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Radiographic Interpretation > Pericoronal Radiolucencies > Flashcards

Pericoronal Radiolucencies Flashcards

1
Q

What are the different types of periapical radiolucencies?

A
  • Periapical Abscess
  • Periapical granuloma
  • Periapical Cyst
  • Residual/Recurrent Cyst
  • Periapical Cementoosseous Dysplasia
  • Fibrous Healing Defect
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2
Q

What are pericoronal radiolucencies?

A
  • around the crown of an unerupted tooth
    *Do not contain radiopaque flecks within the lumen
    *May or may not contain radiopaque flecks within the lumen
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3
Q

What are the types of pericoronal radiolucencies that DO NOT contain radiographic flecks?

A
  • Normal Follicular Space
  • Pericoronitis
  • Dentigerous Cyst
    – Ameloblastoma
    – Squamous cell carcinoma
  • Eruption Cyst
  • Ameloblastic Fibroma
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4
Q

What are the types of pericoronal radiolucencies that DO contain radiographic flecks?

A
  • Ameloblastic Fibro-odontoma
  • Odontoameloblastoma
  • Adenomatoid Odontogenic Tumor
  • Calcifying Epithelial Odontogenic Tumor
  • Calcifying Odontogenic Cyst
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5
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
– 3.0mm wide on panoramic image
– 2.5mm wide on intraoral film image
– 2.0mm on CBCT

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6
Q
A

follicular space

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7
Q

What is pericoronitis?

A

If dental follicle gets infected, the inflammation often spreads along the deep fascial planes

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8
Q

What are the clinical symptoms of pericoronitis?

A
  • Edematous
  • erythematous mucosa
  • pain
  • fever
  • malaise
  • Cellulitis to fascial plane deep spaces causing dramatic facial swelling (shown in pic)
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9
Q

What is a dentigerous cyst?

A

Cystic lining arises from remnants of dental follicle

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10
Q

Dentigerous cysts account for __% of the jaw cysts

A

20%

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11
Q

What does the dentigerous cyst look like radiographically?

A
  • Consistently widened follicular space of >3.0mm
  • Well-delineated radiolucency with corticated borders
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12
Q
A

dentigerous cyst

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13
Q

If you do not stop the disease process of a dentigerous cyst what can happen?

A
  • expansion of cyst and displacement of normal structures
  • Potential for degeneration of the cyst lining to an ameloblastoma or a squamous cell carcinoma
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14
Q

Where is the most common site of dentigerous cyst?

A
  • around teeth that are impacted
  • Most common in mandibular third molars and maxillary canines; can affect any impacted tooth
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15
Q

What age range is most affected by dentigerous cysts?

A

20-30

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16
Q

How do you manage/treat a dentigerous cyst?

A

*Enucleate
*Degree of surgery dependent on size of tumor

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17
Q
A

dentigerous cyst that was left untreated for many, many years

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18
Q

What is 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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19
Q

What does an eruption cyst look like radiographically?

A

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

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20
Q

What age group is most affected by eruption cysts?

A

< 10 years
- mixed dentition stage

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21
Q

What side is most common to have eruption cysts?

A

Most common in mandibular molar region

22
Q

What is the management for an eruption cyst?

A
  • Often rupture spontaneously
  • Some may require simple excision
23
Q

What is an ameloblastic fibroma?

A
  • A mixed odontogenic tumor
  • solid mass of cells (not a cyst)
24
Q

What do ameloblastic fibromas look like radiographically?

A

● pericoronal radiolucency associated with a developing tooth
● well demarcared
● often corticated
● expansive

also can be…
● unilocular radiolucency not always associated with a developing tooth

25
Q

How can you tell an ameloblastic fibroma from a dentigerous cyst based on history?

A
  • ameloblastic fibroma is in the mixed dentition stage (younger people)
  • dentigerous cyst happens when the tooth is impacted for a longer period of time

Prolly need a biopsy

26
Q
A

ameloblastic fibroma

27
Q

___% of cases of ameloblastic fibroma are <20 years

A

70%

Mean age 14-15.5 years

28
Q

Where is the most common site for ameloblastic fibroma?

A

Highest incidence in mandibular molar-premolar region

29
Q

What is the management for an ameloblastic fibroma?

A
  • enucleation
  • 20% recurrence
30
Q

What is 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
31
Q

What does the ameloblastic fibro-odontoma look like radiographically?

A
  • Pericoronal radiolucency associated with a developing tooth
  • Radiopaque flecks or globular radiopacities-tooth-like structures noted in the lumen
  • Well demarcared
  • Often corticated
  • Expansive
32
Q

What is the age range of a patient with ameloblastic fibro-odontoma?

A

mean age - 15 years

33
Q

What is the main site of an ameloblastic fibro-odontoma?

A

posterior mandible

34
Q

How can you tell the difference between an ameloblastic fibro-odontoma and a odontoameloblastoma?

A

odontoameloblastoma is more
aggressive

35
Q

Adenomatoid odontogenic tumors make up ___% of odontogenic tumors

36
Q

What is the histology of an Adenomatoid odontogenic tumor?

A
  • Histologically a cross between a dentigerous cyst and ameloblastoma
  • Odontogenic epithelium is arranged in duct like glandular array
37
Q

What does an adenomatoid odontogenic tumor look like radiographically?

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
38
Q

asymptomatic tumor
well demarkated and corugated

A

adenomatoid odontogenic tumor

39
Q
A

adenomatoid odontogenic tumor

40
Q

What age range is affected by adenomatoid odontogenic tumor?

A

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

no gender predilection

41
Q

What site is common for adenomatoid odontogenic tumors?

A
  • 65% occur in anterior jaws
  • Maxilla:Mandible is 2:1
42
Q

What is the management for adenomatoid odontogenic tumor?

A

Enucleation with rare recurrence

43
Q

What are the clinical features of calcifying epithelial odontogenic tumor?

A
  • Approximately 50% occur in association with impacted teeth
  • another name for the tumor is pindborg tumor
44
Q

What is the management for a Calcifying Epithelial Odontogenic Tumor?

A

Larger lesions require en bloc resections

45
Q

What does a Calcifying Epithelial Odontogenic Tumor look like radiographically?

A
  • Radiopaque flecks are due to calcified amyloid
  • A breakdown product of the neoplastic epithelial cells; these mineralizations are called Leisegang’s rings
46
Q

What is the age range of those with Calcifying Epithelial Odontogenic Tumor?

A

Mean age of 40 years

47
Q

What site are alcifying Epithelial Odontogenic Tumor most common?

A
  • Mandible:Maxilla is 2:1
  • More likely in posterior mandible
48
Q

What is a calcifying odontogenic cyst?

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
49
Q

What does the calcifying odontogenic cyst look like radiographically?

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

What is the age, gender, site, etc. for calcifying odontogenic cyst?

A

not really that specific
- must be included in a differential diagnosis even though it is rare

51
Q

What is the management for a calcifying odontogenic cyst?

A

Simple enucleation with minimal recurrence

Radiographic Interpretation (5 decks)

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