Pericoronal Radiolucencies Flashcards by Pickle Rick

What are the different types of periapical radiolucencies?

Periapical Abscess
Periapical granuloma
Periapical Cyst
Residual/Recurrent Cyst
Periapical Cementoosseous Dysplasia
Fibrous Healing Defect

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What are pericoronal radiolucencies?

around the crown of an unerupted tooth
*Do not contain radiopaque flecks within the lumen
*May or may not contain radiopaque flecks within the lumen

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What are the types of pericoronal radiolucencies that DO NOT contain radiographic flecks?

Normal Follicular Space
Pericoronitis
Dentigerous Cyst
– Ameloblastoma
– Squamous cell carcinoma
Eruption Cyst
Ameloblastic Fibroma

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What are the types of pericoronal radiolucencies that MAY contain radiographic flecks?

Ameloblastic Fibro-odontoma
Odontoameloblastoma
Adenomatoid Odontogenic Tumor
Calcifying Epithelial Odontogenic Tumor
Calcifying Odontogenic Cyst

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What is the follicular space?

Remnant of dental follicle adjacent a developed crown of an unerupted or impacted tooth should be no greater than
– 3.0mm wide on panoramic image
– 2.5mm wide on intraoral film image
– 2.0mm on CBCT

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follicular space

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What is pericoronitis?

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

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What are the clinical symptoms of pericoronitis?

Edematous
erythematous mucosa
pain
fever
malaise
Cellulitis to fascial plane deep spaces causing dramatic facial swelling (shown in pic)

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What is the treatment of pericoronitis?

antibiotic and therapy & long term: extract impacted tooth

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What is a dentigerous cyst?

Cystic lining arises from remnants of dental follicle

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Dentigerous cysts account for __% of the jaw cysts

20%

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What does the dentigerous cyst look like radiographically?

Consistently widened follicular space of >3.0mm
Well-delineated radiolucency with corticated borders

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dentigerous cyst

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If you do not stop the disease process of a dentigerous cyst what can happen?

expansion of cyst and displacement of normal structures
Potential for degeneration of the cyst lining to an ameloblastoma or a squamous cell carcinoma

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Where is the most common site of dentigerous cyst?

around teeth that are impacted
Most common in mandibular third molars and maxillary canines; can affect any impacted tooth

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What age range is most affected by dentigerous cysts?

20-30

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How do you manage/treat a dentigerous cyst?

*Enucleate
*Degree of surgery dependent on size of tumor

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dentigerous cyst that was left untreated for many, many years

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What is an eruption cyst?

Presents as a soft fluid-filled swelling of crestal mucosa in area of an erupting tooth
Often has bluish coloration due to trauma creating blood in cystic fluid

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What does an eruption cyst look like radiographically?

May see lack of crestal alveolar bone because of position of erupting crown and cyst near crest

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What age group is most affected by eruption cysts?

< 10 years
- mixed dentition stage

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What side is most common to have eruption cysts?

Most common in mandibular molar region

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What is the management for an eruption cyst?

Study These Flashcards

Often rupture spontaneously
Some may require simple excision

What is an ameloblastic fibroma?

Study These Flashcards

A mixed odontogenic tumor
solid mass of cells (not a cyst)

What do ameloblastic fibromas look like radiographically?

● pericoronal radiolucency associated with a developing tooth ● well demarcated ● often corticated ● expansive ## Footnote also can be... ● unilocular radiolucency not always associated with a developing tooth

How can you tell an ameloblastic fibroma from a dentigerous cyst based on histology?

- ameloblastic fibroma is in the mixed dentition stage (younger people) - dentigerous cyst happens when the tooth is impacted for a longer period of time | Prolly need a biopsy

ameloblastic fibroma

___% of cases of ameloblastic fibroma are <20 years

70% | Mean age 14-15.5 years

Where is the most common site for ameloblastic fibroma?

Highest incidence in mandibular molar-premolar region

What is the management for an ameloblastic fibroma?

- enucleation - 20% recurrence

What is an ameloblastic fibro-odontoma?

- A mixed odontogenic tumor, similar to ameloblastic fibroma but has a mineralized stroma - If mineralization is high, then radiopaque flecks may be evident radiographically

What does the ameloblastic fibro-odontoma look like radiographically?

- Pericoronal radiolucency associated with a developing tooth - Radiopaque flecks or globular radiopacities-tooth-like structures noted in the lumen - Well demarcared - Often corticated - Expansive

What is the age range of a patient with ameloblastic fibro-odontoma?

mean age - 15 years

What is the main site of an ameloblastic fibro-odontoma?

posterior mandible

How can you tell the difference between an ameloblastic fibro-odontoma and a odontoameloblastoma?

odontoameloblastoma is more aggressive

Adenomatoid odontogenic tumors make up ___% of odontogenic tumors

3-7%

What is the histology of an Adenomatoid odontogenic tumor?

- Histologically a cross between a dentigerous cyst and ameloblastoma - Odontogenic epithelium is arranged in duct like glandular array

What does an adenomatoid odontogenic tumor look like radiographically?

* Consistently widened follicular space of >3.0mm if associated with crown of impacted tooth (75% of cases are pericoronal). * Well-delineated radioluceny with corticated border, usually >3.0cm

asymptomatic tumor well demarcated and corugated

adenomatoid odontogenic tumor

What age range is affected by adenomatoid odontogenic tumor?

Occur at any age but majority occur in teens (10- 19 years) and young adults (~20 -35 years) | no gender predilection

What site is common for adenomatoid odontogenic tumors?

- 65% occur in anterior jaws - Maxilla:Mandible is 2:1

What is the management for adenomatoid odontogenic tumor?

Enucleation with rare recurrence

What are the clinical features of calcifying epithelial odontogenic tumor?

- Approximately 50% occur in association with impacted teeth

What is another name for calcifying epthelial odontogenic tumor?

Pindborg tumor

What is the management for a Calcifying Epithelial Odontogenic Tumor?

Larger lesions require en bloc resections

What is enculeation?

remove just the tumor

What is en bloc resection?

have to remove host tissue along with the tumor

What does a Calcifying Epithelial Odontogenic Tumor look like radiographically?

* Radiopaque flecks are due to calcified amyloid * A breakdown product of the neoplastic epithelial cells; these mineralizations are called Leisegang’s rings