Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
33 Cards in this Set
- Front
- Back
|
osteogenesis imperfecta
|
genetic collagen maturation DO
MC* type of genetic bone disease systemic manifestation of dentinogenesis imperfecta |
|
|
Osteopetrosis (albers-shoenberg, marble bone disease)
|
genetic
dense bone replaces bone marrow bc: defective osteoclasts = amorphous bone deposit |
|
|
infantile osteopetrosis
|
fatal (anemia, infections) form
hepatosplenomegaly narrow skull foramina (blind, deaf, face paralysis) Osteomyelitis following tooth extraction (bone infect) |
|
|
adult osteopetrosis
|
non fatal form
no anemia, hepatosplenomegaly, blindness, or deafness osteomyelitis common & mandible fractures during extractions |
|
|
focal osteoporotic marrow defect
|
marrow hyperplasia or aberrant healing after tooth extraction
asymp, female posterior mandible RL w/ thin fine RO trabeculae within |
|
|
idiopathic osteosclerosis (enostosis, dense bone island, bone scar)
|
not due to inflammation or neoplasia
round or triangular RO w/ no RLs around apex mandibular 1st molar region confused w/ condensing osteitis no tx required |
|
|
condensing osteitis (sclerosing osteitis)
|
Pulpitis or pulpal necrosis association
children & young adults RO at or adjacent to apex of tooth w/ inflammation no RL border (ddx from focal cemento-osseous dysplasia) tooth needs extraction or endo |
|
|
massive osteolysis (Gorham's, vanishing bone disease)
|
destruction of one or more bones & replacement w/ vascular dense c.t.
<40 yo, males |
|
|
Paget's disease ( osteitis deformans)
|
excessive bone turnover due to slow viral infect.
causing thickened distortion & weak bones localized rather than all bones (seen in osteoporosis) older white pts. narrow foramina -->vertigo, deafness, visual disturb jaw 17% of cases (maxilla, bilateral) 'lion-like' facial deformity 'Cotton-wool' ROs (like cemnto-osseous dysplasias) AP elevation 'Jigsaw puzzle' or 'mosaic pattern' & reversal lines urinary hydroxyproline |
|
|
complications of pagets disease of bone
|
Hypercementosis
osteosarcoma (pelvis & long bones) CHF |
|
|
Central Giant cell granuloma (CGCG)
|
benign condition of the anterior jaw. it is twice as likely to affect women & happens in <30 yos. they are more common in the mandible & cross the midline. asymptomatic large lesions that expand the cortical plate & can reabsorb roots & move teeth. radiographically appear as multilocular RLs. Histologically indistinguishable from hyperparathyroidism, cherubim, & PGCG
|
|
|
Peripheral Giant Cell Granuloma (PGCG)
|
same as CGCG except it has a soft tissue component
|
|
|
CGCG ddx
|
included ddx: hyperparathyroid tumor, cherubism, OKC, ameloblastoma, odontogenic myxoma, central odontogenic fibroma, hemangioma
|
|
|
cherubism
|
gentic mutation that occurs in 7 yos. Bilateral mandibular swelling is caused by bone loss which is replaced by fibrous tissue. Maxillary involvement stretches the skin exposing more sclera of the eye. Teeth often fail to erupt. Radiographically multiple, multilocular RLs are seen.
|
|
|
Simple Bone cyst
|
no epi lining (pseudocyst)
usually asymptomatic. prior trauma results in intrabony hemorrhage however no hx of trauma in 50% of cases. Mostly found in young adult males 2:1 on mandibular body, ramus, symphysis and can cross the midline. Radiographically a characteristic scalloped-shape margins extending between roots of involved teeth w/o affecting them. explorative surgery reveals an empty cavity or more rarely, one filled with serosanginous fluid |
|
|
aneurysmal bone cyst (ABC)
|
radiographically 'blow-out' distension of bone contours seen. Occurs in young adults in the mandible molar region with rapid facial swelling & pain
|
|
|
cemento-osseous dysplasias
|
these belong to this group of benign fibro-osseous lesions:
pa cemento-osseous dysplasia (pa cemental dysp) focal cemento-osseous dysplasia florid cemento-osseous dysplasia |
|
|
fibrous dysplasia
|
pre puberty onset of a painless slow developmental tumor that replaces bone with cellular FCT intermixed with irregular bony trabeculae. slightly more in the maxilla than mandible. 80% of cases are monostolic (one bone) although adjacent 'craniofacial' bones involved. Radiographically seen is 'Ground glass' RO bone with poorly defined margins. Histologically irregular trabeculaes of immature bone that look like 'Chinese' writing characters. Treatment for this is delayed until growth stops. Also avoid radiation therapy because osteosarcomatous transformation has been seen.
|
|
|
Jaffe's syndrome
|
polystotic version of fibrous dysplasia where Cafe au lait pigmentation is seen. can affect any bone
|
|
|
McCune-Albright's syndrome
|
polystotic version in which multiple cafe au lait pigmented macules are seen. endocrine disturbances are seen = precocious sexual development in girls
|
|
|
periapical cemento-osseous dysplasia (cementoma)
|
usually occurs in 30-50 yos. more common in blacks & heavy female 14:1 predominance. Seen in anterior mandibular vital teeth. Radio shows asymp pa RLs which transform into ROs. no tx required
|
|
|
focal cemento-osseous dysplasia
|
asymptomatic solitary lesion. this is the most common fibro-osseous lesion. seen in white* 30-50 yos of which are 90% women. found in the posterior mandible. tx is to observe after diagnosis. this dysplasia has fragmented gritty tissue (rather than ossifying fibroma which shells out easily from bone)
|
|
|
florid -cemento-osseous dysplasia
|
bilateral , symmetrical posterior jaw involvement which is in multiple quadrants & is NOT tooth related. seen in middle aged black women (90%). may become infected & mimic chronic sclerosing osteomyelitis. Histologically sequestrum is seen with secondary infection. if asymptomatic tx is to control periodontitis. if symptomatic osteomyelitis is present and tx is with antibiotics
|
|
|
Ossifying Fibroma (cementifying-ossifying fibroma)
|
Characterized by centripetal expansion of the inferior border of the mandible. this occurs between 20-40 yo and females 5:1. 90% in the mandible molar region. Radiographs show well-defined unilocular RL to RO lesion. tx is to curettage 'shell out' from surrounding bone. this is s true neoplasm
|
|
|
Osteoma
|
benign tumor of mature compact bone of the mandibular angle
|
|
|
Gardner Syndrome
|
multiple osteomas of the jaw at puberty. pt. has supernumerary teeth, impacted teeth, & odontomas. Also multiple epidermoid cysts of the skin & multiple polyps of the colon & rectum. 50% of the rectal polyps have malignant transformation by age 30. 100% transformation with increasing age. Dx of oral lesion leads to prophylactic colonectomy
|
|
|
cementoblastoma
|
true neoplasm of the cementum. seen in young adults in the mandibular first molar region.
vital tooth and pain & swelling. Radio shows root anatomy & PDL obscured by dense RO tumor with a thin RL border |
|
|
Central (intrabony) Hemangioma
|
pulsating
Jaw swelling & tooth mobility w/ a 'pumping action' or pulsation present. happens in females 10-20 yo in the mandible. sunburst appearance at times |
|
|
malignant bone diseases
|
this group belongs to:
osteosarcoma chondrosarcoma ewing's disease |
|
|
osteosarcoma
|
'Codman's triangle' is seen on radio where the tumor raises the periosteum away from the bone. Symmetrical widening of the PDL space. 25% have 'Sunburst' pattern.
occurs in the jaw 10-15 yrs later than in long bones. bone pain & swelling with tooth mobility & displacement. Radio shows ill-defined RL or "moth-eaten" RO. 5 yr survival is 30-70%. if in the maxilla with older age there is a worse prognosis. metastasis is most common to the brain & lung |
|
|
chondrosarcoma
|
seen in 35 yo. maxilla 4:1. painless mass or swelling is MC presentation. similar appearance to osteosarcoma.
prognosis is related to specific grade |
|
|
Ewing's Sarcoma
|
small 'Blue dot' tumors. ages 5-25 yo. slightly more in white males in the mandible. Pain, rapid swelling, tooth mobility & paresthesia present. Misdiagnosed as a dental infection. Ill-defined RL, 'Onion skin' periosteal proliferation (ddx for Garre's osteomyelitis)
|
|
|
metastatic tumors to the jaw
|
much more common than primary bone malignancy. most commonly come from: Lung, Breast, Kidney, colon, prostate, thyroid glands. Batson's plexus is the route of metastasis.
Mandible 4:1, >50 yo, bone swelling, pain or parasthesia. tooth mobility & post-extraction extrusion. Radio - ill-defined RL, although some (Lung, breast, prostate) are RO bc they produce calcifications. ddx: SCC, osteomyelitis, osteosarcoma |
