theme 12

Question 1

2 types of developmental bone lesions of mouth

Answer 1

torus palatinus

torus mandibularis

Question 2

what is reactive exostosis

Answer 2

projection of bone caused by chronic trauma = periosteal irritation = bone deposition

remove surgically

Question 3

what is an osteoma and what are the 3 causes

Answer 3

benign bony mass in jaw

developmental, reactive, benign neoplastic

Question 4

2 clinical classifications for osteomaas

Answer 4

solitary or multiple

Question 5

syndrome causing multiple osteomas and multiple odontomes

Answer 5

gardner syndrome

Question 6

features of benign neoplasms of jaw

Answer 6

rare, slow growing, circumscribed,

overlap with odontogenic neoplasms clinically
mimic cysts on radiograph

Question 7

what sort of carcinoma presents in jaw

Answer 7

metastatic carcinoma - metastasis of SCC

Question 8

3 types of malignant neoplasms in jaw

Answer 8

metastatic carcinoma
marrow neoplasms
primary bone tumours - osteosarcoma, chondrosarcoma, mesenchymal chondrosarcoma

Question 9

premalignant disease putting elderly patients at risk of osteosarcoma?

Answer 9

pagets

Question 10

name for newly laid down bone by osteoblasts

Answer 10

osteoid

Question 11

role of RANKL

Answer 11

ensure bony remodelling is balanced

Question 12

2 types of giant cell lesions of jaw

Answer 12

giant cell granuloma - peripheral or central

hyperparathyroidism - produces lesions called brown tumour

Question 13

characteristic of giant cell lesions

Answer 13

presence of osteoclasts

Question 14

where does a peripheral giant cell granuloma present

Answer 14

gingiva only - friable + painless

Question 15

where does a central giant cell granuloma present

Answer 15

involves underlying jaw bone

Question 16

management of central giant cell granuloma

Answer 16

1. curretage

2. injection of slow release steroids

Question 17

subtle change that takes place in oral cavity due to hyperparathyroidism

Answer 17

loss of lamina dura of interdental bone

Question 18

test to differentiation GCG and hyperparathyroidism

Answer 18

serum calcium elevated in hyper

Question 19

what is pagets disease

Answer 19

unregulated bone turnover

osteitis deformans

Question 20

complications of pagets disease

Answer 20

heart disease - bone normally helps shunt

pre-malignant to osteosarcoma

Question 21

symptoms of pagets

Answer 21

middle aged - elderly
slow onset
deafness, vision
facial distortion
numbness
skeletal symptoms 
oral - bone overgrowth, tooth spacing, bleeding after extractions, osteomyelitis, pain/numbness

Question 22

diagnosis of pagets

Answer 22

history
examination
radiographs - abnormal trabecular bone
alkaline phosphate levels elevated
bone biopsy - avoid as painful

Question 23

treatment of pagets

Answer 23

bisphophanates

denosumab

Question 24

4 types of fibro-osseous lesions

Answer 24

fibrous dysplasia
ossifying fibroma
cements-osseous dysplasia
cherubism

Question 25

3 forms of fibrous dysplasia

Answer 25

monostotic - solitary multiple - in craniofacial bones polyostotic - throughout skeleton

Question 26

mutation responsible for fibrous dysplasia

Answer 26

GNAS mutation

Question 27

features of monostotic fibrous dysplasia

Answer 27

childhood onset, slow growth no tooth displacement - teeth grow through no systemic abnormality radiograph - diffuse edge, initially radiolucent then trabecular bone forms = ground glass

Question 28

management of FD

Answer 28

self-limiting review until skeletal maturity cosmetic re-contouring denosumab - targeted therapy to with RANLK off

Question 29

how to differentiate FD + ossifying fibroma

Answer 29

FD diffuse border, OF well circumscribed

Question 30

features of ossifying fibroma

Answer 30

``` benign, slow growing mandible more common juvenile or adult ground glass radiolucenency well circumscribed progressive growth displaced adjacent structures ```

Question 31

treatment of ossifying fibroma

Answer 31

surgical removal clear margins conservative removal

Question 32

radiographic appearance of cementoosseous dysplasia

Answer 32

radiolucencies with radio-dense central areas (NIDUS)

Question 33

what is cherubism

Answer 33

multilocular cystic lesions bilateral mandible + maxilla submandibular lymph nodes enlarged swelling at 3-4yrs, stable by 30

Question 34

gene causing cherubism

Answer 34

autosomal dominant SH3BP2