Radiolucent lesions 1 Part 2 Flashcards by Abigail Cook

Nasopalatine cyst is considered what type

well-defined unilocular radiolucency

other locations

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Nasopalatine cyst synonym

nasopalatine canal cyst, median palatine cyst, median anterior maxillary cyst

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disease mechanism of Nasopalatine cyst

contains remnants of nasopalantine duct and nasopalantine nerves and vessels

*nasopalatine duct epithelial remnants undergo proliferation and cystic degeneration

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clinical features of Nasopalatine cyst

broad age range, most discovered in 4th to 6th decades

3x more common in males

swelling posterior to incisive papilla

most are asymptomatic but can cause burning or numbness over palatal mucosa and can drain with a salty taste

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location of Nasopalatine cyst

in the nasopalatine canal and can extend posteriorly into the hard palate or anteriorly between the incisors and expand and destroy the buccal cortex

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shape and periphery of Nasopalatine cyst

well-defined, circular to oval, heart shaped if the nasal spine superimposes

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internal structure of Nasopalatine cyst

typical of cysts

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effects on adacent structures with Nasopalatine cyst

divergence of the roots of central incisors, occasional root resorption, expansion of labial cortex, displacement of the floor of nasal fossa superiorly

uniform periodontal membrane space around all the apices

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residual cyst disease mechanism

a cyst that remains after incomplete removal of the orginal cyst

most commonly extraction of the tooth

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clinical features of a residual cyst

asymptomatic history of tooth extraction

commonly discoered incidentally on radiographic examination of endentulous area

may cause jaw expansion and pain in case of secondary infection

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location of residual cyst

apical region of missing tooth

in mandible ALWAYS ABOVE THE IAC
slightly more often seen in the mandible

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location of residual cyst

apical region of missing tooth

in mandible ALWAYS ABOVE THE IAC
slightly more often seen in the mandible

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differential diagnosis with residual cyst

patients history and previous radiographs will help determine that something is a residual cyst

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simple bone cyst synonyms

traumatic bone cyst, hemorrhagic cyst, extravasation cyst, progressive bone cavity, solitary bone cyst and unicaeral bone cyst

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simple bone cyst disease mechanism

a cavity within bone that is empty or may contain some fluid and lined with connective tissue

possibly due to local aberration in normal bone remodeling or metabolism

no evidence of trauma

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clinical features of simple bone cyst

most occur in less than 20 Yrs old

males 2x more than females

multiple traumatic bone cyst (simple bone cyst) can occur in conjunction with cemento-ossous dysplasia

asymptomatic
unusual to have bone expansion and tooth resorption

can become large

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location of simple bone cyst

mandible&raquo_space;> maxilla

anywhere in mandible but most often in the ramus and posterior mandible

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shape and periphery of simple bone cyst

well defined DELICATE CORTEX TO ILL-DEFINED,

LACKING A CORTEX

THE SUPERIOR BORDER IS USUALLY CORTICATED

SCALLOPS BETWEEN THE ROOTS OF TEETH
grow along long axis of the bone

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internal structure of simple bone cyst

radiolucent

- occasionally multilocular

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effects on adjacent structures with simple bone cyst

INTACT LAMINA DURA AND MINIMAL EXPANSION

no effect - rare to cause root resorption

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Differential diagnosis with simple bone cyst

note the maintenance of the lamina dura and it still being in tact

(a malignant one would not - and malignant would also invade cortical bone)

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management of simple bone cyst

curettage of the lining
- initiates bleeding and healing and they can also heal on their own

rare to reoccur

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describe salivary gland depression

relationship to IAC?

also called stafne defect

it is well-defined and corticated

typically arises in the posterior mandible inferior to the IAC

can occur in anterior (sublingual gland) in tooth region

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benign neural tumor is called

neurilemoma aka schwannoma

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neurilemoma aka

schwanoma

neurilemoma origin and arise from

tumor of neuroectodermal in origin and arises from schwann cells

neurilemoma age?

any but more common in 2nd and 3rd decades

neurilemoma occurs where and brief description

10:1 in MANDIBLE - WD and corticated EXPAND THE WALLS OF IAC -FUSIFORM -FOOTBALL SHAPE -may scallop, enlarge the foramina

neuroma

benign neural tumor | - impossible to differentiate from other benign neural tumors

neuroma is from?

overgrowth of severed nerve fibers attempting to regenerate | - usually less than 1 cm and can CAUSE SEVERE PAIN

location of occurrence of neuroma?

MENTAL FORAMEN > anterior maxilla > posterior mandible you see expansion of the IAC (inferior alveolar canal)

difference between neurofibroma and schwannomas

a neurofibroma will incorporate axons but schwannomas will displace them

neur ofibroma caused by?

proliferation of schwann cells in a disorderly pattern | - as they grow they incorporate axons

neurofibroma age?

usually younger but can occur at any age

neurofibroma associated with pain?

yes - it may produce pain or paresthesia

neurofibromatosis aka

von Recklinghausen's disease

neurofibroma is consiered a ___ consiting of ___?

a syndrome consisting of cafe au lait spots on the skin multipler peripheral nerve tumors, and various other dysplastic abnormalities of the skin, nervous system, bones, endocrine organs, and blood vessels NF1- generalized, Nf2 - central *oral lesions occur with NF1

neurofibromatosis can also have?

schwannomas and neurofibromas

location of neurofibromatosis

mandible - ENLARGEMENT OF THE CORONOID NOTCH - an obtuse angle between the body and the ramus - deformity of the condylar head - lengthening of the condylar neck, and lateral bowing and thinning of the ramus

major findings assocaited with neurofibromatosis

ENLARGEMENT OF THE CORONOID NOTCH ENLARGEMENT OF THE MANDIBULAR CANAL AND MENTAL AND MANDIBULAR FORAMIN INTERFERENCE WITH NORMAL ERUPTION OF THE MOLARS - increased incidence of branched mandibular canal - erosive changes to the outer contour of the mandible - abnormal accumulations of fatty tissue within deformitites of the mandible have been observed

septa with ameloblastoma?

note the COARSE, CURVED SEPTA

central giant cell granuloma considered?

consider it a benign tumor but can behave more aggressively, esp, in maxillary

central giant cell granuloma occur in who?

young | 60% are less than 20 years old

central giant cell granuloma where and describe

more in mandible WD, slight to NO CORTICATION radiolucent to granular with WISPY SEPTA DISPLACE AND RESORB TEETH LOSS OF LD AND EXPANSIVE

Aneurysmal bone cyst

Considered a benign tumor - can behave agggressively - proliferation of vascular spaces, fibroblasts, woven bone rapid swelling and may cause pain

Aneurysmal bone cyst occurs in who and where

90% are less than 30 years old female >male Mand> Max and POSTERIOR REGIONS more

Aneurysmal bone cyst to surrounding? and describe on radiograph

WD, cirvular and Radiolucent to wispy septa EXPANISLE -- and can displace and resorb teeth

Aneurysmal bone cyst aspiration

yes - it is hemorrhagic

Odontogenic Myxoma | describe

not encapsulated | tend to infiltrate the surrounding cancellous bone, loose, gelatinous consistency with high reccurence rate

Odontogenic Myxoma occur when

almost always between 10-50 with over 50% between 10 and 30

Odontogenic Myxoma septa? peripheray?

most are curved but should have some thin straight septa as well -- LOOK FOR STRAIGHT SEPTA WD, cortical but CAN BE ID, especially in the maxilla - scallops

which also has straight septa with Odontogenic Myxoma?

Odontogenic Fibroma

disease mechanism of inflammation

it is the response to chemical , physical, or microbiological injury the inflammatory response destroys or walls off the injurious stimuli

acute inflammation

Acute - rapid onset - pronounced pain - fever - swelling - BONE RESORPTION

chronic inflammatino

Chronic - Insidious onset - less intense pain - intermittent- lower grade fever - gradual swelling - BONE FORMATION *There can be cycling between these two mechanisms and some chronic low grade infections may not show any signs of symptoms

sources of inflammation

Necrotic tooth soft tissue bone

Nectoric tooth inflammation

Peri-apical inflammatory lesion

soft tissue inflammation results

periodontitis and pericoronitis

if inflammation spreads through bone?

osteomyeletis | - spreads to bone and not contained within the region of the apex

how does inflammation look on a radiograph

usually ill-defined BLENDING - surrounding bone gradually blends with radiolucent region of bone loss or sclerosis