Non-Odontogenic Poorly Defined Entities

Question 1

What is osteoradionecrosis? Characterized by? Risk by radiation dose?

Answer 1

Chronic infection of bone following high dose radiation therapy.

• Extreme Pain, necrosis, and sequestration.
• More often in mandible

Greater than 75 gray= significant incidence
Less than 60 gray= Minimal risk

Question 2

What are the predisposing factors of osteoradionecrosis? Radiographic?

Answer 2

• Post-radiation extractions
• Perio disease

Irregular, poorly defined lesions.

Question 3

What is medication-related Osteonecrosis of the jaws (MRONJ)? Radiographic? Intraoral findings? Treatment?

Answer 3

Drugs that inhibit bone turnover and are used in management of cancer and osteoporosis can cause necrosis of the jaws.

• Mixed, poorly defined.
• Single or multifocal areas of exposed necrotic bone.

Treatment: Minimize pain, antibiotics, exposed bone gently smoothed.

Question 4

What is the most common malignant neoplasm OF the jaw? Most common malignant neoplams IN the jaw

Answer 4

OF: Metastatic carcinoma.
IN: Metastatic neoplasm that travel to jaw

Question 5

What is osteosarcoma? Radiographic? Treatment?

Answer 5

Malignant bone cancer.
-RL, RO, or Mixed, poorly defined, some have “sun-ray”, Widening of PDL, loss of lamina dura.

Treatment: Radical surgery. Prognosis poor.

Question 6

What is radiographic features of chondrosarcoma? Treatment?

Answer 6

-RL,RO,M, poorly defined,Widened PDL,

Treatment: Radical surgery

Question 7

What are the clinical features of Ewing’s Sarcoma? Radiographic?

Answer 7

• Occurs in under 20 patients
• Pain and swelling are early signs.
• Poorly defined, radiolucent, onion peel appearance.

Question 8

What is multiple myeloma? Characteristics? Radiographic? Treatment?

Answer 8

Multiple tumors of plasma cells.

• Always in patients above 40
• Bone pain, especially in back
• M Protein (Bence-jones)
• Multiple punched out lesions

Treatment: Chemotherapy