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5th year final - all cards combined > Radiology > Flashcards

Radiology Flashcards

1
Q

Jaw lesions exhibit a spectrum of different radiographic appearances
such as

A

Radiolucent - dark areas

Radiopaque - white areas

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2
Q

majority of pathologies of the jaw appear as radiolucent or radiopaque

A

radiolucent

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3
Q

Majority of pathologies are radiolucent
* Includes almost all of the most common pathologies

why is this

A
  • Due to reduced radiodensity compared to surrounding bone
  • Result of either:
  • Resorption of bone
  • ↓ mineralisation of bone
  • ↓ thickness of bone
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4
Q

what is the most common presentation of pathologies of the jaw

A

cyst like presentation

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5
Q

What is a cyst?

A

A pathological cavity having fluid, semi-fluid
or gaseous contents & which is not created
by the accumulation of pus

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6
Q

what does indolent mean

A

in reference to a cyst - it means that the cyst is just present there and not really affecting anything, remains the same size and not affecting the structures around it

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7
Q

there are diverse group of lesions what are they in their presentation?

A

Diverse group of lesions

  • Asymptomatic ↔ symptomatic
  • Slow growing ↔ fast growing
  • Indolent ↔ destructive
  • Almost all benign
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8
Q

jaw cysts can be split in to two groups what are they

A

90% of jaw cysts are odontogenic (releated to jaw and teeth)

Non-odontogenic

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9
Q

odontogenic cyst is then split in to what types of cysts

A

developmental

inflammatory

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10
Q

radicular cyst
inflammatory collateral cysts
paradental cyst
buccal bifurcation cyst

the above cyst belong to which group

A

inflammatory cysts of the odontogenic cysts

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11
Q

dentigerous cyst
odontogenic keratocyst
lateral periodontal dental cyst

the above cyst belong to which group of cyst

A

developmental cyst of odontogenic cyst

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12
Q

what three things should you assess when you first see a radiolucency to help with diagnosis

A

is it either

  1. anatomical - no problem
  2. artefactual - part of the imaging/equipment
  3. pathological
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13
Q

what is unilocular

A

having, consisting of, or characterized by only one loculus or cavity; single-chambered.

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14
Q

when you have identified a radiolucency, you need to describe it.

what 7 things do you describe

A

1.Site
2. Size
3. Shape
4. Margins
5. Internal structure
6. Effect on adjacent anatomy
7. Number

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15
Q

when describing a radiolucency point 6 - effect on adjacent anatomy

what are we looking for?

A

to see if there has been any displacement

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16
Q

which bone holds the part of the teeth

alveolar bone or basal bone

A

alveolar bone

so if a radiolucency is present within the area of the tooth and its bone, we would describe the location as in the alveolar bone

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17
Q

what is the basal bone

A

Basal bone is the osseous tissue of the mandible and maxilla. It forms the dental skeletal structure. Basal bone is found below the alveolar process. In contrast, basal bone is a part of the alveolar process. It is the thin bone that lines the alveolus

this bone lies below the alveolar bone

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18
Q

what is the maxillary tuberosity

A

The maxillary tuberosity is the most hind-most (distal) aspect of the upper jaw (maxilla), housing the sockets of the upper wisdom teeth, with its back (posterior) border curving upward and distally. The upper wisdom tooth lies just in front and within the maxillary tuberosity

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19
Q

lesions below alveolar canal - highly unlikely to be

A

odontogenic

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20
Q

maxillary sinus floor – lesions entirely above are highly unlikely to be

A

odontogenic

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21
Q

Describe the boundaries
*
“Extends between teeth 44 & 48, & from the
alveolar crest to the inferior cortical margin of the
mandible”

A
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22
Q

what is pseudolocular

A

one locule, which is begining to seperate, but theres no definite walls separating the areas of differnet compartments

looks like a shit

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23
Q

what is multilocular

A

multiple locules bunched togther

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24
Q

when describing the shape of a radiolucency what would we include

A

“Locularity”

  • Unilocular
  • Pseudolocular
  • Multilocular

General
* Rounded
* Scalloped - can see scalloped margins
* Irregular - resembles no shape

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25
Q

irregular shaped cysts tend to be more sinister and associated with malginancies

A
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26
Q

when describing a margin of a lesion there are two groups what are they

A

well-defined &

poorly defined &

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27
Q

when describing the margin of a cyst it can be described as* Well-defined &…
a. Corticated
b. Non
-corticated

what does this mean

A

well defined means that you can see where the radiolucency starts and stops

corticated means - there is a dense layer of bone surrounding that cyst

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28
Q

poorly defined margins are described as

A

c. Blending into the adjacent normal anatomy
d. “Ragged” or “moth
-eaten” - edges of radiolucency in surronding areas

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29
Q

defined & corticated but can become
poorly defined if

A

infected
– typically
associated with clinical signs/symptoms

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30
Q

when defining the internal structure of cyst

it can be the following

A
  1. Entirely radiolucent – most common
  2. Radiolucent with some internal
    radiopacity
  3. (Radiopaque)
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31
Q

when describing the internal radiopacities, how would we describe them?

A

Description of internal radiopacities
* Amount
Scant, multiple, dispersed, etc.

  • Bony septae
    Thin/coarse, prominent/faint,
    straight/curved
  • Particular structure
    Enamel & dentine radiodensity
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32
Q

if a radiolucency has an involvement of tooth, this can help aid in diagnosis

where can expect the position of the radiolucency near a tooth?

A
  • Around apex/apices - radicular cyst
  • At side of root - lateral periodontal cyst
  • Around crown - dentigerious cyst
  • Around entire tooth
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33
Q

what is a dentigerous cyst

A

Dentigerous cyst – this type of cyst is usually seen nearby or on the crown of an un-erupted wisdom tooth, upper canines or lower wisdom teeth. Periapical cyst (aka odontogenic or radicular cyst) – caused by trauma or tooth decay, which, in turn, causes death or necrosis of the tooth pulp.

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34
Q

cyst involvement of tooth typically means what

A

Typically means lesion is related to tooth
* Important note: proximity may be
incidental if lesion simply occurred near
tooth (so do not assume they must be
related)

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35
Q

what effects can a cyst have on a neighboring tooth

A

Displacement/impaction
* Resorption
* Loss of lamina dura
* Widening of PDL space
* Hypercementosis

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36
Q

what effects can a cyst have on a neighboring bone

A

Bone
* Displacement of cortices
* Perforation of cortices
* Sclerosis of trabecular
bone

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37
Q

what effects can a cyst have on Inferior alveolar canal /
maxillary sinus / nasal cavity

A

Displacement
* Erosion
* Compression

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38
Q

the number of lesions present can help diagnosis,

a few particular lesions occur?

A

bilaterally - this helps narrow the diagnosis

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39
Q

majority of lesions occur in what numbers?

A

alone

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40
Q

how many lesions need to be present to suspect a syndrome

A

if multiple >2

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41
Q

what is a paradental cyst

A

The paradental cyst is an odontogenic cyst of inflammatory origin, which occurs on either the buccal, distal, or (rarely) mesial aspects of partially erupted mandibular third molars. In most cases there is an associated history of recurrent pericoronitis.

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42
Q

why are paradental cysts associated with lower 8s

A

lower 8s - unerupted/partialy erupted can cause complications such as infection, these infections give rise to inflammatory cysts

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43
Q

Most common pathological radiolucency in jaw bones

A

radicular cyst

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44
Q

Radicular cyst is an Inflammatory odontogenic cyst initiated by

A
  • Initiated by chronic inflammation at apex of tooth
    due to pulp necrosis
  • Always associated with a non-vital tooth

pulpal necrosis
↓
periapical periodontitis
↓
periapical granuloma
↓
radicular cyst

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45
Q

if you are looking at a radiolucency around the apex of a tooth and it is vital - what type of cyst is it not

A

radicular cyst

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46
Q

radciular cyst is most common in 4th and 5th decade why?

A

most common time for caries to develop to cause pulpal necrosis

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47
Q

what is the presentation of a radicular cyst?

A

Presentation
* Often asymptomatic
* May become infected → pain
* Typically slow-growing with limited expansion

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48
Q

what are the difference between a radicular cyst vs periapical granuloma

A
  • Difficult to differentiate radiographically
  • Radicular cysts typically larger
  • If radiolucency diameter >15mm → 2/3’s of cases will be radicular cysts
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49
Q

what is a residual cyst

A

Residual cyst
* When radicular cyst persists after loss of tooth
(or after tooth is successfully root canal treated)
* Knowledge of clinical/treatment history important
to avoid misdiagnosis

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50
Q

what is a lateral radicular cyst

A

Radicular cyst associated with an accessory
canal
* Located at side of tooth instead of apex

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51
Q

what changes of the unerupted tooth to form a dentigerous cyst?

A

Developmental odontogenic cyst
* Cystic change of dental follicle
* Associated with crown of unerupted/impacted tooth
* e.g. mandibular third molars, maxillary canines

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52
Q

the shape of a dentigerous cyst is always

A

: unilocular & rounded but can be scalloped if large

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53
Q

a dentigerous cyst arises from a follicular space, if follicular space is greater than how many mm, does it qualify as a dentigerous cyst?

A

Consider cyst if follicular space ≥5mm
* Measure from surface of crown to edge of follicle
* Normal follicular space typically 2-3mm
* Assume cyst if >10mm

Consider cyst if radiolucency is asymmetrical

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54
Q

Inflammatory collateral cysts

A

Inflammatory odontogenic cysts

  • Associated with a vital tooth
  • 2-7% of odontogenic cysts
  • Most common in 1st-2
    nd decades
  • Asymptomatic but can cause swelling

Collective term for:
* Buccal bifurcation cyst
- Typically occurs at buccal aspect of mandibular first molar

  • Paradental cyst
    -Typically occurs at distal aspect of partially-erupted mandibular third molar
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55
Q

Odontogenic keratocyst

A

Developmental odontogenic cyst
* No specific relationship to teeth
* Can grow large before clinically evident
* High recurrence rates

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56
Q

trabecular bone is easier to displace as it isnt as compact as cortical bone.

cortical bone is greatest bucco-lingually

so an a 2d image the cyst may appear very big but may not have had much displacement

A
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57
Q

Basal cell naevus syndrome

A
  • Multiple basal cell carcinomas
  • Palmar & plantar pitting
  • Calcification of intracranial dura mater
  • etc.
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58
Q

Ameloblastoma

A

Benign epithelial odontogenic tumour
* Locally destructive but slow-growing
* Typically painless
* High recurrence rates

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59
Q

Nasopalatine duct cyst

A

Developmental non-odontogenic cyst
* Arises from nasopalatine duct epithelial remnants
* Occurs in anterior maxilla
* Often asymptomatic but patient may notice “salty” discharge

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60
Q

why do infected cysts lose their well-defined and corticated margins

A

the inflammatory response eats away in to the bone, losing it that well defined margin

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61
Q

infected cysts Can mimic radiographic features of malignancy what clinical features should you check for to eliminate such diagnosis

A

Check for clinical features of secondary infection
* Pain
* Soft tissue swelling/redness/hotness
* Purulent exudate

62
Q

what are the clinical signs and symptoms for malignancy in oral cavity?

A
  1. leukoplakia
  2. erythoplakia
  3. erythroleukoplakia
  4. non healing socket
  5. non healing ulcer
  6. unusually mobile tooth - no hx of periodontal disease
  7. swelling/exophytic mass
  8. lymphadenopathy
63
Q

signs and symptoms for malignancy in oral cavity, known as B symptoms

A
  1. weight loss
  2. night sweats
  3. problem moving tongue
  4. dysphagia - prob swallowing
  5. dysphonia - chnage in voice
  6. loss of hearing (more advanced)
  7. pathological fracture - no hx of trauma
64
Q

what is meant by exophytic

A

Exophytic is a descriptive term used by radiologists/pathologists to describe solid organ lesions arising from the outer surface of the organ of origin

65
Q

what are the radiographic signs of malignancy

A
  1. moth eaten bone
  2. non-healing sockets
  3. floating teeth
  4. unusual periodontal bone loss
  5. unusual widening of the periodontal ligament space
  6. generalised loss off lamina dura
  7. loss of bony outlines for anatomical features - walls of antrum, corticated margins of IDC
66
Q

if the size of the lesion is rapidly increasing it more likely to be referred to as?

A

aggressive/malignant

67
Q

benign vs malignant margin - what would we like to see?

A

well defined lesions
corticated margin

cortication demonstrates that the bone has had time to remodel at the periphery of the radiolucency = slow growing = benign

68
Q

lack of cortication may represent

A

healing lesion
superimposed infection

69
Q

what does a moth eaten radiolucent bone with no margin demonstrate

A

bad prognostic sign

aggressive and more likely to be malignant pathologies

70
Q

malignancy grows at a rate that does not allow cortical bone to react and will be eroded and perforated by the lesion and may form a more aggressive periosteal reaction

A
71
Q

benign vs malignant - effect on other structures

A
  1. benign lesions will displace anatomical structures due to slow growth
  2. malignant lesions destroy anatomical structures
  • know what is normal, particularly for the maxillary sinus
72
Q

benign lesion between two teeths will see them displaced which way

A

laterally

the following will be noticed with malignancy

  1. spiking root resorption
  2. generalised widening of the PDL space
  3. generalised loss of lamina dura
73
Q

what are the radiographic features of multiple myeloma

A
  1. round/unilocular
  2. radiolucent
  3. punched out
  4. well defined, not corticated
  5. large lesions can lead to pathological fracture
  6. if multifocal, can affect all skeleton (do a skeletal survey)
74
Q

lymphoma

A
  1. lymphoproliferative group of diseases
  2. typically B cell lymphoma
  3. can present initialy as soft tissue lump
75
Q

we can get bone metastasis from?

A
  1. lungs
  2. prostrate
  3. breast
  4. kidney
  5. thyroid
76
Q

what are the imaging modalities that we can use for the TMJ

A
  1. plain films
  2. Cone beam CT
  3. Computed Tomography
  4. MRI
  5. Nuclear medicine
77
Q

Plain films of the TMJ will include which modalities

A
  1. Panoramic (DPT/OPT)
  2. PA mandible
  3. Reverse Townes
  4. Lateral Obliques
78
Q

what are the indications for doing an OPT for TMJ assessment?

A

indicated if

  1. recent trauma
  2. change in occlusion
  3. mandibular shift
  4. sensory/motor alterations
  5. change in range of movement
79
Q

why do we image the salivary glands

A

obstruction

Mucous plugs
Salivary stones (sialoliths)
Neoplasia

Dry mouth

Swelling

80
Q

What imaging modalities can we use for salivary glands?

A

Plain radiographic techniques

Ultrasound

Injection of iodinated contrast (sialography)

CT (Computed Tomography)

MRI (Magnetic Resonance Imaging)

Nuclear Medicin

81
Q

Plain film radiography for the salivary glands include which ones

A

Lower true occlusal (potential for submandibular salivary stones)

OPT (assesing sialoiths in the submandibular gland)

Lateral Oblique

82
Q

Other calcifications that could bemistaken for sialoliths

A

Tonsilloliths (tonsil stones)

Phleboliths

Calcified plaques (atheromas) in carotid artery

Normal anatomy (hyoid bone)

Elongated/calcified stylohyoid ligament

Calcified lymph nodes

83
Q

Ultrasound
Ultrasound–what is it?

A

No ionising radiation

High frequency sound waves
Frequency that cannot be heard audibly

Sound waves have short wave length which are not transmittablethrough air
Require coupling agent to help sound waves get into tissue

84
Q

Ultrasound–how does it work?

A

Transducer emits and detects sound waves/echoes

Transducer creates sound waves when electric current is given to crystals on transducer surface

Sound waves enter body and reflect back to transducer when boundaries between different tissues are met e.g. boundary between muscles and salivary gland.

Using speed of sound and time to return the echo, the tissue depths are calculated and the ultrasound unit creates a 2D image

85
Q

what do the following mean

HYPOECHOIC

HYPERECHOIC

HOMOGENEOUS

HETEROGENEOUS

A
86
Q

Why is ultrasound good for salivary glands?
why is

A

Glands are superficially positioned

Apart from the deep lobe of the parotid (hidden deep to the ramus)

87
Q

can you give whilst using ultrasonic to aid saliva flow

A

can give sialogogue (ie citric acid) to aid saliva flow

88
Q

Obstructive salivary gland disease symptoms include

A

“Meal time symptoms”
Prandial swelling and pain
“rush of saliva into the mouth”
Bad taste
Thick saliva
Dry mouth

89
Q

what is a sialolith

A

salivary stome

90
Q

Sialography–what is it?

A

Injection of iodinated radiographic contrast into salivary duct tolook for obstruction.

Done either with Panoramic (DPT), skull views (rotated PA mandible+ Lateral Oblique) or Fluoroscopic approach.

No local anaesthetic

Very small volume of contrast injected (typically 0.8-1.5ml)

91
Q

what are the indications for sialography

A

Looking for obstruction or stricture(narrowing) of salivary duct which could be leading meal time symptoms

Planning for access for interventional procedures (basket retrieval of stones or balloon dilatation of ductal strictures)

92
Q

what are the Risks of procedure sialography

A

Discomfort

Swelling

Infection

Any stone could move

Allergy to contrast (very rare)

  • MRI is alternative as no contrastused
93
Q

what is the benefit of fluoroscopic sialography

A

can watch the contrast entering ductal system in “real time”

94
Q

Fluoroscopic Sialography Useful to using minimally invasive salivary gland interventions such as

A

basket retrieval of stones

Can see the exact location of the basket/balloon in relation to the duct.

95
Q

what are the 3 phases of sialography

A

pre-contrast

contrast/filling phase

emptying phase

96
Q

contrast is injected via

A

canula

97
Q

what is the makeup of the contrast

A
  1. iodine based
  2. aqueous rather than oil based
  3. iso-osmolar
98
Q

extravasation means what

A

perforation of the ductal wall

99
Q

normal findings of the parotid gland through sialography will show the parotid gland having an appearance of what

A

a tree in winter appearance

thick trunk = main duct
narrowing of the other ductile structures

100
Q

normal findings of the submandibular gland through sialography will show the submandibular gland having an appearance of what

A

bush in winter appearance

101
Q

acinar changes

A

affects the image

102
Q

what is the aciniar

A

The acinus is the basic functional unit of the exocrine pancreas. It is composed of acinar cells, centroacinar cells, and duct cells

103
Q

what is blushing

A

over filling the acinar with too much contrast

104
Q

What if the patient has an iodineallergy?

A

MRI Sialography

Heavy T2W scan

Gets rid of all tissues apart from fluid

105
Q

what is the Selection Criteria for stone removal

A
  1. Stone must be mobile
  2. Stone should be located within lumen on main duct distal to posterior border of mylohyoid (SMG)
  3. Stone should be distal to hilum orat anterior border of the gland(parotid)
  4. Duct should be patent and wide to allow passage of the stone
106
Q

what would the parotid gland look like under a ultrasound with a patient with sjogrens

A

a hetrogenous appearance

gland not as well defined

107
Q

sjogrens will affect pair of glands

compared to obstructive - with just one gland

this helps with diagnosis

A
108
Q

what is Scintigraphy

A

Intra-venous Injection of radioactive Technetium 99mpertechnetate

  • half life 6 hours
  • use gamma camera to gain images

this assesses how well the glands are working

uptake into glands if they are working well

most tumors will have reduced uptake, apart from warthins tumour (adenolymphoma)

109
Q

is warthins tumor benign or malignant

A

benign - pleomorphic adenoma

110
Q

low grade malignancy will mimic benign pathology

A

that is why we bioposy a submandibular gland that is neoplastic in origin

111
Q

minor salivary glands have a higher chance of malignancy compared to a large salivary gland with a lesion

A
112
Q

pathologies appearing radiopaque on radiographs will do so due to

A

↑ thickness of bone

Osteosclerosis of bone

Presence of abnormal tissues

Mineralisation of normally non-mineralised tissues

113
Q

when describing radiopaque and radiolucent lesions , they both share the same categories. how do each of these differ when it comes to describing

A

Main deviation is “internal structure”

Entirely radiopaque vs. mixed
i.e. homogeneous vs. heterogeneous
Organised vs. haphazard

114
Q

what is a dental odontoma

A

Benign tumour composed of dental tissues
Enamel, dentine, cementum & pulp

Similarities to normal teeth
- Surrounded by a dental follicle

  • Mature to a certain stage(i.e. do not grow indefinitely)
115
Q

what is the incidence of odontoma

A

1stor 2ndmost common odontogenic tumour (vs. ameloblastoma)

Most common in 2nd decade

Correlates with development of normal dentition

F = M

116
Q

odontomas present as two sub types what are they

A

“Compound” (ordered dental structures)
May present as multiple “mini teeth” (i.e. denticles)
More common in anterior maxilla

“Complex” (disorganised mass of dental tissue)
May have a “clump of cotton” appearance
More common in posterior body of mandible

117
Q

Radiographic features to look for: Odontoma

A

Well-defined radiopacity/radiopacities of varying radiodensity

Areas with radiodensity of enamel

Thin radiolucent margin (i.e. follicle)

118
Q

what are the potential clinical issues an odontoma can cause as an unerupted tooth

A

Impaction of adjacent teeth
External root resorption of adjacent teeth
Development of dentigerous cyst

119
Q

what is the management of of odontomas

A

excision - no risk of recurrence

120
Q

what is enucleation of a cyst

A

Enucleation has been most effective and reliable method to treat cysts. It completely removes the cystic capsule, thus reducing the possibility of recurrence.

121
Q

what is idiopathic osteosclerosis

A

Localised area of ↑ bone density of unknown cause

No association with inflammatory, neoplastic or dysplastic processes

Asymptomaticincidental finding on radiographs

Potential relevance to orthodontics

a.k.a. “dense bone island” or “enostosis”

122
Q

idiopathic osteosclerosis is asymptomatic, so it can be an incidental finding when you’re looking at radiographs

A
123
Q

what relevance does idiopathic osteosclerosis have on dental treatment

A

may have some impact on orthodontic treatment. the orthodontist may have trouble moving tooth in areas where there is an increase density of bone.

124
Q

where is the most common location for a idiopathic osteosclerosis

A

premolar, molar region of the mandible

125
Q

what is the radiographic presentation of idiopathic osteosclerosis

A

Well-defined radiopacity

Often homogeneous
- But can have slightly radiolucent internal areas
No radiolucent margin

Variable shape
Round, elliptical, irregular, etc.
Size usually < 2cm

Not associated with teeth but will often appear next to them simply due to circumstance

Teeth not displaced
No affect on PDL spaces of teeth

126
Q

what is sclerosing osteitis

A

Localised area of ↑ bone densityin response to inflammation

  • Inflammation often low-grade & chronic
  • May have concurrent symptoms due to source of inflammation
  • No expansion or displacement of adjacent structures

a.k.a“condensing osteitis”

Radiographic presentation

  • Well-defined or poorly-defined radiopacity
  • Directly associated with source of inflammation
    Apex of necrotic tooth, infected cyst, etc
127
Q

Sclerosing osteitis vs. idiopathic osteosclerosis

A

If radiographic features inconclusive then look for a source of inflammation

e.g. check for signs/symptoms; sensibility test teeth

128
Q

what is hypercementosis

A

Excessive deposition of cementum around root

  • Non-neoplastic & asymptomatic
  • Tooth vital (unless necrotic due to another reason)

Cause unknown but more common in certain conditions

e.g. Paget’s disease of bone, acromegaly

Clinical relevance: makes extractions more difficult

129
Q

what is the radiographic presentation of hypercementosis

A

Single or multiple teeth involved

  • Involves either entirety of root or just a section

Homogeneous radiopacity continuous with root surface

  • Radiodensity subtly different to dentine of root

PDL space of tooth extends around periphery

Margins often smooth but can be irregular

130
Q

what is cementoblastoma

A

Benign odontogenic tumour of cementum

  • Occurs around root of a tooth (which remains vital)
  • Often painful
  • Can displace adjacent teeth & cortical bone

Incidence

  • Rare
  • Wide age range but often in 2nd-3rddecades
  • Typically affects mandibular premolars or 1stmolars
131
Q

what is the radiographic presentation of cementoblastoma

A

Attached to a tooth root

  • Root outline may become indistinct

Thin radiolucent margin continuous with PDLspace of root

Note:no radiolucent margin separatingtumour from root surface
Well-defined & radiopaque

Typically homogeneous & round
Can be mixed radiodensity & irregularly-shaped

132
Q
A
133
Q

what is the name of this bony protuberance

A

torus palatanus

134
Q

what is the name of this bony protuberance

A

torus mandibularis

135
Q

what is the clinical relevance of tori

A

can hamper denture wear
potentially traumatised during eating

136
Q

what is an osteoma

A

Benign tumour of bone

  • Can occur anywhere but has predilection for craniofacial skeleton
  • Clinically presents as a hard, asymptomatic, slow-growing lump
  • Single or multiple

Incidence

Rare
Wide age range
Posterior mandible ismost common jaw site

137
Q

Osteoma
Radiographic presentation

A

Radiographic presentation

  • Entirely cortical bone or a mix of cortical & trabecular
  • Sessile or pedunculated
  • Rounded, smooth margins

Clinical relevance

  • No malignant potential
  • Cosmetic or functional issuesexcision
  • Multiple osteomas may indicate Gardner syndrome
138
Q

what is Cleidocranial dysplasia

A

Rare genetic condition with various skeletal defects (including teeth & jaws)

Teeth & jaws

Generally delayed eruption

Multiple supernumerary teethimpaction of other teeth

Multiple unerupted secondary teethmultiple retained
primary teeth

Hypoplastic maxilla with high arched palate

Increased prevalence of cleft palate

Coarse trabecular pattern

139
Q

name this condition

A

cleidocranial dysplasia

140
Q

what is Osteomyelitis & osteonecrosis

A

Osteomyelitis
Inflammation of bone & bone marrow due to bacterial infection

Osteoradionecrosis
Bone death resulting from irradiation
Requires high energies of radiation (e.g. radiotherapy)

Medication-related
osteonecrosis of the jaw (MRONJ)
Bone death associated with anti-resorptive or anti-angiogenic drugs

141
Q

why is it important to have a good medical history when dealing with a patient with one of the following

Osteomyelitis & osteonecrosis

A

these conditions both have similar radiographic features

142
Q

what are the radiographic features of Osteomyelitis & osteonecrosis

A

Osteolysis & osteosclerosis of affected region

Results in a variable mixture of radiolucent & radiopaque areas

Irregularities on inner/outer aspects of cortical bone

Sequestration of bone

143
Q

if there is significant amount of osteomyelitis what can it result in

A

pathological fracture of bone

144
Q

what is giant cell granuloma

A

Reactive lesion with benign tumour-like behaviour

Slow-growing lesion causing expansion of bone & displacement of teeth
- Minority of cases more aggressive & grow rapidly

Often asymptomatic but may be tender to palpation

May invade into the overlying soft tissues

Incidence

Wide age range but majority before age 20

F > M

Most commonly affects mandible anterior to molar

145
Q

Central giant cell granuloma:Typical radiographic presentation

A

Site:mandible anterior to molars

Size:any size

Shape:unilocular or multilocular (when large)

Margins:well-defined;
poorly corticated;scalloped

Internal structure:radiolucent

Tooth involvement:no

Effects:displacement of cortices; displacementof teeth; occasional external root resorption

Number: single

146
Q

Focal COD: single or few localised lesions

Periapical COD: lesions associated with apices of anterior mandibular teeth

Florid COD: extensive lesion or many lesions

what dysplasia is being shown

A

cemento-osseous dysplasia

147
Q

which race is cemento-osseous dysplasia most common with

A

black people

148
Q

what is focal COD

A

Focal cemento-osseous dysplasia (FCOD) is a benign fibro-osseous lesion of bone characterized by the replacement of normal bone by fibrous tissue and subsequently followed by its calcification with osseous and cementum-like material. It is mostly asymptomatic in nature and requires no treatment

149
Q

what is florid cemento-osseous dysplasia

A

Florid cemento-osseous dysplasia (FCOD) is a condition that occurs in the jaw bone, especially close to where the teeth are formed.

150
Q

what is pagets disease

A

Chronic condition causing disordered remodelling of bone

Affects multiple bones at same time
Results in enlargement of bones, malocclusion, nerve impingement (e.g. cranial nervedeficits), brittle bones
Majority asymptomatic

151
Q

what are the radiographic features of pagets disease

A

General enlargement of bones

Abnormal bone pattern (e.g. “cotton wool” appearance)

Osteolytic or osteosclerotic patches of bone

Radiodensity of altered areas linked to stage of disease

Early/osteolyticintermediate/mixedlate/osteosclerotic
Dental issues

Migration,hypercementosis, loss of lamina dura

5th year final - all cards combined (174 decks)

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