Oral Path Radiolucencies Flashcards
Dental Granuloma
Well-defined UL
Periapical RL assoc. w/ nonvital tooth
Radicular Cyst
Odontogenic rests in DG
Asymptomatic
Well define UL
Periapical RL assoc. w/ nonvital tooth
Radicular Cyst
Residual Cyst
Unilocular
Maxilla
Asymptomatic
Ovoid UL RL with:
Sclerotic borders in apical area of missing tooth
Fibrous Bony Defect
Lack of complete bony fill
Dense Fibrous CT
Asymptomatic
Well defined, small UL periapical RL
Dentigerous Cyst
Developmental
Asymptomatic
Most are central type
Variable growth pattern
Dentigerous Cyst
Root Resorption:
3rd Molar 1-1.5%
Mx Canines 10-12%
Dentigerous Cyst
Marsupialization
Dentigerous Cyst
Incisive Canal Cyst
Nasopalatine Cysts
Hard palate swelling
Salty Taste with Rupture (nasty)
Enucleation +/- Marsupialization
Incisive Canal Cyst
Well defined UL RL
Interradicular to Mx Centrals
Heart Shaped
Lateral Perio Cyst
Developmental
Asymptomatic
Ovoid UL RL interradicular to 2 adj. vital teeth
Mandibular Premolar-Canine Region
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%
Lingual Submandibular Gland Depression
Variable Cortical Involvement
SMG
Blood Vessels
Muscle
Lymph Node
Fat or Empty
Traumatic Bone Cyst
Misnomer
Empty cavity in Bone
Etiology????
Asymptomatic
10-20 Years
Traumatic Bone Cyst
Hallmark: Scallops b/w roots
Bx necessary for diagnosis
Empty cavity - Serosanguinous fluid
Bony fill after exploration
Hematopoetic Bone Marrow Defect
Asymptomatic
Genesis?
Edentulous area of posterior mandible in postemenopausal women
Hematopoetic Bone Marrow Defect
Nonspecific appearance required incisional biopsy
Once confirmed, to tx needed.
Zygomatic Air Cell Defect (ZACD)
UL or ML
Articular eminence or distal zygomatic arch
symmetrical and asymptomatic
weaker, no eminectomy
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
Ameloblastoma
Perforation in most RL areas
Marginal resection with 1.0 cm margins
Posterior Maxilla
Unicystic
Odontogenic Keratocyst (OKC)
Asymptomatic
3rd Molar/Ramus area of Mandible
UL or ML
Grows in anterior-posterior direction before expansion
Endosteal scalloping
Odontogenic Keratocyst (OKC)
Root resorption less common than Ameloblastoma
Satellite/daughter cysts
Wide excision +/- marsupialization
Carnoy’s Solution
Long term recurrence
Nevoid Basal Cell Carcinoma (Gorlin Syndrome)
Multilocular
Multiple OKCs
Bifid ribs
Calcified Falx Cerebri
Epidermoid Cysts
Palmar-plantar pits
Central Giant Cell Granuloma
60% under age 30
70% Mandible
Check for Hyperthyroidism
Thorough curettage, surgery
Steroids, Calcitonin, Interferon Alpha 2a
Central Giant Cell Granuloma
Interferon A2a Tx
Chronic Osteomyelitis
** MIXED LESION **
Immune Compromised or Hypovascular Bone
Subacute (2-6 weeks): Ragged RL
Chronic:
Ragged RL + RO Sequestra
Chronic Osteomyelitis
Osteonecrosis 2ndary to Chronic Osteomyelitis
Complication from Low voltage Radiotherapy
Bone is:
Hypocellular, Hypovascular, Hypoxic
Necrosis upon trauma
Hyperbaric Chamber
Bisphosphonates
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
Periapical Cemento-Osseous Dysplasia
Florid Cemento-Osseous Dysplasia
Tori
Mn Tori
Bilateral above mylohyoid line
Lingual in region of premolars
Size corresponds to bruxism and stress
Remvl necessary for dentures
Root Tips
PDL space and Lamina Dura are Confirmatory
Fully examine tooth at time of extraction
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
Focal Idiopathic Osteosclerosis
Asymptomatic
Area of increasing RO with no known cause
90% Mn premolar region
Ceases growth by skeletal maturity
ADJACENT TEETH VITAL
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
Compound Odontoma
Mini-teeth inside fibrous sac
Anterior of maxilla
Histologic layers preserved
Enucleation and curettage
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
Amalgam tattoo
Metal in mucosa
Must find out if it is a tattoo or intraoral nevus or melanoma
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
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
Calcified Carotid Atheromata
Heterogenous RO in soft tissues of neck
Adjacent to epiglottis
Can be above or below hyoid
Adjacent to C3-C4
