Week 9 - Bone Formation and Resorption II

Question 1

Architecture/shape of the tooth-associated facial and lingual cortical bone is dictated by

Answer 1

o Facial-lingual alignment of teeth
o Mesial-distal contour of CEJ
o Facial-lingual width of teeth
o Presence of enamel pearls or cervical enamel projections

Question 2

Architecture/shape of the interproximal alveolar bone is dictated by

Answer 2

o Facial-lingual contour of the CEJ
o Mesial-distal tilt to the tooth
o Root proximity (roots that are close together result in thinner bone)
o Presence of enamel pearls
o State of tooth eruption (bone follows CEJ)

Question 3

What is a fenestration defect?

Answer 3

An isolated “porthole”/window in the cortical bone that allows exposure of the underlying root surface
- Excessive buccal inclination (can happen in orthodontics/teeth moving too quickly or genetically)

Question 4

What is a dehiscence defect?

Answer 4

A denuded area of cortical bone that extends through the marginal bone creating a “cleft-like” defect

Question 5

What is an exostosis defect?

Answer 5

• Area of bone formation that exceeds the average for a given anatomical area
• The term is generally used in reference to the maxillary facial and lingual and mandibular facial
• Typically not pre-cancerous

Question 6

What are torus/tori?

Answer 6

• An area of bone formation that exceeds average for a given anatomic area
• The term is used in reference to the mandibular lingual or midline of the palate (torus palatini)
• Don’t typically need to be removed unless they exhibit problems like rapid growth, pain, interfere with mastication, speech, or denture fabrication

Question 7

What is a giant cell tumor?

Answer 7

Generally asymptomatic causing a painless expansion of bone. Usually a single lesion that can be wither unilocular or multilocular

Question 8

What is giant cell tumor often confused with?

Answer 8

Often confused with ameloblastoma, periapical granuloma, or periapical cyst (consider biopsy to determine)

Question 9

What is giant cell tumor histologically characterized by?

Answer 9

presence of numerous multinucleated giant cells in a stroma of ovoid and spindle shaped mesenchymal cells

Question 10

What is multiple myeloma?

Answer 10

Malignancy of plasma cell origin that accounts for nearly 50% of all

Question 11

What are multiple myeloma plasma cells like?

Answer 11

The abnormal plasma cells are typically monoclonal (arise from a single cell, all look exactly the same)

Question 12

What do patients suffer from in multiple myeloma?

Answer 12

Patients frequently suffer kidney failure due to overload of circulating light chain protein (Bence Jones Protein) produced by the abnormal plasma cells and clot up the kidneys causing failure

Question 13

What do patients histologically show in multiple myeloma?

Answer 13

shows monotonous sheets of neoplastic, variably differentiated, plasmacytoid cells that invade and replace normal host tissue

Question 14

What do patients radiographically show in multiple myeloma?

Answer 14

Patients may exhibit “punched out” areas in the cranium. Such areas are filled with neoplastic plasmacytoid cells

Question 15

What is osteogenic sarcoma?

Answer 15

A malignancy of mesenchymal cells that have the ability to produce osteoid or immature bone

Question 16

What is one of the most common types of malignancies that start in bone?

Answer 16

Osteogenic sarcoma
**excluding hematopoietic neoplasms

Question 17

What are the most common symptoms of osteogenic sarcoma?

Answer 17

Pain and swelling are most common symptoms (**one of the few cancers in head and neck area that cause pain/swelling)

Question 18

What are radiographic findings of osteogenic sarcoma?

Answer 18

Radiographically patients findings vary from sense sclerosis to a mixed sclerotic-radiolucent lesion. About 25% of lesion exhibit a “sunburst” pattern

Question 19

How do enamel, dentin, cementum, and bone compare in overview?

Answer 19