simplified charts Flashcards
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.
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
Histology
Thin, non-keratinized epithelial lining, multipotential (may have mucous or other cells present), Inflamed cyst=APC histo
dentigerous cyst (DC)
Radiology
WD, CB, UL, RL around crown of an unerupted tooth, attached to the CEJ
dentigerous cyst (DC)
Histology
Thin layer of keratinized squamous epithelium, may contain blood
eruption cyst (eruption hematoma)
Radiology
Soft, translucent swelling in gingival mucosa overlying the crown of an erupting tooth (most commonly 1st perm molars)
eruption cyst (eruption hematoma)
Histology
“inflamed dentigerous cyst”, Hx of pericoronitis
Paradental cyst
Radiology
Cyst on distal or buccal of partially erupted 3rd molar
Paradental cyst
Histology
Small satellite cysts in fibrous wall, uniformly thin epithelium, corrugated parakeratin, palisaded basal layer with hyperchromatic nuclei
odontogenic keratocyst (OKC)
Radiology
WD, smooth and CB, UL, RL between teeth. Smetimes ML. resemnbles other cytsts, Rx descriotion not diagnostic
odontogenic keratocyst (OKC)
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”
Radiology
Jaw cysts present in 75% of patients
nevoid basal cell carcinoma syndrome “Gorlin syndrome”
Histology
Orthokeratin WITHOUT nuclei, prominent granular cell layer, basal cell layer NOT PALISADED and less hyperchromatic
orthokeratinized odontogenic cyst
Radiology
Posterior mandible, unerupted 3rd molars, UL, RL. Resembles DC
orthokeratinized odontogenic cyst
Histology
Focal nodular thickenings (epithelial plaques), lined by uniformly flattened squamous cells, swirl appearance
lateral periodontal cyst
Radiology
WD, CB, RL lateral to the roots of VITAL teeth
lateral periodontal cyst
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
Radiology
N/A
gingival cyst of the newborn
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
Radiology
Usually not seen on radiograph due to soft-tissue nature
gingival cyst of the adult
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)
Radiology
WD, UL, RL with or without RO’s or Cal’s.
calcifying odontogenic cyst (Gorlin cyst or dentinoGENIC ghost cell tumor)
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)
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
- Decreased risk of fracture No risk to the IA nerve
- 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?
- aneurysmal bone cyst
- fibro-osseous lesions
- giant cell granuloma
