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Year 2 sem 1 Radiology > ***Oral Pathology > Flashcards

***Oral Pathology Flashcards

1
Q

What details are required when describing a pathological radiographic finding? (7)

A
  • Site
  • Size
  • Shape
  • Outline or edge
  • Relative radiodensity
  • Effect on adjacent structures
  • Time present, if known
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2
Q

Describe the types of details that should be recorded when talking about “site”

A

The location of the lesion, as well as whether it is generalised or localised.

  • Mandible
  • Maxilla
  • Both jaws
  • Other bones
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3
Q

Describe the types of details that should be recorded when talking about “size”

A
  • Centimetres: vertical and horizontal dimensions

* Boundaries

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4
Q

Describe the types of details that should be recorded when talking about “shape”

A
  • Monolocular
  • Multilocular
  • Pseudoloculated
  • Round
  • Oval
  • Irregular
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5
Q

Describe the types of details that should be recorded when talking about “outline”

A
  • Definition of the outline

* Cortication of the outline: radiopaque margins

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6
Q

Describe the types of details that should be recorded when talking about “relative radiodensity”

A
  • Uniformly radiolucent
  • Of variable radiolucency
  • Radiolucent with patchy opacities
  • Radiopaque
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7
Q

Describe the types of details that should be recorded when talking about “effect on adjacent structures”

A

Impact on:
• Teeth
• Bone
• Soft tissues

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8
Q

Describe the types of details that should be recorded when talking about “time present”

A

The time it has occurred

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9
Q

Define the following terms:
- Periapical abscess

  • Periodontal abscess
  • Granuloma
  • Cyst
  • Tumour
A
  • Periapical abscess: suppuration around the apices due to acute or chronic inflammation
  • Periodontal abscess: localised area of acute or chronic inflammation of the gingival tissues, infra-bony pockets or periodontal ligament
  • Granuloma: structure filled with immune cells and is formed due to inflammation
  • Cyst: a pathologic space in bone or soft tissue containing fluid. Clinically, it is lined with epithelium
  • Tumour: an abnormal and excessive growth of tissue, inconsistent with the growth of normal tissue.
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10
Q

List the types of radiographic lesions that are normally seen

A

· Radiolucent lesions of the jaw
· Apical lesions: Acute inflammation and chronic inflammation
· Periodontal lesions
· Cysts
· Radiopaque lesions of jaw: odontomas, bony lesions, soft tissue calcification and foreign bodies
· Mixed radiolucency lesions: periapical cemental dysplasia

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11
Q

List radiolucent lesions of the jaw

A

Osteoradionecrosis

Osteomyelitis

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12
Q

Describe the diagnosis of an apical lesion

A

· The diagnosis of an abscess, granuloma or cyst cannot be determined on radiographic appearance alone
· Histological investigation is necessary for confirmation and definitive diagnosis
· When describing a radiolucent apical lesion (without clinical or histological evidence), the correct term is Apical Periodontitis

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13
Q

Describe the general appearance apical lesion

A

· Areas of radiolucency often appear ill-defined and may be located at the apex or in the furcation area

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14
Q

List the two main types of apical lesions

A

Acute apical inflammation

Chronic apical inflammation

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15
Q

List the types of chronic apical inflammation

A
  • epithelial tissue/ granuloma
  • granulation tissue and fibrous tissue
  • Neutrophil domination
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16
Q

Describe causes and appearance of acute apical inflammation

A
  • Inflammatory exudate accumulates in the apex of tooth
  • Occurs due to bacterial invasion of pulp

Radiographic appearance:
• May see widened PDL space
• As inflammation spreads, there is loss of the lamina dura and eventually bone

17
Q

Describe chronic apical inflammation: epithelial tissue/ granuloma

A

Radiographic appearance
• Radiopaque border
• Well defined radiolucency

18
Q

Describe chronic apical inflammation: granulation tissue and fibrous tissue domination

A

Radiographic appearance:
• Radiolucent area
• No radiopaque border

19
Q

Describe chronic apical inflammation: neutrophil domination

A

Radiographic appearance:
• Diffuse radiolucent area
• Accompanied by resorption of root apex

20
Q

Describe apical lesions in the primary dentition

A

Apical lesions in the primary dentition is usually seen as a radiolucency. For molars, this is located in the furcation area. For other teeth, it is seen in the apex. However, a developing tooth bud follicle may obscure pathology.

21
Q

Describe the radiographic appearance of periodontal lesions

A
  • Any radiolucency off the alveolar bone and PDL

* Common to see “J” shaped lesions

22
Q

Discuss the difference between Endodontic-Periodontal Lesion and Periodontal-Endodontic Lesion

A

Endodontic-Periodontal Lesion
• Pulpal necrosis precedes periodontal changes
• May drain to the oral cavity through the periodontal ligament resulting in destruction of the periodontal ligament and the adjacent alveolar bone

Periodontal-Endodontic Lesion
• Bacterial infection from the periodontal pocket associated with the loss of attachment and root exposure
• May spread to the pulp – resulting in pulp necrosis

23
Q

List the two main types of cysts that occur and their associated sub-categories

A 
Odontogenic (related to teeth)	
• Periodontal 	
• Radicular	
• Residual	
• Dentigerous

Non- odontogenic (not related to teeth)
• Median mandibular cyst
• Nasopalatine duct

24
Q

Describe the four types of odontogenic cysts

A
  • Periodontal: occurs on lateral aspect of root. Has a radiopaque border
  • Radicular: Occurs on apex of root
  • Residual: Cyst that remain after the tooth causing it is extracted
  • Dentigerous: Radiolucency around the crown of the tooth of a developing tooth
25
Q

Describe the two types of non- odontogenic cysts and their causes

A

Nasopalatine duct/ incisive canal cyst
• Radiolucency between central incisors, extending to nasopalatine ridge and beyond
• Develops from epithelial remnants of the nasopalatine duct/ incisive canal

Median mandibular cyst
• Radiolucency on the mandible behind the central incisors
• Due to embryonic epithelial remnants

26
Q

List the radiopaque lesions of the jaw

A

Pulp stones

Condensing osteitis

Odontoma

Enostosis (bone island)

Exostoses (tori)

Soft tissue calcifications: salivary calculi

Lymph node and tonsil calcifications

Hypercementosis

27
Q

Describe pulp stones, hypercementosis and odontoma

A

Pulp stones:
• Radiopaque calcification within the pulp with radiolucent border

Hypercementosis:
• Excessive deposition of cementum on the roots

Odontoma:
• Overgrowth of dental tissue
• Complex: not like tooth
• Compound: like tooth

28
Q

Describe enostosis

A

Round radiopacity (calcification) in the cancellous bone

29
Q

Describe exostosis

A
  • Calcifications in places where soft tissue should be

* Superimpositions of diffuse radiopacity on teeth

30
Q

Describe soft tissue calcifications

A

• Calcified masses where salivary glands should be: submandibular and sublingual salivary glands

31
Q

Describe lymph node and tonsil calcifications

A

• Calcified masses where lymph nodes should be

32
Q

Describe condensing osteitis

A

• Increased osteoblastic activity due to long term irritation

Radiographic appearance
• Increase radiopacity in alveolar bone
• Common site: near apices of premolars and molars

33
Q

Name the mixed radiolucency lesion seen in the jaw and describe it

A

Periapical cemental dysplasia
• Tooth or teeth are still vital

  • 3 variations in appearance can occur
  • Early stage: Radiolucent;
  • Mixed stage: Radiolucent with radiopacity inclusion
  • Mature stage: may appear as a mixed radiolucent or radiopaque lesion

Year 2 sem 1 Radiology (4 decks)

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