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Radiographic Interpretation > Pericoronal Radiolucencies > Flashcards

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
Q

Ameloblastic Fibro-Odontoma
Radiographic

A

Pericoronal radio-
lucency associated
with a developing
tooth
Radiopaque flecks
noted in the lumen

26
Q

Ameloblastic Fibro-Odontoma
Age – mean age ~– years
Site –

A

15
posterior mandible

27
Q

Ameloblastic Fibro-Odontoma
Other
Must be differentiated from the
— as the latter is more
aggressive.

A

odontoameloblastoma

28
Q

Odontoameloblastoma
(a.k.a. ameloblastic odontoma)
Clinical
Rare
Must be differentiated from the

A

ameloblastic
fibro-odontoma, as it is more aggressive
and requires surgical resection

29
Q

Odontoameloblastoma
(a.k.a. ameloblastic odontoma)
Clinical
- Seen mainly in –
- Affects

A

mandible
teens and children

30
Q

Odontoameloblastoma
(a.k.a. ameloblastic odontoma)
Radiographic
(2)

A

Expansive with destruction of adjacent bone
Rudimentary tooth-like structures similar to
complex odontoma

31
Q

Adenomatoid Odontogenic
Tumor
Clinical
–% of odontogenic tumors

A

3-7

32
Q

Adenomatoid Odontogenic
Tumor
Histological
(2)

A

Histologically a cross between a
dentigerous cyst and ameloblastoma
Odontogenic epithelium is arranged in duct-
like glandular array

33
Q

Adenomatoid Odontogenic
Tumor
Radiographic

A
  • 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
Q

Adenomatoid Odontogenic Tumormore recent systematic reviews report
Age
Occur at any age but majority occur in

A

teens (10- 19 years) and
young adults (~20 -35 years)

34
Q

Adenomatoid Odontogenic
Tumor
Site

A

65% occur in anterior jaws
Maxilla:Mandible is 2:1

35
Q

Adenomatoid Odontogenic
Tumor
Gender

A

no gender predilection
previously reported as female:male is 2:1

35
Q

Adenomatoid Odontogenic
Tumor
Management

A

Enucleation with rare recurrence

35
Q

Calcifying Epithelial
Odontogenic Tumor
Clinical

A

Approximately 50% occur in association with
impacted teeth.

35
Q

Calcifying Epithelial
Odontogenic Tumor
Another name for the tumor is…..

A

Pindborg tumor

36
Q

Calcifying Epithelial
Odontogenic Tumor
Management

A

Larger lesions
require en bloc
resections

37
Q

Calcifying Epithelial
Odontogenic Tumor
Radiographic
(2)

A
  • Radiopaque flecks are
    due to calcified
    amyloid
  • A breakdown product
    of the neoplastic
    epithelial cells; these
    mineralizations are
    called Leisegang’s
    rings
38
Q

Calcifying Epithelial
Odontogenic Tumor
Age

A

Mean age of 40 years

39
Q

Calcifying Epithelial
Odontogenic Tumor
Site

A

Mandible:Maxilla is 2:1
More likely in posterior mandible

40
Q

Calcifying Odontogenic Cyst
Clinical
* a.k.a.
* Extremely variable presentation
* Approximately —% behave as
neoplasms
* Present from — diameter; as large
as —

A

Gorlin cyst
2-16
2.0-4.0cm, 12cm

41
Q

Calcifying Odontogenic Cyst
Radiographic
(3)

A
  • Vary from uni to
    multilocular
  • 50% have
    radiopacities in the
    lumen
  • 33% present as
    pericoronal
    radiolucencies
42
Q

Calcifying Odontogenic Cyst
Age

A

Occur at any age but majority diagnosed in
teens and young adults

43
Q

Calcifying Odontogenic Cyst
Site

A

65% in anterior maxilla

44
Q

Calcifying Odontogenic Cyst
Sex

A

No predilection

45
Q

Calcifying Odontogenic Cyst
Management

A

Simple enucleation with minimal
recurrence

Radiographic Interpretation (13 decks)

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