome-shaped swellings of the interdental papilla, attached gingiva or alveolar mucosa
This is not necessarily apical cyst, it is not displacing the root but growing B and L and starts to form biconcave and grows around the root
XR: well defined radiolucency’s. It is round to ovid in shape. Normally in interradicular areas between alveolar crest and apices.
May or may not come in contact with the root surface
Age: adults
Site: MD around the C-PM area
Gender: more in Males
Tx: enucleation, this should be removed, the cyst does not recur. But must be differentiated from early stage OKCs and ameloblastomas
Posterior lingual mandibular salivary gland depressions
This is not an actual cyst but looks like it
Age: adults, 50+
Site: between md canal and inf border
Gender: males
Tx: positive dx based on clinical and radiographic hx negate the need for biopsy and histologic examinations
Posterior lingual mandibular salivary gland depressions
This is not an actual cyst but looks like it
Age: adults, 50+
Site: between md canal and inf border
Gender: males
Tx: positive dx based on clinical and radiographic hx negate the need for biopsy and histologic examinations
Posterior lingual mandibular salivary gland depressions
This is not an actual cyst but looks like it
Age: adults, 50+
Site: between md canal and inf border
Gender: males
Tx: positive dx based on clinical and radiographic hx negate the need for biopsy and histologic examinations
Posterior lingual mandibular salivary gland depressions
This is not an actual cyst but looks like it
Age: adults, 50+
Site: between md canal and inf border
Gender: males
Tx: positive dx based on clinical and radiographic hx negate the need for biopsy and histologic examinations
Focal osteoporotic bone marrow defects of the jaw
Clinical: asymptomatic
XR: unilocular, faint radiolucency, not ragged but difficult to discern as a separate entity
Looks similar to a solidarity bone loss cyst but not turning bone over. It looks irregular but well defined.
Age: all
Site: md
Gender: slightly more in F but not really.
Tx: none
Focal osteoporotic bone marrow defects of the jaw
Clinical: asymptomatic
XR: unilocular, faint radiolucency, not ragged but difficult to discern as a separate entity
Looks similar to a solidarity bone loss cyst but not turning bone over. It looks irregular but well defined.
Age: all
Site: md
Gender: slightly more in F but not really.
Tx: none
Residual cyst
Clinical: asymp, normally found on radiographic examinations of edentulous areas
Tooth or root may or may not be present. If previously extracted may not be any root present
XR: well defined radiolucency with smooth, round, corticated borders, around 5mm or less in diameter
Age: middle age or older
Site: more common in mx
Gender: more common in M
Tx: same as a PA cyst so requires removal of cyst lining and enucleation if a large cyst.
residual cyst
Clinical: asymp, normally found on radiographic examinations of edentulous areas
Tooth or root may or may not be present. If previously extracted may not be any root present
XR: well defined radiolucency with smooth, round, corticated borders, around 5mm or less in diameter
Age: middle age or older
Site: more common in mx
Gender: more common in M
Tx: same as a PA cyst so requires removal of cyst lining and enucleation if a large cyst.
fibrous healing defect
Pathophysiology: develops after inflammation that affects the integrity of the periosteum. After ds is eradicated, the bone deals wo mineralized boney matrix. So only fibrous CT fills the site
Clinical: asymptomatic, noted in areas with a hx of ds or trauma
XR: well circumscribed radiolucent lesion at site of prev surgery
We see “punched out” or see through appearance
May resemble residual cyst in edentulous areas but LACK cortication.
Tx: no tx. Med hx is critical in dx.
fibrous healing defect
Pathophysiology: develops after inflammation that affects the integrity of the periosteum. After ds is eradicated, the bone deals wo mineralized boney matrix. So only fibrous CT fills the site
Clinical: asymptomatic, noted in areas with a hx of ds or trauma
XR: well circumscribed radiolucent lesion at site of prev surgery
We see “punched out” or see through appearance
May resemble residual cyst in edentulous areas but LACK cortication.
Tx: no tx. Med hx is critical in dx.
fibrous healing defect
Pathophysiology: develops after inflammation that affects the integrity of the periosteum. After ds is eradicated, the bone deals wo mineralized boney matrix. So only fibrous CT fills the site
Clinical: asymptomatic, noted in areas with a hx of ds or trauma
XR: well circumscribed radiolucent lesion at site of prev surgery
We see “punched out” or see through appearance
May resemble residual cyst in edentulous areas but LACK cortication.
Tx: no tx. Med hx is critical in dx.
Neuroma, neurofibroma
Clinical: expansion, pain, or paresthesia
Symptoms: complaints of burning, tingling and aching sensations
XR: well circumscribed radiolucency of various shapes. In md usually forms in md canal.
Tx: excision, recurrence is rare.
Neuroma, neurofibroma
Clinical: expansion, pain, or paresthesia
Symptoms: complaints of burning, tingling and aching sensations
XR: well circumscribed radiolucency of various shapes. In md usually forms in md canal.
Tx: excision, recurrence is rare.
Ameloblastoma
Aka conventional (multicystic) ameloblastoma
85-90% of all ameloblastomas
Clinical: slow painless swellings, small lesions detected by XR, larger lesions detected clinically
XR: small lesions are unilocular with corticated borders. Large, aggressive lesions develop multilocular patterns. It displaces and resorbs teeth
Age: adults 3rd to 7th decade
Site: MAND 85% mx 15%
Gender: none
Tx: large aggressive lesions need bone resection. Higher likelihood for recurrence. If not resected then 50 to 90% of recurrence.
“classic appearance”
Ameloblastoma
Aka conventional (multicystic) ameloblastoma
85-90% of all ameloblastomas
Clinical: slow painless swellings, small lesions detected by XR, larger lesions detected clinically
XR: small lesions are unilocular with corticated borders. Large, aggressive lesions develop multilocular patterns. It displaces and resorbs teeth
Age: adults 3rd to 7th decade
Site: MAND 85% mx 15%
Gender: none
Tx: large aggressive lesions need bone resection. Higher likelihood for recurrence. If not resected then 50 to 90% of recurrence.
Ameloblastoma
Aka conventional (multicystic) ameloblastoma
85-90% of all ameloblastomas
Clinical: slow painless swellings, small lesions detected by XR, larger lesions detected clinically
XR: small lesions are unilocular with corticated borders. Large, aggressive lesions develop multilocular patterns. It displaces and resorbs teeth
Age: adults 3rd to 7th decade
Site: MAND 85% mx 15%
Gender: none
Tx: large aggressive lesions need bone resection. Higher likelihood for recurrence. If not resected then 50 to 90% of recurrence.
Ameloblastoma
Aka conventional (multicystic) ameloblastoma
85-90% of all ameloblastomas
Clinical: slow painless swellings, small lesions detected by XR, larger lesions detected clinically
XR: small lesions are unilocular with corticated borders. Large, aggressive lesions develop multilocular patterns. It displaces and resorbs teeth
Age: adults 3rd to 7th decade
Site: MAND 85% mx 15%
Gender: none
Tx: large aggressive lesions need bone resection. Higher likelihood for recurrence. If not resected then 50 to 90% of recurrence.
Ameloblastoma
Aka conventional (multicystic) ameloblastoma
85-90% of all ameloblastomas
Clinical: slow painless swellings, small lesions detected by XR, larger lesions detected clinically
XR: small lesions are unilocular with corticated borders. Large, aggressive lesions develop multilocular patterns. It displaces and resorbs teeth
Age: adults 3rd to 7th decade
Site: MAND 85% mx 15%
Gender: none
Tx: large aggressive lesions need bone resection. Higher likelihood for recurrence. If not resected then 50 to 90% of recurrence.
Odontogenic keratocyst aka OKC
THE THIRD MOST COMMON CYST (#1: PA CYST, #2: DENTIGEROUS)
Pathophysiology: 10 to 12% of all odontogenic cyst, aggressive behave more like benign neoplasms, thought to arise from cell rests of dental lamina
Clinical: normally asymptomatic with increasing size, pain, swelling and exudate may occur
XR: well-defined, smooth, corticated borders, thinning and mild expansion with some perforation of cortical plates, displacement of teeth.
Only occasional root resorption (less than dentigerous and radicular cysts)
Mild b - L expansion but extensive ant-post extension
Age: 2nd to 4th decade
Site: Most in md post to C
Gender: more in M
Tx: enucleation with currettage, a high recurrance rate.
When multiple OKC are found they may be a part of the basal cell nevus syndrome (aka nevoid basal cell carcinoma syndrome)
Odontogenic keratocyst aka OKC
THE THIRD MOST COMMON CYST (#1: PA CYST, #2: DENTIGEROUS)
Pathophysiology: 10 to 12% of all odontogenic cyst, aggressive behave more like benign neoplasms, thought to arise from cell rests of dental lamina
Clinical: normally asymptomatic with increasing size, pain, swelling and exudate may occur
XR: well-defined, smooth, corticated borders, thinning and mild expansion with some perforation of cortical plates, displacement of teeth.
Only occasional root resorption (less than dentigerous and radicular cysts)
Mild b - L expansion but extensive ant-post extension
Age: 2nd to 4th decade
Site: Most in md post to C
Gender: more in M
Tx: enucleation with currettage, a high recurrance rate.
When multiple OKC are found they may be a part of the basal cell nevus syndrome (aka nevoid basal cell carcinoma syndrome)
Odontogenic keratocyst aka OKC
THE THIRD MOST COMMON CYST (#1: PA CYST, #2: DENTIGEROUS)
Pathophysiology: 10 to 12% of all odontogenic cyst, aggressive behave more like benign neoplasms, thought to arise from cell rests of dental lamina
Clinical: normally asymptomatic with increasing size, pain, swelling and exudate may occur
XR: well-defined, smooth, corticated borders, thinning and mild expansion with some perforation of cortical plates, displacement of teeth.
Only occasional root resorption (less than dentigerous and radicular cysts)
Mild b - L expansion but extensive ant-post extension
Age: 2nd to 4th decade
Site: Most in md post to C
Gender: more in M
Tx: enucleation with currettage, a high recurrance rate.
When multiple OKC are found they may be a part of the basal cell nevus syndrome (aka nevoid basal cell carcinoma syndrome)
Odontogenic keratocyst aka OKC small stage
THE THIRD MOST COMMON CYST (#1: PA CYST, #2: DENTIGEROUS)
Pathophysiology: 10 to 12% of all odontogenic cyst, aggressive behave more like benign neoplasms, thought to arise from cell rests of dental lamina
Clinical: normally asymptomatic with increasing size, pain, swelling and exudate may occur
XR: well-defined, smooth, corticated borders, thinning and mild expansion with some perforation of cortical plates, displacement of teeth.
Only occasional root resorption (less than dentigerous and radicular cysts)
Mild b - L expansion but extensive ant-post extension
Age: 2nd to 4th decade
Site: Most in md post to C
Gender: more in M
Tx: enucleation with currettage, a high recurrance rate.
When multiple OKC are found they may be a part of the basal cell nevus syndrome (aka nevoid basal cell carcinoma syndrome)
Odontogenic keratocyst aka OKC
THE THIRD MOST COMMON CYST (#1: PA CYST, #2: DENTIGEROUS)
Pathophysiology: 10 to 12% of all odontogenic cyst, aggressive behave more like benign neoplasms, thought to arise from cell rests of dental lamina
Clinical: normally asymptomatic with increasing size, pain, swelling and exudate may occur
XR: well-defined, smooth, corticated borders, thinning and mild expansion with some perforation of cortical plates, displacement of teeth.
Only occasional root resorption (less than dentigerous and radicular cysts)
Mild b - L expansion but extensive ant-post extension
Age: 2nd to 4th decade
Site: Most in md post to C
Gender: more in M
Tx: enucleation with currettage, a high recurrance rate.
When multiple OKC are found they may be a part of the basal cell nevus syndrome (aka nevoid basal cell carcinoma syndrome)
Odontogenic keratocyst aka OKC
THE THIRD MOST COMMON CYST (#1: PA CYST, #2: DENTIGEROUS)
Pathophysiology: 10 to 12% of all odontogenic cyst, aggressive behave more like benign neoplasms, thought to arise from cell rests of dental lamina
Clinical: normally asymptomatic with increasing size, pain, swelling and exudate may occur
XR: well-defined, smooth, corticated borders, thinning and mild expansion with some perforation of cortical plates, displacement of teeth.
Only occasional root resorption (less than dentigerous and radicular cysts)
Mild b - L expansion but extensive ant-post extension
Age: 2nd to 4th decade
Site: Most in md post to C
Gender: more in M
Tx: enucleation with currettage, a high recurrance rate.
When multiple OKC are found they may be a part of the basal cell nevus syndrome (aka nevoid basal cell carcinoma syndrome)
Odontogenic keratocyst aka OKC
THE THIRD MOST COMMON CYST (#1: PA CYST, #2: DENTIGEROUS)
Pathophysiology: 10 to 12% of all odontogenic cyst, aggressive behave more like benign neoplasms, thought to arise from cell rests of dental lamina
Clinical: normally asymptomatic with increasing size, pain, swelling and exudate may occur
XR: well-defined, smooth, corticated borders, thinning and mild expansion with some perforation of cortical plates, displacement of teeth.
Only occasional root resorption (less than dentigerous and radicular cysts)
Mild b - L expansion but extensive ant-post extension
Age: 2nd to 4th decade
Site: Most in md post to C
Gender: more in M
Tx: enucleation with currettage, a high recurrance rate.
When multiple OKC are found they may be a part of the basal cell nevus syndrome (aka nevoid basal cell carcinoma syndrome)
Odontogenic keratocyst aka OKC
THE THIRD MOST COMMON CYST (#1: PA CYST, #2: DENTIGEROUS)
Pathophysiology: 10 to 12% of all odontogenic cyst, aggressive behave more like benign neoplasms, thought to arise from cell rests of dental lamina
Clinical: normally asymptomatic with increasing size, pain, swelling and exudate may occur
XR: well-defined, smooth, corticated borders, thinning and mild expansion with some perforation of cortical plates, displacement of teeth.
Only occasional root resorption (less than dentigerous and radicular cysts)
Mild b - L expansion but extensive ant-post extension
Age: 2nd to 4th decade
Site: Most in md post to C
Gender: more in M
Tx: enucleation with currettage, a high recurrance rate.
When multiple OKC are found they may be a part of the basal cell nevus syndrome (aka nevoid basal cell carcinoma syndrome)
Odontogenic keratocyst aka OKC bilateral bc nevoid basal cell carcinoma syndrome
THE THIRD MOST COMMON CYST (#1: PA CYST, #2: DENTIGEROUS)
Pathophysiology: 10 to 12% of all odontogenic cyst, aggressive behave more like benign neoplasms, thought to arise from cell rests of dental lamina
Clinical: normally asymptomatic with increasing size, pain, swelling and exudate may occur
XR: well-defined, smooth, corticated borders, thinning and mild expansion with some perforation of cortical plates, displacement of teeth.
Only occasional root resorption (less than dentigerous and radicular cysts)
Mild b - L expansion but extensive ant-post extension
Age: 2nd to 4th decade
Site: Most in md post to C
Gender: more in M
Tx: enucleation with currettage, a high recurrance rate.
When multiple OKC are found they may be a part of the basal cell nevus syndrome (aka nevoid basal cell carcinoma syndrome)
Central giant cell granuloma
Clinical: asymptomatic swelling. Can be aggressive.
XR: well-defined borders, can be multilocular. Thinning and expansion of cortical plates. Displacement of teeth and occasional root resportion.
Age: usually < 30 years (60%)
Site: md 70% and frequently between the molars
Gender: F>M (2:1)
Tx: enucleation with aggressive curretage. Pts with CGCG should be evaluated for systemic ds with blood tests. (increased serum calcium and alkaline phosphatase, decreased serum phosphorus)
Central giant cell granuloma
Clinical: asymptomatic swelling. Can be aggressive.
XR: well-defined borders, can be multilocular. Thinning and expansion of cortical plates. Displacement of teeth and occasional root resportion.
Age: usually < 30 years (60%)
Site: md 70% and frequently between the molars
Gender: F>M (2:1)
Tx: enucleation with aggressive curretage. Pts with CGCG should be evaluated for systemic ds with blood tests. (increased serum calcium and alkaline phosphatase, decreased serum phosphorus)
Central giant cell granuloma cant really tell. but just a lot more swelling.
Clinical: asymptomatic swelling. Can be aggressive.
XR: well-defined borders, can be multilocular. Thinning and expansion of cortical plates. Displacement of teeth and occasional root resportion.
Age: usually < 30 years (60%)
Site: md 70% and frequently between the molars
Gender: F>M (2:1)
Tx: enucleation with aggressive curretage. Pts with CGCG should be evaluated for systemic ds with blood tests. (increased serum calcium and alkaline phosphatase, decreased serum phosphorus)
Central giant cell granuloma
Clinical: asymptomatic swelling. Can be aggressive.
XR: well-defined borders, can be multilocular. Thinning and expansion of cortical plates. Displacement of teeth and occasional root resportion.
Age: usually < 30 years (60%)
Site: md 70% and frequently between the molars
Gender: F>M (2:1)
Tx: enucleation with aggressive curretage. Pts with CGCG should be evaluated for systemic ds with blood tests. (increased serum calcium and alkaline phosphatase, decreased serum phosphorus)
Central giant cell granuloma
Clinical: asymptomatic swelling. Can be aggressive.
XR: well-defined borders, can be multilocular. Thinning and expansion of cortical plates. Displacement of teeth and occasional root resportion.
Age: usually < 30 years (60%)
Site: md 70% and frequently between the molars
Gender: F>M (2:1)
Tx: enucleation with aggressive curretage. Pts with CGCG should be evaluated for systemic ds with blood tests. (increased serum calcium and alkaline phosphatase, decreased serum phosphorus)
Central giant cell granuloma
Clinical: asymptomatic swelling. Can be aggressive.
XR: well-defined borders, can be multilocular. Thinning and expansion of cortical plates. Displacement of teeth and occasional root resportion.
Age: usually < 30 years (60%)
Site: md 70% and frequently between the molars
Gender: F>M (2:1)
Tx: enucleation with aggressive curretage. Pts with CGCG should be evaluated for systemic ds with blood tests. (increased serum calcium and alkaline phosphatase, decreased serum phosphorus)
Central giant cell granuloma
Clinical: asymptomatic swelling. Can be aggressive.
XR: well-defined borders, can be multilocular. Thinning and expansion of cortical plates. Displacement of teeth and occasional root resportion.
Age: usually < 30 years (60%)
Site: md 70% and frequently between the molars
Gender: F>M (2:1)
Tx: enucleation with aggressive curretage. Pts with CGCG should be evaluated for systemic ds with blood tests. (increased serum calcium and alkaline phosphatase, decreased serum phosphorus)
Odontogenic myxoma
Clinical: less common. Primarily a lesion of alveolar bone. Basically a fibrous lesion.
XR: scalloped and multilocular
Age: young adults (25 to 30)
Site: greater prevalence in md
Tx: excision. Recurrence is up to 25% bc lesions are not encapsulated.
Odontogenic myxoma
Clinical: less common. Primarily a lesion of alveolar bone. Basically a fibrous lesion.
XR: scalloped and multilocular
Age: young adults (25 to 30)
Site: greater prevalence in md
Tx: excision. Recurrence is up to 25% bc lesions are not encapsulated.
Central hemangioma
Clinical: jaws are the next most common site after skull and vertebrae. Firm, slow-growing. Overlying mucosa is erythematous and warm. Spontaneous gingival bleeding. May need needle aspiration.
Age: teens and young adults
Site: post mand
Sex: F:M 2:1
Tx: radiation, enucleation, sclerosing agents.
Etiology is traumatic/dev or benign neoplasm
Central hemangioma
Clinical: jaws are the next most common site after skull and vertebrae. Firm, slow-growing. Overlying mucosa is erythematous and warm. Spontaneous gingival bleeding. May need needle aspiration.
Age: teens and young adults
Site: post mand
Sex: F:M 2:1
Tx: radiation, enucleation, sclerosing agents.
Etiology is traumatic/dev or benign neoplasm
Central hemangioma
Clinical: jaws are the next most common site after skull and vertebrae. Firm, slow-growing. Overlying mucosa is erythematous and warm. Spontaneous gingival bleeding. May need needle aspiration.
Age: teens and young adults
Site: post mand
Sex: F:M 2:1
Tx: radiation, enucleation, sclerosing agents.
Etiology is traumatic/dev or benign neoplasm
Central hemangioma
Clinical: jaws are the next most common site after skull and vertebrae. Firm, slow-growing. Overlying mucosa is erythematous and warm. Spontaneous gingival bleeding. May need needle aspiration.
Age: teens and young adults
Site: post mand
Sex: F:M 2:1
Tx: radiation, enucleation, sclerosing agents.
Etiology is traumatic/dev or benign neoplasm
Cherubism
Clinical: looking face by 5 years of age due to bilateral bony expansions. Asymptomatic. Bone lesion are more active in younger pts. After 12 it diminishes.
XR: bilateral, multilocular cyst-like, expansive lesion, usually affecting the md and sometimes mx.
Age: by age 5
Site: bilateral mandible, may affect maxillar
Sex: M:F 2:1
Tx: cosmetic osseous contouring at age 12 or older.
Cherubism
Clinical: looking face by 5 years of age due to bilateral bony expansions. Asymptomatic. Bone lesion are more active in younger pts. After 12 it diminishes.
XR: bilateral, multilocular cyst-like, expansive lesion, usually affecting the md and sometimes mx.
Age: by age 5
Site: bilateral mandible, may affect maxillar
Sex: M:F 2:1
Tx: cosmetic osseous contouring at age 12 or older.
which is vital
L: has non vital tooth
here the tooth went non vital when the patient was younger.
but once it went non vital, the secondary dentin stopped as well which proceeded to the cause of the PA radiolucency that we see
whats wrong with this canal
Looks like an obliturated tooth because cannot see the root canal. But, can see it very thinly and narrow.
common see this in pts who have edge to edge occlusion on anteriors.
where is the secondary dentin
secondary dentin formation @ D pulp horn of 1M
whats wrong with this
pulp stones
Are calcifications within the pulp
Pulp chamber, RC space, or both.
The etiology is unknown, can vary in size and numbers.
Tx: none, just an incidental finding. For endo, this makes the case harder.
The borders can be well or ill defined
what do we see here
there are pulp stones in some of the teeth
Are calcifications within the pulp
Pulp chamber, RC space, or both.
The etiology is unknown, can vary in size and numbers.
Tx: none, just an incidental finding. For endo, this makes the case harder.
The borders can be well or ill defined
IRR
Internal –> pulpal path related
If you get inflammation of pulp you get resorption of dentin at the root
Spreads from inside outwards
Margins of defect are well defined
Shape: ovoid to round lesion
Tx: RCT to try to stop resorbing processes if its restorable (and not perforated)
irr
Internal –> pulpal path related
If you get inflammation of pulp you get resorption of dentin at the root
Spreads from inside outwards
Margins of defect are well defined
Shape: ovoid to round lesion
Tx: RCT to try to stop resorbing processes if its restorable (and not perforated)
ERR
External –> caused by external pressure from outside toothSometimes needs tx
Eliminate stimulus that causes it
Ex of external sources:
ortho tx
Tumor
Edges of the margins are smooth
Teeth are still vital
err on the crown
External –> caused by external pressure from outside toothSometimes needs tx
Eliminate stimulus that causes it
Ex of external sources:
ortho tx
Tumor
Edges of the margins are smooth
Teeth are still vital
err on the crown.
External –> caused by external pressure from outside toothSometimes needs tx
Eliminate stimulus that causes it
Ex of external sources:
ortho tx
Tumor
Edges of the margins are smooth
Teeth are still vital
ERR
External –> caused by external pressure from outside toothSometimes needs tx
Eliminate stimulus that causes it
Ex of external sources:
ortho tx
Tumor
Edges of the margins are smooth
Teeth are still vital
nasopalatine foramen
can mimic PA pathology
Can be assymetrical, see at one CI or both.
See radiolucency near root apex
Follow lamina dura all the way around the tooth, make sure that it is in tact.
MX
lateral fossa
can mimic a PA lesion
A large radiolucent area following the root
The bone is thinner here so that is why it looks radiolucent to begin with
Follow the lamina dura around the root and apex.
MX
mental foramen
can mimic PA lesion
Can be superimposed onto the root apex of the PM
Dn see lamina dura very well,, so could give more suspicion.
open apices in young pt
can mimic pa leison
These can stimulate a periapical lesion
This is because the tooth has erupted but NOT fully developed so the apices are not closed yet
FOLLOW the lamina dura
Apical abscess
Radiographic findings at apex
- PDL space thickening
- Discontinuity of lamina dura
- Periapical radiolucency into the surrounding bone.
Apical abscess
Radiographic findings at apex
- PDL space thickening
- Discontinuity of lamina dura
- Periapical radiolucency into the surrounding bone.
Apical abscess
Radiographic findings at apex
- PDL space thickening
- Discontinuity of lamina dura
- Periapical radiolucency into the surrounding bone.
chronic apical abscess
tooth is non-vital
Ill defined
Size is variable
Loss of lamina dura
chronic apical abscess
tooth is non-vital
Ill defined
Size is variable
Loss of lamina dura
periapical granuloma
Have granulation tissue
Granulation may develop from an abscess.
periapical cyst
PA usually from granulomas
DOES have sclerotic border around radiolucency
Tx –> RCT
Have well defined margins.
periapical cyst
Here ^ large lesion are often cysts
PA usually from granulomas
DOES have sclerotic border around radiolucency
Tx –> RCT
Have well defined margins.
Larger radiolucency
Has sclerotic bone around it
chronic apical abscess with DST
Ill defined
Size is variable
Loss of lamina dura
fibrous healing defect
If infection is large enough that it resorbs B+L + periosteum
Margins are well defined
Overtime cannot change must or at all.
Pathophysiology: develops after inflammation that affects the integrity of the periosteum. After ds is eradicated, the bone deals wo mineralized boney matrix. So only fibrous CT fills the site
Clinical: asymptomatic, noted in areas with a hx of ds or trauma
XR: well circumscribed radiolucent lesion at site of prev surgery
We see “punched out” or see through appearance
May resemble residual cyst in edentulous areas but LACK cortication.
Tx: no tx. Med hx is critical in dx.
Periapical cemento-osseuous dysplasia
Early stage must be differentiated from other radiolucent periapical lesions
Want to be aware and know of
One of the most “common” to misinterpret
Radiolucent
Filled in with calcification
If predominantly radiopaque harder to see.
Do not automatically assume the tooth is NON-VITAL. These teeth are vital and do not require non vital tx
metastatic carcinoma
Seen in areas of apex of the tooth, may have some pain
Notice the strands of trabeculation at the lesion this is distinguish from others
