abnormalities of bone

Question 1

What is a focal osteoporotic marrow defect?

Answer 1

An area of hematopoietic marrow sufficient in size to produce a radiolucency.

Question 2

What does a focal osteoporotic marrow defect mimic?

Answer 2

Pathology.

Question 3

Where is a focal osteoporotic marrow defect typically located?

Answer 3

Posterior mandible.

Question 4

What is idiopathic osteosclerosis?

Answer 4

A focal increase in bone density.

Question 5

What does idiopathic osteosclerosis appear as?

Answer 5

Dense bone islands.

Question 6

Where is idiopathic osteosclerosis located?

Answer 6

Mandible.

Question 7

Is idiopathic osteosclerosis expansile?

Answer 7

Non-expansile.

Question 8

What is a simple bone cyst?

Answer 8

A benign empty or fluid-filled cavity.

Question 9

Is a simple bone cyst a true cyst?

Answer 9

Not a true cyst.

Question 10

What radiographic appearance is associated with simple bone cyst?

Answer 10

Scalloping between roots.

Question 11

What is a central giant cell granuloma?

Answer 11

Destructive lesions of the jaw comprised of osteoclast giant cells.

Question 12

Where is a central giant cell granuloma typically located?

Answer 12

Mandible, anterior to the first molar.

Question 13

Can a central giant cell granuloma cross the midline?

Answer 13

Yes, it may cross the midline.

Question 14

What is cherubism?

Answer 14

A rare autosomal dominant condition.

Question 15

What are the characteristics of cherubism?

Answer 15

Bilateral expansion in the posterior mandible.

Question 16

What is the typical disease course of Cherubism?

Answer 16

Remission and involution after puberty.

Question 17

What are the types of benign fibro-osseous lesions?

Answer 17

Cemento-osseous dysplasia, including peri-apical, focal, and florid cemento-osseous dysplasia, and fibrous dysplasia.

Question 18

Where does Peri-apical cemento-osseous dysplasia occur and in whom?

Answer 18

Anterior mandible, black females.

Question 19

Where does focal cemento-osseous dysplasia occur?

Answer 19

Posterior mandible and is solitary.

Question 20

Where does florid cemento-osseous dysplasia occur?

Answer 20

Multifocal involvement, often symmetric in all four quadrants.

Question 21

What are the stages of benign fibro-osseous lesions?

Answer 21

Fibroblastic early stage progressing to a later stage with bone deposition.

Question 22

What is the treatment for benign fibro-osseous lesions?

Answer 22

No treatment is needed.

Question 23

Is it safe to place implants in areas of benign fibro-osseous lesions?

Answer 23

Do not place implants in areas of lesions.

Question 24

What gene is mutated in fibrous dysplasia?

Answer 24

Postzygotic mutation of the GNAS1 gene.

Question 25

What is monostotic fibrous dysplasia?

Answer 25

Enlargement of a single bone, often the maxilla, with ground-glass opacification.

Question 26

What syndromes are associated with fibrous dysplasia?

Answer 26

Jaffe-Lichtenstein and McCune-Albright syndrome, associated with café au lait spots.

Question 27

What is Mazabraud syndrome?

Answer 27

Fibrous dysplasia + myxomas.

Question 28

What radiographic appearance is associated with fibrous dysplasia?

Answer 28

Chinese character bone.

Question 29

What is an ossifying fibroma?

Answer 29

A neoplasm of fibro-osseous differentiation.

Question 30

Where is ossifying fibroma typically located?

Answer 30

Mandibular molar-premolar region.

Question 31

What is the growth potential of ossifying fibroma?

Answer 31

Potential for massive growth.

Question 32

What is Langerhans Cell Histiocytosis?

Answer 32

Neoplastic proliferation of Langerhans cells.

Question 33

What genetic mutation is associated with Langerhans Cell Histiocytosis?

Answer 33

BRAF mutation in 40-60%.

Question 34

What are the types of Langerhans Cell Histiocytosis?

Answer 34

Acute/chronic disseminated histiocytosis, monostotic/polyostotic eosinophilic granuloma of bone.

Question 35

Who is typically affected by Langerhans Cell Histiocytosis?

Answer 35

Young patients.

Question 36

What oral manifestations are associated with Langerhans Cell Histiocytosis?

Answer 36

Proliferative gingival mass.

Question 37

What radiographic appearance is associated with Langerhans Cell Histiocytosis?

Answer 37

"Floating in air" appearance.

Question 38

What condition does Langerhans Cell Histiocytosis mimic?

Answer 38

Chronic periodontitis.

Question 39

What is the treatment for Langerhans Cell Histiocytosis?

Answer 39

Curettage.

Question 40

The most common primary malignant tumor of bone.

Answer 40

Osteosarcoma

Question 41

What is the main characteristic of osteosarcoma?

Answer 41

Malignancy with the ability to produce osteoid or bone.

Question 42

Age is typically affected by osteosarcoma?

Answer 42

Adolescents or those above age 60.

Question 43

What radiographic features are associated with osteosarcoma?

Answer 43

Widening of PDL, spiking root resorption, Sunburst/Sunray appearance.

Question 44

What is the most common malignancy affecting bone?

Answer 44

Metastatic carcinoma.

Question 45

What are the most common primary sites for malignancies that metastasize to the jaw?

Answer 45

Breast (in females), lung, thyroid, prostate (in males), kidney, colorectal, melanoma.

Question 46

What bones are most frequently affected by metastasis?

Answer 46

Vertebrae, ribs, pelvis, skull.

Question 47

How does metastasis spread to the jaw?

Answer 47

Hematogenous spread via the Batson paravertebral plexus of veins.

Question 48

What is the significance of jaw metastasis?

Answer 48

In 20-25% of cases, the metastatic deposit is the first indication of malignancy.

Question 49

What radiographic appearance is associated with metastasis to the jaw?

Answer 49

Moth-eaten radiolucency.

Question 50

What are bone characteristics of osteogenesis imperfecta?

Answer 50

Low bone density and bone fragility.

Question 51

What is the genetic basis of osteogenesis imperfecta?

Answer 51

Autosomal dominant mutation of COL1A1 and COL1A2 affecting type 1 collagen formation.

Question 52

What does type 1 collagen affect?

Answer 52

Bone, dentin, sclerae, ligaments, skin.

Question 53

What are the dental alterations seen in osteogenesis imperfecta?

Answer 53

Dental alterations identical to dentinogenesis imperfecta, translucent teeth, shell teeth (Types 3 and 4).

Question 54

What is osteopetrosis?

Answer 54

Increased bone density.

Question 55

What is the underlying defect in osteopetrosis?

Answer 55

Defect in osteoclastic function/differentiation.

Question 56

What are the types of osteopetrosis?

Answer 56

Autosomal recessive infantile, autosomal recessive intermediate, autosomal dominant adult.

Question 57

What are the characteristics of autosomal recessive infantile osteopetrosis?

Answer 57

At birth or early infancy, normocytic anemia, bone marrow failure.

Question 58

What are the characteristics of autosomal recessive intermediate osteopetrosis?

Answer 58

Later childhood onset, rare bone marrow failure.

Question 59

What are the characteristics of autosomal dominant adult osteopetrosis?

Answer 59

Adolescence/adulthood onset, mildest form and most common, no anemia or bone marrow failure, increased density of jaw bones = susceptible to infection and fracture.

Question 60

What does cleidocranial dysplasia affect?

Answer 60

Bone and teeth formation.

Question 61

What gene is associated with cleidocranial dysplasia?

Answer 61

RUNX2 gene.

Question 62

What skeletal features are affected in cleidocranial dysplasia?

Answer 62

Clavicles and skull (hypoplastic, discontinuous, or absent).

Question 63

What oral features are associated with cleidocranial dysplasia?

Answer 63

Narrow, high arch palate, increased incidence of cleft palate, mandibular prognathism, failed eruption of permanent teeth, over-retention of primary teeth, supernumerary teeth.