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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

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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
What are the 2 classifications of cysts?
Developmental Inflammatory
26
What are the 2 categories of developmental cysts?
Odontogenic (related to tooth development) Non-odontogenic
27
Odontogenic and non-odontogenic developmental cysts can be ___________ or ___________
intraosseous; extraosseous
28
What type of developmental cyst? Inside bone
Intraosseous
29
What type of developmental cyst? Inside soft tissue
Extraosseous
30
What type of developmental cyst? Dentigerous cyst Odontogenic keratocyst Lateral periodontal cyst
Odontogenic, intraosseous
31
What type of developmental cyst? Eruption cyst Gingival cyst
Odontogenic, extraosseous
32
What type of developmental cyst? Nasopalatine duct cyst
Non-odontogenic, intraosseous
33
What type of developmental cyst? Epidermoid cyst Thyroglossal tract cyst
Non-odontogenic, extraosseous
34
Where do odontogenic cysts/tumors come from? (3)
Dental lamina rests (rests of Serres) Rests of Malassez Reduced enamel epithelium
35
A cyst that forms around the crown of an impacted tooth
Dentigerous cyst
36
2nd most common odontogenic cyst, after periapical cyst
Dentigerous cyst
37
What epithelium do dentigerous cysts arise from?
Reduced enamel epithelium
38
These cysts have > 3-4mm pericoronal radiolucency
Dentigerous cysts
39
If these cysts are smaller, they are virtually identical to a hyperplastic dental follicle (lacks a true epithelial lining)
Dentigerous cysts
40
What is the treatment for a dentigerous cyst?
Enucleation
41
What type of cyst? Prognosis is excellent, minimal tendency to recur Tissue should be sent for microscopic exam to exclude other diagnoses
Dentigerous cysts
42
When is it NOT a dentigerous cyst? (3)
1. Not around the crown 2. Multilocular 3. Any sign of opacity
43
When is it less likely to be a dentigerous cyst? (2)
1. Impacted tooth other than 3rd molar/canine 2. Larger lesions
44
What do dentigerous cysts mimic? (4)
1. Odontogenic keratocyst (most common) 2. Unicystic ameloblastoma (infrequent) 3. Odontogenic myxoma (uncommon) 4. Central giant cell granuloma
45
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
uninflamed
46
What type of cyst? Represents a dentigerous cyst that forms in the soft tissue overlying the crown of an erupting tooth
Eruption cyst
47
What type of cyst? Usually somewhat translucent swelling, but may be bluish due to blood accumulation
Eruption cyst
48
What patients are usually affected by eruption cysts?
Children
49
What should you do to confirm an eruption cyst?
Take X-Ray
50
What is the treatment for an eruption cyst?
Ruptures spontaneously or excise to allow tooth to erupt
51
What type of cyst? Derived from dental lamina rests
Lateral periodontal cysts Odontogenic keratocysts
52
What patients are usually affected by lateral periodontal cysts?
Middle aged
53
What type of cyst? Asymptomatic; adjacent teeth are vital
Lateral periodontal cysts
54
What type of cyst? Unilocular radiolucency Can look multilocular (grape-like)
Lateral periodontal cyst
55
What is the name of a lateral periodontal cyst that looks multilocular/grape-like?
Botryoid odontogenic cyst
56
Where are lateral periodontal cysts found?
Mandibular canine/premolar region
57
What type of cyst? < 1 cm
Lateral periodontal cyst
58
What type of cysts? Excision is curative
Lateral periodontal cyst Gingival cyst
59
What type of cyst? Identical to the lateral periodontal cyst but occurs within gingival soft tissues, not within bone
Gingival cyst
60
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!)
Gingival cyst
61
What type of cyst? Also known as incisive canal cyst
Nasopalatine duct cyst
62
Where are nasopalatine duct cysts located? What does this cause?
Within incisive canal Causes palatal swelling over foramen
63
What type of cyst? Radiolucency between apices of #8-9 in middle-aged adults
Nasopalatine duct cyst
64
Are teeth vital or non-vital in nasopalatine duct cysts?
Vital
65
What is the treatment for nasopalatine duct cysts?
Surgical removal
66
What should you do if you suspect a nasopalatine duct cyst between #8 and 9?
Take a CBCT to confirm it's in the incisive canal
67
Benign, but locally aggressive developmental odontogenic cyst
Odontogenic keratocyst
68
Where are odontogenic keratocysts most often found?
Posterior mandible (but any segment of the jaws can be affected)
69
Odontogenic keratocysts are often _____________, or cause swelling when large
asymptomatic
70
What type of cyst? When small: unilocular radiolucency When large: multilocular
Odontogenic keratocyst
71
What type of cyst? Uniform, thin, stratified squamous epithelial lining
Odontogenic keratocyst
72
What type of cyst? Luminal parakeratin production
Odontogenic keratocyst
73
What type of cyst? Palisaded ("picket fence") appearance of basal cell nuclei
Odontogenic keratocyst
74
What type of cyst? Features are altered with inflammation Satellite cyst formation may be seen
Odontogenic keratocyst
75
What type of lesion is treated by the following method? Excision with curettage
Small odontogenic keratocyst
76
What type of lesion is treated by the following method? Resection, marsupialization followed by surgical excision of residual cystic epithelium
Large odontogenic keratocyst
77
With occurrence in the first decade or with multiple odontogenic keratocysts, what should be ruled out?
Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome)
78
What type of genetic inheritance does Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome) have?
Autosomal dominant
79
What is a characteristic finding in the jaws of patients with Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome)?
Odontogenic keratocysts (arise at early age, may be multiple)
80
Name the 2 cutaneous features in patients with Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome)
Basal cell carcinomas (early onset) Palmar/plantar pitting
81
Name the 3 skeletal features in patients with Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome)
Calcified falx cerebri Increased cranial circumference Bifid ribs
82
What is involved in the treatment and management of patients with Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome)? (4)
Sunscreen Excision of basal cell carcinomas Excision of odontogenic keratocysts Genetic counseling
83
T/F: Periapical cysts or granulomas are typically multilocular
FALSE, they are unilocular
84
Also known as the "traumatic bone cyst," even though trauma isn't present in most cases
Simple bone cyst
85
This cyst occurs in young patients aged 10-20; found in the mandible only; premolar/molar region
Simple bone cyst
86
Are the teeth vital or non-vital with a simple bone cyst?
Vital!
87
Are simple bone cysts symptomatic or asymptomatic?
Asymptomatic
88
What type of cyst? Well-defined radiolucency that "scallops" between adjacent roots
Simple bone cyst
89
What type of cyst? Diagnosed by biopsy; there is no cyst lining, just a hole in the bone ("empty bone cavity")
Simple bone cyst
90
What type of cyst? Tx = scrape (curettage) inside bony cavity to promote bleeding and regeneration of bone
Simple bone cyst

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