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25 Cards in this Set
- Front
- Back
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traumatic bone cyst
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developmental
scallop b/t roots tx: enter cavity which causes bleeding and a clot which organizes and the defect fills in |
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lingual mandibular salivary gland depression
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aka stafne cyst aka static bone cyst
adult males radiolucency below IA canal diagnosed by xray no treatment |
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focal osteoporotic bone marrow defect
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post mand.
middle aged females at old extraction site no tx, excellent prognosis |
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idiopathic osteosclerosis
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dense bone island
premolar/molar region radiopaque no expansion no tx; biopsy NOT necessary |
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cherubism
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autosomal dominant
children asymptomatic bilateral swelling of post mand multilocular expansile radiolucencies displacement of teeth bx shows benign giant cell lesion tx: unsure |
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osteogenesis imperfecta
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defective collagen
depends on severity(autosomal dominant vs. recessive) severe: death during birth (crushed) blue sclera or DI tx: set fractures, if DI is present treat teeth |
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osteopetrosis
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lack of osteoclasts
obliteration of marrow spaces autosomal recessive is more severe pancytopenia (low rbc's, wbc's and platelets) due to myelophthisic anemia blindness due to pressure on optic nerve teeth slow to erupt or impacted b/c they can't get through the dense bone overall density of skeleton tx: transfusions, antibiotics for infection, bone marrow transplant...most patients die before age 20 |
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cleidocranial dysplasia
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autosomal dominant
born w/o clavicles many impactions supernumerary teeth shoulders sloped down and chest sunk in primary dentition is retained need combo of surgery and ortho |
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Paget's disease
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aka osteitis deformans
elderly the affected bones are extremely active (haphazard resorption and deposition) males bowing of legs (simian stance) increased head circumfrence maxilla xray: cotton wool hypercementosis elevated alkaline phosphatase mosaic pattern under microscope tx: nothing good; bisphosphonates neuro complications due to bone formation around foramina osteosarcoma may arise |
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fibrous dysplasia
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monostotic vs. polyostotic
mon: more severe, usually maxialla, not inherited (post zygotic mutation) poly: jaffe (cafe au lait coast of maine) and mccune albright (cafe au lait plus early puberty...endocrine effects) young people either sex maxilla ground glass xray chinese character microscope tx: do NOT do radiation...may lead to malignant transformation |
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hyperparathyroidism
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primary vs secondary
primary: hyperplasia, adenoma, or carcinoma of parathyroid, female over 60 y.o., "stones, bones, groans", tumor must be removed secondary: associated w/ renal failure (during renal dialysis), no tx necessary but vit. d helps, may see renal osteodystrophy w/ poorly controlled secondary causing jaw enlargment ground glass loss of lamina dura micro: brown tumor (unilocular or multilocular) looks identical to central giant cell granuloma |
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cemento-osseous dysplasia
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black females
spectrum of severity: periapical-focal-florid comes from PDL fibroblast periapical: mandib ant, middle aged black females, radiolucent around apices then develops central radiopacity; no tx focal: black fem. 20-40, body of mand, lucency develops central pacity, need biopsy for diagnosis (small, gritty fragments) florid: middle aged and older black females, multiple quads, radiopacities w/ surrounding radiolucencies, expansion, if exposed to oral env sequestraion is problem (so maintain the teeth so the calcified masses arent exposed to oral cavity) PA and florid dx by xray and clinical; focal needs biopsy, focal have irreg trabeculae looking like woven bone or cellular cementum no tx for pa curette focal (after incisional biopsy) florid: maintain teeth to prevent exposure and infection |
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osteoma
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benign neoplasm
hard to touch slow growing tx: conservative excision |
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gardner syndrome
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autosomal dominant
intestinal polyps, epidermoid cysts, desmoid tumors, and multiple osteomas affecting jaws or face polyps are precancerous multiple radioPAQUE masses in jaws impacted supernumerary teeth tx: colectomy ASAP (b/c if not pt will have colon cancer by age 30...chance is 100%), genetic counseling |
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central giant cell granuloma
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young person ant. mandible crossing midline
uni or multilocular, expansile radulucency looks same as brown tumor of hyperparathyroidism under microscope tx: curetage; recur 15-20% but keep curettaging |
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langerhans cell histiocytosis
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monoclonal proliferations of langerhans cells (a type of monocyte)
3 forms: acute disseminated histiocytosis (letterer-siwe disease; infants; skin rash with liver and spleen problems, very aggressive; poor prognosis; need chemo) chronic disseminated (hand-schuller-christian; older kids; triad of exopthalmos, diabetes insipidus w/ pitu involv, and bone lesions, guarded prognosis; need radiation and/or chemo) eosinophilic granuloma of bone: (monostotic in older adults and polyostotic in teens; well defined but not corticated lucency, histiocytes mixed with eosinophils, need to curette or radiation) "floating teeth with punched out lesions" xrays kinda resemble periodontitis |
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ossifying fibroma
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confused with focal cod in the past
mandib premolar/molar adult females 3rd or 4th decade unilocular lucency w/ varying central calcification (sometimes completely radiolucent) removed in one large piece (as opposed to focal cod which comes out as gritty pieces) irregular spicules of material (looks like either immature bone or cellular cementum) tx: enucleation b/c so well circumscribed, excellent prognosis, recurrence is rare |
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chondrosarcoma
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cartilaginous differentiation
rare adults complain of swelling, pain or loose teeth xrays vary...radiolucent through radiopaque, ill defined margins invasive lobules of cartilaginous appearing tissue tx: radical surgical excision, poor prognosis, death results from uncontrolled local disease not metastisis |
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osteosarcoma
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most common primary bone malignancy
2x as common as chondrosarcoma but still very rare 900 cases/yr and only 7% affect jaws of longbones: age 18 of jaws: age 28 sunburst pattern in longbones but rare in jaws pt will complain of swelling, pain, loose teeth or paresthesia mixed lucent/paque, illdefined margins widening of pdl sunburst see malignant cells producing osteoid tx: radical surgery; poor prognosis 30-50% 5 yr survival but 80% cure rate after initial radical surgery death due to uncontrolled local disease not metastasis |
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plasmacytoma and multiple myeloma
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malig. of plasma cell
affect primarily bone plasmacyoma: one lesion (solitary), if other lesions are found elsewhere in skeleton it is multiple myeloma (more than 1 lesion)...much more seious these are 47% of the bone malignancies (excluding mets) 14,000 cases/yr in US age 70 males bone pain Bence jones protein in urine amyloid deposits near eyes punched out radiolucencies with non-corticated, well defined borders or ill-defined borders will see amyloid if a lesion is biopsied diagnosis made by serum immunoelectrophoresis for a rise in the Ab that the tumor cell is secreting tx: chemo with cyclophosphamide (alkylating agent) and prednisone poor prognosis: will live 30-36 months after diagnosis 25% 5 yr survival |
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metastatic disease
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not common but very serious
most are from carcinomas breast, lung, colon, thyroid, prostate, kidney will note paresthesia/numbness or pain and swelling ill defined radiolucency (less common is an ill defined radiopacity) micro: depends on source; "seeded" pattern of malignant cells tx: palliative (keep them comfortable) poor prognosis; most pts die within a year after diagnosis mets from below the neck maw affect jaws via batson's paravertebral plexus of veins (no valves) over 1/2 the pts are over 50 yrs old mand: 61% max:24% soft tissue (tongue and ging): 15% |
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benign bone neoplasms
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osteoma
gardner syndrome central giant cell granuloma langerhans cell histiocytosis ossifying fibroma |
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malignant bone neoplasms
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chondrosarcoma
osteosarcoma plasmacytoma and multiple myeloma metastatic disease |
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developmental bone disorders
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traumatic bone cyst
lingual mandib. salivary gland depression (aka stafne cyst aka static bone cyst) focal osteoporotic bone marrow defect idiopathic osteosclerosis cherubism osteogenesis imperfecta osteopetrosis cleidocranial dysplasia |
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metabolic bone disorders
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paget's disease (osteitis deformans)
fibrous dysplasia (jaffe and mccune albright) hyperparathyroidism cemento-osseous dysplasia |
