midterm

Question 1

will get inflammatory exudate enter the PDL at root apex= widening of PDL space= first xr appearance
-discont. of lamina dura

Answer 1

acute periapical abscess

reversible and irreverisble pulpitis (acute= may not see anything or may see widening of PDL)

Question 2

eventually get a PPA radiolucency = chronic

can be CPA, periapical granuloma, periapical cyst

these are all under the same term

abscess and granulomas go back and forth

Answer 2

periapical rarefying osteitis

Question 3

normal to see small radiolucency with sclerotic bone around it

requires RCT

usually ill defined border

Answer 3

chronic periapical apical abscess

Question 4

Inflammatory like granulation tissue

Develops from pre-existing abscess and then changed to granuloma
OR initial PA lesion from infection

Can have well or ill defined borders, may have a thin radiopaque border around it, may have external root resorption at apex

Requires RCT

Answer 4

periapical granuloma

Question 5

most common cyst in jaw

-usually develops from granuloma, cystic degeneration of granuloma= fluid filled cavity

-may get larger and flatten out by other teeth
-usually well defined RADIOPAQUE BORDER

does not require RCT

Answer 5

periapical cyst

Question 6

residual remnants of periapical cysts. they occur due to incomplete removal of periapical cysts during a previous tooth ext= more common

=cyst was nucleated during procedure but has returned is this:

Answer 6

recurrent/residual cyst

Question 7

Aka parulis or gum boil or DST

Infection perforates through bone, drains, builds up, and drains again = feel good for a little bit

May or may not see the draining sinus tract in the radiograp

Answer 7

chronic apical abscess

Question 8

Inflammatory fluid penetrating through sinus and elevates the periosteum = stimulates it to lay down a thin layer of bone, this process repeats itself multiple times

Aka periostitis

Essentially elevating the floor of sinus in that area

Answer 8

periapical halo formation

Question 9

etiology unknown

mainly involves lower incisors (anterior mandible) → multiple lesions

Lamina dura is discontinuous, well-defined margins, BUT teeth are vital

radiolucent can easily be misdx as PA lesion

middle aged AA and asian females

3 stages of development:
radiolucent, fills in with small radiopacities, eventually mainly radiopaque with thin radiolucnet border

Answer 9

periapical cemento-osseous dysplasia

Question 10

after tooth ext

If periosteum is destroyed, loses ability to produce bone = distinct radiolucent area with sharp border that is NOT corticated (not radiopaque)

should NOT change over time

also after surgery such as surgical apicoectomy

Answer 10

fibrous healing defect

Question 11

variation of fibrous healing defect after doing endo on tooth

near apex, may reach a point where it stops filling in with bone

DOES NOT change over time and doesn’t mean RCT wasnt unsuccessful

Answer 11

apical scar

Question 12

if cancer metastasizes from different other, it can affect teeth

PA radiolucent with strands of trabecular bone

if gets in PDL= irregular widening of PDL (not uniform)

Answer 12

metastatic carcinoma

Question 13

remnant of dental follicle adjacent to a developed crown of an unerupted or impacted tooth should be no greater than

3 pano
2.5 PA
2 CBCT

Answer 13

follicular space

Question 14

if dental follicle gets infected, the inflammation spreads along the deep fascial planes

redness, pain, fever

can cause cellulitis- facial swelling

abx and ext

Answer 14

pericoronitis

Question 15

2nd most common cyst in jaw (20%)

-cystic lining arises from remnants of dental follicle

wider than 3mm
well defined radiolucency with corticated borders

ages 20-30

enucleate, surgery and remove tooth as well

older pts= dont need to remove impacted tooth bc hasn’t become cystic yet

-it can expand and displace nearby teeth, and eventually turn in to two things:

Answer 15

dentigerous cyst

ameloblastoma and squamous cell carcinoma

Question 16

soft tissue fluid filled swelling of crestal mucosa in area of erupting tooth, usually blueish color due to trauma

lack of alveolar bone

younger than 10 and in mixed dent

usually mand molars

can rupture on own or may need simple excision

Answer 16

eruption cyst

Question 17

mixed odontgenic tumor, filled with solid mass of cells

well defined pericoronal radiolucency assoc with developing tooth, usually corticated and can expand

exception: sometimes tissue can separate from developing tooth and be on its own

70 younger than 20yo!!!!!!!

sites: mand molar and PM area

enucleation and usually tooth with it

Answer 17

ameloblastic fibroma

where is it located again?

Question 18

mixed odontogenic tumor, similar to ameloblastic fibroma but has mineralized stroma

radiopacity tooth like structures in the lumen, well corticated

younger than 15yo

site: posterior mandible

if it EXPANDs and displace tissues, really aggressive= odontoameloblastoma

Answer 18

ameloblastic fibro-odontoma

where is it located again?

Question 19

3-7% of odontogenic tumors, can cause asymptomatic swelling in jaw, will get larger and displaced more tissue

histo: arranged into duct like glandular array

widened follicular space, well demarcated radiolucency with corticated border, may or may not see flecks on xr

mostly in anterior jaw of maxilla

remove tumor and usually doesnt reoccur

Answer 19

adenomatoid odontogenic tumor

where is it located again?

Question 20

aka pindborg tumor

50% assoc with impacted teeth
VERY aggressive, rare

radiopaque flecks due to calcifed amyloid, breakdown product of neoplastic epithelial cells that calcify called Leisegang rings

tx resection (tumor and more tissue)

age 40 yo

most in mandible posterior

Answer 20

calcifying epithelial odontogenic tumor

where is it located?

age?

Question 21

gorlin cyst

variable, can behave as neoplasm but is true cyst

varies from uni-multi and have some radiopacities in lumen

not age/gender specific

enucleation, minimal recurrence

Answer 21

calcifying odontogenic cyst

Question 22

described as heart shaped radiolucency when superimposed with anterior nasal spine, but its actually shaped ovoid

Answer 22

incisive canal (nasopalatine) cyst

Question 23

developmental cyst that occurs along line of embryonic fusion

when primary and secondary palate fuse

between CI where incise foramen is

may have DST, very slow growing

unilocular radiolucency in max midline, alters incisive canals, can cause root divergence, usually corticated

older age

Answer 23

incisive canal (nasopalatine) cyst

Question 24

development cyst from fusion of mand halves, VERY rare

in middle of mandible (symphysis)

unilocular radiolucency in the symphyseal region

Answer 24

median mandibular cyst

Question 25

development cyst from fusion of palatal shelves, more posterior to nasopalatine mid palatine posterior to papilla simple enucleation

Answer 25

mid-palatine cyst

Question 26

occurs between roots, pathognomonic canine/PM region in mandible well defined, radiolucency, round, corticated MIDDLE AGE MORE IN MALES not recurrent, surgical enculeation, diff from OKC and ameloblastoma

Answer 26

lateral periodontal cyst

Question 27

area where there is NOT trabecular pattern due to uncoordinated bone growth and turnover, not actually a cyst at all >1 root apex in body and ramus of mandible no solid tumor, no cystic lining, just empty bone pattern, unilocular radiolucency with interradicular scalloped superior margins <25yo because activity growing **INITIATE BLEEDING by scraping the bone= bone healing, rare recurrent

Answer 27

simple (solitary, Traumatic bone) cyst

Question 28

other names for simple bone cyst

Answer 28

USHITE unicameral bone cyst solitary bone cyst hemorrhagic bone cyst itravastional bone cyst traumatic bone cystic extravasational bone cyst

Question 29

pathognomonic, WILL see and need to know, occurs in BASAL bone, not alveolar bone depresion in posterior mandible, M3 area anterior to mandibular canal between mandibular canal and inferior border over 50 yo VERY specific to men monitor over time!!!! do NOT biopsy

Answer 29

PLMSG posterior lingual mandibular salivary gland depression stafne cyst PLMSG bone defect

Question 30

lack of trabeculation (bone is less dense), mandible not expansive unilocular FAINT radiolucency, difficult to discern as separate entity, not clearly defined lack of trabeculation females since slower bone turnover no tx

Answer 30

focal osteoporotic bone marrow defect

Question 31

went away and came back: never was removed completely (usually this):

Answer 31

recurrent went away and came back residual never was removed completel

Question 32

more common in max -found on xr of edentulous areas tooth or root may be present, hx of PA disease well defined radiolucency with smooth round corticated borders middle age or older males

Answer 32

recurrent/residual cyst

Question 33

develops after trauma that affects the integrity of periosteum and only fibrous CT fills the site--> seen in fractures location is where there has been previous disease or trauma well circumscribed radiolucent lesion at site of previous surgery "punched out or see through"

Answer 33

fibrous healing defect

Question 34

IN MANDIBULAR CANAL expanison, pain, paraesthesia, burning, tingling, aching sensations well circumscribed radiolucency of various shapes in the mand and it usually forms in the mand canal excision, rare recurrence

Answer 34

neuroma, neurofibroma

Question 35

**benign odontogenic neoplasm (solid tumor of odontogenic origin) capable of uncontrolled, unlimited growth if leave alone 1. most common type 2. five subtypes: follicular is most common 3. painless, small lesions detected by xr, large by clinically -unilocular, corticated small lesions or large aggressive lesions (finger like extensions, can displace teeth, soap bubbles) adults more 85% in mand BONE RESECTION 50-90% RECURRENT if not resected (v high due to finger like projections)

Answer 35

conventional (multicystic) ameloblastoma

Question 36

amelobastoma arising within a lining of a cyst (dentigerous or PA) still within wall of cyst and is contained 1. less aggressive form bc contained 2. no finger like projections lower recurrence rates and no need for resection looks like dentigerous cyst but attachment is at root and like CEJ (looks like periapical cyst) age: 23 90% mand

Answer 36

unilocular ameloblastoma

Question 37

3rd most common cyst in jaw 10-12% - arises from cell rests of dental lamina, very aggressive and behaves like benign neoplasm -increasing size and produces keraitn -multilocular -MILD B-L expansion, most AP males 60-80% posterior mand to canines do NOT resection because well contained ****multiple (bilateral) found in jaw in nevoid basal cell carcinoma syndrome *****

Answer 37

OKC odontogenic keratocyst

Question 38

benign, intraosseous lesion of jaw, multinnucleated giant cells well-defined borders, displacement of teeth, MULTILOCULAR, MIXED <30 yo females 70% mand between molars (looks like browns tumor of hyperparathy, so need to rule out)

Answer 38

central giant cell granuloma CGCG

Question 39

CT/pulpal tissue growing out of control, lesion of alveolar bone consider ameloblastoma, CGCG, need, biopsy scalloped and multiolocular 25-30 mandible not resect

Answer 39

odontogenic myxoma

Question 40

autosomal dominant inherited = 50% offspring cosmetic osseous contouring at age 12+, can leave because is self-limiting bilateral multilocular

Answer 40

Familial Fibrous Dysplasia Aka Cherubism

Question 41

most serious because arterial proliferation in jaw bone vascular lesion more blood= more red, firm, gingival bleeding variable soap buubbles teens and young adults, females posterior mand sclerosing agents, radiation, ebolization of major artieries prior to surgery

Answer 41

Central Hemangioma

Question 42

island of dead bones because pockets of bone break off

Answer 42

sequestration

Question 43

Localized inflammation and infection of alveolar bone, consequently it will be; around teeth and generally milder than acute osteomyelitis *Predisposing Factors: immunodeficient states (leukemia) *Sequestration >30 days!! (osteomyelitis: inflamm of alveolar bone AND basal bone) (oesteitis is ONLY alveolar bone) 40-80 yo males body of mand (doe this affect trabecular, cortical and periosteal bone?)

Answer 43

chronic osteomyelitis

Question 44

classic TRIAD: radiation therapy, ,trauma, infection when patient has radiaiton for malign 40-80yo male hyperbaric oxygen tanks

Answer 44

osteoradionecrosis (ORN)

Question 45

joint and muscle pain?? -take medication that prevent angiogenesis to bone which makes them compromised to fight off infection sequestration

Answer 45

MRONJ (BRONJ) medication related osteonecrosis of the jaws bisphosphonate related oestonecrosis of the jaws

Question 46

malignancies that START in the jaw CSCC, this poorly ragged borders, rapid growth, follow path of least resistance, push thru bone

Answer 46

Primary Epidermoid Carcinoma

Question 47

Malignancies that have metastasized to the jaw, <1% Can be local invasion, lymphatic spread (usually this), vascular spread, or transcoelomic spread ******mandible:maxilla is 7:1

Answer 47

metastatic disease

Question 48

Well-contained May push teeth apart Expands bone to create onion skin layers of reactive bone Smooth outline

Answer 48

benign

Question 49

Not well contained because rapidly grow Do not push teeth Does not expand bone, pushes through it instead by following path of least resistance Poorly defined borders, ragged irregular borders

Answer 49

malignant