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5th yr- CMS2- Imagining and Radiography > Radiolucency > Flashcards

Radiolucency Flashcards

1
Q

What is a radiolucency

A

A darker area on a radiograph

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2
Q

Why do radiolucencies occur?

A

Due to:

  1. Thinning or hard tissue relative to the adjacent area
  2. Reduced hard tissue mineral
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3
Q

Why does caries use a radiolucent area in the tooth

A

Due to reduction of mineral content

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4
Q

What can cause a radiolucency in dentistry

A
  1. Normal anatomy
  2. Artefact
  3. Pathology
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5
Q

Give examples of normal anatomy that appear radiolucent on a radiograph

A
  1. Maxillary antrum
  2. Mental foramen
  3. Submandibular fossa
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6
Q

Does overexpose or underexposure lead to a more radiolucent image

A

Over exposure

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7
Q

How do we describe a radiolucency

A
  1. Position/ site
  2. Size
  3. Shape
  4. Locularity
  5. Margin
  6. Effect on adjacent structures
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8
Q

What does odontogenic mean

A

Derived from the dental tissues

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9
Q

How do describe the relationship of a radiolucent to dentition/ a tooth

A
  1. Periapical
  2. Pericoronal
  3. Radicular
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10
Q

What does Periapical mean

A

At the apex

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11
Q

What does pericoronal mean

A

Around the crown

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12
Q

What does radicular mean

A

Related to the root

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13
Q

What words do we use to describe the margin of a radiolucency

A
  1. Corticated VS Moth eaten
  2. Well defined vs ill-defined/ indistinct
  3. Smooth vs punched out
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14
Q

Describe margins of a radiolucency that suggest a slow benign growth

A
  1. Corticated
  2. Well defined
  3. Smooth
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15
Q

Describe margins of a radiolucency that suggest rapid more infectious or malignant growth

A
  1. Moth eaten
  2. Ill defined/ indistinct
  3. Punched out
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16
Q

What can radiolucencies surrounding teeth suggest

A
  1. Resorption
  2. Displacement
  3. Delayed eruption
  4. Loss of associated lamina dura
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17
Q

List some pathological causes of radiolucencies

A
  1. Cysts
  2. Tumours
  3. Bone related lesion
  4. Bone diseases
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18
Q

What are cysts split into

A

Odontogenic or non odontogenic

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19
Q

What can odontogenic cysts be split into

A
  1. Inflammatory

2. Developmental

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20
Q

What are tumours split into

A

Benign vs malignant

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21
Q

List bone bone relates lesions that can cause radiolucencies

A
  1. Giant cell lesion

2. Cemento osseous dysplasia

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22
Q

List bone bone diseases that can cause radiolucencies

A
  1. Osteoporosis
  2. Sickle cell disease
  3. Hyperparathyroidism
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23
Q

What Is a cyst

A

A pathological cavity within the tissues

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24
Q

Describe cysts

A
  1. Can be filled with fluid, semifluid or gas

2. Usually lined by epithelium

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25
Q

Are cysts caused by an accusation of pus

A

no but they can become secondarily infected with pus

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26
Q

What can epithelial lined cysts of the jaws be split into

A

odontogenic vs non odontogenic

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27
Q

What can odontogenic cysts of the jaw be further split into

A

Inflammatory vs developmental

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28
Q

List some epithelial lined odontogenic inflammatory cysts of the jaw

A
  1. Radicular

2. Residual

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29
Q

List some epithelial lined odontogenic developmental cysts of the jaw

A
  1. Dentigerous
  2. Keratocyst
  3. Lateral periodontal
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30
Q

List some epithelial lined NON odontogenic cysts of the jaw

A

Nasopalatine duct cyst

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31
Q

List some non epithelial lined cysts of the jaw

A
  1. Solitary bone cyst

2. Aneurysmal bone cyst

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32
Q

Talk through the symptoms of a cyst

A
  1. Frequently asymptomatic
  2. Patient may be aware of swelling or numb
  3. Can be painful if secondarily infected
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33
Q

How are cyst usually diagnosed

A

As an unexpected incidental finding on a radiograph

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34
Q

Name the most common type of cyst

A

Inflammatory cysts

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35
Q

Where do radicular cyst form

A

At the apex of a non vital tooth

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36
Q

Name the most common cyst of the jaw

A

Radicular cysts (70%)

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37
Q

What can radicular cysts be mistaken for on a radiograph

A

Periapical granuloma

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38
Q

How can be begin to differentiate a periapical granuloma from a radicular cyst

A

Size

The bigger the radiolucency the more likely it is to be a radicular cyst

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39
Q

Describe how radicular cysts present on a radiograph

A
  1. Round, unilocular, smooth and well define
  2. Continuous with lamina dura of the affected tooth
  3. Adjacent teeth displaced
  4. Buccal expansion
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40
Q

What is a residual cyst

A

A radicular cyst remaining following extraction of the tooth

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41
Q

Describe how a residual cyst may appear on a radiograph

A

Unilocular, well defined and corticated

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42
Q

What is a dentigerous cyst

A

Fluid accumulation between reduced enamel epithelium and enamel

43
Q

What are dentigerous cysts associated with

A

Crowns of un erupted and displaced teeth

44
Q

Are dentigerous cysts common

A

Yes account fro 20% of all jaw cysts

45
Q

In which sites are dentigerous cysts common

A 
Lower 8s
Upper 3s
Lower premolars
Upper 8s 
Supernumeraries
46
Q

How can a dentigerous cyst affect the oral cavity

A
  1. Teeth can be displaced but rarely resorbed
  2. Antrum floor can be displaced
  3. Buccal expansion may occur
47
Q

What other terms are used to describe keratocysts

A
  1. Keratocystic odonotgenic tumour

2. Premordial cyst

48
Q

Are keratocysts common

A

No rare (<5%)

49
Q

In which sites are keratocysts common

A
  1. Posterior body. angle of mandible
  2. Anterior maxilla, canine region
  3. Can appear in dentigerous relationship
50
Q

Describe how keratocysts can appear ragiogrpahically

A
  1. Pseudolocular or multilocular
  2. Well defined, corticated
  3. Frequently non or minimally expansile
51
Q

What can cause a keratocysts to recur

A
  1. Thin friable lining

2. Daughter cysts

52
Q

How are keratocysts managed

A

Surgically

53
Q

In which syndrome are multiple keratocysts common

A

Gorlin Goltz syndrom

54
Q

Where are lateral periodontal cysts found

A

Mandibular premolar

Anterior maxilla

55
Q

What are lateral periodontal cysts associated with

A

Vital tooth

56
Q

Describe how a lateral periodontal cyst looks on a radiograph

A
  1. Round/ oval radiolucency between apex and ADJ
  2. Usually less than a cm
  3. Unilocular
  4. Adjacent teeth may be displaced
57
Q

Name the most common non odontogenic cyst of the jaws

A

Nasopalatine duct cyst

58
Q

How common are Nasopalatine duct cyst

A

Approx 1% of population affected

59
Q

Where are Nasopalatine duct cysts found

A

Usually midline

60
Q

Describe how Nasopalatine duct cysts appear on a radiograph

A
  1. Unilocular and round

2. May appear chart shaped due to superimposition of anterior nasal spine

61
Q

What are solitary bone cysts also Called

A
  1. Traumatic
  2. Haemorrhagic
  3. Unicameral
62
Q

Where are solitary bone cysts usually found

A

Mostly in mandible, anterior and in the premolar, molar region

63
Q

Do solitary bone cysts have an epithelial lining

64
Q

What can benign tumours be split into

A

Odontogenic

Non Odontogenic

65
Q

What can malignant tumours be split into

A

Primary or secondary

66
Q

Give examples of odontogenic benign tumours

A
  1. Ameloblastoma

2. Odontogenic myxoma

67
Q

How do begin tumours present radiographically

A

Initially radiolucent but calcify with maturity

68
Q

Give an example of a odontogenic benign tumours

A

Intrasosseous haemangioma

69
Q

Name the most common odontogenic tumour

A

Ameloblastoma

70
Q

Are Ameloblastomas common

A

No they are rare

71
Q

Describe Ameloblastomas

A

Aggressive but non metastasising

72
Q

Where are Ameloblastomas usually found

A

Posterior to the mandible

73
Q

Describe how Ameloblastomas present radiographically

A
  1. Usually mutlolocular bur can be unilocular If unicystic Ameloblastoma
  2. Expansile
  3. Well defined smooth margin
  4. Root resorption seen
74
Q

In whom are odontogenic myxomas seen in

A

Young adults but rare condition

75
Q

Describe how odontogenic myxomas present radiographically

A

Multilocular lesions with internal septa arranged at right angles
Expansile and can displace teeth

76
Q

What are haemangiomas

A

Vasulcar tumours in the marrow space

77
Q

Describe how haemangiomas present radiographically

A

very variable
most common: multilocular, expansile resin with a soap bubble appearance
Displacement and resorption of teeth is common

78
Q

Where are intrinsic primary malignant bone tumours four

A

They arise within the bone

79
Q

Give an example of an intrinsic primary malignant bone tumours

A

Osteosarcoma

80
Q

Give an example of an extrinsic primary tumour involving bone

A

Squamous cell carcinoma

81
Q

What are secondary tumours

A

Metastatic tumours deposited from a primary tumour elsewhere in the body

82
Q

What are osteosarcomas

A

It is a rare primary intrinsic bone malignancy that causes rapid destruction

83
Q

Describe how osteosarcomas present radiographically

A
  1. Osteolytic or Osteoscarlotic
  2. Ill defined, ragged margins
  3. Loosening of associated teeth
84
Q

Where are squamous cell carcinomas

A

mandible more common than maxilla

85
Q

How do squamous cell carcinomas present radiographically

A

Once bone is involved appearance ranges from crystal erosion to gross resorption
irregular bone destruction and not corticated

86
Q

Tumours from were can metastasis to the jaw?

A
  1. Breast
  2. Bronchus
  3. Kidney
  4. Prostrate
  5. Thyroid
87
Q

How can secondary bone tumours present radiorgpahically

A

Irregular areas of bone destruction mot corticated

88
Q

Where can secondary bone tumours of jaw arise

A

Along the inferior alveolar cancel and mental foramen region

89
Q

How do lymphoreticular tumours of the bone present radiographically

A

Multiple round unilocular well defined but not corticated lesions

90
Q

What is langerhans cell disease

A

Proliferation of the langerhans cells and eosinophilic leucocytes producing tumour like lesions

91
Q

What can langerhans cell disease cause

A

Tumour like lesions in bone

92
Q

How does langerhans disease present radiographically

A

Round, unilocular
Well defined but not corticated
Floating teeth

93
Q

wHat can giant cell lesions be caused by

A
  1. Central giant cell granuloma
  2. Hyperparathyroidism
  3. Cherubism
  4. Anerurysmal bone cyst
94
Q

What are giant cell granulomas

A

Benign proliferations of fibrous tissue

95
Q

Where are giant cell granulomas found

A

Often anterior mandibel

96
Q

How do Giant cell granulomas appear radiographically

A
  1. Uni lor multilocular
  2. Smooth and well defined
  3. Corticated
  4. Displaced teeth
97
Q

What is hyperparathyroidism

A

A condition linked with elevated parathyroid hormone

98
Q

What does hyperparathyroidism cause

A

Generalised decrease in bone density (osteopenia)

99
Q

How does bone appear in patients suffering from osteopenia

A

Vey fine trabecular pattern ground glass appearance

100
Q

What is cherubism

A

A rare autosomal dominant condition

101
Q

How can cherubism present radiographically

A

Bilateral multilocular radiolucencies at angle of mandible

102
Q

What is osteoporosis

A

Generalised decrease in bone mass

103
Q

What can osteoporosis increase patents risk of

5th yr- CMS2- Imagining and Radiography (2 decks)

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