theme 12 Flashcards
2 types of developmental bone lesions of mouth
torus palatinus
torus mandibularis
what is reactive exostosis
projection of bone caused by chronic trauma = periosteal irritation = bone deposition
remove surgically
what is an osteoma and what are the 3 causes
benign bony mass in jaw
developmental, reactive, benign neoplastic
2 clinical classifications for osteomaas
solitary or multiple
syndrome causing multiple osteomas and multiple odontomes
gardner syndrome
features of benign neoplasms of jaw
rare, slow growing, circumscribed,
overlap with odontogenic neoplasms clinically
mimic cysts on radiograph
what sort of carcinoma presents in jaw
metastatic carcinoma - metastasis of SCC
3 types of malignant neoplasms in jaw
metastatic carcinoma
marrow neoplasms
primary bone tumours - osteosarcoma, chondrosarcoma, mesenchymal chondrosarcoma
premalignant disease putting elderly patients at risk of osteosarcoma?
pagets
name for newly laid down bone by osteoblasts
osteoid
role of RANKL
ensure bony remodelling is balanced
2 types of giant cell lesions of jaw
giant cell granuloma - peripheral or central
hyperparathyroidism - produces lesions called brown tumour
characteristic of giant cell lesions
presence of osteoclasts
where does a peripheral giant cell granuloma present
gingiva only - friable + painless
where does a central giant cell granuloma present
involves underlying jaw bone
management of central giant cell granuloma
- curretage
2. injection of slow release steroids
subtle change that takes place in oral cavity due to hyperparathyroidism
loss of lamina dura of interdental bone
test to differentiation GCG and hyperparathyroidism
serum calcium elevated in hyper
what is pagets disease
unregulated bone turnover
osteitis deformans
complications of pagets disease
heart disease - bone normally helps shunt
pre-malignant to osteosarcoma
symptoms of pagets
middle aged - elderly slow onset deafness, vision facial distortion numbness skeletal symptoms oral - bone overgrowth, tooth spacing, bleeding after extractions, osteomyelitis, pain/numbness
diagnosis of pagets
history examination radiographs - abnormal trabecular bone alkaline phosphate levels elevated bone biopsy - avoid as painful
treatment of pagets
bisphophanates
denosumab
4 types of fibro-osseous lesions
fibrous dysplasia
ossifying fibroma
cements-osseous dysplasia
cherubism
3 forms of fibrous dysplasia
monostotic - solitary
multiple - in craniofacial bones
polyostotic - throughout skeleton
mutation responsible for fibrous dysplasia
GNAS mutation
features of monostotic fibrous dysplasia
childhood onset, slow growth
no tooth displacement - teeth grow through
no systemic abnormality
radiograph - diffuse edge, initially radiolucent then trabecular bone forms = ground glass
management of FD
self-limiting
review until skeletal maturity
cosmetic re-contouring
denosumab - targeted therapy to with RANLK off
how to differentiate FD + ossifying fibroma
FD diffuse border, OF well circumscribed
features of ossifying fibroma
benign, slow growing mandible more common juvenile or adult ground glass radiolucenency well circumscribed progressive growth displaced adjacent structures
treatment of ossifying fibroma
surgical removal
clear margins
conservative removal
radiographic appearance of cementoosseous dysplasia
radiolucencies with radio-dense central areas (NIDUS)
what is cherubism
multilocular cystic lesions bilateral
mandible + maxilla
submandibular lymph nodes enlarged
swelling at 3-4yrs, stable by 30
gene causing cherubism
autosomal dominant SH3BP2
