Solitary & Interradicular Radiolucencies Flashcards
(63 cards)
1
Q
What are the interradicular and solitary radiolucencies?
A
- Incisive Canal (Nasopalatine) Cyst
- Median Mandibular Cyst
- Mid Palatine Cyst
- Lateral Periodontal Cyst
- (Traumatic) Solitary Bone Cyst
- Posterior Lingual Mandibular Salivary Gland Depression (Bone Defect), (Stafne Cyst)
- Focal Osteoporotic Bone Marrow Defect
- Residual Cyst
- Fibrous Healing Defect
- Neuroma, Neurofibroma
2
Q
What are the lines of embryonic fusion and sites of developmental cyst?
A
naso-labial
naso-palatine duct
median palatal
3
Q
What is 1?
A
naso-labial line
4
Q
What is 3?
A
naso-palatine line
5
Q
What is 4?
A
median palatal line
6
Q
What is the most common line of embryonic fusion for a cyst to form?
A
naso-palatine duct
7
Q
What is the incisive canal cyst/naso-palatine duct cyst?
A
- Painless swelling
- Sinus tract may be present
- Not an aggressive cyst
- Slow growing
8
Q
What does the incisive canal cyst/naso-palatine duct cyst look like radiographically?
A
- Unilocular radiolucency in vicinity of maxillary midline
- Cause alterations to walls of incisive canals
- Root divergence in cases of large cysts
9
Q
A
incisive canal cyst/naso-palatine duct cyst
10
Q
heart-shaped radiolucency
A
incisive canal cyst/naso-palatine duct cyst
11
Q
A
aggressive incisive canal cyst/naso-palatine duct cyst
12
Q
A
incisive canal cyst/naso-palatine duct cyst
13
Q
What age/gender is the incisive canal cyst prevelant?
A
4th and 6th decades
male: female = 3:1
14
Q
What site is most common for incisive canal cyst?
A
anterior maxilla; close to midline
VERY STRONG predilection
15
Q
What is the management for an incisive canal cyst?
A
- Simple enucleation; degree of surgery is dependent on size of lesion
- no treatment if not aggressive and patient wants to leave it
- recurrence unusual
16
Q
What is a median mandibular cyst?
A
- asymptomatic
17
Q
What does a median mandibular cyst look like radiographically?
A
- Unilocular radiolucency in the symphyseal region
18
Q
What is a mid-palatine cyst?
A
- asymptomatic
19
Q
What does a mid-palatine cyst look like radiographically?
A
- Unilocular radiolucency
- Palatal midline, posterior to papilla
more likely seen on pano
20
Q
What age/gender is the mid-palatine cyst prevelant?
A
- any age
- no gender predilection
21
Q
What site is the most common for a mid-palatine cyst?
A
Midpalate posterior to papilla
22
Q
What is the management for a mid-palatine cyst?
A
Simple enucleation; degree of surgery is dependent on size of lesion
23
Q
What is a lateral periodontal cyst?
be very familar with this… easy to tell what it is
A
Asymptomatic, dome-shaped swellings of the interdental papilla, attached gingiva, or alveolar mucosa
24
Q
What does a lateral periodontal cyst look like radiographically?
A
- Well defined radiolucency
- Round to ovoid
- Normally in interradicular areas between alveolar crest and apices
- May or may not come in contact with the root surface
25
lateral periodontal cyst
26
lateral periodontal cyst
27
What age/gender is the lateral periodontal cyst prevelant?
- adult
- male
28
What site is the lateral periodontal cyst most common?
Mandible
Canine/premolar region
29
What is the management for a lateral periodontal cyst?
- Surgical enucleation
- The cyst does not recur
- Must be differentiated from early stage OKC’s and ameloblastomas
30
What is a simple bone cyst?
Normally asymptomatic, may have swelling or pain
31
What are the other names for simple bone cyst?
Solitary Bone Cyst*
Hemorrhagic Bone Cyst*
Traumatic Bone Cyst*
Intravasational Bone Cyst
Extravasational Bone Cyst
Unicameral Bone cyst
| * is the most common
32
What does the simple bone cyst look like radiographically?
- Unilocular radiolucency with interradicular scalloped superior margins
- Usually >10mm and associated with > 1 root apex
- Aggressive lesions can be expansive
33
simple bone cyst
34
simple bone cyst
35
What age/gender is the simple bone cyst prevelant?
- age: second decade (usually <25 years)
- gender: no predilection
36
What site is a simple bone cyst most common?
Body and ramus of mandible
37
What is the management for the simple bone cyst?
- Initiate bleeding
- Recurrence is rare
38
What is a posterior lingual mandibular salivary gland depression (stafne cyst)?
| be very familar with this... easy to tell what it is
Asymptomatic, usually found in routine radiographic examinations
39
What does the posterior lingual mandibular salivary gland depression (stafne cyst) look like radiographically?
Well circumscribed posterior radiolucency in molar region between mandibular canal and inferior border
40
posterior lingual mandibular salivary gland depression (stafne cyst)
41
posterior lingual mandibular salivary gland depression (stafne cyst)
42
What age/gender is the posterior lingual mandibular salivary gland depression prevelant?
- adults; prominent over 50 years
- almost exclusively male predilection
43
What site is most common to have a posterior lingual mandibular salivary gland depression?
Between the mandibular canal and inferior border
44
What is the management for a posterior lingual mandibular salivary gland depression?
Positive diagnosis based on clincial and radiologic history negates the need for biopsy and histologic examination
45
What is a focal osteoporotic bone marrow defect of the jaws?
* Asymptomatic
46
What does the focal osteoporotic bone marrow defect of the jaws look like radiographically?
* Unilocular, faint radiolucency
* Not ragged but difficult to discern as a separate entity
47
What age/gender is the focal osteoporotic bone marrow defect of the jaws prevelant?
- all age
- slightly higher in females but no predominant gender
48
What site is focal osteoporotic bone marrow defect of the jaws most commonly found?
Mandible
49
What is the treatment for a focal osteoporotic bone marrow defect of the jaws?
No treatment
50
What is the pathophysiology for a residual/recurrent cyst?
- Results from incomplete removal or residual viable epithelial cystic lining following treatment of a cyst
- Previous history of periapical disease
51
What is a residual cyst?
- Asymptomatic, normally found on radiographic examinations of edentulous areas
- Tooth or root may or may not be present
52
What does a residual cyst look like radiographically?
* Well defined radiolucency with smooth, round, corticated borders
* Usually 5mm or less in diameter
* May not be any root present if tooth was previously extracted
53
What age/gender is the residual cyst prevelant?
- middle age or older
- more common in males
54
What site is more common to find a residual cyst?
more common in maxilla
55
What is the management for a residual/recurrent cyst?
- Requires removal of the cyst lining
- Enucleation if a large cyst
- same as a PA cyst
56
What is the pathophysiology of a fibrous healing defect (apical scar)?
* Develops after inflammation that affects the integrity of the periosteum
* Once disease is eradicated, the bone heals without a mineralized bony matrix
* Due to the loss of the periosteum, only fibrous connective tissue fills the site of the previous disease
57
What is a fibrous healing defect (apical scar)?
* Asymptomatic
* Noted in areas with a previous history of disease or trauma
58
What does a fibrous healing defect (apical scar) look like radiographically?
* Well circumscribed radiolucent lesion at site of previous surgery
* “punched out” or “see through” appearance
* May resemble residual cysts in edentulous areas but lack cortication
59
What is the managment for a fibrous healing defect (apical scar)?
- No treatment indicated
- A previous history of disease is critical in establishing the diagnosis
60
What is a neuroma/neurofibroma?
* Expansion, pain, or paresthesia
* Symptoms include complaints of burning, tingling, and aching sensations
61
What does a neuroma/neurofibroma look like radiographically?
* Well circumscribed radiolucency of various shapes
* In the mandible it usually forms in the mandibular canal
62
What is the management for a neuroma/neurofibroma?
Excision, recurrence is rare
63
Many other odontogenic and non-odontogenic lesions may manifest as solitary “cyst-like” radiolucencies such as...
Odontogenic
*Amelobastoma
*Central giant cell granuloma
*Ossifying fibroma (early stage)
Non-odontogenic
*Chronic localized Langerhans’ cell disease
*Myeloma
