what is a fibrosseous lesion

Question 1

what is a fibrosseous lesion

Answer 1

Lesions where the normal bone is replaced by fibrous tissue in which abnormal bone is laid down.

Question 2

what is an ossifying fibroma

Answer 2

Benign neoplasm composed of fibrous tissue
which forms spicules, islands or cementicles
of bone

Question 3

where is the most common site for an ossifying fibroma

Answer 3

premolar or molar region

Question 4

what is the main type of bone in an OF

Answer 4

Woven bone - amorphous patterns

Question 5

what does an OF look like radio graphically?

Answer 5

a radiolucent, well demarcated, corticated lesion. often little speckles of bone

Question 6

what is the management of an OF?

Answer 6

CONSERVATIVE enucleation

resection if severe

Question 7

do OF recur?

Answer 7

yes but low recurrence

Question 8

what type of lesion is FD

Answer 8

a developmental lesion - tends to occur in developing children

Question 9

how does FD present clinically?

Answer 9

Painless smooth enlargement/swellings

Question 10

what is the most common site of FD

Answer 10

posterior maxilla

Question 11

what is the most common site of OF

Answer 11

posterior mandible

Question 12

how does FD appear radiologically

Answer 12

a poorly demarcated radiopacity
looks like frosted glass
will blend in with normal bone - cant tell where it starts or ends

Question 13

what bones does FD affect

Answer 13

can affect ANY bone in the body. tends to be longer bones

Question 14

what are the 2 types of FD

Answer 14

Monostotic

Polyostotic

Question 15

what syndrome is polyostotic FD associated with?

Answer 15

McCune - Albrights Syndrome

Question 16

what is the management of FD

Answer 16

Leave as growth stabilises over time.
ideally wait until after growth spurt and then do any debulking and contouring of bone
if really large can surigcally remove but try to avoid this
then ortho/orthognathic surgery later to correct any malocclusion

Question 17

is there risk of malignant transformation in FD

Answer 17

yes, usually to osteosarcoma but risk is LOW

Question 18

what are the main differences between FD and OF

Answer 18

FD
Poorly defined lesion - frosted glass appearance
No margin
Females = males
Often posterior maxilla

OF 
Well defined lesion - could draw around outside
Clear margin
Females > males
Often posterior mandible

Question 19

what type of lesion is OD

Answer 19

a reactive lesion

Question 20

who does OD usually affect?

Answer 20

often middle aged afro Caribbeans/east asians

Question 21

what are the 3 types of OD

Answer 21

Focal - single lesions usually posterior mandible
PA - multiple lesions usually at apex of anterior teeth. in early stages when fibrous can look like PA granulomas but occurs on all teeth together
Florid - multiple lesions throughout the jaws

Question 22

how does OD affect general dental treatment

Answer 22

because can become v sclerotic you can get a decrease in blood supply so if you get and infection in the tooth then you get poor wound healing

Question 23

what is pagets

Answer 23

a rare disorder affecting all bones where bone turnover is increased and no longer related to functional demands

Question 24

what is a difference between FD and Pagets

Answer 24

Pagets tends to affect the WHOLE bone whereas FD can just affect part of the bone

Question 25

histology what is present in pagets

Answer 25

lots of resting and reveral lines showing ahuge increase in bone turnover

Question 26

what is the difference in early and ate stages of pagets

Answer 26

early stages are v vascular

late stages bone becomes v sclerotic

Question 27

what are the clinical features of Pagets

Answer 27

legs become BOWED as in early stages when v vascular bone cant support weight
enlargement of the skull causing constriction of foramen - deafness and hats dont fit. can get flattened skull
jaws become enlarged - teeth become spaced and often dentures no longer fit

Question 28

what are the dental implications of pagets

Answer 28

Bone is sclerotic so difficulty with extractions and more prone to infections and decreased blood supply
Hypercementosis - makes extractions more difficult
Pt may be on bisphosphonates
has a chance of malignancy to osteosarcoma