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Oral Pathology > Oral Pathology Chapter 14 > Flashcards

Oral Pathology Chapter 14 Flashcards

1
Q

What disease is also known as “marble bone disease” and is caused by failure of normal osteoclast function?

A

Osteopetrosis

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2
Q

What two major types of Osteopetrosis are there?

A
  1. Infantile and 2. Adult
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3
Q

What type of Osteopetrosis is associated with marrow failure, frequent fractures, cranial nerve compression, facial deformities, delayed tooth eruption and osteomyelitis post tooth infraction?

A

Infantile Osteopetrosis

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4
Q

What two radiographic signs are present in Infantile Osteopetrosis?

A
  1. Widespread increase in skeletal density and 2. Roots of teeth are difficult to make out due to bone density
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5
Q

Which form of Osteopetrosis has less severe manifestations, is 40% asymptomatic and has marrow failure only rarely?

A

Adult Osteopetrosis (benign osteopetrosis)

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6
Q

What are two significant complications of Osteopetrosis?

A
  1. Fracture and 2. Osteomyelitis after tooth extraction
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7
Q

What is the only hope for Infantile Osteopetrosis?

A

Bone marrow transplant

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8
Q

What disease is associated with dental and clavicle abnormalities?

A

Cleidocranial Dysplasia

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9
Q

What percentage of the time are the clavicles completely unformed in Cleidocranial Dysplasia?

A

10%

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10
Q

What four appearance abnormalities are signs of Cleidocranial Dysplasia?

A
  1. Short stature/big head, 2. Frontal Bossing, 3. Ocular hypertelorism and 4. Broad base of nose
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11
Q

What two palatal effects does Cleidocranial Dysplasia exhibit?

A
  1. High-arched palate and 2. Increased prevalence of cleft palate
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12
Q

What is the name of an area of hematopoietic marrow that produces a radiolucency, may be confused with an intraosseous neoplasm and is NOT a pathology?

A

Focal Osteoporotic Marrow Defect

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13
Q

How do Focal Osteoporotic Marrow Defects typically present in radiographs?

A
  1. Typically asymptomatic, 2. Ill-defined borders with well-defined trabeculations and 3. 75% in adult women, often in the posterior mandible
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14
Q

What pathology is a focal area of increased radiodensity that is of unknown cause and cannot be attributed to anything else?

A

Idiopathic Osteosclerosis

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15
Q

Where are Idiopathic Osteosclerosis lessons typically located?

A

Mandible (90%)

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16
Q

What must NOT be present for a diagnosis of Idiopathic Osteosclerosis to be accurate?

A

A radiolucent rim

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17
Q

What pathology is associated with abnormal resorption and deposition of bone that results in the weakening of affected bones?

A

Paget’s Disease of Bone

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18
Q

What group is most affected by Paget’s Disease?

A

Caucasian men

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19
Q

Where does Pagetic bone form?

A

Near joints

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20
Q

What four bones are the most commonly affected?

A
  1. Vertebrae, 2. Pelvis, 3. Skull and 4. Femur
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21
Q

What are the two key dental complaints that someone might have with Paget’s Disease of Bone?

A
  1. Hat won’t fit and 2. Dentures no longer fit
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22
Q

What is the name given to the lion-like facial deformity found in Paget’s Disease of Bone?

A

Leontiasis Ossea

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23
Q

What is the key radiographic appearance of Paget’s Disease?

A

“Cotton Wool/Roll” appearance

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24
Q

What can often happen to the teeth of patients with Paget’s disease?

A

Hypercementosis

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25
Q

What blood ions are present in a patient with Paget’s Disease (3)?

A
  1. High alkaline Phosphatase levels, 2. Normal Calcium and 3. Normal Phosphorus levels
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26
Q

What three types of drugs are often give to treat patients with Paget’s Disease?

A
  1. NSAIDS for pain, 2. Antiresorptive drugs (patients > 50% alkaline phosphatase) and 3. Bisphosphonates
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27
Q

What is a recognized complication of Paget’s Disease?

A

Development of a malignant osteosarcoma

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28
Q

Where do malignant bone tumors typically form in Paget’s Disease?

A

Pelvis/Long bones of lower extremities

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29
Q

Which pathology is considered a nonneoplastic lesion that is more common in the anterior jaw and frequently crosses the midline?

A

Central Giant Cell Granuloma

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30
Q

What other two pathologies are identical histopathologically to Central Giant Cell Granulomas?

A
  1. Brown tumor of hyperparathyroidism and 2. Cherubism
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31
Q

Should a Central Giant Cell Granuloma be aggressive (doesn’t occur often), what treatment can be used to slow them?

A

Injections of Corticosteroids

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32
Q

What pathology is associated with an autosomal dominant inheritance, plump faces and eyes turned heavenward?

A

Cherubism

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33
Q

When does Cherubism typically manifest?

A

Ages between 2-5

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34
Q

Microscopic findings in Cherubism are identical to those found in what other disease?

A

Central Giant Cell Granulomas

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35
Q

What is a benign, empty or fluid-filled cavity within the bone called?

A

Traumatic Bone Cyst

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36
Q

What is thought to cause Traumatic Bone Cysts?

A

When Bones receive trauma that is insufficient to cause fracture but results in intraosseous hematoma. This hematoma does not undergo organization and repair

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37
Q

What is the most suggestive radiographic sign of Traumatic Bone Cysts?

A

“Scalloped” Margins

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38
Q

What should be done to rule out thin-walled lesions in Traumatic Bone Cyst cases?

A

Curettage of the wall of the cavity

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39
Q

What effect do Traumatic Bone Cysts have on the teeth?

A

None - they stay vital

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40
Q

What is the treatment of Bone Cysts?

A

Surgical Exploration

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41
Q

What pathology is described as an intraosseous accumulation of blood-filled spaces surrounded by connective tissue?

A

Aneurysmal Bone Cyst

42
Q

Where is the most common presentation of an aneurysmal bone cyst in head and neck?

A

Posterior mandible

43
Q

What are the two most common symptoms of an aneurysmal bone cyst?

A
  1. Pain and 2. Rapidly developing swelling
44
Q

What surgical appearance does removing an aneurysmal bone cyst resemble?

A

“Blood-soaked Sponge”

45
Q

What is the recurrence of the removal of an aneurysmal bone cyst?

A

10-60%

46
Q

What tumor-like pathology is defined as replacement of normal bone by fibrous connective tissue intermixed with bone?

A

Fibrous Dysplasia

47
Q

What three types of fibrous dysplasia exist?

A
  1. Monostotic, 2. Jaffe-Lichtenstein Syndrome (polyostotic) and 3. McCune-Albright Syndrome (polyostotic)
48
Q

What percentage of fibrous dysplasia cases are monostotic?

A

80%

49
Q

What is the key radiographic feature of a monostotic fibrous dysplasia lesion?

A

“Ground-glass” opacification

50
Q

Should a case of monostotic fibrous dysplasia occur in the mandible, what would be the result?

A

Expansion of both the buccal and lingual plates

51
Q

Should a case of monostotic fibrous dysplasia occur in the maxilla, what would be the result?

A

Obliteration of the maxillary sinus

52
Q

Which syndrome has polyostotic fibrous dysplasia and Cafe au lait spots?

A

Jaffe-Lichenstein Syndrome

53
Q

Which syndrome has polyostotic fibrous dysplasia and Cafe au lait spots and multiple endocrinopathies?

A

McCune-Albright Syndrome

54
Q

What is the most common sign of McCune-Albright Syndrome?

A

Sexual precocity within the first few years of life

55
Q

What are two other symptoms of McCune-Albright Syndrome that are less common?

A
  1. Pituitary Adenoma and 2. Hyperthyroidism
56
Q

What is the most common fibro-osseous lesion encountered in clinical practice?

A

Cemento-Osseous Dysplasias

57
Q

What are the three types of Cemento-Osseous Dysplasia?

A
  1. Focal, 2. Periapical and 3. Florid
58
Q

What gender bias do Focal Cemento-Osseous Dysplasias have?

A

90% females

59
Q

What is the key radiographic finding that designates Focal Cemento-Osseous Dysplasia?

A

Lesions have a thin radiolucent rim

60
Q

What two groups are most likely to get Periapical Cemento-Osseous Dysplasia?

A
  1. Women (90%) and 2. African Americans (70%)
61
Q

How does the PDL react to Periapical Cemento-Osseous Dysplasia?

A

It remains intact - the lesion never fuses with the tooth

62
Q

Why is biopsy discouraged with Periapical and Florid Cemento-Osseous Dysplasia?

A

The areas are hypovascularized and biopsy may cause necrosis

63
Q

What pathology is defined as a true neoplasm that contains a variable mixture of bone and cementum with a significant growth potential?

A

Ossifying Fibroma

64
Q

What are the five major x-ray features of an ossifying fibroma?

A
  1. Well-defined, 2. Usually unilocular, 3. Completely radiolucent or mixed, 4. Root divergence/resorption and 5. mandibular fibromas create downward bowing of inferior cortex of the mandible
65
Q

What pathology is just like an ossifying fibroma but differs in age of the patient, common sites of involvement and clinical behavior?

A

Juvenille (Active) Ossifying Fibroma

66
Q

What are the two key differences between Ossifying Fibromas and Juvenille Active Ossifying Fibromas?

A
  1. Males more likely to get Juvenille and 2. Maxilla more common than mandible (for Juvenille - opposite would be true of Ossifying)
67
Q

What is the recurrence rate of a Juvenille Active Ossifying Fibroma?

A

30-60%

68
Q

What pathology is a benign tumor of mature bone that is restricted to the craniofacial skeleton?

A

Osteoma

69
Q

Where is the most common location of an Osteoma?

A

Paranasal Sinuses

70
Q

How do osteomas differ depending on the type of bone they form in?

A

Compact bone for radio opaque lesions while cancellous bone produces mixed lesions

71
Q

What pathology is associated with colon polyps/adenocarcinomas, skeletal abnormalities and dental abnormalities?

A

Gardner Syndrome

72
Q

What procedure is usually performed prophylactically in patients with Gardner’s Syndrome?

A

Colonectomy

73
Q

What is the first sign typically presented in Gardner’s Syndrome?

A

Multiple Osteomas

74
Q

What dental abnormalities are present in Gardner’s Syndrome (3)?

A
  1. Supernumerary teeth, 2. Impacted teeth and 3. Odontomas
75
Q

What two pathologies are closely related, involve bone tumors and have identical histopathologic features?

A

Osteoblastoma and Osteoid Osteoma

76
Q

What two ways exist to differentiate Osteoid osteomas from Osteoblastomas?

A
  1. Osteoid osteomas have pain relieved by asprin and 2. Osteoid Osteomas are smaller than 2 cm
77
Q

Which lesion can a small radio opaque nidus be seen resulting in a target-like appearance?

A

Osteoid Osteoma

78
Q

Besides being relieved by asprin, what other fact about pain points to an osteoid osteoma?

A

Nocturnal pain

79
Q

What pathology can be described as Odontogenic neoplasm of cementoblasts?

A

Cementoblastoma

80
Q

What three radiographic features are suggestive of Cementoblastomas?

A
  1. Radio opaque mass that is fused to one or more teeth, 2. Outline of the roots is often obscured and 3. Surrounded by a thin Radiolucent rim
81
Q

What is the treatment of a cementoblastoma?

A

Extraction of the tooth and mass

82
Q

What pathology is a mesenchymal malignancy where cells produce immature bone and is the most common malignancy to originate within bone (besides hematopoietic neoplasms)?

A

Osteosarcoma

83
Q

What age distrubution is affected by Osteosarcomas?

A

Bimodal - 10-20 most common with a group after 50

84
Q

Where are the two most common sites of development for osteosarcomas?

A
  1. Distal femur and 2. Proximal Tibia
85
Q

When osteosarcomas develop in the jaw, what is the average age?

A

33

86
Q

Where are osteosarcomas likely to develop in the facial area?

A

Mandibular and Maxillary Osteosarcomas are each equally likely

87
Q

Mandibular osteosarcomas often present where?

A

Posterior Jaw

88
Q

Maxillary Osteosarcomas are likely to present in which three locations?

A
  1. Alveolar ridge, 2. Sinus floor and 3. Palate
89
Q

Should a maxillary Osteosarcoma present superiorly, where would it likely be (2)?

A
  1. Zygoma or 2. Orbital rim
90
Q

Should root resorption occur in an Osteosarcoma, what is the name of the special tapering of the root called?

A

Spiking resorption

91
Q

What is the classic radiographic presentation of an osteosarcoma?

A

Sunburst appearance

92
Q

What x-ray should be used to see osteosarcomas?

A

Occlusal

93
Q

What is the name of the triangular elevation of periosteum in osteosarcomas?

A

Codman’s Triangle

94
Q

What occurs in the PDL in Osteosarcomas (and other malignancies)?

A

It widens due to tumor infiltration

95
Q

What is the most important prognostic indicator for osteosarcomas?

A

The ability to achieve an initial complete surgical removal

96
Q

What is the most common form of cancer involving bone?

A

Metastatic Carcinoma

97
Q

What are the five most common sites of origin when cancer metastasizes from the jaw?

A
  1. Breast, 2. Lung, 3. Thyroid, 4. Prostate and 5. Kidney
98
Q

What are the four most common metastatic tumors that go to the jaws?

A
  1. Vertebrae, 2. Ribs, 3. Pelvis and 4. Skull
99
Q

Where do the majority of jaw metastasis occur?

A

Mandible

100
Q

What term is employed when metastasis to the mandible involves the inferior alveolar nerve and produces a distinct pattern of anesthesia?

A

Numb-Chin Syndrome

101
Q

What are the three radiographic characteristics of metastatic tumors to the jaws?

A
  1. Moth-eaten ill-defined borders, 2. Widening of PDL and 3. May stimulate bone formation to create a mixed RL-RO lesion

Oral Pathology (14 decks)

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