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409 Cards in this Set
- Front
- Back
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Reactive lesion, or 'true' neoplasia? Overgrowth is in response to irritation
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Reactive lesion
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Reactive lesion, or 'true' neoplasia? Associated with a stimulus
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Reactive lesion
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Reactive lesion, or 'true' neoplasia? Usually inflammation a consistent finding
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Reactive lesion
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Reactive lesion, or 'true' neoplasia? Growth continues after stimulus is removed/no stimulus required
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'true' neoplasia
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Reactive lesion, or 'true' neoplasia? No regression with normal therapy
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'true' neoplasia
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Reactive lesion, or 'true' neoplasia? Unrestricted new growth
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'true' neoplasia
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What is the most common 'tumor'/lesion in the oral cavity?
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Irritation fibroma
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Where is the most common location to find an irritation fibroma?
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Buccal mucosa, at the occlusal plane
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What age group and gender is most often affected by irritation fibromas?
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40-60 year old females
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What two colors are irritation fibromas (usually)?
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1 Pink (same shade as mucosa) 2 White from hyperkeratosis
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Name 3 histological findings in irritation fibromas.
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1 Dense CT 2 Inflammatory cells 3 Stratified squamous epithelium
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What is the term used for an irritation fibroma caused by a denture?
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Epulis Fissuratum
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What characterizes Epulis Fissuratum?
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Long folds of dense CT
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Name 3 common causes for papillary hyperplasia.
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1 Ill-fitting dentures 2 Dentures worn 24 hours/day 3 Poor denture hygiene
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What clinical feature is pathognomonic for Papillary Hyperplasia?
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Raspberry, bubbly, papillary look, usually on hard palate
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What microorganism is often to blame for Papillary Hyperplasia?
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Candida
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Pyogenic granuloma, peripheral giant cell granuloma, or peripheral fibroma (or more than one)? Usually on gingiva, but occur anywhere
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Pyogenic granuloma
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Pyogenic granuloma, peripheral giant cell granuloma, or peripheral fibroma (or more than one)? Bright red color
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Pyogenic granuloma OR ulcerated peripheral fibroma
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Pyogenic granuloma, peripheral giant cell granuloma, or peripheral fibroma (or more than one)? Bleeds easily
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Pyogenic granuloma
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Pyogenic granuloma, peripheral giant cell granuloma, or peripheral fibroma (or more than one)? Painless
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Pyogenic granuloma and peripheral giant cell granuloma for sure
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Pyogenic granuloma, peripheral giant cell granuloma, or peripheral fibroma (or more than one)? Caused by irritation
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All three
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Pyogenic granuloma, peripheral giant cell granuloma, or peripheral fibroma (or more than one)? Develops rapidly
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Pyogenic granuloma
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Pyogenic granuloma, peripheral giant cell granuloma, or peripheral fibroma (or more than one)? More common in children and young adults
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Pyogenic granuloma and peripheral fibroma
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Pyogenic granuloma, peripheral giant cell granuloma, or peripheral fibroma (or more than one)? Found in pregnant women
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Pyogenic granuloma
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Pyogenic granuloma, peripheral giant cell granuloma, or peripheral fibroma (or more than one)? Female predilection
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All three
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Pyogenic granuloma, peripheral giant cell granuloma, or peripheral fibroma (or more than one)? Histologically has endothelial lined vascular spaces
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Pyogenic granuloma
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Pyogenic granuloma, peripheral giant cell granuloma, or peripheral fibroma (or more than one)? Most common of the three
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Pyogenic granuloma
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Pyogenic granuloma, peripheral giant cell granuloma, or peripheral fibroma (or more than one)? Bluish-purple in color
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Peripheral Giant Cell Granuloma
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Pyogenic granuloma, peripheral giant cell granuloma, or peripheral fibroma (or more than one)? Pink color
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peripheral fibroma OR Peripheral Giant Cell Granuloma
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Pyogenic granuloma, peripheral giant cell granuloma, or peripheral fibroma (or more than one)? Affects individuals around age 30
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Peripheral Giant Cell Granuloma
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Pyogenic granuloma, peripheral giant cell granuloma, or peripheral fibroma (or more than one)? Can only occur on the gingiva
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Peripheral Giant Cell Granuloma or Peripheral fibroma
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Pyogenic granuloma, peripheral giant cell granuloma, or peripheral fibroma (or more than one)? Histologically has CT stroma, mesenchymal cells, and multinucleated giant cells
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Peripheral Giant Cell Granuloma
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Pyogenic granuloma, peripheral giant cell granuloma, or peripheral fibroma (or more than one)? Results from pyogenic granuloma developing over time
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Peripheral fibroma
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Pyogenic granuloma, peripheral giant cell granuloma, or peripheral fibroma (or more than one)? Histologically has dense CT with mineralization (calcified or ossified)
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Peripheral (ossifying) fibroma
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What term is used for red vascular tissue growing out of recent extraction site or socket?
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Epulis Granulomatosa
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Name the most common oral area to have a lipoma.
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Buccal mucosa
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What color is a lipoma?
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Yellowish
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What kind of cells are subject to neurolemoma?
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Schwann cells (it's also called a schwannoma)
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Are neurolemomas fast or slow-growing?
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Slow-growing
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Name the most common oral area to have a neurolemoma.
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Tongue
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What soft tissue lesion is associated with Antoni A and B tissue types?
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Neurolemoma (Schwannoma)
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What soft tissue lesion is associated with Verocay bodies?
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Neurolemoma (Schwannoma)
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Name the most common peripheral nerve neoplasm, which is rare but not uncommon.
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Neurofibroma
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What soft tissue lesion is associated with spindle cells, and Mast cells intermingled with neurites?
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Neurofibroma
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Name the hereditary/systemic form of neurofibromas.
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Von Recklinghausen's Disease of the Skin
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Name two clinical features of Von Recklinghausen's Disease of the Skin.
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1 Multiple neurofibromas 2 Café au lait spots
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What 'neoplasm' occurs when a damaged nerve attempts to repair itself?
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Traumatic neuroma
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Is a Traumatic neuroma painless or painful?
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Painful
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What lesion has the following histology: Neurofibrils and Schwann cells in CT?
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Traumatic neuroma
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What is the most common tumor of infancy?
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Hemangioma
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What causes a hemangioma?
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Proliferation of blood vessels
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What color is a hemangioma?
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Deep blue (this helps diagnose)
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If a hemangioma is present as a large, flat lesion of the skin, what term is used?
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Birthmark
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If a hemangioma is present as a large, unilateral lesion on the face following the division of the trigeminal nerve, what term is used?
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Port-wine stain
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What type of biopsy must be done on a hemangioma: Incisional or excisional?
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Excisional, because it bleeds profusely with incisional
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What is "diascopy"?
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Blanching with pressure
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A hemangioma (does/does not) blanch with pressure.
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DOES
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If a hemangioma is present due to small capillary proliferation, what disease is this?
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Hereditary Hemorrhagic Telangiectasia (Osler-Weber-Rendu)
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What disease features Port-wine stian, and maybe convulsive disorders and mental retardation due to calcifications in the brain?
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Sturge-Weber Syndrome
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What is more common, hemangioma or lymphangioma?
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Hemangioma
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How can you differentiate a lymphangioma from a hemangioma?
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Lymphangiomas are pink, or colorless, not red.
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If a lymphangioma is present in the tongue, what syndrome could occur secondarily?
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Macroglossia
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Name the most common oral area to have a granular cell tumor.
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Tongue
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What lesion has the following histology: Large, granular cells with eosinophils, keratin production, and pseudoepitheliomatous hyperplasia?
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Granular cell tumor
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What soft tissue lesion may be confused with carcinoma?
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Granular cell tumor
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What disease features fibroma-looking lesion at birth?
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Congenital Granular Cell Epulis
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Where is the most common location to find a Congenital Granular Cell Epulis?
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Maxillary anterior gingiva
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T/F: Congenital Granular Cell Epulis most commonly affects males.
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False; the predilection is 90% female, suggesting a hormonal link
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What disease features rapidly-growing dark, pigmented lesion at birth?
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Melanotic Neuroectodermal Tumor of infancy
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What disease is associated with high levels of vanilmadelic acid in the urine?
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Melanotic Neuroectodermal Tumor of infancy
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What lesion has the following histology: Mass of cells arranged in a pattern of alveolus-like spaces, lined by cuboidal cells, maybe containing melanin?
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Melanotic Neuroectodermal Tumor of infancy
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What is another name for physiologic (racial) pigmentation?
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Melanoplakia
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Name the most common location for physiologic (racial) pigmentation/melanoplakia.
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Attached gingiva
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What causes physiologic (racial) pigmentation/melanoplakia?
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Increased ACTIVITY (not number) of melanocytes
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Name two risk factors (besides smoking) for Smoker's Melanosis.
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1 Female 2 Females on the Pill
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Name the three most common areas to see Smoker's Melanosis.
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1 Mandibular anterior (gingiva) 2 Buccal mucosa 3 Palate
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Is Smoker's Melanosis premalignant?
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No, not alone
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Does Smoker's Melanosis go away after quitting smoking?
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Yes, probably
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T/F: Oral Melanotic Macules are due to sun-exposure.
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False, freckles are
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What disease histologically features an increase in melanin granules, which is confined to the basal cell layer?
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Oral melanotic macule
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What is the most common of all human 'tumors'?
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Pigmented Cellular Nevus/ Acquired melanocytic nevus/Mole
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Name 2 synonyms for a mole.
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1 Pigmented Cellular Nevus 2 Acquired melanocytic nevus
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What's the difference between a mole and a freckle (ephelis)?
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A mole does NOT depend on sun exposure; freckles do.
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What do nevus cells look like (4)?
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1 Large 2 Oval 3 Epithelioid 4 Arranged in clumps
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What type of mole do all moles start out as?
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Junctional nevus
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What variant of mole is the second most common intraoral nevus?
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Blue
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Malignant melanoma is the (#) most common skin cancer. ____% of skin melanomas occur in the head/neck area. (Chronic/acute) sun damage is more important when it comes to malignant melanoma. The lifetime risk for a __(ethnicity)__ to get malignant melanoma is 1 in _____.
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3rd most common. 25% in head and neck. Acute is worse. Caucasians 1:100 will get them.
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What is the most common type of Malignant melanoma?
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Superficial spreading melanoma
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What type of Malignant melanoma is multicolored and flat?
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Superficial spreading melanoma
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1/3 of this type of Malignant melanoma are in the head and neck area.
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Nodular melanoma
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What type of Malignant melanoma is elevated, and sometimes has no pigmentation?
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Nodular melanoma
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What type of Malignant melanoma is melanoma in situ?
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Lentigo maligna melanoma
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What is the most common type of oral Malignant melanoma?
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Acral lentiginous melanoma
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Name the two most common sites for oral Malignant melanoma.
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1 Maxillary anterior mucosa 2 Hard palate
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Most oral Malignant melanomas are (primary/metastatic) and have (good/bad) prognosis.
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Metastatic, bad
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How does Addison's disease manifest in the skin/mucous membranes?
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Bronzing
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What are two clinical features of Peutz-Jeghers Syndrome?
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1 Oral freckles (melanotic macules) 2 Intestinal polyposis
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What are the three structural parts of a cyst?
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1 Central cavity (containing fluid, etc) 2 Lining (usually strat squa) 3 CT Capsule
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How are cysts usually discovered?
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Routine exam/xrays
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Name the cyst characterized by a non-vital tooth, inflammation, radiolucent, derived from rest of Malassez, either asympomatic or acute pain.
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Dental Granuloma
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Name the cyst characterized by a non-vital tooth, cholesterol clefts, radiolucent, either asympomatic or acute pain.
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Radicular/Periradicular/Periapical Cyst
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Name the cyst that develops from fragments of an apical cyst after removal of a tooth.
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Residual cyst
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Name the cyst that is associated with the crown of a normal/supernumerary impacted tooth.
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Dentigerous cyst
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What is the origin of a dentigerous cyst?
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Reduced enamel epithelium, after the crown has formed
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Name the 2 most common sites for a dentigerous cyst.
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1 3rd molars 2 Maxillary cuspids
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Dentigerous cysts usually occur from age ____ to ____, and is lined by ______ _________ epithelium.
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10-30, stratified squamous epi
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Name 3 possible progressions of a dentigerous cyst.
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1 Ameloblastoma 2 Squamous cell carcinoma 3 Mucoepidermoid carcinoma (salivary gland tumor)
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If a radiolucency is less than 2.5 mm, it is probably not a dentigerous cyst, but is probably…
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Perifollicular fibrosis
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Can you see an eruption cyst on an xray?
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NO
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Name the cyst that is a soft-tissue counterpart of a dentigerous cyst.
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Eruption cyst
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Name the cyst that develops in place of a tooth (no history of extraction or existing tooth).
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Primordial cyst
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What is the origin of a primordial cyst?
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Remnants/degeneration of the enamel organ
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Where is the most common location to find a primordial cyst?
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3rd molar area
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T/F: Primordial cysts can be multilocular.
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TRUE
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Name the cyst that shows keratinization.
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Odontogenic keratocyst
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What is the origin of an Odontogenic keratocyst?
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Dental lamina/cell rests
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Odontogenic keratocysts are (rare/common) make up ___-____% of all odontogenic cysts. OKC affects ____-____ year olds. They are lined by (thin/thick) epithelium.
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Common, 3-11% of all odontogenic cysts, 10-40 year olds. Thin
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What is the most common location to find an Odontogenic keratocyst?
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Mandibular molar area
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T/F: Odontogenic keratocysts can be aggressive.
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True, can cause tooth movement and resorption
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Name the syndrome which features multiple Odontogenic keratocysts.
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Jaw cyst-basal cell nevus-Bifid rib syndrome
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T/F: Odontogenic keratocysts can be multilocular.
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TRUE
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On an xray, name two things that Odontogenic keratocysts may resemble (and cannot be differentiated from).
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1 Dentigerous cyst 2 Lateral periodontal cyst
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Name a unique histologic feature of Odontogenic keratocysts.
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Satellite cysts
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T/F: Recurrence rate is high for Odontogenic keratocysts.
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True, due to satellite cysts and wavy epi lining
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Name a variant of Odontogenic keratocysts. Is its recurrence rate higher or lower than Odontogenic keratocysts?
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Orthokeratinized odontogenic cyst. Recurrence is much lower (2% instead of 30%)
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T/F: Gingival cyst of the newborn is rare.
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False, it is found in 50% of all newborns!
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What is the origin of Gingival cyst of the newborn and adult?
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Remnants of the dental lamina
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T/F: Gingival cyst of the adult is rare.
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TRUE
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Where is the most common area to find a Gingival cyst of the adult?
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Mandibular bicuspid/anterior area
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Name the cyst that is the bony counterpart to a gingival cyst of the adult.
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Lateral periodontal cyst
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T/F: Lateral periodontal cysts can be multilocular.
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True, it would be called a Botryoid odontogenic cyst
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Where is the most common area to find a Lateral periodontal cyst?
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Mandibular premolar/cuspid area
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Name the multilocular variant of a Lateral periodontal cyst.
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Botryoid odontogenic cyst (grape-like cluster)
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T/F: Recurrence rate is high for Lateral periodontal cysts.
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False, it is low
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Name the cyst that is more like a neoplasm than a cyst.
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Calcifying Odontogenic Cyst (Gorlin cyst)
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Where is the most common area to find a Calcifying Odontogenic Cyst (Gorlin cyst)?
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Trick question - it's found equally in maxilla and mandible, but tends to be in the anterior area
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Name a unique histologic feature of a Calcifying Odontogenic Cyst (Gorlin cyst).
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Ghost cells, usually with calcifications (diffuse or clumpy)
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Name the cyst that has glandular differentiation.
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Glandular Odontogenic Cyst
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Where is the most common area to find a Glandular Odontogenic Cyst?
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Mandibular anteriors
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What is a (better) synonym for a paradental cyst?
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Buccal bifurcation cyst
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Name the cyst that usually occurs on mandibular molars that have a history of pericoronitis.
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Paradental/Buccal bifurcation cyst
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What is the cause of Paradental/Buccal bifurcation cysts?
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Infection stimulates Inflammation, which stimulates rests of Malassez to make enamel
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What is the age predilection for Paradental/Buccal bifurcation cysts?
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20-30 years old
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Name the most common site to find a Paradental/Buccal bifurcation cyst.
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Mandibular second/third molars
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Name the cyst that is small, white, and found on the palate of newborns. Name 2 synonyms.
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Palatal cyst of the newborn. 1 Epstein Pearls 2 Bohn's Nodules
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Name the cyst that is caused by ectoderm entrapped in median palatal fusion line and/or epithelial remnants of developing palatal salivary glands.
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Palatal cyst of the newborn/ Epstein Pearls/Bohn's Nodules
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What is one differential diagnosis for Palatal cyst of the newborn?
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Gingival cyst of the newborn
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Name the rare soft tissue cyst affecting the lower portion of the nasolacrimal duct.
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Nasolabial or Nasoalveolar cysts
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Nasolabial or Nasoalveolar cysts affect more (males/females).
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Females
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Name the characteristic histological feature of Nasolabial or Nasoalveolar cyst.
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Psuedostratified columnar epithelium
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Name the cyst that occurs between the roots of the maxillary lateral and canines.
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Globulomaxillary cyst
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What shape is a Globulomaxillary cyst, usually?
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Pear-shaped
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Name 3 differential diagnoses for Globulomaxillary cysts.
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1 Periapical cysts 2 Odontogenic cysts 3 Lateral periodontal cysts
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Name the cyst that occurs in the incisive canal.
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Nasopalatine Duct/Incisive Canal cyst
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What is the soft-tissue counterpart of the Nasopalatine Duct/Incisive Canal cyst?
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Palatine papilla cyst
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Does the Nasopalatine Duct/Incisive Canal cyst affect (non/vital) teeth?
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Vital
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Nasopalatine Duct/Incisive Canal cysts usually occur in (males/females) age ____-_____.
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Males, 40-60
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What is the rule of thumb for Nasopalatine Duct/Incisive Canal cysts?
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If it is less than .6 mm, it is probably just an enlarged incisive canal
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Where is the most common location for Nasopalatine Duct/Incisive Canal cysts?
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Between the maxillary centrals
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What shape is a Nasopalatine Duct/Incisive Canal cyst, usually?
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Heart-shaped
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Name the cyst that is located posterior to the incisive papilla in the midline of the hard palate.
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Median palatal cyst
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Name the cyst that is lined by keratinized stratified squamous epithelium and is often filled with keratin.
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Epidermoid cyst
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Name the cyst that is lined by keratinized stratified squamous epithelium and is often filled with sebaceous glands, hair follicles, bone, muscle, etc.
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Dermoid cyst
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What other neoplasm does a dermoid cyst resemble?
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Teratoma
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Where is the most common location for an epi/dermoid cyst?
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Floor of the mouth
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If the patient has a bulge in the floor of the mouth/has no neck, the epi/dermoid cyst is (above/below) the mylohyoid.
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Above
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If the patient has a double chin, the epi/dermoid cyst is (above/below) the mylohyoid.
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Below
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Name the cyst that occurs on the midline, between the foramen cecum of the tongue and the suprasternal notch.
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Thyroglossal duct cysts
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What causes a thyroglossal duct cyst?
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Epithelial remnants of the thyroid migration turn into cysts
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What is the treatment for a thyroglossal duct cyst, and why?
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Remove, because it may turn malignant
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What % of thyroglossal duct cysts occur below the hyoid?
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70%
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Name the cyst that comes from epithelium trapped in lymph nodes.
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Cervical Lymphoepithelial cyst (Branchial Cleft Cyst)
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Name the cyst that occurs in the lateral neck as an asymptomatic, slow-growing fluctuant mass.
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Cervical Lymphoepithelial cyst (Branchial Cleft Cyst)
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Name the cyst that occurs in oral lymphoid tissue, is yellow, and has no rete pegs.
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Oral lymphoepithelial cyst
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Where do 50% of oral lymphoepithelial cysts occur?
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Floor of the mouth
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Name the cyst that occurs in the maxilla, after a maxillary sinus surgery/extraction.
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Surgical Ciliated Cyst of the maxilla
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What type of lining does a Surgical Ciliated Cyst of the maxilla have?
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Respiratory epi
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What causes a surgical ciliated cyst of the maxilla?
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Epi becomes implanted/trapped at the site of surgery and starts to proliferate and cavitate
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Name the cyst that is similar to dermoid but has gastric/intestinal mucosa lining.
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Heterotropic Oral Gastrointestinal Cyst/Anterior Median Lingual Cyst/Gastric Cystic Choristoma
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What is the age and gender predilection for Heterotropic Oral Gastrointestinal Cysts?
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Infants/young children, males
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Where is the most common location for a Heterotropic Oral Gastrointestinal Cyst (2)?
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1 Tongue 2 Floor of the mouth
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Name the pseudocyst that should be completely obvious on a radiograph.
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Simple bone cyst/Traumatic Bone cyst
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Why is a Simple bone cyst not a cyst?
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It has no epithelium, and the cavity is empty
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What is a key characteristic on the radiographs for a Simple bone cyst?
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Scalloped border
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What is the age group for Simple bone cysts?
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Young adults
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Are simple bone cysts associated with (non/vital) teeth?
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Vital
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What is the treatment for a Simple bone cyst?
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Curette to start bleeding, then it heals on its own
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Name the pseudocyst that has salivary gland tissue in it.
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Lingual Mandibular Salivary Gland Depression (Static bone cyst/Stafne bone cyst)
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Name the pseudocyst that radiographically occurs as an ovoid lucency between the mandibular canal and inferior border, with a sclerotic border.
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Lingual Mandibular Salivary Gland Depression (Static bone cyst/Stafne bone cyst)
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Name the uncommon vascular lesion of jaws/bones that resembles a "blood-soaked sponge".
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Aneurysmal Bone Cyst
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Do Aneurysmal bone cysts occur mainly in the maxilla or mandible?
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Mandible
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What is a differential diagnosis for an Aneurysmal Bone Cyst?
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OKC
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Name three other lesions that may be associated with an Aneurysmal Bone Cyst.
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1 Fibrous dysplasia 2 Hemangioma 3 Traumatic bone cyst
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|
|
What is the most common type of oral change?
|
Aphthous Minor
|
|
|
Minor, Herpetiform, or Major Aphthous: Lowest recurrence rate of the three types.
|
Aphthous Minor
|
|
|
Minor, Herpetiform, or Major Aphthous: Childhood/Late teens - 20s
|
Aphthous Minor and Major
|
|
|
Minor, Herpetiform, or Major Aphthous: Affects more females than males
|
All three
|
|
|
Minor, Herpetiform, or Major Aphthous: Affects 20% of the general population
|
Aphthous Minor
|
|
|
Minor, Herpetiform, or Major Aphthous: Affects non-smokers
|
Aphthous Minor and Major
|
|
|
Minor, Herpetiform, or Major Aphthous: Caused by - Inherited and immunodysregulation, mucosa decrease, and antigen increase
|
Aphthous Minor and Major
|
|
|
What is the most common clinically significant odontogenic tumor?
|
Ameloblastoma
|
|
|
Common, Unicystic, or Peripheral Ameloblastoma: Average age of occurrence is 30 years old.
|
Common
|
|
|
Common, Unicystic, or Peripheral Ameloblastoma: Benign aggressive
|
Common
|
|
|
Where do 85% of Common ameloblastomas occur?
|
Posterior mandible
|
|
|
Common, Unicystic, or Peripheral Ameloblastoma: Multilocular radiolucency with small compartments
|
Common
|
|
|
How do you differentate the multilocular radiolucency of a common ameloblastoma from a cyst?
|
Ameloblastoma has SMALL compartments, but cysts have BIG compartments
|
|
|
What disease features nests of odontogenic epithelium with stellate reticulum inside a rim of columnar ameloblasts?
|
Common Ameloblastoma
|
|
|
What disease features connective tissue stroma separating epithelial nests?
|
Common Ameloblastoma
|
|
|
Common, Unicystic, or Peripheral Ameloblastoma:Not encapsulated
|
Common
|
|
|
Common, Unicystic, or Peripheral Ameloblastoma: Resection is the typical treatment
|
Common
|
|
|
If a Common ameloblastoma is curetted, what is the recurrence rate (____-____%)?
|
50-90%
|
|
|
Name a differential diagnosis for Common ameloblastoma, and why it is similar.
|
Simple bone cyst - Scalloped border
|
|
|
Common, Unicystic, or Peripheral Ameloblastoma:Benign and not locally destructive
|
Unicystic
|
|
|
Common, Unicystic, or Peripheral Ameloblastoma:Average age of occurrence is 23 years old
|
Unicystic
|
|
|
Where do 90% of unicystic ameloblastomas occur?
|
Posterior mandible
|
|
|
Common, Unicystic, or Peripheral Ameloblastoma: Unilocular radiolucency, well-circumscribed
|
Unicystic
|
|
|
What disease features a cystic cavity, lined by ameloblasts, filled with stellate reticulum?
|
Unicystic Ameloblastoma
|
|
|
Common, Unicystic, or Peripheral Ameloblastoma: Capsulated
|
Unicystic
|
|
|
Name 3 differential diagnoses for Unicystic Ameloblastoma.
|
1 OKC 2 Dentigerous cysts 3 Simple bone cysts
|
|
|
How do you differentate Unicystic Ameloblastoma from Dentigerous cysts?
|
Unicystic Ameloblastomas are larger on radiographs
|
|
|
Name 3 differential diagnoses for Peripheral Ameloblastoma.
|
1 Pyogenic granuloma 2 Peripheral Giant Cell Granuloma 3 Peripheral Fibroma
|
|
|
Does peripheral Ameloblastoma look more like a well defined Common or Unicystic Ameloblastoma?
|
Common
|
|
|
What is the age and gender predilection for Adenomatoid odontogenic tumors?
|
10-19 years old, females
|
|
|
What is the MOST common site for an Adenomatoid odontogenic tumor?
|
Anterior maxilla, which is VERY unusual for an odontogenic tumor
|
|
|
T/F: Adenomatoid odontogenic tumors never occur around teeth.
|
False, 75% occur around unerupted teeth
|
|
|
How do you differentiate Adenomatoid odontogenic tumors from Dentigerous cysts?
|
Adenomatoid odontogenic tumors attach somewhere other than the CEJ, and occur in kids (not adults)
|
|
|
What disease histologically features columnar cells in duct-like arrangement, and polyhedral cells arranged in loose sheets?
|
Adenomatoid odontogenic tumors
|
|
|
Why are Adenomatoid odontogenic tumors so easy to remove, and have rare recurrence?
|
Because of their thick fibrous capsules, excision is curative
|
|
|
What is the age predilection for Calcifying Epithelial Odontogenic Tumors/Pindborg tumors?
|
Adults, 30-50 (a 40+ disease)
|
|
|
Name the tumor that most commonly presents as a painless, slow-growing swelling.
|
Calcifying Epithelial Odontogenic Tumors/Pindborg tumors
|
|
|
Calcifying Epithelial Odontogenic Tumors/Pindborg tumors can be (radiolucent/opaque/mixed/more than one)?
|
Pure radioluent or mixed
|
|
|
If Calcifying Epithelial Odontogenic Tumors/Pindborg tumors are mixed radiolucencies, what two patterns of radioopacity are often seen?
|
1 Ground glass 2 Cotton wool
|
|
|
What disease histologically features polyhedral epithelial cells, and amyloid or amyloid-like material?
|
Calcifying Epithelial Odontogenic Tumors/Pindborg tumors
|
|
|
Calcifying Epithelial Odontogenic Tumors/Pindborg tumors are classified as (innocuous, benign, benign aggressive, malignant).
|
Benign
|
|
|
Name the exceptionally rare tumor that appears to arise from neoplastic transformation of the rests of Malassez.
|
Squamous odontogenic tumor
|
|
|
What age range can squamous odontogenic tumor occur within?
|
8-74 years old
|
|
|
Name the disease that radiographically looks like a periodontal defect, destroyig crestal bone, and occurring as a triangular lucency lateral to tooth roots.
|
Squamous odontogenic tumor
|
|
|
What disease histologically features nests of bland stratified squamous epithelium?
|
Squamous odontogenic tumor
|
|
|
What uncommon tumor has both epithelial and mesenchymal tissue that are neoplastic?
|
Ameloblastic fibroma
|
|
|
What age group is most often affected by ameloblastic fibroma?
|
Teens, or younger
|
|
|
What is the site predilection for ameloblastic fibroma?
|
Posterior mandible
|
|
|
If any child presents with a radiolucent lesion in the posterior mandible, what disease is it until proven otherwise?
|
Ameloblastic fibroma
|
|
|
What disease histologically features islands of odontogenic epithelium, and developing tooth germ, with plump fibroblasts?
|
Ameloblastic fibroma
|
|
|
How does ameloblastic fibroma histologically differ from ameloblastoma?
|
Epithelial islands are small,and too skinny to be filled with stellate reticulum
|
|
|
What is the most common type of odontogenic tumor, exceeding the prevalence of all other odontogenic tumors combined?
|
Odontoma
|
|
|
What disease features multiple, small structures with recognizable tooth morphology?
|
Compound odontoma
|
|
|
What disease features masses/globs of tissue with no anatomic resemblance to a tooth?
|
Complex odontoma
|
|
|
During what age range are odontomas usually detected?
|
0-20
|
|
|
What is the site predilection for compound odontomas?
|
Anterior maxilla
|
|
|
What is the site predilection for complex odontomas?
|
Posterior mandible
|
|
|
If you cannot tell the type of odontoma by looking at the morphology,what is a reliable indicator of type?
|
Site of occurrence
|
|
|
If an odontoma is associated with a tooth, will it be around the crown or the root?
|
Crown
|
|
|
What is the age predilection for ameloblastic fibro-odontoma?
|
Children
|
|
|
What is the more common pattern of odontogenic fibroma; peripheral or central?
|
Peripheral
|
|
|
Name the tumor that most commonly presents as a painless, slow-growing gingival swelling, which occurs at any age.
|
Peripheral odontogenic fibroma
|
|
|
What disease histologically featues fibrous connectiv tissue and odontogenic epithelial nests?
|
Peripheral odontogenic fibroma
|
|
|
What is gender predilection for central odontogenic fibroma?
|
Females, 2.2:1
|
|
|
What are the two most common site predilections for odontogenic fibromas?
|
Anterior maxilla, or posterior mandible
|
|
|
What disease is often associated with a palatal mucosal groove when the lesions are in the maxilla?
|
Central odontogenic fibroma
|
|
|
What is the age predilection for odontogenic myxomas?
|
Young adults
|
|
|
Name the disease that radiographically has small honeycomb loculations, and often has a delicate, wispy appearance.
|
Odontogenic myxoma
|
|
|
Why is an odontogenic myxoma hard to remove?
|
It is soft, mushy, and gelatinous, like an umbilical cord, and clean margins are hard to get
|
|
|
What disease is histologically indistinguishable from osteoblastoma?
|
Cementoblastoma
|
|
|
What is the age predilection for cementoblastomas?
|
Young adults, under 25
|
|
|
What is the single-most common site for cementoblastomas to occur?
|
Mandibular first molars
|
|
|
With cementoblastomas, are the teeth (non/vital)?
|
Vital *KEY
|
|
|
What tumor should be easily identifiable only by radiographs?
|
Cementoblastoma
|
|
|
What does a cementoblastoma look like on radiographs?
|
Mixed, well-defined radiolucency/opacity, with a central opaque portion that obscures the root outline of the tooth
|
|
|
Why might cementoblastoma be mistaken for osteoblastoma/sarcoma?
|
Histologically indistinguishable
|
|
|
How is a cementoblastoma treated?
|
Remove, with the entire tooth, or do root canal and do partial amputation
|
|
|
Name the systemic disease defined as an absolute decrease in amount of bone due to bone resorption.
|
Osteoporosis
|
|
|
What is the age and gender predilection for osteoporosis?
|
50+ females
|
|
|
What is the generic term for increased amounts of calcified bone, and thus, increased density?
|
Osteosclerosis
|
|
|
Name 3 conditions that would produce osteosclerosis.
|
1 Metastatic tumors from prostate/breast 2 Lead poisoning 3 Hypothyroidism
|
|
|
Name two synonyms for Hyperparathyroidism.
|
1 Von Recklinghausen's 2 Osteitis fibrosa cystica
|
|
|
What generally characterizes hyperparathyroidism?
|
Generalized bone loss, replaced by fibrous tissue
|
|
|
What is the age and gender predilection for hyperparathyroidism?
|
Middle-aged females
|
|
|
What causes primary hyperparathyroidism?
|
Parathyroid adenoma
|
|
|
What causes secondary hyperparathyroidism?
|
Poor renal function, leading to decreased vitamin D, and decreased calcium
|
|
|
Name the two classic radiographic features of hyperparathyroidism.
|
1 Ground glass 2 Loss of lamina dura
|
|
|
Name 3 histological findings in hyperparathyroidism.
|
1 Cellular fibrous stoma 2 Vascular brown tumors 3 Giant cells
|
|
|
Name the disease that is characterized by abnormal/no bone resorption, so new bone is added on top of a crumbling foundation.
|
Osteopetrosis
|
|
|
Name the disease that features blue sclera.
|
Osteopetrosis
|
|
|
How is benign osteopetrosis transmitted?
|
Autosomal dominant
|
|
|
What is the age of onset for benign osteopetrosis?
|
Middle-to-older age
|
|
|
What disease has common manifestations of: Multiple pathologic fractures, pain, cranial nerve palsy, and osteomyelitis?
|
Benign osteopetrosis
|
|
|
How is malignant osteopetrosis transmitted?
|
Autosomal recessive
|
|
|
What is the age of onset for malignant osteopetrosis?
|
Birth; none survive to 20 years old
|
|
|
What disease has common manifestations of: Optic atrophy, hepatosplenomegaly, loss of hearing, pathological fractures, and osteomyelitis/secondary infections?
|
Malignant osteopetrosis
|
|
|
Name four dental findings in osteopetrosis.
|
1 Delayed eruption 2 Enamel hypoplasia 3 Osteomyelitis risk 4 Pathologic jaw fracture
|
|
|
What are the 2 radiographic features of osteopetrosis?
|
1 Milky, opaque changes 2 Increased cortical thickening
|
|
|
What disease classically features bilateral, symmetrical swelling of the mandible?
|
Cherubism
|
|
|
What is the 100% site predilection for cherubism?
|
Mandible
|
|
|
What is the age and gender predilection for cherubism?
|
Children, males
|
|
|
Why is the inheritance pattern for cherubism unique?
|
100% penetrance for males, 75% for females
|
|
|
What is the classic radiographic feature for cherubism?
|
Soap-bubble pattern radiolucencies
|
|
|
What disease is cherubism histologically similar to? How do you differentiate the two?
|
Hyperparathyroidism, but kids are too young to get it
|
|
|
What histologic feature is classic for cherubism?
|
Pink zone of eosinophilic cuffing
|
|
|
What is the most common bony lesion in the jaw?
|
Tori/exostoses
|
|
|
If a tori is located in the palate at the midline,what is it called? What about those that are anywhere other than midline palate?
|
Tori palatinus = Palate midline. Palatal tubercles/Buccal or palatal exostoses if anywhere else
|
|
|
Name the disease characterized by inflamed/necrosing bone that occurs in bone that was previously iradiated.
|
Osteoradionecrosis
|
|
|
What is the cause of osteoradionecrosis?
|
Compromised blood supply from radiation
|
|
|
What is the best treatment for osteoradionecrosis?
|
PREVENTION
|
|
|
What type of drugs can cause the same pattern as osteoradionecrosis?
|
Bisphosphonate drugs
|
|
|
Name the disease that is an inflammatory condition spreading in the medullary saces or cortical surface of bone.
|
Osteomyelitis
|
|
|
What causes most of the cases of osteomyelitis in the jaws?
|
Odontogenic infection
|
|
|
What radiographic features are seen in osteomyelitis after 1-2 weeks of acute onset?
|
Moth-eaten, skip radiolucencies
|
|
|
What is unique about the lacunae in osteomyelitis?
|
They are empty!
|
|
|
Name the disease that is a unique proliferative reaction in inflamed or irritated bone.
|
Osteomyelitis with proliferative periostitis
|
|
|
Name the age predilection for Osteomyelitis with proliferative periostitis.
|
Young people, way below 25 years old
|
|
|
What is the classic radiographic feature for Osteomyelitis with proliferative periostitis?
|
Onion-skin layering of new bone over the cortex
|
|
|
What is the treatment for Osteomyelitis with proliferative periostitis and osteomyelitis?
|
Remove the source of infection
|
|
|
Name the disease that is a localized area of osteosclerosis associated with the apex of a tooth with pulpal inflammation.
|
Condensing osteitis
|
|
|
What is the radiographic feature of condensing osteitis?
|
Radioopacity that blends with adjacent patterns
|
|
|
Name the disease that is radiographically indistinguishable from condensing osteitis. What is the difference? Which is more common?
|
Idiopathic osteosclerosis. Idiopathic has no obvious source of trauma/inflammation. Idiopathic is more common
|
|
|
Where do 90% of idiopathic osteosclerosis occur?
|
Mandible
|
|
|
Name the three types of Cemento-Osseous Dysplasias.
|
1 Periapical 2 Focal 3 Florid
|
|
|
What are the most common fibro-osseous lesions encountered in dentistry that we WILL see?
|
Cemento-Osseous Dysplasias
|
|
|
Cemento-osseous dysplasia is (almost always/very rarely) biopsied.
|
Very rarely
|
|
|
Name the three stages of Cemento-osseous dysplasia that are common to all three types.
|
1 Osteolytic 2 Blastic 3 Mature
|
|
|
What stage of Cemento-osseous dysplasia is always radiolucent, and features proliferating cellular fibroblastic tissue?
|
Osteolytic
|
|
|
What stage of Cemento-osseous dysplasia is mixed radiolucent/opaque, and features irregular immature bone/cementum within a fibrous stroma?
|
Blastic
|
|
|
What stage of Cemento-osseous dysplasia is mostly opaque, with a lucent rim, and features a central core of dense cementum/bone with fibrous tissue at the periphery?
|
Mature
|
|
|
What is the basis for determining the type of Cemento-osseous dysplasia?
|
Site of occurrence
|
|
|
What is the most common form of Cemento-osseous dysplasia?
|
Periapical
|
|
|
What is the age, gender, and ethnic predilection for Periapical Cemento-osseous dysplasia?
|
30-50 years old, Black, Women
|
|
|
What is the site predilection for Periapical Cemento-osseous dysplasia?
|
Anterior mandibular teeth ONLY
|
|
|
With Cemento-osseous dysplasia (all types), teeth are (non/vital).
|
Vital
|
|
|
What is the age, gender, and ethnic predilection for Focal Cemento-osseous dysplasia?
|
30-60 years old, White, Women
|
|
|
What is the site predilection for Focal Cemento-osseous dysplasia?
|
Trick question- It can occur anywhere, but is SOLITARY
|
|
|
What is the age, gender, and ethnic predilection for Florid Cemento-osseous dysplasia?
|
Middle-aged Black females
|
|
|
What classifies a Florid Cemento-osseous dysplasia?
|
At least one lesion in all four quadrants
|
|
|
What type of Cemento-osseous dysplasia may require attention because complications will require treatment?
|
Florid Cemento-osseous dysplasia
|
|
|
Name 5 complications of Florid Cemento-osseous dysplasia if teeth are not well-maintained.
|
1 Secondary infection 2 Poor healing after ext 3 Simple bone cysts 4 Resorption of ridges 5 OSTEOMYELITIS (yuck)
|
|
|
Name the disease that is classified as a developmental anomaly and features ground-glass radiographs, with no distinguished borders, and bone trabeculae that appear to arise directly from bone.
|
Fibrous dysplasia
|
|
|
What name is used for fibrous dysplasia that involves multiple bones, but not the entire skeleton, and features café-au-lait spots but no endocrine involvement?
|
Jaffe-Lictenstein Syndrome, a type of polyostotic fibrous dysplasia
|
|
|
What radiographic features are seen in Jaffe-Lictenstein syndrome that are not seen in other fibrous dysplasias?
|
Cotton-wool appearance, NOT ground glass
|
|
|
What is more important for diagnosing Jaffe-Lictenstein syndrome, radiographs or clinical findings?
|
Clinical findings
|
|
|
What name is used for fibrous dysplasia that involves multiple bones, features café-au-lait spots with endocrine involvement?
|
McCune-Albright syndrome
|
|
|
What is the most common type of fibrous dysplasia?
|
Monostotic
|
|
|
What is the classic radiographic appearance for fibrous dysplasia?
|
Finely stippled ground glass appearance, with ill-defined borders
|
|
|
If Richards shows an occlusal film with ground glass appearance, what is the most likely diagnosis?
|
Fibrous dysplasia
|
|
|
What is another name for Osteitis Deformans?
|
Paget Disease of Bone
|
|
|
Describe the etiologic development of Paget Disease of bone.
|
Osteoblasts exceed osteoclasts
|
|
|
What is the age predilection for Paget Disease of bone?
|
Adults over 40
|
|
|
What dental complaints will be seen with Paget Disease of bone?
|
"Occlusion is changing" "Denture doesn't fit anymore"
|
|
|
What is the classic radiographic presentation for Paget Disease of bone?
|
Cotton-wool appearance, loss of lamina dura, and hypercementosis
|
|
|
Besides biopsy, what can be used to diagnose Paget Disease of bone?
|
Serum alkaline phosphatase
|
|
|
What disease is associated with a 30X risk for developing osteosarcoma, and therefore patients should not be radiographed?
|
Paget Disease of Bone
|
|
|
What disease might come from fibroblasts, cementoblasts, or osteoblasts, but we're not sure?
|
Cemento-ossifying Fibroma
|
|
|
Where does cemento-ossifying fibroma occur more: Maxilla or mandible?
|
Mandible
|
|
|
What is the age predilection for Cemento-ossifying fibroma?
|
Young adults, rarely over 40
|
|
|
Cemento-ossifying fibroma should never be used on a differential diagnosis if the unknown lesion is (pure radiolucent/opaque/mixed).
|
Pure radiolucent - COF is usually mixed
|
|
|
What is the only bone disease (besides benign/malignant bone tumors) that must be excised? Why?
|
Cemento-ossifying Fibroma - It continues to grow
|
|
|
How can you differentiate a Cemento-ossifying fibroma from a Cemento-osseous dysplasia?
|
Osteoblastic/Cementoblastic rimming is common with COF
|
|
|
What shape are benign bone tumors, usually?
|
Round
|
|
|
What disease looks similar to tori/exostoses, and fibrous dysplasia? How do you tell the difference?
|
Osteoma - osteomas grow!
|
|
|
What systemic disease is associated with Osteomas?
|
Gardner's syndrome
|
|
|
Name 5 clinical features of Gardner's syndrome.
|
1 Multiple osteomas 2 Epidermoid cysts 3 Adenomatous polyps 4 Impacted/supernumerary teeth 5 Colon cancer risk
|
|
|
Name two closely related fibro-osseous neoplasms that are only distinguished on size.
|
Osteoid osteomas and osteoblastomas
|
|
|
What is the age predilection for osteoblastoma/osteoid osteoma?
|
Adolescents/young people
|
|
|
Name the clinical feature of osteoblastoma/osteoid osteoma.
|
Pain and swelling
|
|
|
What rare disease features knobby growths on cartilage?
|
Chondroma
|
|
|
Name the disease that is Richards' favorite, which is histologically indistinguishable from the brown tumor of hyperperathyroidism.
|
Central Giant Cell Granuloma
|
|
|
What is the age and gender predilection for central giant cell granulomas?
|
Children/young adult females
|
|
|
What is the site predilection for central giant cell granuloma?
|
Mandible
|
|
|
What is the usual clinical presentation for a central giant cell granuloma?
|
Bony swelling
|
|
|
What is the radiographic appearance of a central giant cell granuloma?
|
Pure radiolucency, NOT multilocular
|
|
|
What disease histologically features multinucleated giant cells resembling osteoclasts and resembles brown tumors of hyperparathyroidism?
|
central giant cell granuloma
|
|
|
Name 2 congenital anomalies that may occur centrally in the jaws.
|
Central Hemangioma and Vascular Malformations
|
|
|
What is the age and site predilection for Central Hemangioma and Vascular Malformations?
|
Adolescents, Mandible
|
|
|
List 4 clinical features of Central Hemangioma and Vascular Malformation.
|
1 Bony destruction 2 Expansion 3 Facial asymmetry 4 Purple gingiva
|
|
|
What is the most common primary malignancy of bone?
|
Osteosarcoma
|
|
|
List 3 contributing factors for osteosarcoma.
|
1 Paget Disease of Bone 2 Prior irradiation tx 3 Osteogenesis Imperfecta
|
|
|
What is the age and site predilection for Osteosarcoma?
|
Avg. age 33, Mand=Max
|
|
|
List 4 S/S of osteosarcoma.
|
1 Pain/swelling 2 Loose teeth 3 Toothache 4 Paresthesia
|
|
|
Describe the radiographic presentation of osteosarcoma.
|
Bony expansion, mixed opacity, Sunburst, widened PDLspace
|
|
|
Name a malignancy that closely resembles Odontogenic myxoma.
|
Chondrosarcoma
|
|
|
What is the age and site predilection for chondrosarcoma?
|
Peak incidence in 7th decade, Max:Mand 4:1
|
|
|
Describe the radiographic presentation of chondrosarcoma.
|
Expansile radiolucent mass, poorly defined margins, possibly speckled opacities
|
|
|
What is the most important histologic feature of chondrosarcoma?
|
Appearance/architecture of cells
|
|
|
What is the cell of origin of Ewing Sarcoma?
|
Neuroectoderm
|
|
|
What is the age, race and site predilection of Ewing Sarcoma?
|
2nd decade, strong white predominance, Mandible
|
|
|
What is the classic radiographic presentation of Ewing Sarcoma?
|
Onion-skin layering of new bone over the cortex
|
|
|
Describe the S/S of Ewing Sarcoma.
|
pain/swelling, paresthesia, loose teeth, fever, leukocytosis
|
|
|
What is the histologic presentation of Ewing Sarcoma?
|
Small dark round cells, scant cytoplasm, little stroma, cells contain glycogen
|
|
|
What is the most common malignancy in bone?
|
metastatic tumor
|
|
|
Name 3 tumors that tend to metastisize to bone.
|
Prostate, Breast, Lung
|
|
|
Name 3 tumors that tend to metastisize to jaws.
|
Breast (30%), Lung (20%), Kidney (15%)
|
|
|
Describe the radiographic presentation of Metastatic lesions.
|
Diffuse radiolucencies, poorly defined (but can be well circumscribed)
|
|
|
What are the two most common PRIMARY malignant bone tumors?
|
Osteosarcoma and Chondrosarcoma
|
|
|
Name the 5 most common MALIGNANT tumors occurring in bone.
|
1 Metastatic Tumor 2 Multiple Myeloma 3 Osteosarcoma 4 Chondrosarcoma 5 Ewing Sarcoma
|
|
|
Name 4 bone disorders that may be difinitively diagnosed by radiograph.
|
1- Cementoblastoma 2- Compound Odontoma 3- Peripheral Cemento- Osseous Dysplasia 4- Nasopalatine Duct Cyst
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Name 2 bone disorders that have "ground glass" appearance.
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1- Hyperparathyroidism 2- Fibrous Dysplasia
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This is a condition that is associated with delayed eruption or unerupted tooth.
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Adenomatoid Odontogenic Tumor
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This bone disorder has diffuse borders and is associated with "tilted teeth."
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Central Giant Cell Granuloma
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The histology of this lesion displays eosinophilic cuffing.
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Cherubism
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My deaf cat Paget lost his dentures while playing with a cotton ball.
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You have my permission to beat the crap out of me if I miss this one!!
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This bone disorder has generalized milky opacity.
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Osteopetrosis
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The residual bone in this lesion is "delicate and wispy."
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Odontogenic Myxoma
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The onion-skin pattern of bone in this bone disorder best seen in an occlusal film.
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Osteomyelitis with proliferative periostitis
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These two bone disorders display brown tumors histologically.
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1- Hyperparathyroidism 2- Central Giant Cell Granuloma
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Name 4 bone disorders that exhibit giant cells histologically.
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1- Central Giant Cell Granuloma 2- ABC 3- Cherubism 4- Peripheral Giant Cell Granuloma
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These two bone diseases display "moth-eaten" pattern of loss.
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1- Osteomyelitis 2- Malignancies
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These 3 bone disorders are round radiographically.
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1- Cementoblastoma 2- Osteoma 3- Osteoblastoma/Osteoid osteoma
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This bone disorder has a palatal mucosal groove.
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Central Odonogenic Fibroma
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Amyloid or amyloid-like material is often present and may contain focal calcifications.
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Calcifying Epithelial Odontogenic Tumors/Pindborg tumors
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Avoid radiation Tx for these two disorders.
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1- Paget Disease of Bone 2- Fibrous Dysplasia
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This one is for me: Name the 3 P's!
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1- Pyogenic Granuloma 2- Peripheral Giant Cell Granuloma 3- Peripheral Fibroma
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