Solitary radiopacities Flashcards
I. EXOSTOSES
Are hamartomous masses of mostly cortical bone, arising from the bone
surface. They may incorporate a small amount of internal cancellous bone
Clinical features:
1.Exostosis:
1. size, amount
2. appearance
3. Always covered with
4. gender, age
May attain a large size, may be solitary or multiple.
May be flat, nodular or pedunculated.
mucosa and are bony hard on palpation.
Male predominance and increase frequency with age.
1.Exostosis:
a. Most commonly on the
b. Less commonly on the
buccal surfaces of the maxillary alveolar processes, usually in the canine or molar area.
palatal surface of the alveolar bone
I. EXOSTOSES
Imaging Features
1. Location.
- The maxillary alveolar process is the most common location. In PAs they are superimposed over the roots of the adjacent teeth.
I. EXOSTOSES
2. Periphery.
- Well defined with a curved border.
I. EXOSTOSES
Imaging Features
3. Internal structure.
(2)
- Usually is homogeneous and radiopaque.
- Although when large it can have an internal cancellous bone,
they most often consist only of cortical bone
I. EXOSTOSES
4. Effects on adjacent structures.
5. Effects on adjacent teeth.
6. Management
- Continuous with the bone surface.
- No effects.
- No treatment required*
Torus
- 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.
Torus
Clinical Features
* The torus palatinus: ~–% of the population
* Mandibular tori: ~–% of the population.
* Gender
* Although tori may be discovered at any age, it is rare in
—. They usually develop in young adults before —
years of age, and they may continue to enlarge slowly during
a lifetime.
20
8
Twice as often in women as in men.
children, 30
Torus
Clinical Features
* The (3) of tori can vary
broadly.
*Palatal tori:
*These lesions have been described as being
(3)
number, size, and shape
The base is in the palate and the bulk extends downward into the oral cavity.
flat, lobulated or nodular
Torus
Clinical Features
*In the mandible, single or multiple tori can develop, and they can be unilateral or bilateral, most often developing in the — region
*Mandibular tori can also vary in size, ranging from an outgrowth that is…
*Normal mucosa covers the bony mass, and the mucosa may be thin and appear pale. Consequently, if traumatized, the mucosa may easily —.
*Patients often are unaware of having tori, and sometimes, patients who do discover them may insist that they
premolar
barely palpable to one that contacts a torus on the opposite side.
ulcerate
have arisen suddenly and have
grown rapidly.
Torus
Imaging Features
Location:
* On maxillary periapical or panoramic images, a torus palatinus
appears as a
*On mandibular periapical images, a torus mandibularis appears
as a
well-defined, oval, dense radiopaque structure
superimposed over the crowns and/or roots of the maxillary
premolar and molar dentition
well-defined, oval, radiopaque entity, usually superimposed
on the roots of premolars and molars and occasionally over a
canine or incisor
Torus
Effects on adjacent structures.
* Effects on adjacent teeth.
* Management
Tori are continuous with the bone surface from which they are
arising.
Tori have no effects on the teeth.
Tori do not usually require treatment, although removal may be
necessary to accommodate a removable denture.
II. Idiopathic osteosclerosis
Disease Mechanism
* A.K.A:
*Are the “—” of exostoses
* Represent localized growths of — bone into the
cancellous bone.
Clinical Features
* —.
Dense bone islands (DBI) or enostosis
internal counterparts
cortical
Asymptomatic
II. Idiopathic osteosclerosis
Imaging Features
Location:
*More common in the
*Most often in the — areas
* Their presence does not correlate with the presence or
absence of —.
mandible than in the maxilla
premolar and molar
teeth
II. Idiopathic osteosclerosis
Periphery:
- DBIs directly abut adjacent normal bone with a well defined periphery that blends with the trabeculae of the surrounding bone.
II. Idiopathic osteosclerosis
Internal structure:
- The internal pattern of DBIs can vary from a ground glass-like pattern
to one that is uniformly radiopaque
II. Idiopathic osteosclerosis
Effects on adjacent structures:
- There are no effects on adjacent structures.
Idiopathic osteosclerosis or dense bone island
Effects on adjacent teeth:
A DBI located periapical to a tooth root can (but rare) induce external root
resorption
In all circumstances, the tooth pulp is vital, and the root resorption appears to
be self-limiting. A visible periodontal ligament space may be visible between
the resorbed tooth root and the DBI.
Idiopathic osteosclerosis or dense bone island
Differential Interpretation
* When a DBI is located at a root apex, it may resemble
* Dense bone islands may also have similarities to
periapical sclerosing osteitis.
periapical cemento-osseous dysplasia, or hypercementosis or cementoblastoma.
Idiopathic osteosclerosis or dense bone island
Management
DBI does not require treatment. If multiple DBIs are present,
the patient’s family history should be reviewed for the
presence of colonic polyps.
V. Osteoma
Disease Mechanism
* It is unclear whether osteomas are …
*Radiologic appearances similar to (3)
* Osteomas develop from the periosteum and
may occur either
hamartomas or neoplasms.
dense bone islands, exostosis, and tori.
externally on a bone surface
or within the paranasal sinuses (most
commonly frontal sinuses or ethmoidal air cells)
IV. Osteoma
Clinical Features
* Can occur at any age but are most commonly — years.
* Can be…
* The osteomas are attached to the cortex of the jaw by a…
* When osteomas develop on a bone surface, a patient may perceive a…
> 40
solitary or multiples, occurring on a single bone or on numerous bones.
pedicle or along a wide base.
hard swelling. The swelling is painless until its size or position interferes with function.
