radiopaque jaw lesions

what can a lucent rim around a lesion represent

-soft tissue capsule

-PDL space

Roots, fragments or tips- post extractions or fractured roots

root remnants

common location of root remnants

-Mesial or distal of premolars.

-Extraction/edentulous sites

periphery of root remnants

- Well-defined

- Usually with a lucent rim

- PDL Space and lamina dura intact

internal structure of root remnants

Pulp canal might be visible

other effects on structures of root remnants

can displace into maxillary sinuses

DDx of root remnants

- Dense bone island (DBI)

-bone graft

-COD

Excessive build up of cementum on tooth roots

hypercementosis

signs/symptoms of hypercementosis

none

clinical feature of the root with hypercementosis

Irregular bulbous enlargement of the root (within the PDL space)

periphery of hypercementosis

- Well-defined

- PDL Space and lamina dura intact

shape of hypercementosis

bulbous

other effects on structures from hypercementosis

-none

-teeth vital

Bony masses arising from cortical (or cancellous) bone- *non-neoplastic

hyperostosis/Exostosis/Tori

most common location of hyperostosis/Exostosis/Tori on maxilla

along buccal alveolar bone; palatal.

most common location of hyperostosis/Exostosis/Tori on mandible

can be buccal or lingual

most common hyperostosis; protuberance of bone

tori

common location of tori

- hard palate

- lingual mandible

location of Hyperostosis/Exostosis/Tori on maxilla

- Tori- palatal midline

- Exostoses- buccal/palatal alveolar bone

location of Hyperostosis/Exostosis/Tori on mandible

- Tori- lingual

- Exostoses- buccal alveolar bone.

periphery of Hyperostosis/Exostosis/Tori

well defined

-no rim

shape of Hyperostosis/Exostosis/Tori

Convex, lobulated

internal structure of Hyperostosis/Exostosis/Tori

-opaque

-no rim

other effects from Hyperostosis/Exostosis/Tori

none

how to tell the difference between tori and exostoses

-location

-tori is more anterior

-buccal will be exostoses

location of foreign Body/Bone Graft

- Sockets,

- sinus floor (sinus lifts/augmentation),

- alveolar ridge within soft tissue

-edentulous sites

appearance of bone graft

• Granular, radiopaque flecks

what is dense bone island

growths of cortical bone into cancellous/trabecular bone

periphery of dense bone island (idiopathic osteosclerosis)

- Well-defined

- Blends with surrounding bone

- No RL Rim (this distinguishing it from a root remnant)

other effects from dense bone island

- Sometimes root resorption.

- Teeth vital

- PDL space around root intact

radiopaque lesion with no lucent rim

-dense bone island

-condensing osteitis

-osteoma

what is dense bone island also known as

Idiopathic osteosclerosis

location of condensing osteitis

- Periapical- epicenter

- Roots

- on-vital or inflamed/infected or root canal treated

- always associated with teeth

periphery of condensing osteitis

- well-defined

- Blends

- No Rim

vitality of teeth with condensing osteitis

non-vital

other effects from condensing osteitis

- PDL space widening

Benign slow growing bone tumor from periosteum that can occur on a bone surface or within paranasal sinuses.

osteoma

location of osteoma

- Sinuses, ramus

- inferior border of mandible

- condyle/coronoid

radiopaque lesion --> ground glass/granular

fibrous dysplasia

Normal bone metabolism is altered, and cancellous bone is replaced by a mixture of fibrous connective tissue and bone

fibrous Dysplasia

appearance of fibrous Dysplasia

- Lots of trabecular bone oriented in random directions

- Creates ground glass/granular appearance.

borders of fibrous dysplasia

-ill-defined

-blending

other effects from fibrous dysplasia

- Superior displacement of IAC

- Expands cortical borders

- maintaining anatomic shape

- No effect on teeth

- no displacement or resorption.

shape of fibrous dysplasia

anatomic expansion

radiopaque lesions with a lucent rim (4)

-cemento osseous dysplasia

-cementoblastoma

-odontoma

-ossifying fibroma

location of Cemento- Osseous Dysplasia

- periapical (POD)= anterior mandible

- Focal (solitary) = posterior mandible

- Florid (FOD) = Multi quadrant

odontogenic neoplasm of cementoblasts

cementoblastoma

other effects from cementoblastoma

Attached to the root w/resorption

-PDL space not visible

internal structure of cementoblastoma

"wheel-spoke" at the center

- Lucent Rim

location of cementoblastoma

Roots/apices of mandibular dentition (premolars, molars)

Benign non-cancerous mass composed of enamel, dentin, cementum, pulp (teeth)

odontoma

3 types of odontoma

-compound

-complex

-dilated

odontoma MUST have ________

enamel density

location of compound odontoma

anterior maxilla

-associated with crowns of teeth

location of complex odontoma

posterior mandible

periphery of ossifying fibroma

- Well-defined

- concentric or lobular

- wide zone of transition or thin cortication

- Expansile

other effects from ossifying fibroma

Root resorption