Oral Path Radiolucencies

Question 1

Answer 1

Dental Granuloma

Well-defined UL

Periapical RL assoc. w/ nonvital tooth

Question 2

Answer 2

Radicular Cyst

Odontogenic rests in DG

Asymptomatic

Well define UL

Periapical RL assoc. w/ nonvital tooth

Question 3

Answer 3

Radicular Cyst

Question 4

Answer 4

Residual Cyst

Unilocular

Maxilla

Asymptomatic

Ovoid UL RL with:

Sclerotic borders in apical area of missing tooth

Question 5

Answer 5

Fibrous Bony Defect

Lack of complete bony fill

Dense Fibrous CT

Asymptomatic

Well defined, small UL periapical RL

Question 6

Answer 6

Dentigerous Cyst

Developmental

Asymptomatic

Most are central type

Variable growth pattern

Question 7

Answer 7

Dentigerous Cyst

Root Resorption:

3rd Molar 1-1.5%

Mx Canines 10-12%

Question 8

Answer 8

Dentigerous Cyst

Marsupialization

Question 9

Answer 9

Dentigerous Cyst

Question 10

Answer 10

Incisive Canal Cyst

Nasopalatine Cysts

Hard palate swelling

Salty Taste with Rupture (nasty)

Enucleation +/- Marsupialization

Question 11

Answer 11

Incisive Canal Cyst

Well defined UL RL

Interradicular to Mx Centrals

Heart Shaped

Question 12

Answer 12

Lateral Perio Cyst

Developmental

Asymptomatic

Ovoid UL RL interradicular to 2 adj. vital teeth

Mandibular Premolar-Canine Region

Question 13

Answer 13

Lingual Salivary Gland Depression

Asymptomatic

Developmental?

Ovoid UL RL immediately inferior to mandibular canal in area of 2nd/3rd molars

80-90% of Males

Common = 0.03%

Question 14

Answer 14

Lingual Submandibular Gland Depression

Variable Cortical Involvement

SMG

Blood Vessels

Muscle

Lymph Node
Fat or Empty

Question 15

Answer 15

Traumatic Bone Cyst

Misnomer

Empty cavity in Bone

Etiology????

Asymptomatic

10-20 Years

Question 16

Answer 16

Traumatic Bone Cyst

Hallmark: Scallops b/w roots

Bx necessary for diagnosis

Empty cavity - Serosanguinous fluid

Bony fill after exploration

Question 17

Answer 17

Hematopoetic Bone Marrow Defect

Asymptomatic

Genesis?

Edentulous area of posterior mandible in postemenopausal women

Question 18

Answer 18

Hematopoetic Bone Marrow Defect

Nonspecific appearance required incisional biopsy

Once confirmed, to tx needed.

Question 19

Answer 19

Zygomatic Air Cell Defect (ZACD)

UL or ML

Articular eminence or distal zygomatic arch

symmetrical and asymptomatic

weaker, no eminectomy

Question 20

Answer 20

Ameloblastoma

Age of diagnosis = 33 yrs on avg.

85% Mandibular 3rd molar/ramus

other 15% posterior maxilla

ML Soap bubble or honeycomb RL

Swelling/Expansion early

Root resorption in 80% of cases

Question 21

Answer 21

Ameloblastoma

Perforation in most RL areas

Marginal resection with 1.0 cm margins

Posterior Maxilla

Unicystic

Question 22

Answer 22

Odontogenic Keratocyst (OKC)

Asymptomatic

3rd Molar/Ramus area of Mandible

UL or ML

Grows in anterior-posterior direction before expansion

Endosteal scalloping

Question 23

Answer 23

Odontogenic Keratocyst (OKC)

Root resorption less common than Ameloblastoma

Satellite/daughter cysts

Wide excision +/- marsupialization

Carnoy’s Solution

Long term recurrence

Question 24

Answer 24

Nevoid Basal Cell Carcinoma (Gorlin Syndrome)

Multilocular

Multiple OKCs

Bifid ribs

Calcified Falx Cerebri

Epidermoid Cysts

Palmar-plantar pits

Question 25

Answer 25

Central Giant Cell Granuloma 60% under age 30 70% Mandible Check for **Hyperthyroidism** Thorough curettage, surgery Steroids, **Calcitonin, Interferon Alpha 2a**

Question 26

Answer 26

Central Giant Cell Granuloma Interferon A2a Tx

Question 27

Answer 27

Chronic Osteomyelitis \*\* **MIXED LESION** \*\* Immune Compromised or Hypovascular Bone Subacute (2-6 weeks): Ragged RL Chronic: **Ragged RL + RO Sequestra**

Question 28

Answer 28

Chronic Osteomyelitis

Question 29

Answer 29

Osteonecrosis 2ndary to Chronic Osteomyelitis Complication from Low voltage Radiotherapy Bone is: **Hypocellular, Hypovascular, Hypoxic** Necrosis upon trauma **Hyperbaric Chamber** **Bisphosphonates**

Question 30

Answer 30

Periapical Cemento-Osseous Dysplasia Asymptomatic **Middle Aged Black Women** **3 maturational phases:** **RL --\> RL w/ RO foci --\> RO** RCT not needed **BX not necessary: Exposure = Osteomyelitis**

Question 31

Answer 31

Periapical Cemento-Osseous Dysplasia

Question 32

Answer 32

Florid Cemento-Osseous Dysplasia

Question 33

Answer 33

Tori

Question 34

Answer 34

Mn Tori **Bilateral above mylohyoid line** Lingual in region of premolars Size corresponds to bruxism and stress Remvl necessary for dentures

Question 35

Answer 35

Root Tips **PDL space and Lamina Dura are Confirmatory** Fully examine tooth at time of extraction

Question 36

Answer 36

Condensing Osteitis Deep Cavity or Large Resto Nonvital tooth Organisms not virulent **Rxn of host bone to wall off product of inflammation** Lesion of bone, not tooth

Question 37

Answer 37

Focal Idiopathic Osteosclerosis Asymptomatic **Area of increasing RO with no known cause** **90% Mn premolar region** **Ceases growth by skeletal maturity** **ADJACENT TEETH VITAL**

Question 38

Answer 38

Focal Idiopathic Osteosclerosis **No RL rim around lesion** Can be next to teeth or central in bone **Enostosis, dense bone island, bone scar** **No tx indicated**

Question 39

Answer 39

Compound Odontoma **Mini-teeth inside fibrous sac** **Anterior of maxilla** Histologic layers preserved Enucleation and curettage

Question 40

Answer 40

Complex Odontoma Posterior jaws....mandible Impede eruption path of teeth Multiobulated mass: **Thin RL rim**, internal density varies with age **Haphazard orientation of Tooth Layers**

Question 41

Answer 41

Amalgam tattoo Metal in mucosa Must find out if it is a tattoo or intraoral nevus or melanoma

Question 42

Answer 42

Amalgam tattoo If you can see the particles then no further action is needed **If you can't see the particles you need to biopsy** **Reticulin fibers**

Question 43

Answer 43

Antral Psuedocyst **Ovoid, dome shaped** Homogenous soft tissue RO rising from floor of antram **Well profiled by air** Asymptomatic, no tx needed **Common in winter**

Question 44

Answer 44

Calcified Carotid Atheromata ## Footnote **Heterogenous RO in soft tissues of neck** **Adjacent to epiglottis** **Can be above or below hyoid** Adjacent to C3-C4