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D2 Spring > Oral Path Exam 1 - Bone Lesion Radiolucencies Part 1 > Flashcards

Oral Path Exam 1 - Bone Lesion Radiolucencies Part 1 Flashcards

1
Q

Inflammation in the pulp leading to involvement of the periapical tissues (acute/chronic periapical periodontitis)

A

Periapical cyst

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2
Q

Most common odontogenic cyst

A

Periapical cyst

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3
Q

Acute periapical cysts are ___________
Chronic periapical cysts are __________

A

painful; asymptomatic

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4
Q

Acute exacerbation of a chronic lesion can cause an __________ with or without swelling

A

abscess

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5
Q

Neutrophils at the apex of a nonvital tooth

A

Abscess

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6
Q

Radiographically present as a round to ovoid
radiolucency at the apex of a non-vital tooth

A

Periapical cyst

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7
Q

Periapical cysts cause loss of _________ _______ and can cause root ___________

A

lamina dura; resorption

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8
Q

Most periapical cysts are less than _______ cm in diameter

A

1.5cm

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9
Q

You can’t distinguish periapical cysts by what 2 things?

A

Size
Radiographic appearance

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10
Q

Cyst between teeth (less common)

A

Lateral radicular cyst

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11
Q

Acute/chronic inflammation + granulation tissue with variably thick, non-keratinized stratified squamous epithelial lining

A

Periapical cyst

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12
Q

Acute/chronic inflammation + granulation tissue without an epithelial lining

A

Periapical granuloma

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13
Q

Describe the tx of a periapical cyst/granuloma

A

Enucleation
Ext or endo

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14
Q

What happens if the periapical lesion is not removed?

A

Residual periapical cyst

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15
Q

Recurrence of a periapical cyst/granuloma is _________

A

unlikely

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16
Q

When should you worry about a periapical cyst/granuloma? (3)

A
  1. Multilocular (not odontogenic infection)
  2. Significant root resorption/movement of teeth (is prob something else)
  3. Doesn’t respond to tx radiographically or clinically (inadequate tx or different diagnosis)
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17
Q

Yellowish/red nodule of granulation tissue representing an intraoral point of drainage for a sinus tract related to necrotic tooth

A

Parulis

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18
Q

Where is a parulis typically found?

A

Facial gingiva/alveolar mucosa apical to tooth of origin

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19
Q

What are the parulis location exceptions?

A

Palatal bone: maxillary lateral incisors
Lingual plate: mandibular 2nd & 3rd molars

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20
Q

Asymptomatic parulis lesions are often patent and ______ can be expressed from the center of the lesion

A

pus

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21
Q

What type of cysts are the following?

Dentigerous cyst/Hyperplastic dental follicle
Eruption cyst
Lateral periodontal cyst
Odontogenic keratocyst
Nasopalatine duct cyst
Simple bone cyst (not a true cyst but mimics)

A

Developmental cysts

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22
Q

What type of cysts are the following?

Periapical cyst
Residual cyst

A

Inflammatory cysts

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23
Q

Abnormal sac or cavity lined by epithelium which is enclosed in connective tissue

A

Cyst

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24
Q

Where does enlargement of a cyst come from?

A

Fluid accumulation inside of it

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25
Q

What are the 2 classifications of cysts?

A

Developmental
Inflammatory

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26
Q

What are the 2 categories of developmental cysts?

A

Odontogenic (related to tooth development)
Non-odontogenic

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27
Q

Odontogenic and non-odontogenic developmental cysts can be ___________ or ___________

A

intraosseous; extraosseous

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28
Q

What type of developmental cyst?

Inside bone

A

Intraosseous

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29
Q

What type of developmental cyst?

Inside soft tissue

A

Extraosseous

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30
Q

What type of developmental cyst?

Dentigerous cyst
Odontogenic keratocyst
Lateral periodontal cyst

A

Odontogenic, intraosseous

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31
Q

What type of developmental cyst?

Eruption cyst
Gingival cyst

A

Odontogenic, extraosseous

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32
Q

What type of developmental cyst?

Nasopalatine duct cyst

A

Non-odontogenic, intraosseous

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33
Q

What type of developmental cyst?

Epidermoid cyst
Thyroglossal tract cyst

A

Non-odontogenic, extraosseous

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34
Q

Where do odontogenic cysts/tumors come from? (3)

A

Dental lamina rests (rests of Serres)
Rests of Malassez
Reduced enamel epithelium

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35
Q

A cyst that forms around the crown of an impacted tooth

A

Dentigerous cyst

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36
Q

2nd most common odontogenic cyst, after periapical cyst

A

Dentigerous cyst

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37
Q

What epithelium do dentigerous cysts arise from?

A

Reduced enamel epithelium

38
Q

These cysts have > 3-4mm pericoronal radiolucency

A

Dentigerous cysts

39
Q

If these cysts are smaller, they are virtually identical to a hyperplastic dental follicle (lacks a true epithelial lining)

A

Dentigerous cysts

40
Q

What is the treatment for a dentigerous cyst?

A

Enucleation

41
Q

What type of cyst?

Prognosis is excellent, minimal tendency to recur
Tissue should be sent for microscopic exam to exclude other diagnoses

A

Dentigerous cysts

42
Q

When is it NOT a dentigerous cyst? (3)

A
  1. Not around the crown
  2. Multilocular
  3. Any sign of opacity
43
Q

When is it less likely to be a dentigerous cyst? (2)

A
  1. Impacted tooth other than 3rd molar/canine
  2. Larger lesions
44
Q

What do dentigerous cysts mimic? (4)

A
  1. Odontogenic keratocyst (most common)
  2. Unicystic ameloblastoma (infrequent)
  3. Odontogenic myxoma (uncommon)
  4. Central giant cell granuloma
45
Q

If you biopsy a large dentigerous cyst, make sure to get an __________ area, and you may need multiple spots, as solid areas would indicate a tumor

A

uninflamed

46
Q

What type of cyst?

Represents a dentigerous cyst that forms in the soft tissue overlying the crown of an erupting tooth

A

Eruption cyst

47
Q

What type of cyst?

Usually somewhat translucent swelling, but may be bluish due to blood accumulation

A

Eruption cyst

48
Q

What patients are usually affected by eruption cysts?

A

Children

49
Q

What should you do to confirm an eruption cyst?

A

Take X-Ray

50
Q

What is the treatment for an eruption cyst?

A

Ruptures spontaneously or excise to allow tooth to erupt

51
Q

What type of cyst?

Derived from dental lamina rests

A

Lateral periodontal cysts

52
Q

What patients are usually affected by lateral periodontal cysts?

A

Middle aged

53
Q

What type of cyst?

Asymptomatic; adjacent teeth are vital

A

Lateral periodontal cysts

54
Q

What type of cyst?

Unilocular radiolucency
Can look multilocular (grape-like)

A

Lateral periodontal cyst

55
Q

What is the name of a lateral periodontal cyst that looks multilocular/grape-like?

A

Botryoid odontogenic cyst

56
Q

Where are lateral periodontal cysts found?

A

Mandibular canine/premolar region

57
Q

What type of cyst?

< 1 cm

A

Lateral periodontal cyst

58
Q

What type of cysts?

Excision is curative

A

Lateral periodontal cyst
Gingival cyst

59
Q

What type of cyst?

Identical to the lateral periodontal cyst but occurs within gingival soft tissues, not within bone

A

Gingival cyst

60
Q

What type of cyst?

Bluish to translucent/clear swelling, often centered in attached gingiva

(can mimic a mucocele but there are no salivary glands on the gingiva!)

A

Gingival cyst

61
Q

What type of cyst?

Also known as incisive canal cyst

A

Nasopalatine duct cyst

62
Q

Where are nasopalatine duct cysts located? What does this cause?

A

Within incisive canal
Causes palatal swelling over foramen

63
Q

What type of cyst?

Radiolucency between apices of #8-9 in middle-aged adults

A

Nasopalatine duct cyst

64
Q

Are teeth vital or non-vital in nasopalatine duct cysts?

A

Vital

65
Q

What is the treatment for nasopalatine duct cysts?

A

Surgical removal

66
Q

What should you do if you suspect a nasopalatine duct cyst between #8 and 9?

A

Take a CBCT to confirm it’s in the incisive canal

67
Q

Benign, but locally aggressive developmental odontogenic cyst

A

Odontogenic keratocyst

68
Q

Where do odontogenic keratocysts arise from?

A

Dental lamina rests

69
Q

Where are odontogenic keratocysts most often found?

A

Posterior mandible

(but any segment of the jaws can be affected)

70
Q

Odontogenic keratocysts are often _____________, or cause swelling when large

A

asymptomatic

71
Q

What type of cyst?

When small: unilocular radiolucency
When large: multilocular

A

Odontogenic keratocyst

72
Q

What type of cyst?

Uniform, thin, stratified squamous epithelial lining

A

Odontogenic keratocyst

73
Q

What type of cyst?

Luminal parakeratin production

A

Odontogenic keratocyst

74
Q

What type of cyst?

Palisaded (“picket fence”) appearance of basal cell nuclei

A

Odontogenic keratocyst

75
Q

What type of cyst?

Features are altered with inflammation
Satellite cyst formation may be seen

A

Odontogenic keratocyst

76
Q

What type of lesion is treated by the following method?

Excision with curettage

A

Small odontogenic keratocyst

77
Q

What type of lesion is treated by the following method?

Resection, marsupialization followed by surgical excision of residual cystic epithelium

A

Large odontogenic keratocyst

78
Q

With occurrence in the first decade or with multiple odontogenic keratocysts, what should be ruled out?

A

Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome)

79
Q

What type of genetic inheritance does Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome) have?

A

Autosomal dominant

80
Q

What is a characteristic finding in the jaws of patients with Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome)?

A

Odontogenic keratocysts

(arise at early age, may be multiple)

81
Q

Name the 2 cutaneous features in patients with Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome)

A

Basal cell carcinomas (early onset)
Palmar/plantar pitting

82
Q

Name the 3 skeletal features in patients with Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome)

A

Calcified falx cerebri
Increased cranial circumference
Bifid ribs

83
Q

What is involved in the treatment and management of patients with Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome)?

A

Sunscreen
Excision of basal cell carcinomas
Excision of odontogenic keratocysts
Genetic counseling

84
Q

T/F: Periapical cysts or granulomas are typically multilocular

A

FALSE, they are unilocular

85
Q

Also known as the “traumatic bone cyst,” even though trauma isn’t present in most cases

A

Simple bone cyst

86
Q

This cyst occurs in young patients aged 10-20; found in the mandible only; premolar/molar region

A

Simple bone cyst

87
Q

Are the teeth vital or non-vital with a simple bone cyst?

A

Vital!

88
Q

Are simple bone cysts symptomatic or asymptomatic?

A

Asymptomatic

89
Q

What type of cyst?

Well-defined radiolucency that “scallops” between adjacent roots

A

Simple bone cyst

90
Q

What type of cyst?

Diagnosed by biopsy; there is no cyst lining, just a hole in the bone

(“empty bone cavity”)

A

Simple bone cyst

91
Q

What type of cyst?

Tx = scrape (curettage) inside bony cavity to promote bleeding and regeneration of bone

A

Simple bone cyst

D2 Spring (18 decks)

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