Radiopacities Flashcards
Where are Palatal Torus located?
Hard palate midline
Where are Mand. Torus located?
Lingual mandible. Usually bilateral
Where are Exostoses located?
Buccal or palatal ridge. Unilateral/bilateral
How do you identify retained root tips radiographically?
Look for PDL space surrounding radiopacity with potential thin central pulp chamber and tapered shape
Condensing Osteitis
-Focal bone sclerosis associated with the apex of a tooth exhibiting pulpal inflammation or necrosis
-Uniform radiopacity, widened PDL
- 85% partial or total regression with extraction or RCT
-Residual condensing osteitis = “bone scar”
Idiopathic Osteosclerosis
- 90% mandible, usually posterior
-Most arise in children or adolescents
-Dense, homogenous radiopacity with some well-defined borders and others that show spicules into surrounding normal bone. Can obscure root but does not fuse to it. May incorporate the lamina dura
-Associated teeth are vital
-No radiolucent rim (like mature cemento-osseous dysplasia) and no radiolucent center (like condensing osteitis)
-Dense viable bone microscopically
-Remains static or slow increase in size until maturity-radiographic follow-up is all that is needed
Antral Pseudocyst
-Common, typically asymptomatic, dome-shaped, homogenous, faintly radiopaque lesion arising from the flood or the Mx sinus due to accumulation of inflammatory (serous) exudate underneath the sinus mucosa
-Etiology: not precisely known, possible adjacent dontogenic infection or sinus lining irritation from sinus infection or allergies
-Tx: r/o odontogenic infection, only treat if there are significant symptoms (expansion, pain)
Antral Pseudocyst vs. Chronic Sinusitis
-Headache, fever, pain from several teeth, nasal congestion/discharge
-Cloudy sinus - not well-defined, uniform dome-shape
Tonsillar Concretions/Tonsillolithiasis
-Bacteria, foreign material and desquamated keratin accumulation in the tonsillar crypts forms compacted, foul-smelling tonsillar concretion. If it calcifies, called a tonsillolith (superimposed on the ramus on pano, CBCT can confirm)
-Causes bad breath (halitosis) and sensation of something stuck in the throat but otherwise asymptomatic
-Variable size and single/multiple, unilateral or bilateral
-While not acutely painful, can predispose to recurrent sonsillar infection leading pain/abscess
-Tx: only symptomatic cases, pt. remove with saltwater gargling or waterpik; enucleating/curettage, laser cryptolysis or tonsillectomy
Ostemoa
-Benign osseous tumor, usually affecting membranous bone
-Painless, slowly enlarging
-Paranasal sinus involvement is common
-Jaw lesions are usually associated with the condylar area and lingual posterior mandible
-Exophytic mass on bone surface (periosteal) simulating a tori/exostoses
-Intramedullary growth (endosteal or central) similar to end stage inflammatory process or sclerotic bone
-Histologically identical to a torus, condensing osteitis or idiopathic osteosclerosis but with continual growth
-Should always rule out Gardner Syndrome
Gardner Syndrome
-Autosomal dominant trait most often
-Mutation in adenomatous polyposis coli (APC) tumor suppressor gene
-One of the multiple intestinal polyposis syndromes
-Characterized by:
1. Osteomas of the facial bones
2. Skin lesions: epidermoid cysts and desmoid tumors (aggressive fibrous lesions)
3. May see impacted supernumerary teeth or, less commonly, odontomas
What can Gardner Syndrome lead to? What is the tx?
-Development of precancerous polyps of the colon. 50% develop colon cancer by age 30 with nearly 100% affected later in life
-Increased risk of thyroid carcinoma
-Tx: Prophylactic colectomy; removal of cosmetically problematic cysts and osteomas; genetic counseling
