Bone pathology Flashcards
What is a torus
- exostosis
- torus palatinus = midline of palate
- torus mandibularis = in mandible
What is an exostosis
defined as an extra growth of bone that extends outward from existing bone
Where is tori mandibularis usually seen
- lingual aspect of mandible
- premolar region
- generally unproblematic unless px wants denture
How do osteogenesis imperfecta px present clinically
weak bones
multiple fractures
sometimes associated with dentinogenesis imperfecta
What is fibrous dysplasia
- due to gene defect
- slow growing, asymptomatic bony swelling where bone is replaced by fibrous tissue
How does fibrous dysplasia appear radiographically
- cotton wool appearance
- ill defined margins which blend into bone
- bone maintains approximate shape initially
- becomes more radiopaque as the lesion matures
What is rarefying osteitis
- localised loss of bone in response to inflammation
- it is a process, not a pathology
What causes rarefying osteitis
- inflammatory factors coming from necrotic pulp and resorb the apex
- if at the apex of the tooth, consider PA periodontitis, periapical granuloma or periapical abscess
What is sclerosising osteitis
- localised increase in bone density in response to low grade inflammation
- most common around apex of a tooth with a necrotic pulp
How does sclerosing osteitis present
- periapical radiopacity
- often poorly defined
- may eventually lead to external root resorption if chronic
*also known as condensing osteitis
What is idiopathic osteosclerosis
- localised increase in bone density of unknown cause
Where is idiopathic osteosclerosis most common
- premolar/molar region of mandible
How does idiopathic osteosclerosis present
- always asymptomatic
- no bony expansion
- no effect on adj structures
- similar to sclerosising osteitis - vitality test and look out for symptoms
What is alveolar osteitis aka
dry socket
complication of XLA
What is alveolar osteitis due to
clot being lost too early
should be recognised as part of healing process
leaves behind bony sequestra
What are risk factors for alveolar osteitis
- smoking
- OCP
- difficult XLA
- mandible
- posterior
- rinsing too soon
What is the management of dry socket
- can use medicaments e.g alveogyl however can slow healing
- best management = encourage healing and allow new clot formation
What is osteomyelitis
rare endogenous infection
What is the theory surrounding the cause of osteomyelitis
- compound fracture creation when performing XLA which exposes the fracture to the air
- can be acute or chronic
What is supparative osteomyelitis
- source of infeciton = teeth e.g abscess
- anaerobic predominate
- mandible most ocmmon
- vascular supply reduced
- organisms proliferate in the marrow space - acute inflammatory reaction
- necrosis and suppuration ensue
- sequestreum may exfoliate or be removed surgically