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RADIO INTERPRETATION > pericoronal radiolucencies > Flashcards

pericoronal radiolucencies Flashcards

1
Q

Pericoronal Radiolucencies

A

typically with non-erupted teeth
* Do not contain radiopaque flecks within the lumen
* May or may not contain radiopaque flecks within the lumen

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2
Q

Pericoronal RadiolucenciesThat do not Contain Radiographic Flecks

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

dentigerous cysts may become:

A

ameolblastoma or SCCa

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4
Q

Pericoronal Radiolucencies
That May Contain Radiopaque Flecks

A
  • Ameloblastic Fibro-odontoma
  • Odontoameloblastoma
  • Adenomatoid Odontogenic Tumor
  • Calcifying Epithelial Odontogenic Tumor
  • Calcifying Odontogenic Cyst
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5
Q

Follicular Space

normal sizes?

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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6
Q

is this pathological?

A

no, WNL follicle size

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7
Q

Pericoronitis

A
  • If dental follicle gets infected, the inflammation often
    spreads along the deep fascial planes
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8
Q

Pericoronitis diagnosis

A

The diagnosis must be based on evidence of pericoronal tissues, and the clinical signs and symptoms of disease

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9
Q

signs and symptoms of pericoronitis

A

Edematous, erythematous mucosa;
pain; fever; malaise, etc…

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10
Q

cellulitis to deep fasical planes in pericoronitis

A

Cellulitis to fascial plane deep spaces causing dramatic facial swelling

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11
Q

dentigerous cyst

% jaw cysts

A

Cystic lining arises from remnants of dental follicle
Accounts for 20% of jaw cysts

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12
Q

Dentigerous Cyst
Radiographic

A
  • Consistently widened follicular space of >3.0mm
  • Well-delineated radiolucency with corticated borders
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13
Q

potential expansion of dentigerous cysts

A

can occur and make surgical managment much more complicated

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14
Q

how can dentigerous cysts affect other teeth

A

potential for displacement of other teeth

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15
Q

dentigerous cyst age group

A

Highest incidence in 20’s and 30’s

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16
Q

most common site of dentigerous cysts

A

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

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17
Q

management dentigerous cysts

A

*Enucleate
*Degree of surgery dependent on size of
tumor

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18
Q

potential future complications of dentigerous cysts

A

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

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19
Q

Eruption Cyst Clinical app

A
  • 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
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20
Q

Eruption Cyst Radiographic app

A

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

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21
Q
A

likely eruption cyst

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22
Q

Eruption Cyst
Age

A

< 10 years
mixed dentition stage

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23
Q

Eruption Cyst most common site

A

Most common in mandibular molar region

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24
Q

Eruption Cyst Management

A
  • Often rupture spontaneously
  • Some may require simple excision
25
Q

Ameloblastic Fibroma
Clinical

A

A mixed odontogenic tumor

26
Q

Ameloblastic Fibroma
Radiographic app

A

A pericoronal radio-lucency associated with a developing tooth

27
Q

Ameloblastic Fibroma
Age

A

70% of cases are < 20 years
Mean age 14-15.5 years

28
Q

ameloblastic fibroma site

A

Highest incidence in mandibular molar-
premolar region

29
Q

Ameloblastic Fibroma
Management

A

Enucleation

30
Q

Ameloblastic Fibroma recurrence %

A

20% recurrence

31
Q

Ameloblastic Fibro-Odontoma
Clinical

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

32
Q

Ameloblastic Fibro-Odontoma
Radiographic app

A

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

33
Q

Ameloblastic Fibro-Odontoma
Age

A

Age – mean age ~15 years

34
Q

Ameloblastic Fibro-Odontoma
Site

A

Site – posterior mandible

35
Q

Ameloblastic Fibro-Odontoma
Must be differentiated from? why?

A

Must be differentiated from the odontoameloblastoma as the latter is more aggressive.

36
Q

Odontoameloblastoma
(a.k.a. ameloblastic odontoma)
Clinical

A

Rare
Must be differentiated from the ameloblastic fibro-odontoma, as it is more aggressive and requires surgical resection

37
Q

Odontoameloblastoma
(a.k.a. ameloblastic odontoma) location

A

mandible

38
Q

Odontoameloblastoma
(a.k.a. ameloblastic odontoma) age

A

children and teens

39
Q

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

A

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

40
Q

Adenomatoid Odontogenic Tumor

% of odontogenic tumors?

A

3-7% of odontogenic tumors

41
Q

Adenomatoid Odontogenic
Tumor
Histological

A

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

42
Q

Adenomatoid Odontogenic
Tumor
Radiographic app

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.
43
Q

AOT lucency always pericoronal?

A

may not app as pericoronal as other lesions discussed, may also be non-attatched to a tooth

44
Q

AOT age

A

Occur at any age but majority occur in teens (10- 19 years) and young adults (~20 -35 years)

45
Q

AOT site

A

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

46
Q

AOt gender?

A

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

47
Q

AOT management

A

Enucleation with rare recurrence

48
Q

Calcifying Epithelial Odontogenic Tumor
Clinical
Approximately % occur in association with
impacted teeth?

A

Approximately 50% occur in association with
impacted teeth.

49
Q

another name for CEOT

A

pindborg tumor

50
Q

Calcifying Epithelial Odontogenic Tumor
Management

A

Larger lesions require en bloc resections to go beyond margins, due to aggressive nature of tumor

51
Q

Calcifying Epithelial Odontogenic Tumor
Radiographic app
felcks? result of?

A
  • Radiopaque flecks are due to calcified amyloid
  • A breakdown product of the neoplastic epithelial cells; these mineralizations are called Leisegang’s rings
    multilocular common
52
Q

Calcifying Epithelial Odontogenic Tumor
Age

A

Mean age of 40 years

53
Q

Calcifying Epithelial Odontogenic Tumor
Site

A

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

54
Q

Calcifying Odontogenic Cyst
Clinical facts
* a.k.a.
* variabilty?
* neoplastic behavior?
* sizes?

A
  • a.k.a. Gorlin cyst
  • Extremely variable presentation
  • Approximately 2-16% behave as neoplasms
  • Present from 2.0-4.0cm diameter; as large as 12cm
55
Q

Calcifying Odontogenic Cyst
Radiographic app

A
  • Vary from uni to multilocular
  • 50% have radiopacities in the lumen
  • 33% present as pericoronal radiolucencies
56
Q

COC age

A

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

57
Q

COC site

A

65% ant maxilla

58
Q

COC gender?

A

no preference

59
Q

COC management/ recurrence

A

Simple enucleation with minimal
recurrence

RADIO INTERPRETATION (18 decks)

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