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D2 Spring > Oral Path Exam 1 - Mixed Lesions and Radiolucent or Mixed Lesions Part 1 > Flashcards

Oral Path Exam 1 - Mixed Lesions and Radiolucent or Mixed Lesions Part 1 Flashcards

1
Q

Mixed lesions always have a ____________ element and a _____________ element

A

radiopaque; radiolucent

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2
Q

The radiopaque component of the mixed lesion represents some sort of ___________

A

calcification

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3
Q

Where is the following calcification seen in a mixed lesion derived from?

Bone or cartilage

A

Bone

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4
Q

Where is the following calcification seen in a mixed lesion derived from?

Tooth-related material

A

Cementum, dentin, and/or enamel

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5
Q

Where is the following calcification seen in a mixed lesion derived from?

Dystrophic calcification

A

Pathologic

(if the tissue is dead, degenerative, or scarred)

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6
Q

What type of lesion?

Rare neoplasm that arises from the PDL

A

Cementoblastoma

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7
Q

What type of lesion?

Affects young adults
Found in the posterior mandible, especially the 1st permanent molar

A

Cementoblastoma

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8
Q

What type of lesion?

Symptoms = pain + swelling

A

Cementoblastoma

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9
Q

What type of lesion?

Looks like an opaque mass fused to root(s) and has a thin radiolucent rim around the mass in mature lesions

A

Cementoblastoma

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10
Q

What type of lesion?

Tx = conservative excision w/ either tooth root amputation and endo, or just ext

A

Cementoblastoma

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11
Q

Does cementoblastoma have a low or high recurrence?

A

Low recurrence

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12
Q

What type of lesion?

Histologically: cellular cementum with plump cementoblasts

A

Cementoblastoma

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13
Q

What type of lesion?

Histologically: often a periphery of radiating columns of calcified material

A

Cementoblastoma

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14
Q

What type of lesion may be mistaken for osteosarcoma?

A

Cementoblastoma

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15
Q

What is the most common odontogenic tumor?

A

Odontoma

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16
Q

What type of lesion?

Detected before 20 yrs, frequently associated with an unerupted tooth

A

Odontoma

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17
Q

What type of lesion?

Typically asymptomatic

A

Odontoma

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18
Q

What are the 2 types of odontomas?

A

Compound
Complex

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19
Q

What type of odontoma?

Found in anterior jaw

A

Compound odontoma

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20
Q

What type of odontoma?

May be associated with unerupted tooth

A

Compound odontoma

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21
Q

What type of odontoma?

Resembles small teeth (toothlets/denticles)

A

Compound odontoma

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22
Q

What type of odontoma?

Found in posterior jaw

A

Complex odontoma

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23
Q

What type of odontoma?

Dense radiopaque mass surrounded by radiolucent rim, usually pericoronal to impacted tooth

A

Complex odontoma

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24
Q

What type of odontoma?

Has odontogenic tissues, but does NOT form small tooth-appearing structures

A

Complex odontoma

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25
Q

What type of lesion?

Tx = enucleation, no recurrence

A

Odontoma

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26
Q

Benign or malignant/infectious/inflammatory?

Odontogenic cyst w/ calcification

A

Benign

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27
Q

Benign or malignant/infectious/inflammatory?

Odontogenic tumor w/ calcification

A

Benign

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28
Q

Benign or malignant/infectious/inflammatory?

Paget disease of bone

A

Benign

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29
Q

Benign or malignant/infectious/inflammatory?

Fibro-osseous lesions like fibrous dysplasia, cemento-osseous dysplasia, central ossifying fibroma

A

Benign

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30
Q

What type of lesion?

Also called the Gorlin cyst

A

Calcifying odontogenic cyst

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31
Q

What type of lesion?

Wide age range
Found in anterior jaw
Root resorption/divergence can be seen

A

Calcifying odontogenic cyst

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32
Q

What type of lesion?

Usually a unilocular radiolucency, but up to 50% can have calcifications (mixed appearance)

A

Calcifying odontogenic cyst

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33
Q

What type of lesion?

Tx = enucleation + curettage; unlikely recurrence

A

Calcifying odontogenic cyst

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34
Q

___________ odontogenic tumors can be radiolucent or mixed

A

Yellow

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35
Q

What are the 3 odontogenic tumor classifications?

A

Odontogenic epithelium
Odontogenic ectomesenchyme
Mixed (epithelium + ectomesenchyme)

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36
Q

What odontogenic tumor classification does the following fall under?

Ameloblastoma

A

Odontogenic epithelium

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37
Q

What odontogenic tumor classification does the following fall under?

Adenomatoid odontogenic tumor

A

Odontogenic epithelium

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38
Q

What odontogenic tumor classification does the following fall under?

Calcifying epithelial odontogenic tumor

A

Odontogenic epithelium

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39
Q

What odontogenic tumor classification does the following fall under?

Odontogenic fibroma

A

Odontogenic ectomesenchyme

40
Q

What odontogenic tumor classification does the following fall under?

Odontogenic myxoma

A

Odontogenic ectomesenchyme

41
Q

What odontogenic tumor classification does the following fall under?

Cementoblastoma

A

Odontogenic ectomesenchyme

42
Q

What odontogenic tumor classification does the following fall under?

Ameloblastic fibroma

A

Mixed (epithelium + ectomesenchyme)

43
Q

What odontogenic tumor classification does the following fall under?

Ameloblastic fibro-odontoma

A

Mixed (epithelium + ectomesenchyme)

44
Q

What odontogenic tumor classification does the following fall under?

Compound or complex odontoma

A

Mixed (epithelium + ectomesenchyme)

45
Q

What type of odontogenic tumor w/ calcification?

Looks identical to complex odontoma

A

Ameloblastic fibro-odontoma

46
Q

All of the benign odontogenic cysts and tumors are asymptomatic or present with a slow growing swelling/expansion with either a unilocular or a multilocular presentation and +/- root divergence and resorption.

Unless secondarily infected, pain would only be expected with what?

A

Cementoblastoma

47
Q

What are the 3 lesions that are clear cut features of a mixed appearance?

A

Compound odontoma
Complex odontoma
Ameloblastic fibro-odontoma

48
Q

In lesions where you see calcification in the tooth-bearing portions of the jaws or in association with an unerupted/impacted tooth that can’t clearly be separated by presentation, how you can simplify the diff. dx?

A

Benign odontogenic cyst or tumor w/ calcification

49
Q

What disease?

Also called osteitis deformans

A

Paget Disease of bone

50
Q

What disease?

Increased/uncontrolled bone remodeling, resulting in thickened but distorted and weakened bones

A

Paget Disease of bone

51
Q

What disease?

Unknown cause
Found in people older than 40
Anglo-Saxon ancestry

A

Paget Disease of bone

52
Q

What disease?

May have bone pain, possible fractures, deafness, and blindness

A

Paget Disease of bone

53
Q

What disease?

Most cases are polyostotic and affect the pelvis, femur, lumbar vertebrae, skull (hat doesn’t fit), and tibia

A

Paget Disease of bone

54
Q

What disease?

When jaw is affected, causes symmetric enlargement (dentures don’t fit) and spaces develop between the teeth

A

Paget Disease of bone

55
Q

What jaw is more often affected in Paget Disease of bone?

A

Maxillary

56
Q

What disease?

Elevated total serum alkaline phosphatase (marker of osteoblastic activity)

A

Paget Disease of bone

57
Q

What disease?

Chronic progression from vascular phase to late lesions that show patchy sclerosis (cotton-wool) appearance w/ thickened cortices

A

Paget Disease of bone

58
Q

What disease?

Extensive hypercementosis of teeth

A

Paget Disease of bone

59
Q

What disease?

Tx = NSAIDs for mild pain, bisphosphonates to slow bone turnover, and monitor pts for development of bone tumors

A

Paget Disease of bone

60
Q

What type of bone tumor could a patient with Paget Disease of bone develop later?

A

Osteosarcoma

61
Q

What disease?

Exts can be hard due to hypercementosis and ankylosis

A

Paget Disease of bone

62
Q

What disease?

Place implants with caution!

A

Paget Disease of bone

63
Q

What disease?

Surgical bleeding risk during vascular lytic phase

A

Paget Disease of bone

64
Q

What disease?

Poor wound healing with risk for osteomyelitis during sclerotic phase

A

Paget Disease of bone

65
Q

Non-specific term that describes a group of processes, with different pathogeneses, where normal bone is replaced by fibrous tissue with a newly formed mineralized product

A

Fibro-osseous lesions

66
Q

Accurate diagnosis requires correlation of the clinical and radiographic features with the microscopic features because they can look very similar microscopically

A

Fibro-osseous lesions

67
Q

What are the 3 fibro-osseous lesions of the jaws?

A

Fibrous dysplasia
Cemento-osseous dysplasia
Central ossifying fibroma

68
Q

What type of fibro-osseous lesion?

Developmental, tumor like lesion due to a stimulatory G protein gene mutation (GNAS)

A

Fibrous dysplasia

69
Q

What type of fibro-osseous lesion?

Presents in 20s or 30s
Slowly growing + painless swelling

A

Fibrous dysplasia

70
Q

What type of fibro-osseous lesion?

Usually monostotic; jaws are affected

If polyostotic, can see cafe au lait pigmentation and endocrine issues

A

Fibrous dysplasia

71
Q

What type of fibro-osseous lesion?

Maxillary lesions that involve adjacent facial bones can cause facial deformity

A

Fibrous dysplasia (craniofacial)

72
Q

What type of fibro-osseous lesion?

Early lesions look radiolucent or mottled, followed by classic “ground glass” pattern with blending margins

A

Fibrous dysplasia

73
Q

What type of fibro-osseous lesion?

Tx = surgical reduction if significant cosmetic or functional deformity; conservative management is advised!!

A

Fibrous dysplasia

74
Q

What type of fibro-osseous lesion?

Benign neoplasm derived from bone, but often has cementum-like material in it as well

A

Central ossifying fibroma

75
Q

What type of fibro-osseous lesion?

Most often found in the posterior mandible

A

Central ossifying fibroma

76
Q

What type of fibro-osseous lesion?

Asymptomatic when small
Large lesions have painless swelling

A

Central ossifying fibroma

77
Q

What type of fibro-osseous lesion?

Well-defined, unilocular, expansile, radiolucent or mixed

A

Central ossifying fibroma

78
Q

What type of fibro-osseous lesion?

When mixed, it has a central radiopacity with a radiolucent periphery

A

Central ossifying fibroma

79
Q

What type of fibro-osseous lesion?

May cause divergence or resorption of roots

A

Central ossifying fibroma

80
Q

What type of fibro-osseous lesion?

During surgical exploration, lesion shells out as one potato-like mass

A

Central ossifying fibroma

81
Q

What type of fibro-osseous lesion?

Made up of cellular fibrous CT w/ interspersed trabeculae or spherules of mineralized tissue that resembles bone and/or cementum

(need x-rays and history to diagnose!)

A

Central ossifying fibroma

82
Q

What type of fibro-osseous lesion?

Tx = enucleation

A

Central ossifying fibroma

83
Q

What type of fibro-osseous lesion?

Found in middle-aged females greater than 30, often in blacks

A

Cemento-osseous dysplasia

84
Q

What type of fibro-osseous lesion?

Painless
No expansion
Found around tooth roots/apices

A

Cemento-osseous dysplasia

85
Q

Are teeth vital or non-vital in cemento-osseous dysplasia?

A

Vital!

86
Q

What type of fibro-osseous lesion?

Well-defined, irregular borders, unilocular radiolucency that develops a central radiopacity over time

A

Cemento-osseous dysplasia

87
Q

What type of fibro-osseous lesion?

Tissue looks easily fragmented, gritty, red/brown early on; becomes more dense as it matures

A

Cemento-osseous dysplasia

88
Q

What type of fibro-osseous lesion?

Tx = vitality testing to prevent doing RCT, take pano to check for multiple lesions, follow-up is all that is needed

A

Cemento-osseous dysplasia

89
Q

What are the 3 variants of cemento-osseous dysplasia?

A

Focal
PA
Florid

90
Q

Which variant of cemento-osseous dysplasia?

Solitary lesion in posterior mandible

A

Focal

91
Q

Which variant of cemento-osseous dysplasia?

Mimics central ossifying fibroma, so it requires biopsy

A

Focal

92
Q

Which variant of cemento-osseous dysplasia?

Multiple lesions in anterior jaw

A

PA

93
Q

Which variant of cemento-osseous dysplasia?

Found in bilateral mandible (anterior + posterior) and can affect all 4 quadrants

A

Florid

94
Q

Which variant of cemento-osseous dysplasia?

Dense radiopacities that CAN fuse to roots

A

Florid

95
Q

Which variant of cemento-osseous dysplasia?

Bone exposure can cause secondary infection and sequestration

A

Florid

D2 Spring (25 decks)

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