Oral Path Exam 1 - Bone Lesion Radiopacities

Question 1

What type of bony growth?

Asymptomatic, smooth, bony growth, can show enlargment

Answer 1

Palatal torus
Mand torus
Exostoses

Question 2

What type of bony growth?

Developmental

Answer 2

Palatal torus
Mand torus
Exostoses

Question 3

What type of bony growth?

Stony hard, variable shape/size, overlying mucosa may ulcerate with trauma

Answer 3

Palatal torus
Mand torus
Exostoses

Question 4

What type of bony growth?

Hard palate; midline

Answer 4

Palatal torus

Question 5

What type of bony growth?

Lingual mandible; usually bilateral

Answer 5

Mand torus

Question 6

What type of bony growth?

Buccal or palatal ridge; unilateral or bilateral

Answer 6

Exostoses

Question 7

What type of bony growth?

Diagnosed by appearance; can be removed surgically if needed

Answer 7

Palatal torus
Mand torus
Exostoses

Question 8

What type of lesion?

PDL space surrounding radiopacity with potential thin central pulp chamber and tapered shape

Answer 8

Retained root tips

Question 9

What type of lesion?

Focal bone sclerosis associated with the apex of a tooth exhibiting pulpal inflammation or necrosis

Answer 9

Condensing osteitis

Question 10

What type of lesion?

Uniform radioopacity
Widened PDL
85% partial or total regression w/ ext or RCT

Answer 10

Condensing osteitis

Question 11

What is residual condensing osteitis called?

Answer 11

Bone scar

Question 12

What type of lesion?

Most in posterior mandible
Affects children/adolescents

Answer 12

Idiopathic osteosclerosis

Question 13

What type of lesion?

Dense, homogenous radioopacity w/ some well-defined borders and others that show spicules into surrounding normal bone

Answer 13

Idiopathic osteosclerosis

Question 14

What type of lesion?

Can obscure root, but does NOT fuse to it; may incorporate the lamina dura

Answer 14

Idiopathic osteosclerosis

Question 15

Are teeth vital or non-vital in idiopathic osteosclerosis?

Answer 15

Vital!

Question 16

What type of lesion?

No radiolucent rim and no radiolucent center

Answer 16

Idiopathic osteosclerosis

Question 17

What type of lesion?

Dense, viable bone microscopically

Answer 17

Idiopathic osteosclerosis

Question 18

What type of lesion?

Remains static or slow increase in size until maturity; X-Ray follow-up is all that is needed

Answer 18

Idiopathic osteosclerosis

Question 19

What type of lesion?

Common, typically asymptomatic, dome-shaped, homogeneous, faintly radiopaque lesion arising from the floor of the maxillary sinus due to accumulation of inflammatory (serous) exudate underneath the sinus mucosa

Answer 19

Antral pseudocyst

Question 20

What type of lesion?

Cause is not known; possible adjacent odontogenic infection or sinus lining irritation from sinus infection or allergies

Answer 20

Antral pseudocyst

Question 21

What type of lesion?

Tx = rule out odontogenic infection; only treat is there are significant symptoms (expansion, pain)

Answer 21

Antral pseudocyst

Question 22

How do you tell the difference between an antral psuedocyst and chronic sinusitis?

Answer 22

Chronic sinusitis = cloudy sinus, not well-defined, pain from several teeth, headache, nasal congestion/discharge

(antral pseudocyst will look like a clear dome shape on pano)

Question 23

What type of lesion?

Bacteria, foreign material and desquamated keratin accumulation in the tonsillar crypts forms compacted, foul-smelling tonsillar concretion

Answer 23

Tonsillar concretions/tonsillolithiasis

Question 24

What type of lesion?

If it calcifies, called a tonsillolith

(looks superimposed on ramus on pano; CBCT can confirm)

Answer 24

Tonsillar concretions/tonsillolithiasis

Question 25

What type of lesion? Causes bad breath (halotosis) Sensation of something stuck in throat, but otherwise asymptomatic

Answer 25

Tonsillar concretions/tonsillolithiasis

Question 26

What type of lesion? Variable size, single/multiple, unilateral/bilateral Not acutely painful, but can predispose to recurrent tonsillar infection leading to pain or abscess

Answer 26

Tonsillar concretions/tonsillolithiasis

Question 27

What type of lesion? Tx = if symptomatic, remove with saltwater gargling or waterpik, enucleation/curettage, laser cryptolysis, or tonsillectomy

Answer 27

Tonsillar concretions/tonsillolithiasis

Question 28

What type of lesion? Benign osseous tumor, affecting membranous bone

Answer 28

Osteoma

Question 29

What type of lesion? Painless, slowly enlarging Paranasal sinus involvement is common

Answer 29

Osteoma

Question 30

How do you tell the difference between an osteoma in the paranasal sinus vs an antral pseudocyst in the sinus?

Answer 30

Antral pseudocyst is on the sinus floor Osteoma is up higher in the sinus

Question 31

What type of lesion? Jaw lesions are associated with condylar area and lingual posterior mandible

Answer 31

Osteoma

Question 32

What type of lesion? Exophytic mass on bone surface (periosteal) stimulating a tori/exostoses

Answer 32

Osteoma

Question 33

What type of lesion? Intramedullary growth (endosteal or central) similar to end stage inflammatory process (condensing osteitis) or sclerotic bone (idiopathic osteosclerosis)

Answer 33

Osteoma

Question 34

What type of lesion? Histologically identical to tori, condensing osteitis, or idiopathic osteosclerosis, but with continual growth

Answer 34

Osteoma

Question 35

What should you always rule out if you see an Osteoma?

Answer 35

Gardner syndrome

Question 36

What type of lesion? Autosomal dominant

Answer 36

Gardner syndrome

Question 37

What type of lesion? Mutation in adenomatous polyposis coli (APC) tumor suppressor gene

Answer 37

Gardner syndrome

Question 38

What type of lesion? One of the multiple intestinal polyposis syndromes

Answer 38

Gardner syndrome

Question 39

What type of lesion? Characterized by osteomas of facial bones, skin lesions like epidermoid cysts/desmoid tumors, impacted supernumerary teeth, or odontomas

Answer 39

Gardner syndrome

Question 40

What type of lesion? Development of precancerous polyps of the colon

Answer 40

Gardner syndrome

Question 41

What type of lesion? Increased risk of thyroid carcinoma

Answer 41

Gardner syndrome

Question 42

What type of lesion? Tx = prophylactic colectomy; removal of cosmetically problematic cysts and osteomas; genetic counseling

Answer 42

Gardner syndrome