Pericoronal radiolucencies Flashcards
Pericoronal Radiolucencies That do or do not Contain Radiographic Flecks? • Normal Follicular Space • Pericoronitis • Dentigerous Cyst – Ameloblastoma – Squamous cell carcinoma • Eruption Cyst • Ameloblastic Fibroma
do not
Pericoronal Radiolucencies That may or may not Contain Radiopaque Flecks? • Ameloblastic Fibro-odontoma • Odontoameloblastoma • Adenomatoid Odontogenic Tumor • Calcifying Epithelial Odontogenic Tumor • Calcifying Odontogenic Cyst
May
• Remnant of dental follicle adjacent a
developed crown of an unerupted or
impacted tooth should be no greater
than;
Follicular Space
• If dental follicle gets infected, the inflammation often spreads along the deep fascial planes
Pericoronitis
• The diagnosis must be based on evidence of pericoronal tissues, and the clinical signs and symptoms of disease • Edematous, erythematous mucosa; pain; fever; malaise, etc... • Cellulitis to fascial plane deep spaces causing dramatic facial swelling -Major clinical signs; not much radiographic signs -Most likely reason why 3rd molars are removed
Pericoronitis
_____ is the most common cyst in the jaw of odontogenic origin
Periapical cyst
_____ is the 2nd most common cyst in the jaw of odontogenic origin
Dentigerous cyst
Cystic lining arises from remnants of dental follicle Accounts for 20% of jaw cysts
Dentigerous cyst
Radiographic • Consistently widened follicular space of >3.0mm • Well-delineated radiolucency with corticated borders
Dentigerous cyst
What can dentigerous cysts degenerate into?
Ameloblastoma
SCC
• Presents as a soft fluid-filled swelling of
crestal mucosa in area of an erupting
tooth
• Often has bluish coloration due to trauma
creating blood in cystic fluid
Eruption cyst
Radiographic May see lack of crestal alveolar bone because of position of erupting crown and cyst near crest
Eruption cyst
Where are the most common areas for eruption cysts?
Mand molars
Where are the most common areas where dentigerous cysts occur?
Max canines
Mand 3rd molars
Where is an ameloblastic fibroma most likely found?
Mand posteiror
A mixed odontogenic tumor Radiographic A pericoronal radio- lucency associated with a developing tooth Younger individuals
Ameloblastic fibroma
A mixed odontogenic tumor, similar to ameloblastic fibroma but has a mineralized stroma If mineralization is high, then radiopaque flecks may be evident radiographically Radiographic Pericoronal radio- lucency associated with a developing tooth Radiopaque flecks noted in the lumen Must be differentiated from the odontoameloblastoma as the latter is more aggressive.
Ameloblastic fibro-odontoma
Must be differentiated from the ameloblastic
fibro-odontoma, as it is more aggressive
and requires surgical resection
Radiographic
Expansive with destruction of adjacent bone
Rudimentary tooth-like structures similar to
complex odontoma
Resection is tx
Odontoameloblastoma
Histologically a cross between a dentigerous cyst and ameloblastoma Odontogenic epithelium is arranged in duct- like glandular array Radiographic • Consistently widened follicular space of >3.0mm if associated with crown of impacted tooth (75% of cases are pericoronal). • Well-delineated radioluceny with corticated border, usually >3.0cm. Seen in adolescent females likely in the anterior maxilla -Enucleation is TX
Adenomatoid Odontogenic Tumor
A breakdown product of the neoplastic epithelial cells; these mineralizations are called
Leisegang’s
rings
Approximately 50% occur in association with impacted teeth. Radiographic • Radiopaque flecks are due to calcified amyloid • A breakdown product of the neoplastic epithelial cells; these mineralizations are called Leisegang’s rings Age Mean age of 40 years Site Mandible:Maxilla is 2:1 More likely in posterior mandible Need Resections
Calcifying Epithelial Odontogenic Tumor
Lindberg Tumor
• Extremely variable presentation • Approximately 2-16% behave as neoplasms • Present from 2.0-4.0cm diameter; as large as 12cm Radiographic • Vary from uni to multilocular • 50% have radiopacities in the lumen • 33% present as pericoronal radiolucencies Age Occur at any age but majority diagnosed in teens and young adults Site 65% in anterior maxilla Sex No predilection Simple enucleation with minimal recurrence
Calcifying Odontogenic Cyst
Gorlin cyst
