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Oral Pathology II > Exam 1 - Radiolucencies 1 > Flashcards

Exam 1 - Radiolucencies 1 Flashcards

1
Q

There is a 1 cm radiolucency at the apex of the right maxillary central incisor.

What clinical test is indicated to determine the nature of the pathologic process?

A
  • Tooth vitality tests (not always 100% accurate)
    • Cold test
    • Percussion
    • Perio probing
    • Heat test
    • Electric pulp test
    • Radiographic evidence of caries
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2
Q

There is a 1 cm radiolucency at the apex of the right maxillary central incisor.

In an asymptomatic patient, what 2 conditions would this most likely represent?

A
  1. Periapical granuloma
  2. Apical periodontal cyst (radicular cyst)

**Periapical abscess - if patient presented with pain**

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3
Q

There is a 1 cm radiolucency at the apex of the right maxillary central incisor.

How would you treat this lesion, after determining that the tooth is NOT vital?

A
  • Root canal therapy - 90% healing chance
  • Periapical surgery
  • Extraction

If the tooth was vital = not tooth related.

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4
Q

17 year old white female, dull pain on left anterior maxilla. Large radiolucency at apex of maxillary left lateral incisor. Vital tests = non-vital

What is the differential diagnosis?

A
  1. Periapical Abscess
  2. Periapical granuloma (looks the same as radicular cysts)
  3. Radicular cyst
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5
Q

17 year old white female, dull pain on left anterior maxilla. Large radiolucency at apex of maxillary left lateral incisor. Vital tests = non-vital

How could one determine from the differential diagnosis what this lesion is?

A
  • Microscopic diagnosis
    • Currette the site and if there’s granulation tissue = periapical granuloma
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6
Q

Define granulation tissue?

A
  • New vascular tissue in granular form on an ulcer or the healing surface of a wound.

** Basic healing tissue **

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7
Q

38 y/o vietnamese male presents with a well-circumscribed radiolucency between mandibular right cuspid and central incisor (lateral was probably extracted). It is symmetrical, asymptomatic, and corticated.

What is the differential diagnosis?

A
  • Residual cyst - cyst that persist in bone after EXT
  • Keratocystic odontogenic tumor (KOT)
  • Stafne bone cyst (rare) - no tx needed
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8
Q

38 y/o vietnamese male presents with a well-circumscribed radiolucency between mandibular right cuspid and central incisor (lateral was probably extracted). It is symmetrical, asymptomatic, and corticated.

What does the radiopacity in the lesion’s margin represent and what does it tell you about the growth characteristics of the pathologic process?

A
  • A corticated border
    • Static or slow growing process
    • Resembles lamina dura surrounding root of a tooth
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9
Q

38 y/o vietnamese male presents with a well-circumscribed radiolucency between mandibular right cuspid and central incisor (lateral was probably extracted). It is symmetrical, asymptomatic, and corticated.

How would you establish a diagnosis in this case?

A
  • Residual cyst - associated with ext tooth, adult males
  • KOT - with adults, no sex predilection
  • CBCT will rule out Stafne bone cyst
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10
Q

38 y/o vietnamese male presents with a well-circumscribed radiolucency between mandibular right cuspid and central incisor (lateral was probably extracted). It is symmetrical, asymptomatic, and corticated.

What are the microscopic diagnosis in this case?

A
  • Residual cyst - lined iwht stratified squamous epithelium, may contain hyaline bodies within spinous cell layer. Inflammatory cell infiltrate
  • KOT has a distinct lumne: filled with desquamated keratin.
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11
Q

32 y/o African-American male presents with divergence of maxillary central insicors. Radiographs show large, well-circumscribed lucency between roots of the involved teeth. Teeth tested vital.

What is the differential diagnosis?

A
  • Periapical granuloma or cyst (pathology)
  • Nasopalatine duct cyst
  • Medican palatal cyst
  • Keratocyst
  • Central giant cell granuloma
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12
Q

32 y/o African-American male presents with divergence of maxillary central insicors. Radiographs show large, well-circumscribed lucency between roots of the involved teeth. Teeth tested vital.

What clinical test could be used to help distinguish between these 2 most likely choices?

A

Vitality testing of #8 and 9

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13
Q

32 y/o African-American male presents with divergence of maxillary central insicors. Radiographs show large, well-circumscribed lucency between roots of the involved teeth. Teeth tested vital.

How would the results of your clinical test alter treatment?

A
  • If teeth tested vital -
    • Surgical removal of cyst (nasopalatine duct cyst)
  • Non-vital
    • RCT
    • EXT
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14
Q

62 y/o white female presents with pain and paresthesia on left mandible. Radiographs show poorly circumscribed lucency of mandibular midbody. Also soft tissue swelling of edentulous alveolar ridge distal to 2nd premolar.

What is the differential diagnosis?

A
  • Metastatic tumor to the jaws
  • Acute osteomyelitis (pus = infection)
  • Osteosarcoma (malignant)
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15
Q

62 y/o white female presents with pain and paresthesia on left mandible. Radiographs show poorly circumscribed lucency of mandibular midbody. Also soft tissue swelling of edentulous alveolar ridge distal to 2nd premolar.

Of what significance, if any, is the paresthesia?

A
  • Indication of involvement of the IA nerve.
  • Can be from acute osteomyelitis, but in general this is indicative of a malignancy.
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16
Q

62 y/o white female presents with pain and paresthesia on left mandible. Radiographs show poorly circumscribed lucency of mandibular midbody. Also soft tissue swelling of edentulous alveolar ridge distal to 2nd premolar.

What is the most commony malignancy affecting the jaws?

A
  • Metastatic disease
    • Females - Breast cancer
    • Males - Lung cancer
17
Q

62 y/o white female presents with pain and paresthesia on left mandible. Radiographs show poorly circumscribed lucency of mandibular midbody. Also soft tissue swelling of edentulous alveolar ridge distal to 2nd premolar.

To determine the diagnosis, what microscopic orders could be performed?

A
  • Test for leukocytes - (elevated WBC count)
18
Q

62 y/o white female presents with pain and paresthesia on left mandible. Radiographs show poorly circumscribed lucency of mandibular midbody. Also soft tissue swelling of edentulous alveolar ridge distal to 2nd premolar.

If this indicates involvement of the IA nerve, what does that mean?

A
  • Can be from acute osteomyelitis - but in general it is indicative of a malignancy
19
Q

A 42 y/o white male presents with impacted 3rd molar with large radiolucency around its crown. The tooth had been displaces to the inferior border of the mandible.

What is the differential diagnosis?

A
  • Denitgerous cyst
  • Orthokeratinized odontogenic cyst
  • Odontogenic keratocyst
20
Q

A 42 y/o white male presents with impacted 3rd molar with large radiolucency around its crown. The tooth had been displaces to the inferior border of the mandible.

What is the provisional diagnosis?

A
  • Dentigerous cyst - (this has to be pericoronal)
  • Very slow process, benign because of the displacement of teeth, symmetrical, corticated
21
Q

14 y/o white male presents with diagnosis of asymptomatic radiolucency of his right posterior mandible. No swelling or tenderness, vital teeth, lucecny was from 2nd PM to 2nd M and extended up between the roots of the teeth.

Differential diagnosis?

A
  • All benign
    • Tramatic bone cyst
    • KOT
    • Cementofying fibroma
    • Gorlin cyst
22
Q

14 y/o white male presents with diagnosis of asymptomatic radiolucency of his right posterior mandible. No swelling or tenderness, vital teeth, lucecny was from 2nd PM to 2nd M and extended up between the roots of the teeth.

Provisional diagnosis?

A
  • Traumatic bone cyst - empty cavity in the bone
23
Q

What presents with the classic feature of scalloping of the lesion up between the roots?

A
  • Traumatic bone cyst
24
Q

Small discrete well circumscribed lucency is found midway between roots of mandibular cuspid and lateral incisor of 37 y/o white male. Pt was asymptomatic and unaware of lesion.

Differential diagnosis?

A
  • Lateral periodontal cyst - (teeth are vital)
  • Odontogenic keratocyst
  • Ameloblastoma
25
Q

Small discrete well circumscribed lucency is found midway between roots of mandibular cuspid and lateral incisor of 37 y/o white male. Pt was asymptomatic and unaware of lesion.

How would you establish a diagnosis?

A
  • Check vitality (if the lesion ever touched the root - do this!)
26
Q

** 17 y/o white female present with discomfort and slight swelling on left mandible. Pano shows multilocular lucency from left 3rd molar to right 1st premolar.

Differential diagnosis?

A

MULTILOCULAR RADIOLUCENCY

  • Ameloblastoma (multilocular)
  • Giant Cell Granuloma (more common in anterior region of jaws)
  • Odontogenic keratocyst (diagnosis)
27
Q

** 17 y/o white female present with discomfort and slight swelling on left mandible. Pano shows multilocular lucency from left 3rd molar to right 1st premolar.

What is the only one lesion that is malignant that wil produce multilocularity?

A

Central Mucoepidermoid Carcinoma

28
Q

34 y/o female complained of swelling of her left body of manible. Radiographs show an expansile lucency containing numerous fine opaque bony trabeculations.

Does the cortical expansion suggest a benign or malignant process? Explain.

A

Pathology putting pressure on inside of the cortex, therefore the mandible body is making new bone on the outside of the cortex.. Bone in ‘moving’ (remodeling).

Cortical expansion - suggest a benign process

29
Q

34 y/o female complained of swelling of her left body of manible. Radiographs show an expansile lucency containing numerous fine opaque bony trabeculations.

Differential diagnosis?

A
  • Ameloblastoma
  • Odontogenic keratocyst
  • Odontogenic Myxoma - diagnosis

Oral Pathology II (5 decks)

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