Mixed/RO Non-Odontogenic Lesions

Question 1

Mixed/ RO Non-odontogenic lesions

Mixed 2

RO 6

Answer 1

• Mixed
  
  • Cemento-osseous dysplasia
  • Central ossifying fibroma
• RO
  
  • Idiopathic osteosclerosis
  • Fibrous dysplasia
  • Hyperparathyroidism
  • Osteoma
  • Sinusitis/Mucositis
  • Mucous retention psudocyst

Question 2

Benign Fibro-Osseous Lesions 3

Answer 2

• Benign neoplasms and non-neoplastic lesions of bone with identical micro features
  
  • Cemento-osseous dysplasia- not a neoplasm
  • Ossifying (cementifying) fibroma- neoplasm
  • Fibrous dysplasia- not a neoplasm

Question 3

Spectrum of Cemento-osseous dysplasias

3 kinds

Answer 3

• Cemento-osseous dysplasia develop in areas of teeth but may represent benign fibro-osseous lesions
• Bone gets broken down and replaced with fibrous tissue
• Focal cemento-osseous dysplasia- solitary lesion, most common
• Periapical cemental dysplasia- multiple lesions usually in anterior mand
• Florid cemento-osseous dysplasia- multiple, bilateral lesions throughout the jaws

Question 4

Cemento-osseous dysplasias

what are they

Do not cause, rarely

Demo, age

tx

Answer 4

• These are not neoplasms
• Do not cause enlargement, rarely tooth resorption
• 90% women 30-50yo
• Tx dont need to be treated

Question 5

Periapical cemento-osseous dysplasia

Location, involving

Demo

May produce

Process

Xray2

Management

Answer 5

• Commonly multiple periapical lesions involving mand ant teeth
• Common in african americans
• ay produce mineralized products
• First becomes RL then mixed
• Surrounded by thin RL line
• Hard to id partly well defined, partly corticated
• Management: dx and then no addnl tx

Question 6

Focal Cemento-osseous Dysplasia

Same as

Location 2

Demo

Xray 2

Tx

Answer 6

• Same feat as PCOD
• Occurs only in one location
• Usually post mand
• Common in caucasians
• RL with RO center
• Partly corticated
• No tx necessary

Question 7

Florid Cemento-osseous Dysplasia

same as

Distribution/ xray

Location

Xray

demo

tx

Answer 7

• Same as PCOD
• Multiple bilateral periapical RL areas w/ formation of mineralized product
• Occurs in only 2+ quadrants
• Mixed
• Common in african americans
• No tx needed

Question 8

Fibrous Dysplasia

Definition

3 diff severities

Tx

Answer 8

• Non-neoplastic developmental disturbance of bone growth
• Severity of disease depends when mutation occurs
• Monostotic- late
• Polyostotic- mid
• Syndrome- ealry
• Tx
  
  • bony recontouring once it stops growing
  • Lesion shout NOT be irradiated as this may cause malignant transformation

Question 9

Monostotic Fibrous dysplasia

Involves

occurs during

occurrence

Answer 9

• Involves one bone
• 1st and 2nd decade of life
• More common than polystotic

Question 10

Polyostotic Fibrous Dysplasia

Involves, begins, features, occurence

2 diff types- involve, app

Answer 10

• Involves multiple bones, begins early in life, systemic features, rare
• Jaffe syndrome
  
  • Involves fewer bones
  • Cafe au lait melanotic macules
• McCune Albright Syndrome
  
  • Involves most of skeleton
  • Endocrine abnormalities, usually precocious puberty in females
  • Cafe au lait macules

Question 11

Fibrous Dysplasia Xray

Specific term

Location

causes

borders

Mand and max

Answer 11

• Ground glass homogenous radiopacity, poorly defined, blends into surrounding bone
• Diffuse uniform RO
• Causes expansion- on mand expands buccal and lingual
• Margins of lesion blend into surrounding bone
• Monostotic only mand
• Max lesions may involve surrounding bones- craniofacial fibrous dysplasia

Question 12

Central Ossifying (& Cementifying) Fibroma

What is it

Growth

can cause, and

xray/ varieties 4

tx

Answer 12

• True neoplasm of bone
• Persistent and progressive growth
• Can cause expansion and displacement of teeth
• Xray
  
  • well demarcated
  • May app in diff patterns
    
    • Entirely RL
    • RL with foci of RO areas
    • Mostly RO
• Tx
  
  • Must be removed
  • Enucleation or curettage

Question 13

Idiopathic Osteosclerosis

Aka

counterpart of

definition

Location

dx

xray 6

Answer 13

• AKA dense bone island, Enostosis
• Intraosseous counterpart of tori
• Focal area of cortical bone of unkown cause
• 90% post mand
• Dx can be done with xrays
• Xray
  
  • round, well defined, sclerotic area
  • Usualy at apex
  • Still have PDL (unlike cementoblastoma)
  • Still have lamina dura

Question 14

Osteoma

What is it

4 areas it can affect

xray 3

tx 2

Answer 14

• Benign tumor of bone restricted to skull
• Periosteal- surface of bone
• Endosteal- medullary bone
• Osteoma cutis- within muscle or dermis
• Common in condyle (shift in midline/occlusion) and paranasal sinuses
• Xray
  
  • Well defined
  • Totally RO
  • Circumscribed sclerotic mass
• Tx
  
  • Small-observe
  • Large-surgery

Question 15

Mucositis and Sinusitis

What is it

caused by

Muco vs sinus

xray 3

Answer 15

• Inflammation of lining of sinus
• Allergy, irritation, foreign body, trauma
• Mucositis- localized- no tx
• Sinusitis- multiple sinuses- control or surgery
• Feels like tooth pain
• Xray
  
  • Well defined
  • Noncorticated
  • RO band of increased radiopacity parelleling the bony wall of max sinus

Question 16

Mucous Retention Pseudocyst

What causes it

Xray 5

tx

Answer 16

• Blockage of seromucous glands in sinus mucosa
  
  • Mucos gets trapped btw epithelium and bone causing domeshaped swelling
• Submucosal accumulation of secretions= dome shaped swelling
• Xray
  
  • Well defined
  • Noncorticated
  • Smooth
  • Dome shaped
  • Sessile RO mass
• No tx needed