simplified charts Flashcards by Kiki Moriguchi

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Histology

Odontogenic developmental cyst

DC. EC/EH. PC. OKC. NBCCS (Gorlin Syndrome). OKOC. LPC. GCA. COC (Gorlin Cyst or Dentinogenic ghost cell tumor). GOD (dialo-odontogenic cyst). Carcinoma arising in odontogenic cysts.

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Radiology

Dentigerous cyst.

Eruption cyst.

Paradental cyst. Odontogenic keratocyst.

Nevoid basal cell carcinoma sydrome “Gorlin syndrome.”

ortokeratinized dentinoGENIC cyst.

Lateral periodontal cyst.

Gingival cyst of a newborn.

Gingival cyst of the adult.

califying odontogenic cyst.

glandular odontogenic cyst.

[carcinoma arising in odontogenic cysts]

developmental cysts- ~12

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Histology

Thin, non-keratinized epithelial lining, multipotential (may have mucous or other cells present), Inflamed cyst=APC histo

dentigerous cyst (DC)

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Radiology

WD, CB, UL, RL around crown of an unerupted tooth, attached to the CEJ

dentigerous cyst (DC)

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Histology

Thin layer of keratinized squamous epithelium, may contain blood

eruption cyst (eruption hematoma)

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Radiology

Soft, translucent swelling in gingival mucosa overlying the crown of an erupting tooth (most commonly 1st perm molars)

eruption cyst (eruption hematoma)

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Histology

“inflamed dentigerous cyst”, Hx of pericoronitis

Paradental cyst

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Radiology

Cyst on distal or buccal of partially erupted 3rd molar

Paradental cyst

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Histology

Small satellite cysts in fibrous wall, uniformly thin epithelium, corrugated parakeratin, palisaded basal layer with hyperchromatic nuclei

odontogenic keratocyst (OKC)

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Radiology

WD, smooth and CB, UL, RL between teeth. Smetimes ML. resemnbles other cytsts, Rx descriotion not diagnostic

odontogenic keratocyst (OKC)

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Histology

Multiple basal cell ca’s, multiple OKCs, palmar/plantar pits, calcified cerebri, enlarged head circumference, Rib anomalies, ocular hypertelorism, spina bifida occulta

nevoid basal cell carcinoma syndrome “Gorlin syndrome”

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Radiology

Jaw cysts present in 75% of patients

nevoid basal cell carcinoma syndrome “Gorlin syndrome”

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Histology

Orthokeratin WITHOUT nuclei, prominent granular cell layer, basal cell layer NOT PALISADED and less hyperchromatic

orthokeratinized odontogenic cyst

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Radiology

Posterior mandible, unerupted 3rd molars, UL, RL. Resembles DC

orthokeratinized odontogenic cyst

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Histology

Focal nodular thickenings (epithelial plaques), lined by uniformly flattened squamous cells, swirl appearance

lateral periodontal cyst

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Radiology

WD, CB, RL lateral to the roots of VITAL teeth

lateral periodontal cyst

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Histology

Multiple whitish papules on mucosa overlying alveolar process on a newborn (<3mos). Derived from rests of dental lamina, Keratin-filled cysts lined by parakeratotic stratified squamous epithelium.

gingival cyst of the newborn

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Radiology

N/A

gingival cyst of the newborn

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Histology

Fluid-filled swelling of the facial gingiva or alveolar mucosa, blue/gray tint, md premolar/anteriors. Derived from rests of dental lamina, soft tissue counterpart of lateral periodontal cyst, focal nodular thickenings

gingival cyst of the adult

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Radiology

Usually not seen on radiograph due to soft-tissue nature

gingival cyst of the adult

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Histology

Ghost cells (outline, but no nuclei), dystrophic calcification of ghost cells (RO’s), ghost cell keratinization, epithelium similar to enamel organ and ameloblastoma, loose stellate/spindle cells, columnar cells

calcifying odontogenic cyst (Gorlin cyst or dentinoGENIC ghost cell tumor)

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Radiology

WD, UL, RL with or without RO’s or Cal’s.

calcifying odontogenic cyst (Gorlin cyst or dentinoGENIC ghost cell tumor)

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Histology

Derived from rests of dental lamina, lined by stratified squamous epithelium with cililated columnar shape, small microcysts and clusters of mucous cells in cystic lining

Glandular odontogenic cyst (sialo-odontogenic cyst)

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# Radiology WD, SB, UL or ML, RL. Anterior mandible

Glandular odontogenic cyst (sialo-odontogenic cyst)

# Histology Well-differentiated SCC

Carcinoma Arising in odontogenic cysts

# Radiology Irregular and ragged margins of a RL defect

Carcinoma Arising in odontogenic cysts

# Histology APC (periapical cyst or radicular cyst). RC. BBC.

inflammatory cysts - 3

# Radiology Apical periodontal cyst. Residual cyst. Buccal bifurcation cyst.

inflammatory cysts - 3

# Histology NON-VITAL TOOTH. Derived from rests of Malassez, SSEpi exhibiting exocytosis and spongious, may have cholesterol clefts, dystrophic calcifications

Apical periodontal cyst (periapical cyst or radicular cyst)

# Radiology WD, CB, UL, RL in periapical area (classical) or interproximal area. May be along lateral aspect of the root

Apical periodontal cyst (periapical cyst or radicular cyst)

# Histology Persistent APC after infected tooth has been extracted. Same histo as APC

residual cyst

# Radiology WD, CB, RL at extraction site

residual cyst

# Histology Buccal of mandibular 1st molars, buccal enamel extension leads to pocket, “Site Specific” paradental cyst

buccal bifurcation cyst

# Radiology WD, UL, RL at buccal bifurcation

buccal bifurcation cyst

# Histology ABC. FOBMD. STBC. ScC. Idiopathic osteosclerosis. CGCG.osteoma. Chondroma.

Non-odontogenic cysts

# Radiology aneurysmal bone cyst. Focal osteoporotic bone marrow defect. Simple traumatic bone cyst. Surgical ciliated cyst. Idiopathic osteosclerosis. Central Giant cell Ganuloma. Osteoma. Chrodroma.

Non-odontogenic cysts

# Histology Blood-filled spaces lined by connective tissue septa, multinucleated giant cells

aneurysmal bone cyst

# Radiology UL or ML, RL with cortical expansion and thinning

aneurysmal bone cyst

# Histology Normal bone marrow, hematopoietic progenitor cells, fat cells. Stimulates an intraosseous neoplasm in an extraction socket

focal osteoporotic bone marrow defect

# Radiology RL with fine trabeculations, circumscribed with ill-defined borders

focal osteoporotic bone marrow defect

# Histology Thin connective tissue with reactive bone, NO epithelium (NOT a true cyst)

simple traumatic bone cyst

# Radiology WD, RL, irregular borders, UL, maybe ML, no tooth displacement or root resorption

simple traumatic bone cyst

# Histology Lined by respiratory epithelium, intrabony cyst caused by implantation of sinus epithelium

surgical ciliated cyst

# Radiology WD, RL in close proximity, but separate from the maxillary sinus

surgical ciliated cyst

# Histology Area of hematopoietic marrow, dense lamellar bone with scant fibro-fatty marrow, NOT pathological

idopathic osteosclerosis

# Radiology RL area with fine trabeculations

idopathic osteosclerosis

# Histology Multinuclated giant cells with plump proliferating mesenchymal cells, RBC extravasation

central giant cell granuloma

# Radiology WD, but NOT corticated, UL or ML, RL defect, anterior mandible

central giant cell granuloma

# Histology Associated with Gardner Syndrome, progressive shift in patient occlusion and deviation of midline. Mature compact or cancellous bone

osteoma

# Radiology Slowly growing masses on surface of mandible/maxilla

osteoma

# Histology Composed of mature hyaline cartilage, located on short trabecular bones of the hands and feet

chrondroma

# Radiology N/A

chrondroma

# Histology Ameloblastoma, conventional solid or multicystic ameloblastoma, unicystic ameloblastoma, peripheral ameloblastoma(extraosseaous), malignant ameloblastoma, ameloblastic carinoma, calcifying epithelial odontogenic tumor (pindborg tumor)

epithelial odontogenic tumors - 8

# Radiology ameloblastoma. Conventional solid or multicystic ameloblastoma. Unicystic ameloblastoma. Peripheral ameloblastoma (extraosseous). Malignant ameloblastoma. Ameloblastic carcinoma. Adenoatoid odontogenic tumor. Calcifying epithelial odontogenic tumor (pindborg).

epithelial odontogenic tumors - 8

# Histology Most common clinically significant odontogenic tumor. Slow growing, locally invasive, usually benign , painless swelling covered by oral mucosa

ameloblastoma

# Radiology RL, UL early, ML later, expansion, tooth displacement, might resorb roots

ameloblastoma

# Histology 86% of Ameloblastomas. Islands of odontogenic epithelium, core resembles stellage reticulum of enamel organ, peripheral columnar cells with REVERSE POLARITY of nuclei

conventional solid or multicystic ameloblastoma

# Radiology ML, RL lesion with “soap bubble” or honeycomb appearance, B/L cortical expansion, root resorption of teeth adjacent to the tumor.

conventional solid or multicystic ameloblastoma

# Histology 13% of Ameloblastomas: Luminal: basal layer columnar/cuboidal cells with hyperchromatic nuclei, reverse polarity, basilar cytoplsmic vacuolization. Intraluminal/Plexiform: one or more nodules of ameloblastomas project from cystic lining into lumen. Mural: fibrous wall of the cyst infiltrated by typical follicular or plexiform ameloblastoma

unicystic ameloblastoma

# Radiology circumscribed RL, may/may not be around the crown. Can resemble DC.

unicystic ameloblastoma

# Histology 1% of Ameloblastomas

peripheral ameloblastoma- extraosseous

# Radiology na

peripheral ameloblastoma- extraosseous

# Histology Ameloblastoma in primary tumor and metastatic deposits

ameloblastic carcinoma

# Radiology na

ameloblastic carcinoma

# Histology Ameloblastoma that has cytologic features of malignancy in the primary tumor, in a recurrence, or in any metastatic deposit

malignant ameloblastoma

# Radiology na

malignant ameloblastoma

# Histology Thick fibrous capsule, duct-like epi structures lined by cuboidal columnar cells, nuclei polarized AWAY from central spaces, all cells are epithelial

adenomatoid odontogenic tumor

# Radiology WD, CB, UL, RL invoving crown of unerupted tooth (below CEJ), tooth displacement, snowflake cal’s

adenomatoid odontogenic tumor

# Histology Large cells with nuclei (different from COC), expansile, painless swelling. Congo Red test + for Amyloid proteins . Concentric Liesegang Ring Calcifications

califying epithelial odontogenic tumor (pindborg)

# Radiology WD or Ill-defined, UL or ML RL with flecks of RO’s, strong tooth displacement, honeycomb appearance

califying epithelial odontogenic tumor (pindborg)

# Histology Central odontogenic fibroma. Peripheral odontogenic fibroma. Odontogenic myxoma. Cementoblastoma.

ectomesenchyme odontogenic tumors

# Radiology central odontogenic fibroma. Peripheral odontogenic fibroma. Odontogenic myoma. Cementoblastoma.

ectomesenchyme odontogenic tumors

# Histology Hyperplastic dental follicle

Central odontogenic fibroma

# Radiology WD, UL (early)/ML (late), RL associated with periradicular areas of erupted teeth, root resorption

Central odontogenic fibroma

# Histology Soft tissue counterpart of central odontogenic fibroma.Slow-growing, sessile mass covered by normal mucosa

peripheral odontogenic fibroma

# Radiology Similar to peripherial ossifying fibroma

peripheral odontogenic fibroma

# Histology Haphazardly arranged stellate, spindle-shaped and round cells, glycosaminoglycans, no capsule, jelly-like. Locally aggressive, jaw lesion only with painless swelling

odontogenic myxoma

# Radiology UL or ML, Irregular/scalloped margins, thin, wispy trabeculae of residual bone, “step ladder” pattern, rare root resorption, soap bubble appearance

odontogenic myxoma

# Histology Slow-growing, dentin-resorbing (not hypercementosis), strongly active osteoblastic activities

comentoblastoma

# Radiology WD, RO (density of cementum), RL halo, attached to root of affected tooth, resorbed root

cementoblastoma

# Histology ameloblastic fibroma. Ameloblastic fibrosarcoma. Ameloblastic fibro-odontoma. Compound odontoma. Complex odontoma.

Mixed odontogenic tumors (odontogenic epithelium and ecomesenchymal elements)

# Radiology ameloblastic fibroma. Ameloblastic fibrosarcoma. Ameloblastic fibro-odontoma. Compound odontoma. Complex odontoma

Mixed odontogenic tumors (odontogenic epithelium and ecomesenchymal elements)

# Histology Narrow cords of odontogenic epithelium anastomosing, peripheral nuclear palisading columnar cells

ameloblastic fibroma

# Radiology WD, UL or ML, RL extending from superior part of the tooth follicle (NOT CEJ) of an unerupted tooth

ameloblastic fibroma

# Histology Malignant counterpart of ameloblastic fibroma

ameloblastic fibrosarcoma

# Histology Disorganized tooth structure, same histo as ameloblastic fibroma,

ameloblastic fibro-odontoma

# Radiology WD, CB, RL defect with variable amt of calcified material with the radiodensity of tooth structure

ameloblastic fibro-odontoma

# Histology Multiple tooth-like structures, anterior maxilla

compound odontoma

# Radiology Collection of ROs (tooth-like structures) surrounded by a narrow RL zone

compound odontoma

# Histology Conglomerate mass of enamel and dentin, NO resemblance to a tooth, may cause impaction

complex odontoma

# Radiology Calcified mass with radiodensity of tooth structure surrounded by RL halo

complex odontoma

# Radiology fibrous dysplasia. Reactive/dysplastic lesions in alveolous (tooth bearing areas of the jaw) or? Cemento-osseous dysplasia. Fibro-osseous neoplasms.

Three categories of fibro-osseous lesions in the jaw (normal bone replaced with excessive proliferation of fcellular fibrous CT)

# Histology Monostotic fibrous dysplasia of the jaw. Polyostotic dysplasia of the jaw. Focal-cemento-osseous dysplasia. Periapical cemento-posseous dysplasia. Florid cemento-osseous dysplasia. Ossifying/cementifying fibroma. Osteoblastoma (and osteoid osteoma)

name 7 fibro-osseous lesions of the jaw

# Radiology FIBROUS DYSPLASIA: monostatic fibrous dysplasia of the jaws. Polyostotic fibrous dysplasia of the jaws. REACTIVE/DYSPLASTIC LESION OF THE ALVEOLOUS AND CEMENTO-OSSEOUS DYSPLASIA: Focal cemento-osseous dysplasia (FCOD). Periapical cemento-osseous dysplasia (PCOD). Florid cemento-osseous dysplasia (FOD, FLCOD). FIBRO-OSSEOUS NEOPLASMS (2): Ossifying/cementifying fibroma. osteoblastoma and osteoid osteoma.

name 7 fibro-osseous lesions of the jaw

# Histology single bone, max\>mandib, young F, poorly calcified bone trabeculae arranged in a disorganized pattern

FD: monostotic fibrous dysplasia of the jaw

# Radiology Fine “ground glass” opacification, not well-demarcated

FD: monostotic fibrous dysplasia of the jaw

# Histology two or more bones, café au lait spots, jaffe-lichtenstein syndrome, McCume-albright syndrome (sexual precosity)

FD: polyostotic fibrous displasia of the jaw

# Radiology Early: RL, WD, UL. Late: ROs take on numerous shapes and sizes, borders blend with bone. Bone exp, tooth displacement, root resorption, obliteration of max sinus.

FD: polyostotic fibrous displasia of the jaw

# Histology anywhere in jaw, singl-site involved, asymptomatic, small

R/DL, COD: focal cemento-osseous dysplasia (FCOD)

# Radiology Mixed RL/RO, thin RL rim

R/DL, COD: focal cemento-osseous dysplasia (FCOD)

# Histology VITAL TEETH, asymptomatic pt, scpecules of bone and some cementum-like hard tissues

R/DL, COD: periapical cemento-osseous dysplasia (PCOD)

# Radiology Uncircumscribed zones of RL involving periapical region of anterior mandible.

R/DL, COD: periapical cemento-osseous dysplasia (PCOD)

# Histology VITAL TEETH, multifocal involvement, not limited to anterior mandible, bilateral symmetry involvement, simple bone cyst may be present, osteomyolitis due to reduced valscularity

R/DL, COD: florid cemento-osseous dysplsia (PLCOD, FOD)

# Radiology Multiple, WD, lobular, \<3m, RL with some ROs, bilateral and symmetric, no tooth resorption, hypercementosis, increased bone density

R/DL, COD: florid cemento-osseous dysplsia (PLCOD, FOD)

# Histology painless swelling with obvious facial asmmatry, jaw expansion, tooth displacement, asymmtomatic

FON: ossifying/cementifying fibroma

# Radiology WD, UL w/varying levels of RO (RL, Mixed or RO), CB (diff from later stage fibrous dysplasia), root resorption

FON: ossifying/cementifying fibroma

# Histology benign bone tumors occasionally seen in the haw, histo identical to OSTEOBLASTOMA

FON: obsteoblastoma and osteoid osteoma

# Radiology N/A

FON: obsteoblastoma and osteoid osteoma

# Histology Osteosarcoma. Chondrosarcoma. Metatstatic tumors of the jaw.

Malignant bone tumors- 3

# Radiology osteosarcoma. Chondrosarcoma. Metastatic tumors of the jaws.

Malignant bone tumors- 3

# Histology redness and bleeding of gingiva. Persistent, non-healing ulcers

clinical findings of bone malignancies (2)

# Radiology clinical findings of bone malignancies: 1. redness and bleeding of gingiva. 2. persistent, non-healing ulcer.

clinical findings of bone malignancies (2)

# Histology superficial horizontal resorption. Erosion of bony SF. RL with ill-defined bornders and ragged Ros. Pathologival fractures. Opacification of sinus. Destruction of sinus walls. Floating teeth. Root resorption.

general RG findings of bone malignancies (8)

# Radiology general RG findings of bone malignancies: 1. superficial horizontal resorption. 2. erosion of bony SF. 3. RL with ill-defined borders and ragged Ros. 4. pathological fractures. 5. opacification of the sinus. 6. destruction of the sinus walls/floor. 7. floating teeth. 8. root resorption.

general RG findings of bone malignancies (8)

# Histology leukemia. Burkitt's lymphoma. Multiple myeloma.

other malignancies of the jaws and O.C. (3)

# Radiology leukemia. Burkitt's lymphoma. Multiple myeloma.

other malignancies of the jaws and O.C. (3)

# Histology malignancy of mesenchymal cells, central lesion. "bad cells, bad bone" malignant cartilage and bone

osteosarcoma

# Radiology Ill-defined and indistinct peripheral border, classic sunburst appearance (periosteal reaction), widening of PDL, elevation of bone height ABOVE CEJ, perforation, exp of cortical margins

osteosarcoma

# Histology maignancy Chx by formation of cartilage and no bone

chomdrosarcoma

# Radiology RL process with poorly defined borders

chomdrosarcoma

# Histology MOST COMMON malignancy of the jaw, from BREAST, PROSTATE, LUNG, KIDNEY carcinomas

metastatic tumors of the jaws

# Radiology Ill-defined, “moth eaten”, destructive margins, irregular shape, destruction of lamina dura, tooth mobility, “floating teeth,” RL defects

metastatic tumors of the jaws

# Histology acute (50-60yo), gingival infiltration, swelling, perio disease

leukemia

# Radiology Destruction of alveolar bone, loss of lamina dura, loosening of teeth, ill-defined RLs

leukemia

# Histology african form has jaw involvement, 5-12yo, loosening, displacement, premature eruption

burkitt's lymphoma

# Radiology Jaw expansion, single or multiple RL foci in molar region, ill-defined borders, perforation, destruction, displacement of B/L corticies

burkitt's lymphoma

# Histology weakness and pain, pathologic fractures, multiple bone involved (%14 JAWS), mobility and migration of teeth, bence-jones protein urine

multiple myeloma

# Radiology Multiple, small, WD, non-corticated RLs, uni- or bilateral, skull often involved, “punched-out”

multiple myeloma

**Unilocular Radiolucencies Well-defined**

_**Unilocular Radiolucencies Well-defined**_ * Odontgenic cysts * Fissural cysts * Cementoma (early) * Odontogenic tumors * Neural tumors * Salivary gland depressions

_**Unilocular Radiolucencies Poorly-defined**_

_**Unilocular Radiolucencies Poorly-defined**_ * Odontogenic cysts * Fissural cysts * Cementoma * Odontogenic tumors * Metastatic tumors * Histiocytosis X * Osteoporotic bone marrow defect

_**Multilocular Radiolucencies Well-defined**_

**Multilocular Radiolucencies Well-defined** * Odontogenic keratocyst * Odontogenic tumors * Giant cell lesions * Fibro-osseous lesions * Hemangioma

_**Multilocular Radiolucencies Poorly-defined**_

_**Multilocular Radiolucencies Poorly-defined**_ Osteomyelitis Fibro-osseous lesions Sarcomas Metastatic tumors

_**Radiopacities Discrete lesions**_

_**Radiopacities Discrete lesions**_ * Cementoma (mature) * Osteoma / osteoblastoma * Sclerosing osteitis / bone scar * Foreign bodies

_**Radiopacities Multiple or diffuse lesions**_

_**Radiopacities Multiple or diffuse lesions**_ Osteomyelitis Florid osseous dysplasia Paget’s disease Blastic metastases Osteosarcoma

**_Mixed lucencies/opacities_**

**_Mixed lucencies/opacities_** * Fibro-osseous disease * Ossifying tumors * Odontomas * Cementoma (intermediate) * Paget’s disease * Chronic osteomyelitis * Blastic metastases * Sarcomas

**_Condylar lesions_**

**_indications for marsupialization ..._**

_indications for marsupialization ..._ * To prevent injury to adjacent structures * To prevent devitalization of teeth * To assist in the eruption of teeth * Where there is difficult surgical access * Where there is a risk of pathologic fracture * In the medically compromised patient * Short surgical procedure * Local anesthesia 1. Decreased risk of fracture No risk to the IA nerve 2. Useful teeth can erupt

a benign reactive lesion that is caused by altered hemodynamics and cause an accumulation of blood in the bone with out a detectable bruit. what two interaosseous lesions can occur in combination with this lesion?

1. aneurysmal bone cyst 2. fibro-osseous lesions 3. giant cell granuloma