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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
how big should margins be for resection of ameloblastoma
1cm
26
complication of ameloblastoma
undergo cystic change
27
features of unicystic ameloblastoma
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
28
4 types of odontogenic tumour - epithelial
ameloblastoma squamous odontogenic tumour adenomatoid odontogenic tumour calcifying epithelial odontogenic tumour
29
features of squamous odontogenic tumour
lesion of PDL maxilla>mandible well circumscribed, triangular radiolucency with sclerotic border
30
effect of squamous odontogenic tumour
tooth displacement
31
features of adenomatoid odontogenic tumour
well defined, can get calcifications causing radio-opacities anterior maxialla most common small, unilocular impedes eruption of teeth
32
features of calcifying epithelial odontogenic tumour
``` rare, benign, locally invasive mandibular molar region most common swelling variable size, multi or unilocular variable outline calcifies so radio-opaque/lucent mix ```
33
effects of calcifying epithelial tumour
cortical expansion tooth displacement root resorption
34
2 types of benign odontogenic tumour with ep + mesenchyme
ameloblastic fibroma | calcifying odontogenic cyst
35
where is ameloblastic fibroma most common
mandible (pre)molar - <20year old
36
presentation of ameloblastic fibroma
asymptomatic slow growing facial deformity loose teeth
37
radiological presentation of ameloblastic fibroma
uni or multi locular well defined, corticated radiolucent
38
effects of ameloblastic fibroma
impeded eruption tooth displacement cortical expansion
39
how to differentiate ameloblastoma + ameloblastic fibroma
ameloblastic fibroma doesn't extend beyond medullary spaces of bone
40
when is calcifying odontogeninc cyst most common
<40year old, maxilla = mandble
41
presentation of calcifying odontogenic cyst
asymptomatic | slow growing swelling
42
radiological features of calcifying odontogenic cyst
size variable unilocular well defined, corticated radiolucent/mixed
43
effects of calcifying odontogenic cyst
impedes eruption, tooth displacement, root resorption
44
3 types of benign mesenchymal tumours
odontogenic fibroma odontogenic myxoma cementoblastoma
45
how to tell odontogenic fibroma + odontogeninc myxoma apart on radiograph
myxoma = multilocular (soap bubble appearance), difficult to remove myxoma in younger people
46
where are odontogenic myxomas mostly found
posterior mandible - get cortical expansion
47
presentation of odontogenic fibromas + myxomas
slow growing well defined asymptomatic
48
what age presents with cementoblastoma
<25years
49
most common site for cementoblastoma
mandible (pre)molar - attached to root
50
features of cementoblastoma
variable size, round shape, well defined outline (radiolucent) - overall radio-opaque
51
effects of cementoblastoma
root resorption + cortical expansion
52
2 types of malignant odontogenic tumours
carcinomas | sarcomas
53
4 types of odontogeninc carcinomas
ameloblastic carcinoma primary intraosseuous SCC clear cell odontogenic carcinoma malignant change in benign odontogenic cyst
54
signs of malignant tumours
``` pain + swelling ulceration of mucoas mobility of teeth parasthesia/anaesthesia extensive bone destruction regional lymph node metastasis distant metastasis ```
55
definition of a cyst
pathological cavity with fluid/semi fluid contents, not created by accumulation of pus +/- ep lined
56
types of epithelial cysts
odontogenic - radicular, paradental, dentigerous, keratocyst, lateral periodontal, gingival non-odontogenic - nasopalatine, nasolabial
57
3 types of non-epithelial cysts
solitary bone aneurysmal stafne bone cavity
58
3 types of radicular cyst
periapical lateral residual
59
features of radicular cyst
apex of non-vital tooth asymptomatic, swelling, tooth mobility/displacement radiologically - round, unilocular, well defined/corticated
60
effects of radicular cyst
buccal expansion root resorption antral-halo tooth displacement
61
what should be suspected if heavy root resorption
malignancy
62
histopathology of radicular/residual cyst
non-keratinised SSE rusthon bodies, squamous metaplasia cyst wall - fibrous, inflammatory cells, cholesterol clefts, haemosiderin
63
how can you tell no invasion into deeper layers
healthy basement membrane layer
64
pathogenesis of radicular cyst
``` 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
features of paradental cyst
side of tooth - usually lower 8s | same features as radicular
66
features of dentigerous cyst
same as radicular - around unerupted tooth
67
histopathology of dentigerous cyst
thin flattened non-keratinised SEE | cyst wall fibrous +/- inflammation
68
pathogenesis of dentigerous cyst
``` pressure of impacted tooth on follicle obstruction of venous drainage serum transudation fluid accumulated between REE + enamel pressure causes expansion ```
69
eruption cyst presentation in mouth
fluctuant bluish swelling
70
presentation of keratocyst
``` asymptomatic swelling +/- pain tooth mobility patholigical fracture adjacent teeth vital ```
71
pathogenesis of keratocyst
derived from dental lamina or remnants (cell rests of serves)
72
radiological presentation of keratocyst
``` body/angle of mandible variable size oval unilocular/multilocular well defined, corticated, scalloped uniformly radiolucent ```
73
effects of keratocyst
minimal affect of adjacent structures expands through cancellous bone may cause fracture
74
histopathology of karatocyst
keratinised SEE cyst wall - fibrous +/- inflammation satellite cysts
75
what would be in keratocyst aspirate
low level of total protein + albumin
76
clinical presentation of keratocyst
through cancellus bone, little/no buck/lingual expansion | intrinsic growth potential
77
what syndrome present as multiple BCC and keratocysts
golin-goltz syndrome also have cleft lip/palate mutation of PTCH1
78
features of lateral periodontal cyst
same as radicular but PDL side of tooth, <1cm, teeth vital
79
histopathology of lateral periodontal cyst
non-keratinised SSE
80
pathogenesis of lateral periodontal cyst
REE serres rests cell rests of a malassez
81
gingival cysts are common in what age of person
infants
82
possible presentation of nasopalatine duct cyst
``` asymptomatic swelling of midline palate pain + salty discharge tooth mobility/displacement anterior teeth vital ```
83
epithelium lining nasopalatine + nasolabial cyst
respiratory ep
84
pathogenesis of nasopalatine cyst
remnants of nasopalatine duct
85
presentation of nasolabial cyst
swelling in nasolabial fold pain nasal obstruction
86
pathogenesis of nasolabial cyst
remnants of embryonic nasolacrimal rod or duct
87
3 types of non-epithelial cysts
solitary bone cyst aneurysmal cyst stafne bone cavity
88
radiological presentation of solitary bone cyst
well defined, corticated unilocular radiolucency undulating
89
radiological presentation of aneurysmal cyst
multilocular radiolucency at angle of mandible
90
4 reasons to treat cysts
stop further growth avoid infection avoid pathological fracture stop displacement/resorption of teeth
91
methods to treat cysts
enuceation +/- extra measure marsupialistion decompression resection
92
what is marsupialisation
open cyst + leave open bone healing from base upwards lining will undergo metaplasia + becomes normal ep may need to pack ope - BIPP/gauze
93
what is decompression
same as marsupialisation but instead of pack, use drink with tube to keep open
94
when might marsupialsiation/decompression be used
larger cysts - reduces threat to vital structures Dentigerous cyst - vitality preserved
95
what is enucleation
remove all cyst lining, close flap over, pack if necessary
96
disadvantages of enucleation
leaves dead space - infection risk damage to adjacent structures - loss of vitality, IAN jaw fracture antra/nasal involvement
97
what is carnoys solution
adjunct to enucleation aims to remove any remaining viable lining in thin friable lines cyst modified carnoys - removed chloroform due to carcinogenic potential
98
what is cryotherapy
adjunct to enucleation freezes everything, cell death by intra/extra cellular ice formation
99
what is a peripheral osteotomy
adjunct to enucleation | margin around cyst removed using bur
100
3 types of adjunct treatment to enucleation
carnoys cryotherapy peripheral osteotomy

Oral Diseases (14 decks)

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