RADIOLOGY - other pathologies Flashcards
what factors contribute to lesions appearing radiopaque on radiographs?
increased thickness of bone
osteosclerosis of bone
presence of abnormal tissues
mineralisation of normally non-mineralised tissues
what are the 3 questions you ask yourself when you see an abnormality on a radiograph?
is it anatomical?
is it artefactual?
is it pathological?
when describing radiopaque and mixed lesions, what is the main deviation when comparing to radiolucencies?
its ‘internal structure’
what are the main categories when describing the internal structure of radiopaque and mixed lesions on imaging?
entirely radiopaque vs mixed (homogenous or heterogenous)
organised vs haphazard
what is an odontoma?
a dental hamartoma - benign tumour composed of dental tissues (enamel, dentine, cementum and pulp)
what similarities are there between normal teeth and odontomas seen on imaging?
surrounded by dental follicle
mature to a certain stage (i.e., do not grow indefinitely)
what is the incidence of odontomas?
1st or 2nd most common odontogenic tumour
most common in 2nd decade (correlates with development of normal dentition)
F=M
what are the sub types of odontomas?
- compound (ordered dental structures)
- complex (disorganised mass of dental tissue)
describe compound odontomas? and where would you find them?
may present as multiple ‘mini teeth’ (denticles)
more common in anterior maxilla
describe complex odontomas? and where would you find them?
may have a ‘clump of cotton’ appearance
more common in posterior body of mandible
what are radiographic features of odontomas?
- well defined radiopacity/ radiopacities of varying radiodensity
- areas with radiodensity of enamel
- thin radiolucent margin i.e., follicle
what clinical issues do odontomas present?
- impaction of adjacent teeth
- external root resorption of adjacent teeth
- development of dentigerous cyst
what is the management of odontomas?
- excision if impeding eruption
- no risk of recurrence
what is idiopathic osteosclerosis?
localised area of increased bone density of unknown cause
- no association with inflammatory, neoplastic or dysplastic processes
what area of dentistry is idiopathic osteosclerosis relevant to?
ortho
what are names for areas of idiopathic osteosclerosis?
‘dense bone island’
‘enostosis’
what is the incidence of idiopathic osteosclerosis?
up to 6% of the population
typically presents in adolescence and stops growing by adulthood
most common in premolar-molar region of mandible
describe the radiographic presentation of idiopathic osteosclerosis?
- well-defined radiopacity
- often homogenous but can have slightly radiolucent internal areas
- no radiolucent margin
- variable shape: round, elliptical, irregular
- size usually <2cm
- not associated with teeth but can appear next to them due to circumstance: teeth not displaced and no affect on the PDL spaces of teeth
what is sclerosing osteitis?
localised area of increased bone density in response to inflammation
- inflammation often low-grade and chronic
does sclerosing osteitis have symptoms?
may have concurrent symptoms due to source of inflammation
no expansion or displacement of adjacent structures
what is another name for sclerosing osteitis?
condensing osteitis
describe the radiographic presentation of sclerosing osteitis?
well defined or poorly defined radiopacity
directly associated with source of inflammation - apex of necrotic tooth, infected cyst etc
how can you differentiate sclerosing osteitis and idiopathic osteosclerosis?
if radiographic features inconclusive then look for a source of inflammation e.g., check for signs and symptoms, sensibility test teeth
what is hypercementosis?
excessive deposition of cementum around root