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Pericoronal Radiolucencies Flashcards

1
Q

Pericoronal Radiolucencies
* Do not contain
* May or may not contain

A

radiopaque flecks within the lumen
radiopaque flecks within the lumen

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2
Q

skipped
Pericoronal RadiolucenciesThat do not Contain Radiographic Flecks
(5)

A
  • Normal Follicular Space
  • Pericoronitis
  • Dentigerous Cyst
    – Ameloblastoma
    – Squamous cell carcinoma
  • Eruption Cyst
  • Ameloblastic Fibroma
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3
Q

skipped
Pericoronal Radiolucencies
That May Contain Radiopaque Flecks
(5)

A
  • Ameloblastic Fibro-odontoma
  • Odontoameloblastoma
  • Adenomatoid Odontogenic
    Tumor
  • Calcifying Epithelial
    Odontogenic Tumor
  • Calcifying Odontogenic Cyst
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4
Q

Follicular Space*

A

Remnant of dental follicle adjacent a
developed crown of an unerupted or
impacted tooth should be no greater
than;
– 3.0mm wide on panoramic image
– 2.5mm wide on intraoral film image
– 2.0mm on CBCT

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5
Q

Pericoronitis

A
  • If dental follicle gets
    infected, the
    inflammation often
    spreads along the
    deep fascial planes
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6
Q

Pericoronitis
* The diagnosis must be based on
evidence of

A

pericoronal tissues,
and the clinical signs and
symptoms of disease

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7
Q

Pericoronitis
Edematous, erythematous mucosa;
pain; fever; malaise, etc…
* Cellulitis to fascial plane deep
spaces causing

A

dramatic facial
swelling

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8
Q

Dentigerous Cyst
Clinical
Cystic lining arises from
remnants of
Accounts for –% of jaw
cysts

A

dental
follicle
20

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9
Q

Dentigerous Cyst
Clinical
Cystic lining arises from
remnants of dental
follicle
Accounts for
–% of jaw
cysts!

A

20

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10
Q

Dentigerous Cyst
Radiographic
(2)

A
  • Consistently
    widened follicular
    space of >3.0mm
  • Well-delineated
    radiolucency with
    corticated borders
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11
Q

Dentigerous Cyst
Age

A

Highest incidence in
20’s and 30’s

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12
Q

Dentigerous Cyst
Site
Most common in

A

mandibular third molars
and maxillary canines;
can affect any impacted
tooth

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13
Q

Dentigerous Cyst
Management
(2)
Other

A

*Enucleate
*Degree of surgery dependent on size of
tumor

Potential for degeneration of the cyst
lining to an ameloblastoma or a
squamous cell carcinoma.

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14
Q

Eruption Cyst
Clinical
* Presents as a
* Often has bluish coloration due to

A

soft fluid-filled swelling of
crestal mucosa in area of an erupting
tooth

trauma
creating blood in cystic fluid

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15
Q

Eruption Cyst
Radiographic
May see lack of

A

crestal alveolar bone
because of position
of erupting crown
and cyst near crest

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16
Q

Eruption Cyst
Age

A

< 10 years
mixed dentition stage

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17
Q

Eruption Cyst
Site

A

Most common in mandibular molar region

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18
Q

Eruption Cyst
Management
(2)

A
  • Often rupture spontaneously
  • Some may require simple excision
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19
Q

Ameloblastic Fibroma
Clinical
A — odontogenic tumor

A

mixed

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20
Q

Ameloblastic Fibroma
Radiographic

A

A pericoronal radio-
lucency associated
with a developing
tooth

21
Q

Ameloblastic Fibroma
Age
70% of cases are — years
Mean age — years

A

< 20
14-15.5

22
Q

Ameloblastic Fibroma
Site
Highest incidence in

A

mandibular molar-
premolar region

23
Q

Ameloblastic Fibroma
Management
Other
–% recurrence

A

Enucleation
20

24
Q

Ameloblastic Fibro-Odontoma
Clinical
(2)

A

A mixed odontogenic tumor, similar to
ameloblastic fibroma but has a mineralized
stroma
If mineralization is high, then radiopaque
flecks may be evident radiographically

25
Ameloblastic Fibro-Odontoma Radiographic
Pericoronal radio- lucency associated with a developing tooth Radiopaque flecks noted in the lumen
26
Ameloblastic Fibro-Odontoma Age – mean age ~-- years Site –
15 posterior mandible
27
Ameloblastic Fibro-Odontoma Other Must be differentiated from the --- as the latter is more aggressive.
odontoameloblastoma
28
Odontoameloblastoma (a.k.a. ameloblastic odontoma) Clinical Rare Must be differentiated from the
ameloblastic fibro-odontoma, as it is more aggressive and requires surgical resection
29
Odontoameloblastoma (a.k.a. ameloblastic odontoma) Clinical - Seen mainly in -- - Affects
mandible teens and children
30
Odontoameloblastoma (a.k.a. ameloblastic odontoma) Radiographic (2)
Expansive with destruction of adjacent bone Rudimentary tooth-like structures similar to complex odontoma
31
Adenomatoid Odontogenic Tumor Clinical --% of odontogenic tumors
3-7
32
Adenomatoid Odontogenic Tumor Histological (2)
Histologically a cross between a dentigerous cyst and ameloblastoma Odontogenic epithelium is arranged in duct- like glandular array
33
Adenomatoid Odontogenic Tumor 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.
33
Adenomatoid Odontogenic Tumormore recent systematic reviews report Age Occur at any age but majority occur in
teens (10- 19 years) and young adults (~20 -35 years)
34
Adenomatoid Odontogenic Tumor Site
65% occur in anterior jaws Maxilla:Mandible is 2:1
35
Adenomatoid Odontogenic Tumor Gender
no gender predilection previously reported as female:male is 2:1
35
Adenomatoid Odontogenic Tumor Management
Enucleation with rare recurrence
35
Calcifying Epithelial Odontogenic Tumor Clinical
Approximately 50% occur in association with impacted teeth.
35
Calcifying Epithelial Odontogenic Tumor Another name for the tumor is.....
Pindborg tumor
36
Calcifying Epithelial Odontogenic Tumor Management
Larger lesions require en bloc resections
37
Calcifying Epithelial Odontogenic Tumor Radiographic (2)
* Radiopaque flecks are due to calcified amyloid * A breakdown product of the neoplastic epithelial cells; these mineralizations are called Leisegang’s rings
38
Calcifying Epithelial Odontogenic Tumor Age
Mean age of 40 years
39
Calcifying Epithelial Odontogenic Tumor Site
Mandible:Maxilla is 2:1 More likely in posterior mandible
40
Calcifying Odontogenic Cyst Clinical * a.k.a. * Extremely variable presentation * Approximately ---% behave as neoplasms * Present from --- diameter; as large as ---
Gorlin cyst 2-16 2.0-4.0cm, 12cm
41
Calcifying Odontogenic Cyst Radiographic (3)
* Vary from uni to multilocular * 50% have radiopacities in the lumen * 33% present as pericoronal radiolucencies
42
Calcifying Odontogenic Cyst Age
Occur at any age but majority diagnosed in teens and young adults
43
Calcifying Odontogenic Cyst Site
65% in anterior maxilla
44
Calcifying Odontogenic Cyst Sex
No predilection
45
Calcifying Odontogenic Cyst Management
Simple enucleation with minimal recurrence

Radiographic Interpretation (13 decks)

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