Radiology abnormalities

Question 1

lingual salivary gland depression

Answer 1

• stafne bone defect
• asymptomatic
• well-defined, ovoid UL RL immediately inferior to mandibular canal in area of 2nd or 3rd molar
• 80-90% males
• commonish 0.3%

Question 2

Traumatic (simple, solitary) bone cyst

Answer 2

• empty cavity in bone, not really a cyst
• asymptomatic, usually in the mandible
• 10-20 years
• unilocular radiolucency
• hallmark-lesion scallops up and down between roots of teeth
• Bx necessary to secure diagnosis
• empty cavity with serosanguinous fluid
• bony fill typical after exploration

Question 3

Hematopoeitic bone marrow defect

Answer 3

• unilocular radiolucency
• asymptomatic
• edentulous areas of posterior mandible in postmenopausal women
• no tx indicated

Question 4

zygomatic air cell defect (ZACD)

Answer 4

• variant of normal, not a disease
• unilocular radiolucency (UL)
• ML (multilocular) RL in articular eminence or distal zygomatic arch
• symmetrical, asymptomatic
• weaker, no eminectomy

Question 5

Ameloblastoma

Answer 5

• ML radiolucencies
• average age at dx 33 years
• 85% mandibular 3rd molar/ramus, remainder posterior maxilla
• classic appearance ML soap bubble or honeycomb RL
• swelling/expansion early
• root resorption 80% of cases
• perforation: darker area in a radiolucency
• pathologic fracture is common

Question 6

Odontogenic Keratocyst (OKC)

Answer 6

• Multilocular RL
• asymptomatic
• 3rd molar/ramus area of mandible
• fairly well-defined UL or ML RL
• grow extensively in anterior-posterior direction before expansion
• endosteal scalloping
• starts as a different type of cyst
• Satellite/daughter cysts common
• wide excision, marsupialization, peripheral ostectomy, Carnoys solution
• long term recurrence

Question 7

Nevoid Basal Cell Carcinoma (Gorlin) syndrome

Answer 7

• multiple OKCs
• Basal cell nevi/carcinomas (external surface)
• bifid ribs
• calcified falx cerebri
• epidermoid cysts
• palmar-plantar pits

Question 8

central giant cell granuloma

Answer 8

• ML RL
• 60% < age 30
• 70% mandible, especially ANTERIOR
• work up for hyperparathyroidism, if it’s not that, its central giant cell granuloma
• thorough curettage, surgery
• steroids, calcitonin, interferon alpha 2a
• TWO TYPES: non-aggressive, and aggressive

Question 9

aggressive central giant cell granuloma

Answer 9

• pain

- rapid growth..

Question 10

Chronic Osteomyelitis

Answer 10

• Mixed rdiolucent/radiopaque lesions
• immune compromised or hypovascular bone
• subacute (2-6 weeks), ragged ill-defined RL
• Chronic (week 6+), ragged RL + RO swquestra

Question 11

dental (periapical) granuloma

Answer 11

mass of granulation tissue at the apex of a non-vital tooth

• it is one of two forms of chronic apical pd (the other is radicular cyst), but they both look the same on rads
• patients are asymptomatic

Question 12

radicular cyst

Answer 12

in some dental granulomas, the odontogenic epithelial rests proliferate and form a cyst

• mostly asymptomatic
• radiographically has the same appearance as dental granuloma
• root resorption common

Question 13

what are radicular cysts lined with?

Answer 13

-nonkeratinized stratified squamous epithlium

Question 14

if inflammatory debris is not curetted out at the time of tooth extration, epithelial remnants may proliferate and become…

Answer 14

a residual cyst

-non-keratinized stratified epithelium

Question 15

residual cysts are more common where?

Answer 15

the maxilla

Question 16

when a defected created by a pa inflammation does not fill in completely with new bone, but instead with dense fibrous connective tissue=…

Answer 16

-fibrous boney defect (apical scar)

Question 17

what is the treatment for a fibrous boney defect?

Answer 17

they do not require treatment, they are a variant of normal healing

Question 18

________ _________ are developmental cysts that arise during separation of the follicle from around the crown of a developing tooth with accumulation of fluid between the reduced enamel epithelium and the crown

Answer 18

dentigerous cysts

• they radiolucency usually has a well-defined and often sclerotic boarter
• the cyst usually attaches at the cej

Question 19

what is the most common type of developmental odontogenic cysts?

Answer 19

dentigerous cysts

Question 20

“heart shaped lesion”

Answer 20

-incisive canal cyst, bc of the superimposition over the anterior nasal spine
-“salty” taste when erupts
Enucleation ± marsupialization

Question 21

cyst that develops along the lateral portion of a vital tooth….

Answer 21

• lateral periodontal cyst
• arises from degeneration of remnants of dental lamina and represents the intraosseous counterpart of the gingival cysts of the adult
• usually in the mandibular premolar-canine region, but some maxillary lesions occur

Question 22

what type of epithelium lines the lateral pd cyst?

-what are the characteristic histopathologic features of the lateral pd cyst?

Answer 22

thin flattened squamous to cuboidal epithelium, usually 1-3 cells thick
-the lining epithelium contains focal glycogen-containing clear cells, and there are focal nodular thickenings (mural plaques)

Question 23

what is a botryoid odontogenic cyst?

Answer 23

recurrence of the lateral pd cyst, a polycystic variant

Question 24

soap bubble or honey comb looking radiolucency=

Answer 24

ameloblastoma

Question 25

which cysts have a predilection for the posterior body and ramus of the mandible?

Answer 25

odontogenic keatocyst (OKC)