Oral Diagnosis Fall 2009 - Sawyer 2 (Final)

Front 1

7 periapical (PA) radiolucent lesions that are sequelae of pulpitis

Back 1

1- PA granuloma
2- PA or radicular cyts
3- PA scar
4- PA abscess
5- PA surgical defect
6- PA osteomyelitis
7- PA hyperplasia of sinus mucosa

Front 2

clinical appearances of teeth suggesting non-vital tooth (6 symptoms)

Back 2

1- dark hue to crown
2- more opaque crown
3- large restoration
4- large carious lesion
5- presence of a draining sinus
6- fracture of a crown

Front 3

radiographic appearances of teeth suggesting a non-vital pulp (4 signs)

Back 3

1- fracture of a root
2- arrested root development with open apex
3- dens invaginatus (dens en dente)
4- absence of a root canal shadow

Front 4

PA granuloma

Back 4

- mass of chronically inflamed granulation tissue at the apex of a non-vital tooth root
- asymptomatic; maybe pain on exacerbation; no response to pulp testing
- apical lucent w/ loss of apical lamina dura; X-RAY EXACT SAME AS PA CYST
- treatment: RCT if restorable or extraction

Front 5

radicular cyst
apical periodontal cyst
PA cyst

Back 5

- most often 30-60 y/o
- apex of non-vital tooth, most often anterior maxilla
- well defined lucency at apex of non-vital tooth, focal loss of lamina dura
- deveolops from inflammatory stimulation of rests of Malassez
- incomplete removal --> residual cyst; usually asymptomatic, common oral lesion

Front 6

PA abscess

Back 6

- accumulation of acute inflammatory cells at apex of non-vital tooth
- can be symptomatic and asymptomatic; symptoms would include: pain, sensitivity to percussion, extrusion of tooth and swelling
- no response to cold or electric pulp testing
- maybe thickened PDL, ill-defined radiolucency or both (not necessarily will have these features, especially early on)
- can --> osteomyelitis, cellulitis, or sinus tract
- resolve w/ RCT or extraction

Front 7

osteomyelitis (name 6 types)

Back 7

- acute vs chronic; focal and diffuse sclerosing; proliferative periostitis; alveolar osteitis
- these diseases are uncommon in developed countries
- chronic systemic diseases, immunocompromised and decreased vascularity of bone predispose pts
- most often in mandible; diffuse radiolucency; maybe pain and pus production (if bacterial infection is cause)

Front 8

PA cemento-osseous dysplasia

Back 8

- 50 y/o, black-american women, mandible (apices of anterior teeth)
- starts as PA lucency that --> more opaque over time
- vital teeth, NO TREATMENT; asymptomatic

Front 9

traumatic bone cyst

Back 9

- 20 y/o, mandible
- defined lucency btw roots of teeth "scalloped" appearance
- dead space in bone w/out epithelial lining

Front 10

which are features suggestive of non-vital pulps
- history of trauma
- history of painful pulpitis
- dark or reddish hue of crown
- all of above
- only two of above

Back 10

all of above

Front 11

which of the following PA-lucent lesions is NOT sequelae of pulpitis
- PA granuloma
- radicular cyst
- abscess
- scar
- dentigerous cyst

Back 11

dentigerous cyst - this is developmental, no inflammation in etiology

Front 12

PA cemento-osseous dysplasia always appears as radiolucent lesion. T/F

Back 12

false

Front 13

traumatic bone cyst is classified as pseudocyst of bone because it does not have epithelial lining. T/F

Back 13

true

Front 14

which of following represents MOSTcommon type of pathologic radiolucency
- radicular cyst
- PA granuloma
- PA abscess
- PA scar

Back 14

PA granuloma

Front 15

dentigerous cyst

Back 15

- develops by separation of follicle from around crown of an unerupted tooth
- the MOST COMMON DEVELOPMENTAL tooth cyst @ 20% of all true cysts of jaws
- mostly 20-30 y/o, males, whites
- unilocular lucent area assoc w/ crown of unerupted tooth (3rd molar most often); well defined and often sclerotic border
- treatment: remove unerupted tooth, maybe leave behind for eruption; prognosis often excellent, may --> ameloblastoma, mucoepidermoid carcinoma, or squamous cell carcinoma from cystic epithelium

Front 16

nevoid basal cell carcinoma syndrome

Back 16

- autosomal dominant trait w/ high penetrance and variable expressivity (no single component present in all pts)
- multiple basal cell carcinomas of skin, jaw, cysts, rib and vertebral anomalies and intracranial calcification (among other clinical features)
- most anomalies are minor and not life-threatening; prognosis depends on behavior of the skin tumors

Front 17

unicystic ameloblastoma

Back 17

- 13% of all ameloblastoma cases
- pts are younger than those w/ conventional ameloblastomas, most often in 20 y/o; mandible posterior region
- lucent around crown of unerupted tooth)

Front 18

ameloblastoma
conventional solid/multicystic ameloblastoma

Back 18

- most common CLINICALLY SIGNIFICANT odontogenic tumor
- slow-growing, locally invasive and runs benign course
- posterior mandible most often
- lucent, well circumscribed, unilocular or multilocular (soap-bubble or honeycomb appearance; sometimes ill-defined w/ ragged border
- often asymptomatic but can --> paresthesia, erode cortical plates, and maybe painful if infected

Front 19

calcifying odontogenic cyst (COC)
gorlin cyst

Back 19

- uncommon lesion w/ histologic diversity and variable clinical behavior
- may or may not be neo-plastic (classified as neoplasm in 1992 WHO classification of cysts and tumors)
- 30 y/o; occurs in both jaws, mostly incisor-K9 region
- well defined, unilocular lucency, may have opaque foci; maybe multilocular; 33% assoc w/ unerupted tooth; may cause resorption and/or divergence
- aggressive intraosseous variety of this lesion has worst prognosis (maybe --> death)

Front 20

adenomatoid odontogenic tumor (AOT)
adenoameloblastoma (not used anymore)

Back 20

- 3-7% of all odontogenic tumors
- epithelial tumor often w/ inductive effect on odontogenic ectomesenchyme; dentinoid produced
- 20 y/o, females; anterior maxilla, assoc w/ crown of unerupted tooth
- pericoronal lucencies
- frequently asymptomatic and discovered on routine radiographic exam, or when searching for "missing" unerupted tooth

Front 21

ameloblastic fribroma

Back 21

- true neoplasm where epithelial and mesenchymal tissues are both neoplastic
- 10-20 y/o; posterior mandible
- unilocular or multilocular lucency; well-defined and may have sclerotic border; 50% assoc w/ unerupted teeth
- encapsulated, small tumors are often asymptomatic; larger ones can produce swelling and can be massive in size
- w/ conservative surgery, recurrence of 20% has been reported

Front 22

the follicular space of a developing tooth would appear as a pericoronal radiolucency. T/F

Back 22

true

Front 23

which of the following is true of dentigerous cyst
- may cause delayed eruption of a tooth
- may cause swelling
- may cause facial asymmetry
- all of above
- two of above

Back 23

all of above

Front 24

dentigerous (follicular cysts) are the SECOND most common odontogenic cysts, after the radicular cyst and the MOST common developmental odontogenic cyst. T/F

Back 24

true

Front 25

which of the following can appear as pericoronal lucencies according to textbook
- ameloblastoma
- ameloblastic fibroma
- adenomatoid odontogenic tumor
- all of above
- two of above

Back 25

all of above
adenomatoid odontogenic tumor is more common than the other two

Front 26

which of the following is seen most commonly in the anterior part of maxilla
- ameloblastoma, desmoplastic type
- ameloblastoma, solid or multicystic type
- adenomatoid odontogenic tumor
- all of above
- only two of above

Back 26

only two of above
desmoplastic type and adenomatoid odontogenic tumor

Front 27

focal osteioporotic defects (marrow spaces)

Back 27

- mostly females (70%), mandible posterior; multilocular multiple cystlike; asymptomatic w/ similar patterns contralaterally

Front 28

residual cyst

Back 28

- males, > 20 y/o ~ 50 y/o; maxilla; multilocular radiolucency; asymptomatic

Front 29

traumatic bone cyst
simple bone cyst
hemorrhagic bone cyst

Back 29

- more common in kids and young adult males
- mandible, above mandibular canal; asymptomatic, occasionally --> enlargement of bone
- lucency w/ characteristic scalloping around roots of teeth above mandibular canal

Front 30

stafne bone cyst
static bone cyst
static bone cavity

Back 30

- developmental depression in mandible often caused by submandibular gland
- adult males mostly; anterior to angle of mandible and inferior to mandibular canal
- asymptomatic; well-circumscribed lucency in mandible below mandibular canal; no treatment

Front 31

primordial cyst
OKC is preferred term

Back 31

- thought to originate from cystic degeneration of enamel organ before development of hard tissue - occurred in place of a tooth
- became odontogenickeratocyst (OKC) in 1950s
- OKC arises from cells rests of dental lamina
- any age, males in 60% of cases, molar area of mandible
- well defined lucent area w/ smooth margins; uni- or multi-locular; root resorption may occur, but not necessarily
- looks like dentigerous, radicular, residual, lateral periodontal or globulomaxillary cyst
- evaluate pt for Nevoid Basal Cell Carcinoma syndrome

Front 32

central giant cell granuloma CGCG

Back 32

- kids and young adults mostly; mostly in mandible, anterior
- well defined multilocular lucency, may be unilocular
- may be aggressive, low recurrence rare, usually asymptomatic
- rule out hyperparathyroidism as histology is similar

Front 33

cherubism

Back 33

- seen in kids; mandible mostly, uniform and bilateral
- bilateral multilocular radiolucencies
- autosomal dominant inheritance; face appears "cherub-like"; histologically similar to central giant cell granuloma
- stabilizes after puberty, uncommon condition

Front 34

odontogenic myxoma

Back 34

- 30 y/o avg; mostly posterior mandible
- lucent lesion multilocular (sometimes honeycombed); may have poorly defined periphery
- tumors may exhibit aggressive behavior; no symptoms but swelling and recurrence

Front 35

aneurysmal bone cyst

Back 35

- 20 y/o; both jaws, also in bones and vertebrae
- lucent lesion which may be poorly defined; honeycomb appearance or soap-bubble multilocular lucent
- a vascular anomaly in bone; blood wells up when lesion entered
- rare lesion, follow-up is important

Front 36

aneurysmal bone cyst is a true cyst because it has an epithelial lining. T/F

Back 36

false - it has no lining, therefore not a true cyst

Front 37

which of the following is a cyst that is found "in place of a tooth"
- dentigerous cyst
- radicular cyst
- odontogenic keratocyst
- lateral periodontal cyst
- primordial cyst

Back 37

primordial cyst

Front 38

which of the statements below is true concerning gender predilection of giant cell lesions of hyperparathyroidism
- mostly males
- mostly females
- equal frequency

Back 38

mostly females

Front 39

stafne cyst occurs most commonly in which of the following locations
- anterior maxilla
- posterior maxilla
- anterior mandible
- posterior mandible

Back 39

posterior mandible

Front 40

which of the following is a solitary cystlike radiolucency NOT necessarily contacting teeth
- traumatic bone cyst
- primordial cyst
- both of above

Back 40

both of above

Front 41

chronic osteitis

Back 41

- mostly males, 5-15 y/o and 50-80 y/o; usually associated w/ root of pulpless tooth; cyst-like lucent-opaque

Front 42

chronic osteomyelitis

Back 42

- males, mandible, premolar-molar, angle, symphysis
- history of debiliation, slow course
- lucent w/ opaque foci

Front 43

squamous cell carcinoma

Back 43

- males, 40-80 y/o, mandibular molar
- hx of tobacco/alcohol use; metastasizes frequently
- lucent w/ opaque foci (like chronic osteomyelitis)

Front 44

fibrous dysplasia (early stage)

Back 44

- 10-20 y/o, rare in anterior maxilla and symphysis
- NO PAIN, NO PARESTHESIA, NO ROOT RESORPTION, SLOW GROWING AND ASYMPTOMATIC
- variants: monostotic; polyostotic w/ endocrine (McCune Albright); polyostotic w/out endocrine (Jaffe-Lichenstein)

- GROUND GLASS, mottled or smoky

Front 45

metastatic tumors to the jaws

Back 45

- most comon form of cancer involving bone in mankind; vertebra, ribs, pelvis and skull are most frequent sites of metastases
- jaws usually considered uncommon sites but may be involved more frequently than reported
- mandible is most likely site for met (vs. maxilla); most often from breast, lung, thyroid, prostate and kidney
- asymptomatic to severe pain, swelling, loosening of teeth
- lucent defect which may be well-circumscribed or ill-defined w/ "moth eaten" appearance
- prognosis is poor, as met to bone places pt in stage IV; <1 year survival

Front 46

osteosarcoma

Back 46

- males 10-40 y/o body of mandible
- metastasizes by vascular route to lungs and other organs
- swelling, pain, paresthesia, tooth mobility
- mixed widening of PDL space

Front 47

chondrosarcoma

Back 47

- males ~30 y/o; swelling, pain, paresthesia
- widening of PDL and canals

Front 48

nevoid basal cell carcinoma
clinical features in order of frequency (high, moderate, low)

Back 48

high: multiple basal cell carcinoma, ODK, epidermal cysts of skin, palmar/plantar pits, calcified falx cerebri, enlarged head circumference, rib anomalies (bifid), mild ocular hypertelorism, spina bifida oculta

moderate: calcified ovarian fibromas, short 4th metacarpals, ...

low: medulloblastoma, meningioma, mental retardation, ...

Front 49

multiple myeloma

Back 49

- most common primary malignant tumor of bone; proliferation of single clone of abnormal plasma cells
- 40-70 y/o; usually in skull, clavicle, vertebrae, ribs, pelvis, femurs, jaw - mandibular involvement
- pain, paresthesia of teeth, mobility or migration of teeth
- increased susceptibility to anemia
- increased alkaline phosphatase; poor prognosis

Front 50

langerhans cell disease
histiocytosis X

3 variants: Letterer-Siwe, Hand-Schuller-Christian, and Eosinophilic Granuloma

Back 50

Lettererer-Siwe: acute disseminated form w/ orans and bone affected; seen in infants and is fatal

Hand-Schuller-Christian: chronic disseminated form w/ bony lesion, exophthalmos, diabetes insipidus and organ lesions; seen in kids, fair prognosis

Eosinophilic granuloma: chronic localized form, affects only bone; seen in kids and young adults - good prognosis

in all: single or multiple lucent lesions - "punched out", teeth described as "floating-in-air"

Front 51

primary hyperparathyroidism

Back 51

- 30-60 y/o females, mandible
- multilocular lucent w/ indistinct borders; "ground glass"
- polydipsia, polyuria, elevated serum calcium and alkaline phosphatase

Front 52

secondary hyperparathyroidism

Back 52

- females, 50-80 y/o, mandible
- multilocular lucent w/ indistinct borders; "ground glass"
- hx of kidney disease; serum phosphate and alkaline phosphate levels elevated

Front 53

osteoporosis

Back 53

- most often postmenopausal; also caused by endocrine disorders, neoplasia, and GI-disorders
- serum calcium, phosphorous, and alkaline phosphatases are all normal

Front 54

osteomalacia
(similar to rickets seen in children)

Back 54

- DEFECT IN MATRIX MINERALIZATION: inadequate synthesis or dietary deficiency of vit D; decreased absorption of fat-soluble vit D; derangement in vit D metabolism; phosphate depletion
- bone that forms during remodeling is undermineralized --> loss of skeleltal mass (osteopenia) ---> bony fractures
- decreased serum calcium and phosphorous; increased serum alkaline phosphatase

Front 55

rickets
(similar to osteomalacia seen in adults)

Back 55

- disorder in children where deranged bone growth produces distinctive skeletal deformities
- frontal bossing, craniotabes, squared appearance of head, "richitic rosary", "pigeon breast" deformity, lumbar lordosis and bowing of legs

Front 56

radiographic changes that may occur in pt w/ leukemia

Back 56

- formation of tooth crowns may be incomplete and delayed
- cortices of tooth crypts may be partially or completely destroyed
- there may be enlargement of crypts w/ failure of bone formation about the apical portion of erupting or developing teeth
- developing tooth may assume asymetric position w/in the crypt
- incompletely formed crowns may be situated entirely above the alveolar crest
- partially formed teeth may have excessively rapid eruption

Front 57

according to textbook, most solitary lucencies w/ ragged and indistinct borders are produced by 3 basic types of pathologic processes; these are...

Back 57

- inflammation
- fibrous dysplasia
- osteolytic malignancy

Front 58

according to textbook, blood chemistry values are pathognomonic for all diseases of bone. T/F

Back 58

false - note the "ALL diseases of bone"

Front 59

fibrous dysplasia is a precancerous lesion occurring mostly in the elderly. T/F

Back 59

false - fibrous dysplasia is non-cancerour and seen in 18-20 y/o

Front 60

multiple myeloma is a malignant tumor composed of which of the following
- langerhans cells
- plasma cells
- lymphocytes
- epithelial cells
- osteoblasts

Back 60

plasma cells

Front 61

leukemia may cause which of the following
- incomplete formation of tooth crowns
- partial or complete destruction of the cortices of tooth crypts
- enlargement of tooth crypts w/ failure of bone formation about the apical portion of the developing or erupting tooth
- all of the above

Back 61

all of the above

Front 62

periapical cemento-osseous dysplasia

Back 62

- females mostly, 40+ y/o, black, anterior mandible
- vital teeth; circular, < 1 cm, well defined margins w/ lucent rim, often multiple

Front 63

cemento-ossifying fibroma

Back 63

- 20-30 y/o females, mostly in mandible posterio
- circular, 2-5 cm, well-demarcated, solitary lucent-opaque lesion

Front 64

cementoblastoma
benign cementoblastoma
true cementoma

Back 64

- 20-30 y/o, mandible, roots of posterior teeth
- attached to and replaceing root of tooth; tooth viable opaque spicules radiate from central area
- slow growth; local expansion may occur; usually asymptomatic
- surgical extraction w/ attached mass

Front 65

odontoma

Back 65

- most common odontogenic tumor; a developmental anomaly (hamartoma) rather than a true neoplasm
- 2 types: COMPOUND - multiple small tooth-like structures; vs. COMPLEX - conglomerated mass of enamel and dentin, no anatomic resemblance to a tooth
- early lesions are lucent w/ smooth contours, later --> well-defined radiopaque
- most are small and asymptomatic; large can cause jaw expansion

Front 66

adenomatoid odontogenic tumor (AOT)

old term: adenoameloblastoma

Back 66

- epithelial tumor w/ inductive effect on odontogenic ectomesenchyme and dentinoid can be produced
- 3-7% of all odontogenic tumors
- 20 y/o females; mostly maxilla K9 region (65%) w/ 95% in anterior
- pericoronal lucency which may have opaque material in it - "snow flake" calcification

Front 67

calcifying odontogenic cyst (COC)
gorlin cyst
dentinogenic ghost cell tumor

Back 67

- wide histologic diversity and variable clinical behavior
- some are non-neoplastic, some are seen as neoplasms
- mostly females in antrerior; well-defined, unilocular lucency but may have opaque foci

Front 68

ameloblastic fibro-odontoma

Back 68

- tumor w/ general features of an ameloblastic fibroma but containing enamel and dentin
- 5-12 y/o, in premolar/molar region
- lucent defect that contains variable amts of calcified material w/ density of tooth structure; calcifed material can appear as multiple small opacities or as solid conglomerate; often assoc w/ unerupted tooth

Front 69

calcifying epithelial odontogenic tumor (CEOT)
pindborg tumor

Back 69

- <1% of all odontogenic tumors; tumor cells resemble cells of stratum intermedium
- 75% in mandible, mostly posterior region
- lucent w/ or w/out opaque foci; well-circumscribed
- bony lesion most often painless, slow-growing swelling; if periperally located - non-specific sessile gingival mass

Front 70

which of the following may appear as a mixed lucent/opaque lesion associated w/ teeth
- PA cemento-osseous dysplasia
- adenomatoid odontogenic tumor
- cemento-ossifying fibroma
- all of above
- two of above

Back 70

all of above

Front 71

which of the following statements is true of PA cemento-osseous dysplasia
- may appear as lucent lesion (osteolytic)
- may appear as mixed lucent/opaque lesion
- may appear as opaque lesion
- all of above
- none of above

Back 71

all of above

Front 72

what is the predominant age predilection for odontomas

Back 72

5-20 years

Front 73

which is true of adenomatoid odontogenic tumors (AOTs)
- more common in females
- site predilection in mandible
- may appears as mixed lucent/opaque lesion
- all of above
- 2 of above

Back 73

2 of above
more common in females
may appear as mixed lucent/opaque lesion

Front 74

a periapical rarefying and condensing osteitis could present as a mixed lucent/opaque lesion. T/F

Back 74

true

Front 75

ossifying post-surgical bony defect

Back 75

- males, mandible
- history of surgery

Front 76

chronic osteomyleitis and osteoradionecrosis

Back 76

- mostly males, 40-80 y/o, mostly body of mandible
- precipitated by trauma, diabetes, Paget disease and/or radiation exposure (in osteoradionecrosis)

Front 77

proliferative periostitis
garre's osteomyelitis

Back 77

- periosteal reaction to presence of inflammation
- affected periosteum forms several rows of reactive vital bone that parallel each other and expand the bone
- 13 y/o, mandible posterior
- most often caused by caries w/ spread to periosteum
- opaque laminations (w/ lucency in btw) of bone that parallel each other
- if bony destruction is seen in association w/ cortical surface or new periosteal bone, then consider possibility of neoplastic process (Ewing Sarcoma)

Front 78

fibrous dysplasia

Back 78

- 10-20 y/o, posterior regions of jaws
- no pain, paresthesia, nor root resorption; slow expansion
- non-circular, borders poorly defined; GROUND GLASS, mottled pattern

Front 79

paget disease (of bone): intermediary stage
osteitis deformans

Back 79

- males, 40+ y/o, maxilla
- cotton-wool appearance; multiple bones involved, elevated serum alkaline phosphatase
- diffuse lucent-opaque changes; opaque described as "cotton-wool"; hypercementosis, obliteration of lamina dura and PDL-space; sometimes root resorption
- may have pain, deafness, blindness, and headache because of bone changes; may complain of DENTURE BEING TOO TIGHT, diastemas may develop

Front 80

cemento-ossifying fibroma

Back 80

- ~26 y/o; 70% in mandible, posterior
- circular 2-5 cm, well-demarcated

Front 81

osteosarcoma
osteogenic sarcoma

Back 81

- males, 10-40 y/o (peak 27); often body of mandible
- sunburst radiographic appearance (can appear differently, however)

Front 82

chodrosarcoma (malignant) and chondroma (benign)

Back 82

- 30-60 years; anterior maxilla, posterior mandible
- maybe pain, difficult to distinguish benign from malignant

Front 83

osteoblastic metastatic carcinoma

Back 83

- 40-80 y/o, body of mandible
- hx of prostate or breast cancer is very helpful

Front 84

condensing osteitis
FOCAL SCLEROSING OSTEOMYELITIS
sclerosing osteitis

Back 84

- know other names (other side of card)
- localized areas of bone sclerosis associated w/ apices of teeth w/ pulpitis or pulpal necrosis
- more common in youth, posterior mandible
- dental pulp demonstrates pulpitis or necrosis
- localized, uniform zone of increased radiodensity adjacent to apex of tooth that has thickened PDL of apical inflammatory lesion
- no lucent border and is not separated from apex (lesion is AT THE APEX)

Front 85

periapical idiopathic osteosclerosis

Back 85

- focal area of increased radiodensity that is of unknown cause and cannot be attributed to any inflammatory, dysplastic, neoplastic or systemic disorder
- 30 y/o peak, 90% in mandible premolar area
- well-defined rounded or elliptic opacity; may be from 3 mm - 2.0 cm
- mostly at apex, can be interradicular

Front 86

cementoblastoma
true cementoma
benign cementoblastoma

Back 86

- mostly kids and young adults <30 y/o, 75% mandible, 90% posterior - mostly mandibular 1st molar
- mass appears opaque that is fused to one or more tooth roots and is surrounded by thin lucent rim; outline of root often obscured as result of resorption and fusion w/ tumor
- rarely produces pain, asymptomatic; maybe cortical expansion; involved tooth is vital

Front 87

name 4 benign fibro-osseous lesions

Back 87

1- periapical cemento-osseous dysplasia
2- focal cemento-osseous dysplasia
3- florid cemento-osseous dysplasia
4- fibrous dysplasia

Front 88

periapical cemento-osseous dysplasia (mature stage)

Back 88

- 50 y/o black females, mandible anterior; asymptomatic, multiple teeth, vital
- well-defined lucency-opacity (depending on stage) at apex of tooth
- no treatment required

Front 89

focal cemento-osseous dysplasia

Back 89

- mostly whilte females 30-50 y/o, posterior mandible; asymptomatic, vital teeth
- well-defined lucency-opacitiy
- no treatment required

Front 90

hypercementosis

Back 90

- excessive formation of cementum on the surface of the root of the tooth
- etiology not understood, maybe assoc w/ periapical inflammatory conditions, periapical cemento-osseous dysplasia, and system diseases (Paget, acromegaly)

Front 91

which of the following may be mixed lucent/opaque lesion not necessarily contacting teeth
- fibrous dysplasia
- chronic osteomyelitis
- osteobalstic metastatic carcinoma
- all of above
- two of above

Back 91

all of above

Front 92

which of following is malignant mixed lucent/opaque lesion
- fibrous dysplasia
- osteogenic sarcoma (osteosarcoma)
- ossifying subperiosteal hematoma
- paget disease (ostetitis deformans)
- all are benign lesions

Back 92

osteogenic sarcoma (osteosarcoma)

Front 93

a rectangular, indistinct, lesion of maxilla of 14 y/o pt would more likely be diagnosed as which of the following
- fibro-osseous lesion of PDLO
- fibrous dysplasia

Back 93

fibrous dysplasia

Front 94

Paget disease most commonly affects the maxilla of pts over age 40. T/F

Back 94

true

Front 95

which of the following is most helpful in identifying an ossifying post-surgical bony defect
- x-ray
- hx of surgery
- clinical features of tenderness and swelling

Back 95

hx of surgery

Front 96

on x-ray, tori, exostoses and periosteal osteomas may appear as single or multiple, smoothly contoured, somewhat dense radiopaque mass. T/F

Back 96

true

Front 97

which of the following terms has been used to describe the radiographic appearance of fibrous dysplasia
- orange peel
- stippled
- salt-and-pepper
- ground glass
- all of above

Back 97

all of above

Front 98

excessive formation of cementum on the surface of the root of the tooth is termed
- FCOD
- hypercementosis
- osteosclerosis
- osteitis

Back 98

hypercementosis

Front 99

calcareous (radiopaque) deposits in the ducts of the major or minor salivary glands or within the glands themselves are given which of the following terms
- rhinoliths
- antroliths
- phleboliths
- sialoliths

Back 99

sialoliths

Front 100

which of the following would NOT appear as PA-opacity
- PA cemento-osseous dysplasia
- PA cyst
- PA idiopathic osteoscllerosis
- condensing osteitis

Back 100

PA cyst

Front 101

tori and exostoses

Back 101

- cause unknown, most likely combo of genetic and environment
- both are most common in females
- tori are located on palate and lingual aspect of mandible
- exostoses are more commonly found on buccal aspect of alveolar bone
- asymptomatic unless traumatized, often removed for prosthetic devices

Front 102

cleidocranial dysplasia

Back 102

- autosomal dominant condition w/ gene 6p21
- affects skull, clavicles and teeth
- short neck, complete or partial abscence of clavicles; large head w/ frontal, parietal and occipital bossing; fontanelles open and maxilla hypoplastic; highest number of supernumerary teeth than other conditions
- no specific treatment but extractions and ortho

Front 103

gardner syndrome

Back 103

- autosomal dominant trait involving gene 5q21-q22; affects both maxilla and mandible
- multiple osteomas, supernumerary teeth, COLON POLYPS --> COLON CANCER

Front 104

florid cemento-osseous dysplasia

Back 104

- black 40+ y/o females
- multiple areas of mixed lucency to opacity
- no treatment unless complicated by osteomyelitis

Front 105

osteopetrosis
marble bone
Albers-Schonberg disease

Back 105

- genetic diseases that are characterized by reduced osteoclastic bone resorption resulting in diffuse symmetric skeletal sclerosis
- 4 types based on mode of inheritance and clinical findings:
- infantile malignant - fractures, anemia, hydrocephaly and more complications if pt survives
- autosomal dominant benign - may not be detected until young adulthood w/ repeated fractures; bone marrow transplants have reversed some skeletal defects

Front 106

florid cemento-osseous dysplasia is the most common cause of pathologic generalized radiopacity of jaws. T/F

Back 106

true

Front 107

Paget disease may appear radiographically as
- a generalized rarefaction
- mixed lucent-opaque lesion
- "cotton-wool" opacity
- all of above
- none of above

Back 107

all of above

Front 108

osteopetrosis is the name given to a group of diseases that affect growth and remodeling of bone. T/F

Back 108

true

Front 109

teeth associated w/ lesion of periapical cemento-osseous dysplasia are typically
- vital
- non-vital
- extracted
- deformed
- exfoliated

Back 109

vital

Front 110

pt complains of pain in floor of mouth particularly around meal time; note swelling, firm to palpation; opaque on x-ray; most likely...

Back 110

sialolith

Front 111

which is most likely for non-vital, mixed opaque-lucent lesion observed at apices of molar tooth
- PA granuloma
- PA abscess
- PA cyst
- idiopathic osteosclerosis
- rarefying and condensing osteitis

Back 111

rarefying and condensing ostetitis

Front 112

55 y/o female that has been on steroids and antibiotics for over 2 weeks because of pulmonary infection; white lesions observed were easily removed w/ tongue blade leaving raw bleeding surface; these white lesions are most likely:
- atrophic (erythematous) candidiasis
- pseudomembranous candidiasis
- chemical burns
- sites of a spreading bacterial infection
- ANUG

Back 112

pseudomembranous candidiasis

Front 113

11 y/o girl; chief complaint = pain and bleeding from gingival along w/ epistaxis and fatigue; both sides of mandible present w/ x-ray lesion (pictured on exam) but maxilla is normal; pt is most likely suffering from:
- sickle cell anemia
- thalassemia
- uncontrolled diabetes
- leukemia
- hyperparathyroidism

Back 113

leukemia

Front 114

20 y/o female health hx = multiple cysts removed from face and forehead; family hlth hx = colon cancer; w/ associated x-ray, this pt may have:
- plummer-vinson syndrome
- gardner syndrome
- nevoid basal cell carcinoma syndrome
- cushing syndrome
- von recklinghausen disease

Back 114

gardner syndrome

Front 115

projected painless, ragged, ill-defined radiolucency observed in 70 y/o male is most likely:
- dentigerous cyst
- fibrous dysplasia
- infection/inflammation or malignancy
- ameloblastic fibroma
- ameloblastic fibro-odontoma

Back 115

infection/inflammation or malignancy

Front 116

asymptomatic mixed lucent-opaque lesion at apex of vital tooth (seen on slide part of exam)...
- focal cemento-osseous dysplasia
- rarefying and condensing osteitis
- complex odontoma
- fibrous dysplasia
- mandibular torus

Back 116

focal cemento-osseous dysplasia

Front 117

which of the following is MOST likely diagnosis of slow-growing, bony-hard, exophytic growth on midline of palate that has been present for years
- pleomorphic adenoma or mixed tumor
- palatal cyst
- torus palatinus
- nasopalatine cyst
- mucocele

Back 117

torus palatinus

Front 118

median rhomboid glossitis is MOST commonly associated w/ which of the following
- A. staph. aureus
- Actinomyces israelii
- mycobacterium tuberculosis
- Candida albicans
- herpes simplex

Back 118

candida albicans

Front 119

MOST common cause of mucocele

Back 119

severing of or trauma to a minor salivary gland

Front 120

which of the following is example of a "true" cyst
- aneurysmal bone cyst
- traumatic bone cyst
- residual cyst
- all of above
- 2 of above

Back 120

residual cyst

Front 121

which of the following disease entities may commonly manirfest a positive Nikolksy sign
- pemphigus vulgaris
- lichen planus, reticular type
- cicatrical pemphigoid
- all of above
- 2 of above

Back 121

2 of above
pemphigus vulgaris
cicatrical pemphigoid

Front 122

which is associated w/ chronic osteomyelitis
- radiation therapy involving bone
- sickle cell anemia
- Paget disease
- all of above
- 2 of above

Back 122

all of above

Front 123

which is true of conventional solid/multicystic ameloblastoma
- occur most often in posterior portion of mandible
- slow growing odontogenic tumors that may cause bone expansion
- treatment consists of marginal resection w/ at least 1 cm margin
- all of above
- 2 of above

Back 123

all of above

Front 124

odontoma is best classified as...
- neoplasm
- choristoma
- developmental (hamartoma) lesion
- inflammatory lesion
- immunological lesion

Back 124

developmental hamartoma

Front 125

most common primary malignant tumor of bone in pts < 40 y/o

Back 125

osteosarcoma

Front 126

which of following is common component of McCune-Abright syndrome:
- polyostotic fibrous dysplasia
- multiple basal cell carcinomas
- multiple oral papillomas
- multiple odontogenic keratocysts
- adenocarcinomas of colon

Back 126

polyostotic fibrous dysplasia

Front 127

synonym for osteitis deformans

Back 127

Paget disease of bone

Front 128

which of following is true of focal cemento-osseous dysplasia
- it is commonly associated w/ non-vital teeth
- occurs most often in posterior mandible
- blacks > whites
- all of above
- 2 of above

Back 128

occurs most commonly in posterior mandible

Front 129

cafe au lait spots are commonly seen in which of the following disease entities
- Paget disease
- Letterer-Siwe disease
- McCune-Albright syndrome
- osteogenesis imperfecta
- osteomalacia

Back 129

McCune-Albright syndrome

Front 130

true of sickle cell anemia
- occurs as result of a point mutation
- weakness, shortness of breath and fatigue are common symptoms
- "hair-on-end" radiographic appearance may occur
- all of above
- 2 of above

Back 130

all of above

Front 131

hypercalcemia, renal stones, and abnormal bone metabolism w/ bone pain are characteristics most closely associated w/ which condition...

Back 131

hyperparathyroidism

Front 132

osteomalacia in kids is called...

Back 132

rickets

Front 133

which of the following is useful in diagnosis of Paget disease of bone
- serum alkaline phosphatase
- serum acid phosphatase
- complete blood count
- serum calcium
- serum vitamin D

Back 133

serum alkaline phosphatase

Front 134

the MOST common odontogenic tumor

Back 134

odontoma

Front 135

example of true mixed tumor where epithelial and mesenchymal tissues are both neoplastic...

Back 135

ameloblastic fibroma

Front 136

which histopathologic variant of unicystic ameloblastoma may warrant a more aggressive surgical approach according to some authorities
- luminal
- intraluminal/plexiform
- mural
- desmoplastic
- granular

Back 136

mural

Front 137

which of the following statements is true of odontomas
- odontoma is true neoplasm
- most odontomas are discovered in 20-30 y/o
- compound odontomas are composed of enamel, dentin, and cementum that is arranged in a random pattern bearing no morphological resemblance to normal teeth
- all of above
- 2 of above

Back 137

compound odontomas are composed of enamel, dentin, and cementum that is arranged in a random pattern bearing no morphological resemblance to normal teeth

Front 138

a "ground-glass" x-ray appearance is most closely associated w/ which disease
- proliferative periostitis
- osteosarcoma
- hyperparathyroidism
- osteitis deformans
- ewing sarcoma

Back 138

hyperparathyroidism

Front 139

which of the following usually presents as a PERICORONAL radiolucency
- unicystic ameloblastoma
- radicular cyst
- stafne cyst
- all of above
- 2 of above

Back 139

unicystic ameloblastoma

Front 140

which of these statements is true of periapical granuloma
- it is a true granuloma
- can be differentiated from periapical cyst based strictly on x-ray
- typically associated w/ non-vital teeth
- all of above
- 2 of above

Back 140

periapical granulomas are typically associated w/ non-vital teeth

Front 141

which of the following statements is true of dentigerous cyst
- most common inflammatory odontogenic cysts
- ameloblastomas have been reported to arise from the lining of dentigerous cysts
- dentigerous cysts are most commonly associated w/ max K9
- all of above
- 2 of above

Back 141

ameloblastomas have been reported to arise from lining of dentigerous cysts

Front 142

which type of ameloblastoma occurs most commonly in anterior maxilla and may appear as mixed lucent/opaque lesion

Back 142

desmoplastic

Front 143

in which of the following does the conventional solid/multicystic ameloblastoma VARY from the ameloblastic fibroma
- common radiographic appearance
- site of predilection
- avg age of pt at diagnosis
- all of above
- 2 of above

Back 143

avg age of pt at diagnosis

Front 144

which of the following statements is true of adenomatoid odontogenic tumor
- femal gender predilection
- mostly in posterior mandible
- often encapsulated
- all of above
- 2 of above

Back 144

2 of above
female gender predilection
often encapsulated

Front 145

which of following most commonly presents as unilocular radiolucency
- ameloblastoma
- ameloblastic fibroma
- cementoblastoma
- dentigerous cyst
- ameloblastic fibro-odontoma

Back 145

dentigerous cyst

Front 146

"sunburst" radiographic appearance is most closely associated w/ which of following
- proliferative periostitis
- osteosarcoma
- Paget disease
- fibrous dysplasia
- ewing sarcoma

Back 146

osteosarcoma

Front 147

"onion-skin" radiographic appearance is most closely associated w/ which disease...

Back 147

proliferative periostitis

Front 148

which is true of fibrous dysplasia
- typically slow growing
- typically painful
- in pts < 25 y/o
- all of above
- 2 of above

Back 148

2 of above
slow growing
in pts < 25 y/o

Front 149

which statement is true of langerhans cell disease
- multiple "punched-out" areas of lucency
- "tooth floating in air" x-ray appearance
- eosinophilic granuloma subtype has only bony lesions
- all of above
- 2 of above

Back 149

tooth floating in air x-ray appearance

Front 150

which is true of proliferative of periostitis
- most common in pts < 20 y/o
- most commonly assoc w/ dental caries
- often assoc w/ non-vital tooth
- all of above
- 2 of above

Back 150

all of above

Front 151

which may appear as generalized lucency (generalized rarefaction)
- osteoporosis
- osteopetrosis
- hyperparathyroidism
- all of above
- 2 of above

Back 151

2 of above
osteoporosis
hyperparathyroidism

Front 152

type of oral leukoplakia MOST LIKELY to undergo malignant transformation

Back 152

proliferative verrucous leukoplakia

Front 153

site prediliection for oral squamous cell carcinoma

Back 153

tongue - lateral border

Front 154

clinical feature MORE CONSISTENT w/ recurrent aphthous ulcers - MINOR TYPE vs. recurrent herpes simplex infection

Back 154

lesions usually occur as single ulcers

Front 155

MOST COMMON type of oral mucosal disorder

Back 155

traumatic ulcers

Front 156

which statement is true of oral papilloma
- caused by EBV
- often undergoes malignant change
- rough, warty (cauliflower-like) appearance
- often invades adjacent tissues
- all of above

Back 156

rough, warty appearance

Front 157

solitary, asymptomatic white lesion in 60 y/o male - heavy drinker and smoker; which is best diagnosis of this adherent white lesion
- lichen planus
- pseudomembranous candidiasis
- leukoedema
- leukoplakia
- frictional keratosis

Back 157

leukoplakia

Front 158

asymptomatic mixed lucent-opaque at apices of viable mandibular incisors is most likely
- odontoma
- osteoma
- periapical cemento-osseous dysplasia
- calcifying odontogenic cyst
- florid cemento-osseous dysplasia

Back 158

periapical cemento-osseous dysplasia

Front 159

which is true of pyogenic granulomas
- female predilection
- often red and may bleed easily due to high degree of vascularity
- conservative surgical excision is treatment choice
- all of above
- 2 of above

Back 159

all of above

Front 160

which is considered to be oral precancerous condition
- leukoplakia
- erythroplakia
- oral submucous fibrosis
- all of above
- 2 of above

Back 160

all of above

Front 161

severe epithelial dysplasia, carcinoma-in-situ or squamous cell carcinoma is discovered in approx what % of oral leukoplakic lesions...

Back 161

5%

Front 162

MOST common oral cancer

Back 162

squamous cell carcinoma

Front 163

malignant tumor characterized by monoclonal spike on immunoelectrophoresis

Back 163

multiple myeloma

Front 164

most common odontogenic cyst of jaws

Back 164

apical periodontal cyst

Front 165

which of the following lesion may present w/ ragged and poorly defined borders
- osteolytic osteosarcoma
- fibrous dysplasia, early stage
- chronic osteomyelitis
- all of above
- 2 of above

Back 165

all of above

Front 166

which has age predilection for pts over 40 y/o
- acute leukemia
- proliferative periostitis
- paget disease
- fibrous dysplasia
- cherubism

Back 166

paget disease

Front 167

which of these may present w/ more than one radiographic appearance (lucent, opaque, or mixed)
- periapical cemento-osseous dysplasia
- osteosarcoma
- calcifying odontogenic cyst
- fibrous dysplasia
- all of above

Back 167

all of above

Front 168

pt presents w/ ulcerated lesion w/ rolled borders on face; panorex reveals multiple cyst-like lucencies diagnosed as OKCs; family member has same diagnosis; which syndrome is pt most likely to have...

Back 168

peutz-jeghers syndrome