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Radiographic Interpretation > Pericoronal Radiolucencies > Flashcards

Pericoronal Radiolucencies Flashcards

(51 cards)

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1
Q

What are the different types of periapical radiolucencies?

A
  • Periapical Abscess
  • Periapical granuloma
  • Periapical Cyst
  • Residual/Recurrent Cyst
  • Periapical Cementoosseous Dysplasia
  • Fibrous Healing Defect
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2
Q

What are pericoronal radiolucencies?

A
  • 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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3
Q

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

A
  • Normal Follicular Space
  • Pericoronitis
  • Dentigerous Cyst
    – Ameloblastoma
    – Squamous cell carcinoma
  • Eruption Cyst
  • Ameloblastic Fibroma
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4
Q

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

A
  • Ameloblastic Fibro-odontoma
  • Odontoameloblastoma
  • Adenomatoid Odontogenic Tumor
  • Calcifying Epithelial Odontogenic Tumor
  • Calcifying Odontogenic Cyst
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5
Q

What is the follicular space?

A

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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6
Q
A

follicular space

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7
Q

What is pericoronitis?

A

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

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8
Q

What are the clinical symptoms of pericoronitis?

A
  • Edematous
  • erythematous mucosa
  • pain
  • fever
  • malaise
  • Cellulitis to fascial plane deep spaces causing dramatic facial swelling (shown in pic)
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9
Q

What is a dentigerous cyst?

A

Cystic lining arises from remnants of dental follicle

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10
Q

Dentigerous cysts account for __% of the jaw cysts

A

20%

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11
Q

What does the dentigerous cyst look like radiographically?

A
  • Consistently widened follicular space of >3.0mm
  • Well-delineated radiolucency with corticated borders
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12
Q
A

dentigerous cyst

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13
Q

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

A
  • 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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14
Q

Where is the most common site of dentigerous cyst?

A
  • around teeth that are impacted
  • Most common in mandibular third molars and maxillary canines; can affect any impacted tooth
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15
Q

What age range is most affected by dentigerous cysts?

A

20-30

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16
Q

How do you manage/treat a dentigerous cyst?

A

*Enucleate
*Degree of surgery dependent on size of tumor

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17
Q
A

dentigerous cyst that was left untreated for many, many years

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18
Q

What is an eruption cyst?

A
  • 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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19
Q

What does an eruption cyst look like radiographically?

A

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

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20
Q

What age group is most affected by eruption cysts?

A

< 10 years
- mixed dentition stage

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21
Q

What side is most common to have eruption cysts?

Study These Flashcards
A

Most common in mandibular molar region

22
Q

What is the management for an eruption cyst?

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A
  • Often rupture spontaneously
  • Some may require simple excision
23
Q

What is an ameloblastic fibroma?

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A
  • A mixed odontogenic tumor
  • solid mass of cells (not a cyst)
24
Q

What do ameloblastic fibromas look like radiographically?

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A

● pericoronal radiolucency associated with a developing tooth
● well demarcared
● often corticated
● expansive

also can be…
● unilocular radiolucency not always associated with a developing tooth

25
How can you tell an ameloblastic fibroma from a dentigerous cyst based on history?
- 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
26
ameloblastic fibroma
27
___% of cases of ameloblastic fibroma are <20 years
70% | Mean age 14-15.5 years
28
Where is the most common site for ameloblastic fibroma?
Highest incidence in mandibular molar-premolar region
29
What is the management for an ameloblastic fibroma?
- enucleation - 20% recurrence
30
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
31
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
32
What is the age range of a patient with ameloblastic fibro-odontoma?
mean age - 15 years
33
What is the main site of an ameloblastic fibro-odontoma?
posterior mandible
34
How can you tell the difference between an ameloblastic fibro-odontoma and a odontoameloblastoma?
odontoameloblastoma is more aggressive
35
Adenomatoid odontogenic tumors make up ___% of odontogenic tumors
3-7%
36
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
37
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
38
asymptomatic tumor well demarkated and corugated
adenomatoid odontogenic tumor
39
adenomatoid odontogenic tumor
40
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
41
What site is common for adenomatoid odontogenic tumors?
- 65% occur in anterior jaws - Maxilla:Mandible is 2:1
42
What is the management for adenomatoid odontogenic tumor?
Enucleation with rare recurrence
43
What are the clinical features of calcifying epithelial odontogenic tumor?
- Approximately 50% occur in association with impacted teeth - another name for the tumor is pindborg tumor
44
What is the management for a Calcifying Epithelial Odontogenic Tumor?
Larger lesions require en bloc resections
45
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
46
What is the age range of those with Calcifying Epithelial Odontogenic Tumor?
Mean age of 40 years
47
What site are alcifying Epithelial Odontogenic Tumor most common?
- Mandible:Maxilla is 2:1 - More likely in posterior mandible
48
What is a calcifying odontogenic cyst?
* a.k.a. Gorlin cyst * Extremely variable presentation * Approximately 2-16% behave as neoplasms * Present from 2.0-4.0cm diameter; as large as 12cm
49
What does the calcifying odontogenic cyst look like radiographically?
* Vary from uni to multilocular * 50% have radiopacities in the lumen * 33% present as pericoronal radiolucencies
50
What is the age, gender, site, etc. for calcifying odontogenic cyst?
not really that specific - must be included in a differential diagnosis even though it is rare
51
What is the management for a calcifying odontogenic cyst?
Simple enucleation with minimal recurrence

Radiographic Interpretation (12 decks)

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