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Flashcards in 4. Physical and Chemical injury Deck (141)
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1

Where do most Traumatic Bone Cysts occur?

Mandible

2

What population is effected by Traumatic Bone Cysts?

Males 10-20 y.o.

3

What is the Pathogenesis of Traumatic Bone Cysts?

Intramedullary Hemorrhage

  • Instead of healing by organization of the clot with bone fill, the clot dissolves leaving an empty hole, rather than organizing with granulation tissue & bone fill

4

What are the unproven Etiologies of Traumatic Bone Cysts?

  • Trauma not proven, but reported in 50%
  • Vascular infarct that causes the bone to dissolve

5

What is the Radiographic appearance of Traumatic Bone Cysts?

  • Small to large, well-defined pure RL with sclerotic border (rim of RO around border)
  • Scalloped upper margin interdigitates bwtn tooth roots
    • “Tooth floating in bone”
  • Lower border of the lesion is above the mandibular canal 

6

What are some surgical findings associated with Traumatic Bone Cysts? (3)

  • Aspiration yeilds - air OR serous/bloody non-clotting fluid 
  • Empty hole at surgery 
  • No epithelial lining, just a thin fibrous membrane

7

What is the Treatment protocol for Traumatic Bone Cysts?

  • Eventually heals spontaneously without tx 
  • Surgery induces hemorrhage which speeds healing 

8

Where is a Hematopoietic (Osteoporotic) Bone Marrow Defect found? 

Posterior Mandible 

9

In what population does Hematopoietic (Osteoporotic) Bone Marrow Defect typically occur in?

Females (5:1)

10

What is the pathogenesis of Hematopoietic (Osteoporotic) Bone Marrow Defect?

  • Healing defect – following an extraction
    • Red bone marrow fills socket instead of bone
    • Left with a RL 

11

What is the etiology of a Hematopoietic Bone Marrow Defect?

Iatrogeneic - follows extraction of a tooth

12

What is the Radiographic appearance of a Hematopoietic Bone Marrow Defect?

  • Small, ill-defined RL in a former extraction site, usually mandibular molar area
  • Lobulated with trabecular pattern

13

What is the Histology of a Hematopoietic Bone Marrow Defect?

  • Normal red bone marrow

  • Pleomorphic looking cells with fat cells & megakaryocytes (large cells with abundant pink cytoplasm, look like they are multinucleated)

14

What is the Treatment for a Hematopoietic Bone Marrow Defect?

  • Innocuous = Leave Alone

15

What is the location of a Surgical Ciliated Cyst?

ONLY in Posterior Maxilla

16

What is the Pathogenesis/Etiology of a Surgical Ciliated Cyst?

  • Iatrogenic = antral surgery or when a dental extraction perforates the sinus & fragments of sinus lining becomes entrapped in the maxilla, fragments drop into alveolar bone & proliferates into a cyst

17

What is the clinical presentation of a Surgical Ciliated Cyst?

  • Vague maxillary pain/swelling or discomfort
  • History of extraction or oral-antral surgery

18

What is the Radiographic presentation of a Surgical CIliated Cyst?

Well-defined RL in Posterior Maxilla approximating the sinus 

19

What is the Histology of a Surgical Ciliated Cyst?

Normal sinus lining = pseudostratified ciliated columnar epithelium with goblet mucous cells

20

What is the Treatment for a Surgical Ciliated Cyst?

Remove and Biopsy

21

Where is a Pulse Granuloma found?

Mandibular 3rd Molar Extraction Site

22

What is the Pathogenesis of a Pulse Granuloma?

  • Leguminous vegetable material (pulse) enters extraction site & evokes chronic foreign body inflammatory rxn 
    • Cellulous can't be digested 

23

What is the Clinical Presentation of a Pulse Granuloma? 

  • Months after an extraction of mandibular 3rd molars the pt gets a dull ache in the area
    • Surgical Ciliated Cysts also has the symptom of a dull/vague pain, but they are location in the posterior maxilla

24

What is the Radiographic appearance of a Pulse Granuloma?

ill-defined RL

25

What is the Histology of a Pulse Granuloma?

  • Spherical bodies surrounded by a foreign body giant cell rxn

26

Where would a Lipid Granuloma (myospherulosis) be found?

Mandibular 3rd Molar Extraction Site 

27

What is the Pathologenesis of a Lipid Granuloma?

  • Oily foreign body enters or is placed in an extraction site (mand 3rd molars)
    • Topical Antibiotic Swab that contains Petroleum 
    • The lipid causes the foreign body giant cell response

28

What is the histology of a Lipid Granuloma?

  • Clear (lipid) Vacuoles surrounded by a Foreign Body - Giant Cell Rxn

29

What is the Treatment for a Lipid Granuloma?

Remove and Biopsy

30

What are the 3 possible ways you can get an Air Emphysema?

  1. Opening up a laceration in the oral cavity
    • Air/water syringe shoots air into the oral cavity

    • Some of the air gets trapped in the laceration & enters soft tissues of face then enters mediastinum

  2. Blowing lots of air into laceration that has potentially infectious debris from oral cavity

  3. Using an air syringe during RCT, where a blast of air gets to the tip of the apex

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