Jaw Lesions (Deluke) Flashcards
(27 cards)
What are 8 differentials for mixed lucent/opaque lesions?
- Fibrous dysplasia
- Ossifying fibroma
- Cementoma
- Pindborg tumor/CEOT
- AOT
- Metastatic tumor
- Osteosarcoma
- ORN/BRON-J
Adenomatoid Odontogenic tumor (AOT) most commonly occurs where ?
Anterior maxilla in pts 10-19 yrs old
What has a ground glass appearance on radiograph?
Fibrous dysplasia
What is an dontogenic neoplasm of cementoblasts that will look fused to root with a radiolucent rim?
Cementoblastoma
What will have a “driven snow” appearance on radiograph due to calcifications within the radiolucent area of this odontogenic tumor?
Calcifying epithelial odontogenic tumor / Pindborg tumor
What is a malignancy of mesenchymal cells that have ability to produce osteoid or immature bone and is the most common type of malignancy to originate within bone (Can have a sunburst radiographic pattern)?
Osteosarcoma
What is the characteristic histologic look of fibrous dysplasia?
Chinese character look of bone trabeculation
Treatment of benign jaw lesions should be approached how?
Tailored to size and behavior of the lesion
What is the most common area for an odontogenic keratocyst to occur?
Posterior mandible (will be multilocular)
What is the most common clinically significant odontogenic tumor, occurring most often in the posterior mandible and can have a soap bubble radiographic appearance?
Ameloblastoma, treated with marginal resection
Myxomas occur in what age group, and can cause displacement teeth or resorb roots, can be soap bubble radiograph as with the ameloblastoma?
25-30 yrs
If you see a soap bubble appearance in the posterior mandible and the differential is myxoma or ameloblastoma, what is the age consideration that can place one above the other on the differential?
Ameloblastoma in 30-70 yr olds
Myxoma common in 20-30 yr olds
What are 5 common radiolucent lesions of the mandible and maxilla?
- Radicular Cyst
- Keratocyst
- Odontogenic tumor (ameloblastoma, myxoma)
- Central Giant Cell Lesion
- Central Vascular Lesion
What is the diagnosis for multilocular radiolucency at the roots of a vital tooth, no root resorption, no expansion and the histology shows Giant cells?
Central Giant Cell
What are 3 possible treatments for Central Giant Cell?
- Curettage
- Excision and peripheral ostectomy
- Wide resection
A central giant cell lesion occurs most commonly before what age?
30 years old
When you get a giant cell histology back, what is the other systemic consideration for the differential?
Hyperparathyroidism because giant cell is histologically identical to Brown’s tumor of hyperparathyroidism
What is the best treatment for a Central Giant cell lesion?
Excision and peripheral ostectomy
The treatment of benign jaw lesions is based on what?
Aggressiveness of pathology and likelihood of recurrence
What are 2 consequences of excising a large dentigerous cyst in the posterior mandible?
- Compromise integrity of mandible
2. Paresthesia
To avoid compromising mandibular and integrity and paresthesia (which are consequences of excision), what is another option for treatment of dentigerous cyst?
Marsupialization / decompression
What are 6 surgical approaches to bony jaw pathology?
- Simple curettage
- Excision with peripheral ostectomy
- En bloc resection
- Decompression or Marsupialization
- Embolization (Vascular lesions)
- Chemical Cautery or Cryotherapy
What is a surgical approach that after cyst has been enucleated a curette or bur is used to remove 1-2 mm of bone around the entire periphery of the cystic cavity to remove any remaining epithelial cells that could proliferate and cause cyst recurrence?
Curettage
What is a surgical approach that after cyst is enucleated, use large round burs to remove a good amount of bone (up to 1 cm) from margin of walls?
Excision with peripheral ostectomy
