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Oral Diseases > theme 11 > Flashcards

theme 11 Flashcards

1
Q

another name for odontomes

A

dental hamartoma

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2
Q

what is an odontome

A

benign tumour linked to tooth development
non-neoplastic
contain calcified dental tissue
limited growth potential

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3
Q

3 types of invaginated odontome

A

dens en dente
dens invaginatus
gestant odontome

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4
Q

which teeth usually affected by invaginated odontomes

A

mandibular premolars

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5
Q

where are dens en dente most common

A

lateral incisors

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6
Q

what is dens en dente

A

infolding of outer surface of tooth into interior
enamel organ invaginated into papilla
cingulum pits

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7
Q

complication of dens en dente

A

can lead to early pulp death

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8
Q

what is an enamel pearl

A

enamel on root
usually furcation of maxillary molar
growth disturbance of HERS

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9
Q

complication of enamel pearl

A

plaque retentive factor

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10
Q

2 types of odontomes

A

complex - not tooth like

compound - tooth like

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11
Q

tissue present in complex odontome

A

enamel, dentine, cementum, connective tissue

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12
Q

tissue present in compound odontome

A

enamel, dentine, cementum, pulp

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13
Q

radiological features of odontome

A

variable sixe
ovoid shape
well defined, radiolucent
radio-opaque as made of calcified tissue

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14
Q

effects of odontomes

A

impeded eruption of permanent dentition
displace teeth
cortical expansion

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15
Q

ages when odontomes common

A

complex - 10-30

compound - 10-20

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16
Q

where are complex odontomes most likely found

A

mandibular molar

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17
Q

where are compound odontomes most likely found

A

anterior maxialla, inter-canine area

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18
Q

3 classifications of benign odontogenic tumours

A

epithelial
epithelial + mesenchymal
mesenchymal

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19
Q

what must be present for odontogenic tumour to contain hard tissue

A

ep + mesenchymal cells

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20
Q

most common odontogenic tumour?

A

ameloblastoma

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21
Q

most common site to find ameloblastoma

A

80% mandbile - angle most common

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22
Q

presentations of ameloblastoma

A

asymptomatic early stage
facial deformity due to expansion of bone can cause loss of teeth
pain rarely

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23
Q

radiological features of ameloblastoma

A

variable size
multilocular
well defined, corticated
radiolucent

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24
Q

effects of ameloblastoma

A

cortical expansion
tooth displacement
knife edge root resorption
can get perforation of bone + extension in soft tissues

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25
Q

how big should margins be for resection of ameloblastoma

A

1cm

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26
Q

complication of ameloblastoma

A

undergo cystic change

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27
Q

features of unicystic ameloblastoma

A

young patients
mandibular third molar region, associated with unerupted tooth
simple uni-cystic cavity lined with ameloblastic ep - no solid tumour
doesn’t invade, low morbidity

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28
Q

4 types of odontogenic tumour - epithelial

A

ameloblastoma
squamous odontogenic tumour
adenomatoid odontogenic tumour
calcifying epithelial odontogenic tumour

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29
Q

features of squamous odontogenic tumour

A

lesion of PDL
maxilla>mandible
well circumscribed, triangular radiolucency with sclerotic border

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30
Q

effect of squamous odontogenic tumour

A

tooth displacement

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31
Q

features of adenomatoid odontogenic tumour

A

well defined, can get calcifications causing radio-opacities
anterior maxialla most common
small, unilocular
impedes eruption of teeth

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32
Q

features of calcifying epithelial odontogenic tumour

A 
rare, benign, locally invasive 
mandibular molar region most common
swelling
variable size, multi or unilocular
variable outline
calcifies so radio-opaque/lucent mix
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33
Q

effects of calcifying epithelial tumour

A

cortical expansion
tooth displacement
root resorption

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34
Q

2 types of benign odontogenic tumour with ep + mesenchyme

A

ameloblastic fibroma

calcifying odontogenic cyst

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35
Q

where is ameloblastic fibroma most common

A

mandible (pre)molar - <20year old

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36
Q

presentation of ameloblastic fibroma

A

asymptomatic
slow growing
facial deformity
loose teeth

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37
Q

radiological presentation of ameloblastic fibroma

A

uni or multi locular
well defined, corticated
radiolucent

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38
Q

effects of ameloblastic fibroma

A

impeded eruption
tooth displacement
cortical expansion

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39
Q

how to differentiate ameloblastoma + ameloblastic fibroma

A

ameloblastic fibroma doesn’t extend beyond medullary spaces of bone

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40
Q

when is calcifying odontogeninc cyst most common

A

<40year old, maxilla = mandble

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41
Q

presentation of calcifying odontogenic cyst

A

asymptomatic

slow growing swelling

42
Q

radiological features of calcifying odontogenic cyst

A

size variable
unilocular
well defined, corticated
radiolucent/mixed

43
Q

effects of calcifying odontogenic cyst

A

impedes eruption, tooth displacement, root resorption

44
Q

3 types of benign mesenchymal tumours

A

odontogenic fibroma
odontogenic myxoma
cementoblastoma

45
Q

how to tell odontogenic fibroma + odontogeninc myxoma apart on radiograph

A

myxoma = multilocular (soap bubble appearance), difficult to remove

myxoma in younger people

46
Q

where are odontogenic myxomas mostly found

A

posterior mandible - get cortical expansion

47
Q

presentation of odontogenic fibromas + myxomas

A

slow growing
well defined
asymptomatic

48
Q

what age presents with cementoblastoma

A

<25years

49
Q

most common site for cementoblastoma

A

mandible (pre)molar - attached to root

50
Q

features of cementoblastoma

A

variable size, round shape, well defined outline (radiolucent) - overall radio-opaque

51
Q

effects of cementoblastoma

A

root resorption + cortical expansion

52
Q

2 types of malignant odontogenic tumours

A

carcinomas

sarcomas

53
Q

4 types of odontogeninc carcinomas

A

ameloblastic carcinoma
primary intraosseuous SCC
clear cell odontogenic carcinoma
malignant change in benign odontogenic cyst

54
Q

signs of malignant tumours

A 
pain + swelling
ulceration of mucoas
mobility of teeth
parasthesia/anaesthesia
extensive bone destruction
regional lymph node metastasis
distant metastasis
55
Q

definition of a cyst

A

pathological cavity with fluid/semi fluid contents, not created by accumulation of pus
+/- ep lined

56
Q

types of epithelial cysts

A

odontogenic - radicular, paradental, dentigerous, keratocyst, lateral periodontal, gingival

non-odontogenic - nasopalatine, nasolabial

57
Q

3 types of non-epithelial cysts

A

solitary bone
aneurysmal
stafne bone cavity

58
Q

3 types of radicular cyst

A

periapical
lateral
residual

59
Q

features of radicular cyst

A

apex of non-vital tooth
asymptomatic, swelling, tooth mobility/displacement
radiologically - round, unilocular, well defined/corticated

60
Q

effects of radicular cyst

A

buccal expansion
root resorption
antral-halo
tooth displacement

61
Q

what should be suspected if heavy root resorption

A

malignancy

62
Q

histopathology of radicular/residual cyst

A

non-keratinised SSE
rusthon bodies, squamous metaplasia
cyst wall - fibrous, inflammatory cells, cholesterol clefts, haemosiderin

63
Q

how can you tell no invasion into deeper layers

A

healthy basement membrane layer

64
Q

pathogenesis of radicular cyst

A 
ep cells of malassez stimulated by inflammatory mediators
degeneration of central ep
ep cuts from blood supply 
cells die off + degrade + form cavity
cavity expands due to osmosis
65
Q

features of paradental cyst

A

side of tooth - usually lower 8s

same features as radicular

66
Q

features of dentigerous cyst

A

same as radicular - around unerupted tooth

67
Q

histopathology of dentigerous cyst

A

thin flattened non-keratinised SEE

cyst wall fibrous +/- inflammation

68
Q

pathogenesis of dentigerous cyst

A 
pressure of impacted tooth on follicle
obstruction of venous drainage
serum transudation
fluid accumulated between REE + enamel
pressure causes expansion
69
Q

eruption cyst presentation in mouth

A

fluctuant bluish swelling

70
Q

presentation of keratocyst

A 
asymptomatic
swelling +/- pain
tooth mobility
patholigical fracture
adjacent teeth vital
71
Q

pathogenesis of keratocyst

A

derived from dental lamina or remnants (cell rests of serves)

72
Q

radiological presentation of keratocyst

A 
body/angle of mandible
variable size
oval unilocular/multilocular
well defined, corticated, scalloped
uniformly radiolucent
73
Q

effects of keratocyst

A

minimal affect of adjacent structures
expands through cancellous bone
may cause fracture

74
Q

histopathology of karatocyst

A

keratinised SEE
cyst wall - fibrous +/- inflammation
satellite cysts

75
Q

what would be in keratocyst aspirate

A

low level of total protein + albumin

76
Q

clinical presentation of keratocyst

A

through cancellus bone, little/no buck/lingual expansion

intrinsic growth potential

77
Q

what syndrome present as multiple BCC and keratocysts

A

golin-goltz syndrome
also have cleft lip/palate
mutation of PTCH1

78
Q

features of lateral periodontal cyst

A

same as radicular but PDL side of tooth, <1cm, teeth vital

79
Q

histopathology of lateral periodontal cyst

A

non-keratinised SSE

80
Q

pathogenesis of lateral periodontal cyst

A

REE
serres rests
cell rests of a malassez

81
Q

gingival cysts are common in what age of person

A

infants

82
Q

possible presentation of nasopalatine duct cyst

A 
asymptomatic 
swelling of midline palate
pain + salty discharge
tooth mobility/displacement 
anterior teeth vital
83
Q

epithelium lining nasopalatine + nasolabial cyst

A

respiratory ep

84
Q

pathogenesis of nasopalatine cyst

A

remnants of nasopalatine duct

85
Q

presentation of nasolabial cyst

A

swelling in nasolabial fold
pain
nasal obstruction

86
Q

pathogenesis of nasolabial cyst

A

remnants of embryonic nasolacrimal rod or duct

87
Q

3 types of non-epithelial cysts

A

solitary bone cyst
aneurysmal cyst
stafne bone cavity

88
Q

radiological presentation of solitary bone cyst

A

well defined, corticated
unilocular radiolucency
undulating

89
Q

radiological presentation of aneurysmal cyst

A

multilocular radiolucency at angle of mandible

90
Q

4 reasons to treat cysts

A

stop further growth
avoid infection
avoid pathological fracture
stop displacement/resorption of teeth

91
Q

methods to treat cysts

A

enuceation +/- extra measure
marsupialistion
decompression
resection

92
Q

what is marsupialisation

A

open cyst + leave open
bone healing from base upwards
lining will undergo metaplasia + becomes normal ep
may need to pack ope - BIPP/gauze

93
Q

what is decompression

A

same as marsupialisation but instead of pack, use drink with tube to keep open

94
Q

when might marsupialsiation/decompression be used

A

larger cysts - reduces threat to vital structures

Dentigerous cyst - vitality preserved

95
Q

what is enucleation

A

remove all cyst lining, close flap over, pack if necessary

96
Q

disadvantages of enucleation

A

leaves dead space - infection risk
damage to adjacent structures - loss of vitality, IAN
jaw fracture
antra/nasal involvement

97
Q

what is carnoys solution

A

adjunct to enucleation
aims to remove any remaining viable lining in thin friable lines cyst

modified carnoys - removed chloroform due to carcinogenic potential

98
Q

what is cryotherapy

A

adjunct to enucleation

freezes everything, cell death by intra/extra cellular ice formation

99
Q

what is a peripheral osteotomy

A

adjunct to enucleation

margin around cyst removed using bur

100
Q

3 types of adjunct treatment to enucleation

A

carnoys
cryotherapy
peripheral osteotomy

Oral Diseases (14 decks)

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