Solitary radiopacities

Question 1

Are hamartomous masses of mostly cortical bone, arising from the bone
surface. They may incorporate a small amount of internal cancellous bone.

Answer 1

Exostoses

Question 2

a. Most commonly on the buccal surfaces of the maxillary alveolar
processes, usually in the canine or molar area.
b. Less commonly on the palatal surface of the alveolar bone
1. May attain a large size, may be solitary or multiple.
2. May be flat, nodular or pedunculated.
3. Always covered with mucosa and are bony hard on palpation.
4. Male predominance and increase frequency with age.

Answer 2

Exostosis

Question 3

• Is an exostosis that may occur in the midline of the hard
palate (torus palatinus) or the lingual surface of the
mandible (torus mandibularis).
•It has been hypothesized that genetic and environmental
factors may be involved in the development of torus
mandibularis, with masticatory forces being reported as an
essential factor underlying formation.

Answer 3

Torus

Question 4

Are tori more common in max or mand?

Answer 4

Max

Question 5

Are tori more common in men or women?

Answer 5

Women

Question 6

Are the “internalcounterparts”of exostoses
• Represent localized growths of cortical bone into the
cancellous bone.
Clinical Features
• Asymptomatic.

Answer 6

Idiopathic osteosclerosis

A.K.A: Dense bone islands (DBI) or enostosis

Question 7

Are Idiopathic osteosclerosismore common in max or mand?

Answer 7

Mand

Question 8

Where are Idiopathic osteosclerosis mostly seen in what area?

Answer 8

PM and Molar areas

Question 9

If a patient has multiple dense bone islands, what syndrome should be suspected?

Answer 9

Gardner’s syndrome

Question 10

• It is unclear whether osteomas are
hamartomas or neoplasms.
•Radiologic appearances similar to dense bone
islands, exostosis, and tori.
• Osteomas develop from the periosteum and
may occur either externally on a bone surface
or within the paranasal sinuses (most
commonly frontal sinuses or ethmoidal air cells)

Answer 10

Osteomas

Question 11

Where are osteomas located usually? 2 places

Answer 11

INferior border/ramus of mand and paranasal sinuses

Question 12

Disease Mechanism
- Multiple osteomas are a feature of ________ , as are multiple dense bone islands, epidermoid cysts, and subcutaneous desmoid
tumors.
- Characterized by the development of multiple colonic polyps (higher risk for developing colon cancer)
- The associated osteomas appear during the second decade
- Increased frequency of supernumerary and impacted teeth, and odontomas may also occur in Gardner syndrome.
Management
- Generally, the removal of osteomas is unnecessary unless the tumors interfere with normal function or present a cosmetic concern.
- It is most important to recognize the relationship of multiple osteomas Gardner syndrome for early diagnosis.
- Multiple osteomas + family history of colorectal cancer = Physician referral for examination of intestinal polyposis and management.

Answer 12

Gardner syndrome

Question 13

If there are more than ___ osteomas, you should suspect Gardner syndrome

Answer 13

5 osteomas

Question 14

• Is a hamartoma that is characterized by the production of
mature enamel, dentin, cementum, and pulp tissue.
• Complex : A nondescript and heterogeneous mass
of the dental hard tissues.
• Compound : Multiple well-formed teeth
(denticles) referred to as a compound odontoma.
• Dilated : may also be a severe expression of a
dens in dente.

Answer 14

Odontoma

Question 15

______ odontoma: A nondescript and heterogeneous mass

of the dental hard tissues.

Answer 15

Complex

Question 16

______ odontoma: Multiple well-formed teeth

(denticles) referred to as a compound odontoma.

Answer 16

Compound

Question 17

_____ odontoma: may also be a severe expression of a

dens in dente.

Answer 17

Dilated

Question 18

Are compound or complex odontomas more common?

Answer 18

Compound odontomas

Question 19

What is the gender breakdown of compound odontomas?

Answer 19

Equal

Question 20

What is the gender breakdown of complex odontomas?

Answer 20

60% in femals

Question 21

The majority of compound odontomas (62%) occur in the ______

Answer 21

anterior maxilla

Question 22

70% of complex odontomas are found in the _____ and _____ area

Answer 22

mandibular first and second molar area

Question 23

- Is a bone dysplasia
Disease Mechanism
- Altered bone metabolism
- Cancellous bone is replaced by
fibrous connective tissue containing
varying amounts of immature,
abnormal bone.
- Compared with normal bone, there
are more trabeculae per unit volume

Answer 23

Fibrous dysplasia

monostotic

Question 24

• Most commonly affects the skeleton unilaterally
• The most common sites include the ribs, femur, tibia, maxilla, and mandible.
• Discover in young individuals (approximately from 12 years of age)
• The lesions usually become static when skeletal growth ceases, but bone changes may
  continue.
• Lesions may become active during pregnancy or with the use of oral contraceptives.
• Does not have sex predilection
• Most of the times is mild and asymptomatic. However, patients with jaw involvement may
  first complain of unilateral facial swelling or an enlarging deformity of the alveolar process.
• If craniofacial lesions involve the skull base, the bone changes may impinge on neural
  foramina

Answer 24

Fibrous dysplasia

Question 25

Is fibrous dysplasia seen more in maxilla or mand?

Answer 25

Maxilla

Question 26

• The internal density may be radiolucent, radiopaque, or a
mixture of both compared with normal bone.
•Granular appearance (ground-glass), a pattern resembling the
surface of an orange, a wispy arrangement (cotton wool), an
amorphous pattern or pattern similar to a fingerprint.

Answer 26

Fibrous dysplasia (monostotic)

Question 27

What are the 4 most common appearances of fibrous dysplasia?

Answer 27

Cotton wool
Finger print
Ground glass
Orange peel

Question 28

What are the 4 most common appearances of fibrous dysplasia?

Answer 28

Cotton wool
Finger print
Ground glass
Orange peel

Question 29

Is fibrous dysplasia seen in younger or older individuals?

Answer 29

Younger; stops growing when kid stops growing

Question 30

Effects on surrounding structures:
• If the lesion is small, it may have no effect on surrounding structures.
• Expansion and intact thinned-outer cortex, affecting the bone more
evenly along its length.
• May expand into the sinus by displacing its cortical boundary
• Usually do not affect the dentition. However, it can displace teeth or
interfere with normal eruption.
• The lamina dura disappears because this bone also is changed into the
abnormal bone pattern. A very narrow PDL space is seen.
• Fibrous dysplasia appears to be unique in its ability to displace the
inferior alveolar nerve canal in a superior direction.

Answer 30

Fibrous dysplasia

monostotic

Question 31

What lesion can displace the inferior alveolar canal superiorly?

Answer 31

Fibrous dysplaisa