Nonneoplastic Diseases of Bone Flashcards
What does dysplasia mean?
Refers to the abnormal and disorderred production of cementum and bone
Not to be confused w/ dysplasia in the context of epithelial dysplasia (premalignant condition affecting squamous epithelium)
What are the benign fibro-osseous lesions?
- Periapical cemento-osseous dysplasia
- Focal cemento-osseous dysplasia
- Florid cemento-osseous dysplasia
- Fibrous dysplasia
Characteristics of periapical cemento-osseous dysplasia
- Common disease of unknown cause that affects periapical bone
- Occurs in anterior mandible of female pts >30yrs typically afrifcan american
- Asymptomatic and usually found on radiographs
- Well circumscribed and radiolucent but become increasingly calcified over time
- Teeth are vital- no treatment
Characteristics of florid cemento-osseous dysplasia
- Asymptomatic fibro-osseous lesion
- Condition of disordered cementum and bone development
- Clinically: occurns mostly in black women >40yrs, typically in multiple quads, isolated, well-circumscribed radiolucent to radiopaque
- Best diagnosed using pt history, radiographs and clinica presentation
- Asymptomatic and no treatment
Characteristics of focal cemento-osseous dysplasia
- Occurs in women 30-50 years old
- Similar appearance to periapical cemento-osseous dysplasia and florid cemento-osseous dysplasia
- More common in white women
- Occurs in posterior mandible
- Less that 1.5cm in size
- Biopsy usually necessary for diagnosis
- Composed of numerous gritty pieces of soft and hard tissue: fibrous connective tissue interspersed w/ bone trabeculae and cementum-like material
What is fibrous dysplasia?
- Characteized by replacement of bone w/ abnormal fibrous connective tissue interspersed w/ varying amounts of calcification
- Benign fibro-osseous lesion, with vascularized cellular fibrous CT interspersed w/ irregular trabeculae of bone
Types of fibrous dysplasia
- Monostotic fibrous dysplasia
- Polyostotic fibrous dysplasia
Characteristics of monostotic fibrous dysplasia
- Involvement of a single bone
Maxilla more frequently involved than mandible - Most commonly diagnosed in children and young adults- no sex prediliction
- Clinical exam reveals painless swelling or bulging of buccal plate
Characteristics of polyostotic fibrous dysplasia
- Involvement of more than one bone
- Typically occuring in children w/ female prediliction
- Long bones may bow and have a dull aching pain. May create and enlargement in the maxilla or mandible
- Pts mayhave skin lesions appearing as light-brown macues called cafe au lait spots
- Typically painless, progressive and unilateral
- Radiographic appeaace is a diffuse radiopacity looking like “gound glass”
Types of polyostotic fibrous dysplasia
- Craniofacial fibrous dysplasia
- Jaffe type
- Albright syndrome
What does craniofacial fibous dysplasia involve?
Maxilla w/ extension into the sinuses and adjacent zygoma, sphenoid and occipital bones
What does the Jaffe type involve?
Multiple bones along w/ cafe au lait macules
What is albright syndrom characterized by?
- Endocrine abnomalities
- Precocious puberty in females (breasts, menses, pubic hair in children as young as 2)
- Stunting or deformity of skeletal growth in both sexes as a result of premature closing of the epiphyseal plates
- Cafe au lait spots
Characteristics of Paget Disease of Bone
- Chronic metabolic bone disease
- Interferes w/ the body’s normal bone recycling process
- Unknown cause
- More in men >50yrs
- Maxill more commonly affected
- Enlargement of affected bone
- Pt often complains of pain
- Spaces btw teeth may increase as jaw enlarges
- Radiogaphically:
-Patchy radiolucency and radiopacity “cotton wool”
-Hypercementosis, loss of lamina dura, obliteration of PDL
Characteristics of central giant cell granuloma
- Composed of well-vascularized CT containing many multinucleated giant cells
- Occurs in tissue (peripheral) and bone (central) locations
- Moe in women <30yrs
- Pin can occur but not common
- Slow-growing
- Destructive
- Sclerotic or ill-defined borders
- Unilocular or multilocular radiolucency
- Divergence of roots
- Treated w/ surgical excision
What is an aneurysmal bone cyst?
- Pseudocyst
- Consists of blood-filled spaces surrounded by multinucleated giant cells and fibrous CT
- Radiographically: “Honeycomb” or “soap bubbles”
- Treated w/ surgical excision and cryotherapy
What is osteomalacia?
- Disease of bone that develops over a long period as the result of a calcium deficiency
- Rickets: softening and weakening of bones in children
- Maybe inherited vit D deficiency (hypophosphatemia vit D resistant rickets)
- Clinical characteristics:
-Delayed tooth eruption
-Periodontal disease
-Pathologic featues - Treatment is based on cause
What is the term used for abnormal and disordered production of cementum and bone?
Dysplasia
What is the term used to explain abnormal bone metabolism, including resorption, osteoblastic repair and remineralization of the involved bone?
What is the disease that develops over a long period of time as a result from calcium deficiency?
Osteomalacia
What condition is seen here?
Aneurysmal bone cyst
What condition is seen here?
Central giant cell granuloma
What condition is seen here?
Paget disease
What condition is seen here?
Polyostotic fibrous dysplasia
