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Radiographic Interpretation > Pericoronal Radiolucencies > Flashcards

Pericoronal Radiolucencies Flashcards

1
Q

what are the periocoronal radiolucencies that do not contain radiographic flecks

A
  • normal follicular space
  • pericorontitis
  • dentigerous cyst: ameloblastoma, SCC
  • eruption cyst
  • ameloblastic fibroma
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2
Q

what are the 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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3
Q

what is the follicular space

A

remnant of dental follicle adjacent a developed crown of an unerupted or impacted tooth should be no greater than 3mm on a pano or 2.5mm wide on intraoral film or 2mm on CBCT

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4
Q

when will the follicle be lost

A

when the tooth erupts

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5
Q

what is pericoronitis

A

if dental follicle gets infected the inflammation often spreads along the deep fascial planes
- staph infection

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6
Q

what is the dx of pericoronitis dependent on

A
  • evidence of periocoronal tissues and the clinical signs and symptoms of disease
  • edematous, erythematous mucosa, pain, fever, malaise
  • cellulitis to fascial plane causing dramatic facial swelling
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7
Q

what is the most common cyst in the jaws

A

a periapical cyst

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8
Q

what is the second most common cyst in the jaws and what is another name for it

A

dentigerous cyst
AKA follicular cyst

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9
Q

what is the clinical cause of a dentigerous cyst

A

cystic lining arises from remnants of dental follicle

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10
Q

dentigerous cyst accounts for ____ of jaw cysts

A

20%

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11
Q

how does a dentigerous cyst appear radiographically

A
  • consistently widened follicular space of greater than 2mm in the widest extension
  • well-delineated radiolucency with corticated borders
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12
Q

what do dentigerous cysts tend to do

A

expand and displace

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13
Q

what is the common age for dentigerous cysts

A

highest incidence in20s and 30s

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14
Q

what are the most common sites for dentigerous cysts

A

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

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15
Q

what is the management of a dentigerous cyst

A

-enucleate
- degree of surgery dependent on size of tumor

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16
Q

there is potential for a dentigerous cyst’s lining to degenerate into:

A

an ameloblastoma or a SCC

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17
Q

what is the clinical presentation of an eruption cyst

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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18
Q

what is the radiographic presentation of an eruption cyst

A

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

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19
Q

what is the common age and site for eruption cysts

A
  • less than 10 years old in the mixed dentition stage
  • most common site in mandibular molar region
20
Q

what is the tx for an eruption cyst

A
  • often rupture spontaneously
  • some may require simple excision
21
Q

what is the clinical presentation of an ameloblastic fibroma

A
  • a mixed odontogenic tumor
  • not cystic
22
Q

what is the radiograophic presnetation of an ameloblastic fibroma

A
  • pericoronal radiolucency associated with a developing tooth
  • well demarcated
  • often corticated
  • explansive
  • displaces structures
  • unilocular radiolucnecy not always associated with a developing tooth
23
Q

what is the predilection for ameloblastic fibroma

A
  • 70% of cases are less than or equal to 20 years
  • mean age 14-15.5 years
  • male = female
  • highest incidence in mandibular molar premolar region
24
Q

what is the tx for ameloblastic fibroma

A

enucleation

25
Q

what is the recurrence rate for ameloblastomic fibroma

A

20%

26
Q

what is the clinical presentation for an ameloblastic fibro-odontoma

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
27
Q

what is the radiographic presentation of an ameloblastic fibro odontoma

A
  • pericoronal radiolucency associated with a developing
  • radiopaque flecks or globular radiopacities tooth like structures noted in the lumen
  • well demarcated
  • often corticated
  • expansive
28
Q

what is the predilection for ameloblastic fibro odontoma

A
  • mean age is 15 years
  • site is posterior mandible
29
Q

an ameloblastic fibro odontoma must be differnetiated from what other lesion and why

A

an odontoameloblastoma because odontoameloblastoma is more aggressive

30
Q

how common are adenomatoid odontogenic tumors

A

3-7% of odontogenic tumors

31
Q

what is the histology of an adenomatoid odontogenic tumor

A
  • a cross between a dentigerous cyst and ameloblastoma
  • odontogenic epithelium is arragned in duct like glandular array
32
Q

what is the radiographic presentation for an adenomatoid odontogenic tumor

A
  • consistently widened follicular space of greater than 3mm if associated with crown of impacted tooth- 75% of cases are pericoronal
  • well- delineated radiolucency with corticated border usually greater than or equal to 3cm
33
Q

what is the predilection for adenomatoid odontogenic tumors

A
  • occur at any age but majority occur in teens 10-19 years and young adults 20-35 years
  • 65% occur in anterior jaws. maxilla: mandible is 2:1
  • no gender predilection
34
Q

what is the tx for adenomatoid odontogenic tumors

A

enucleation with rare recurrence

35
Q

what percent of calcifying epithelial odontogenic tumors occur in associated with impacted teeth

A

50%

36
Q

what is another name for the calcifying epithelial odontogenic tumor

A

pindborg tumor

37
Q

what is the tx for calcifying epithelial odontogenic tumor

A

larger lesions require en block resections

38
Q

what is the radiographic appearance of a calcifying epithelial odontogenic tumor

A
  • radiopaque flecks are due to calcified amyloid
  • a breakdown product of the neoplastic epithelial cells; these are mineralizations called Leisegang’s rings
39
Q

what is the prediliction for calcifying epithelial odontogenic tumor

A
  • mean age of 40 years
  • mandible: maxilla is 2:1
  • more likely in posterior mandible
40
Q

what is another name for the calcifying odontogenic cyst

A

gorlin cyst

41
Q

what is the clinical presentation of the calcifying odontogenic cyst

A
  • extremely variable presentation
  • approximately 2-16% behave as neoplasms
  • present fro 2-4cm diameter, as large as 12cm
  • very aggressive
42
Q

what is the radiographic appearance of the calcifying odontogenic cyst

A
  • vary from uni to multilocular
  • 50% have radiopacities in the lumen
  • 33% present as pericoronal radiolucencies
43
Q

what is the predilection for calcifying odontogenic cyst

A
  • occur at any age but majority diagnosed in teens and young adults
  • 65% in anterior maxilla
  • no sex predilection
44
Q

what is the tx for calcifying odontogenic cyst

A

simple enucleation with minimal recurrence

45
Q
A

Radiographic Interpretation (13 decks)

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