612 Benign bone lesions, Benign bone disorders

Osteogenesis imperfecta

- characteristics

- Blue sclera

- Bowed leg bones (pts often short)

Dentinogenesis imperfecta

- Discolored teeth (yellow/brown/grey)

- Lack of enamel, exposed dentin

- Bulbous crowns

- Obliterated pulp chamber

- Short roots

Cleidocranial dysplasia

- Lack of clavicles

- Many supernumerary, impacted teeth

Focal osteoporotic bone marrow defect

Focal osteoporotic bone marrow defect - histology

When biopsied, see bone marrow:

- Usually hematopoeitic BM

- Huge cells in bone marrow: Megakaryocytes

Traumatic bone cyst

= Well defined RL, scalloping

- #1: test teeth

- #2: biopsy

Traumatic bone cyst - histology

- Osteoclasts

- Vital bone

- Fibrous CT

Aneurysmal bone cyst

= "Blow out fracture"

- Bone is thinning

- Contains multinucleated giant cells

Aneurysmal bone cyst - histology

Lakes of blood

- No endothelium around spaces

Paget's disease of bone

- characteristics?

- Heavy brow

- Upper skull

- Upper midface in nose region

- Enlarged mandible

Paget's disease of bone =

Osteitis Deformans

- Abnormal collagen creating abnormal bone

- bowing of legs

- Hat and dentures may no longer fit

Pagets disease of bone - radiographic appearance

Cotton woll appearance = appositional bone growth

Paget's disease - histology

- Reversal lines

Leontiasis ossea

= Lion face

- Pagets

- Smashed in look centrally in face

- Thick ribs and vertebrae

- ~2% of cases become osteosarcoma

Langerhans cell disease

= aka Histiocytosis

- Mostly RL lesions

Langerhans cell disease - cells

Birbeck granules

- tennis racquet shaped cells

Langerhans cell disease - histology

Friable gingiva

= Fragile gingiva

- Can be localized (eosinophilic granuloma) or generalized

Central giant cell granuloma

- RL --> will keep growing if left alone

- Always check tooth vitality

- Beehive combe (multilocular)

- more common in younger pts

Central giant cell granuloma - histology

- Multinucleated giant cells

- Marcophages

- Areas of hemorrhage

Cherubism

- characteristics

- what kind of inheritance pattern?

- Bilateral multilocular radiolucencies

- Autosomal dominant inheritance

- Classic facies, Proptotic eyes, Lengthening of ramus, Prominent condyle

- Usually resolve after puberty

Cherubism - histology

Same as CGCG

Cherubism - Radiographic

bilateral multilocular lucencies

Central hemangioma

- Honeycomb (multilocular) appearace

If unilocular, use a stethescope nd listen for pulse - if it has pulse, leave alone bc may be AV malformation

Central hemangioma - guidelines (3)

- Check for bruits

- Do not extract teeth

- Perform angiogram

Osteogenesis imperfecta is associated with what dental disorder?

Dentinogensis imperfecta

Characteristics of OI

- discolored and weak teeth

- wear of enamel

- pupil dilation

- blue slcera