Path bone section

most common oral scc site

lateral tongue

2nd most common oral scc site

floor of the mouth

list 3 fibro-osseous lesions

1. fibrous dysplasia

2. PA C-O dysplasia

3. ossifying fibroma

what is a periapical cyst / radicular cyst

• the most common odontogenic tumor

• it is an asymptomatic cyst arising from the periapical granuloma

• it is located on the apex of any teeth and is ass. w/ non-vital teeth

what is a periapical granuloma

• it is a painful asymptomatic cyst located on the apex of any teeth and is as w/ non-vital teeth

• it has a diffuse lucency = widened PDL space

what is acute/chronic osteomyelitis

• it is a painful bone infection characterized by necrotic bone and ill-defined radiolucency

• it is as w/ Paget’s disease, BIS, and radiation therapy

• common location = mandible

what is amelogenesis imperfecta and the 3 types

it is characterized by genetic abnormal enamel

• hypocalcified a.i → decreased enamel density

• hypomaturation a.i → decreased enamel density

• hypoplastic a.i → thin enamel

what is dentinogenesis imperfecta

• a genetic condition characterized by blue translucent teeth, short roots, and no pulp

• multiple radiolucencies = PA abscesses

what is dentin dysplasia and its 2 types

• type 1 → most common; normal crown + short roots + no pulp; PA abscesses

• type 2 → rare; normal crown + normal roots + thistle pulp; primary teeth have an amber crown appearance

list the odontogenic epithelial tumors (3)

1. ameloblastoma

2. peripheral ameloblastoma

3. adenomatoid odontogenic tumor

ameloblastoma (+ common location, associations/radiographic appearance, population)

common locations: posterior mandible

clinical features: asymptomatic; unerupted teeth

radiographic: uniocular, multiocular (soap/bubble honeycomb),

appearance: bone expansion, resorbs + displaces teeth

population: young>>middle aged, wide range

what is a peripheral ameloblastoma (NOT ON STUDY GUIDE)

it is a rare presentation of an ameloblastoma on the gingiva. most odontogenic cysts/tumors will have a peripheral apperance

it is not as invasive and has little to no bony involvement

what is an adenomatoid odontogenic tumor (AOT) / odontogenic adenomatoid tumor (OAT)

it an encapsulated benign tumor

AOT/OAT (+ common location, associations/radiographic appearance, population)

common locations: maxilla, anterior (80%), ass w impacted tooth (75%)

radiographic: uniocular radiolucency w opaque snowflakes

population: 70% young ppl <20; females

list the epithelial/mesenchymal mixed tumors (5)

1. odontoma

2. compound odontoma

3. complex odontoma

4. ameloblastic fibroma

5. ameloblastic fibro-odontoma

what is an odontoma

it is the most common odontogenic tumor; it is composed of enamel, dentin, cementum, and pulp tissue

two types are compound odontoma + complex odontoma

what is a compound odontoma

it appears as a cluster of small teeth, toothlets, denticles

compound odontoma (+ common location, associations/radiographic appearance, population)

common locations: anterior jaws

clinical features: asymptomatic; ass w impacted/unerupted teeth

Radio: cluster of mini teeth

population: young 10-20yrs

what is a complex odontoma

it contains odontogenic tissue w no small teeth

complex odontoma (+ common location, associations/radiographic appearance, population)

common locations: posterior jaws

clinical features: asymptomatic; ass w/ impacted/unerupted teeth

radiographic: unilocular radiopaque mass w radiolucent rim

population: young adults (10-20)

what is an ameloblastic fibroma

it is a benign unencapsulated tumor

what is an ameloblastic fibroma (+common location, clinical features, radiographic, population)

common locations: posterior mandible

clinical features: ass w unerupted teeth (75%)

radiographic: uniocular/multiocular radiolucency

population: young 10-20yrs; males

what is an ameloblastic fibro-odontoma

a tumor w features of an ameloblastic fibroma and odontoma

ameloblastic fibro-odontoma (+ common location, associations/radiographic appearance, population)

common locations: posterior mandible

clinical features: asymptomic; ass w impacted tooth

radiographic: well-defined radiolucency w radiopaque component

population: children

AOT/OAT impacts this gender population. ameloblastic fibroma impacts this gender population

AOT/OAT: females

AF: males

all epithelial tumors (except peripheral ameloblastoma) are ass w impacted, unerupted teeth or both. which are impacted by what

impacted teeth

-ameloblastoma

-AOT/OAT

-ameloblastic fibro-odontoma

both impacted/unerupted

-odontomas

unerupted teeth

-ameloblastic fibroma

--------------------

impacted

impacted

(2) impacted/unerupted

unerupted

impacted

define cyst **

a sac or cavity that is lined w epithelium and enclosed w CT

describe the basic info section of cysts **

there are two types of cysts - developmental cysts which include intraosseous and extraosseous cysts. the other are inflammatory cysts such as periapical cysts and residual cysts

developmental cysts are broken down further into non-odontogenic and odontogenic. if it is an odontogenic cysts this means they develop from the dental lamina, rests of malassez, and REE

what is the most common cyst **

a periapical cyst

what is the second most common cyst **

dentigerous cyst

list the intraosseous odontogenic developmental cysts (5)

1. dentigerous cyst

2. primordial cyst

3. odontogenic keratocyst (OKC)

4. lateral periodontal cyst

5. calcifying odontogenic cyst

what is a dentigerous cyst

it is a cyst which forms around the crown of an impacted tooth

dentigerous cyst / follicular cyst (+ common location, associations/radiographic appearance, population)

common locations: mand 3rd crown; the crown of any unerupted tooth

clinical features: if large it may displace teeth

radiographic: well-defined uniocular radiolucency

population: young adults; males

what is a primordial cyst

it is a cyst which arises instead of a tooth

primordial cyst (+ common location, associations/radiographic appearance, population)

common locations: mand 3rd molars; posterior to developing 3rd molar

radiographic: uniocular/multiocular well-defined radiolucency

prognosis: most are histologically OKC

population: young adults

what is an odontogenic keratocyst / keratocystic odontogenic tumor **

it is a benign cyst but it can grow to be super aggressive; ass/ w Gorlin SX/NevoidBCCSx

OKC (+ common location, associations/radiographic appearance, population)

common locations: posterior mandible

clinical features: asymptomatic; displacement and resorbs teeth structure

radiographic: well-defined uniocular (when small)/multiiocular radiolucency

population: young adults 20-30s; males

what developmental cyst is considered the "great mimicker" **

OKC

what is a lateral periodontal cyst

it is a cyst which develops on the lateral aspect of the root surface of other vital teeth

lateral periodontal cyst (+common locations, clinical features, XR, population

common locations: mand canine/premolar area

clinical features: asymptomatic; adjacent teeth are vital

radiographic: uniocular/multiocular grape like radiolucency on the lateral aspect of a root

population: middle-aged adults (50-60s); males

which developmental cyst has a uniocular/multiocular grapelike radiolucency

lateral periodontal cyst

similarities of the 4 developmental cysts

-all these developmental cysts appear on the mandible

-require surgical removal

-require surgical excision

-arise from the dental lamina

-uniocular/multiocular

-impacts males

-minimal-high recurrence

-young adults

-resorbs/displace teeth

mandible locations (mand 3rd+crown, mand 3rd+posterior of 3rd, posterior mand, mand can/prem area)

surgical removal = dentigerous cyst, primordial cyst, and gingival cysts

surgical excision = everything else; OKC also requires curettage

dental lamina = OKC and lateral periodontal cyst

uniocular radiolucency = dentigerous cyst and COC; everything else is uniocular/multiocular

impacts males = primordial cysts, OKC, and lateral periodontal cyst

minimal recurrence = dentigerous cysts;

high recurrence = primordial cysts and OKC

young adults = everyone except lateral periodontal cysts + gingival cysts (50-60s); OKC and COC are YA (20-30s)

resorbs/displace teeth = dentigerous cysts, OKC, COC

what is a calcifying odontogenic cyst (COC) / Gorlin cyst

it is a nonaggressive developmental cyst

COC / Gorlin cyst (+ common location, associations/radiographic appearance, population)

common locations: anterior portion of jaws (65%)

clinical features: asymptomatic; slow growing; ass w impacted tooth; histologically = ghost cells

radiographic: uniocular radiolucency +/- opacities; resorption + displacement of roots

population: young adults (20-30s)

list the extraosseous cysts

eruption cysts

gingival cysts

list the non-odontogenic intraosseous developmental cysts (3)

1. nasopalatine cyst

2. median palatal cyst

3. globumaxillary cyst

what is a nasoplaotine cyst / incisive canal cyst

it is a cyst within the nasopalatine canal

nasopalatine cyst / incisive canal cyst (+ common location, associations/radiographic appearance, population)

common locations: nasopalatine canal/papilla bt central incisors and hard palate

clinical features; vital teeth

radiographic: well-defined "heart shaped" radiolucency

population: middled-aged (40-60s); males

what is the median palatal cyst

it is a cyst which arises at the midline of the hard palate, posterior the nasopalatine canal cyst

medial palatal cyst (+ common location, associations/radiographic appearance, population)

common locations: midline of the heart palate

clinical features: swelling at the midline of the hard palate

population: any age

what cyst is not an acceptable term/dx and was once believed to be a developmental fissural cyst

globulomaxillary cyst

list the nonodontogenic intraosseous cysts (3)

1. nasopalatine duct cyst

2. median palatal cyst

3. globulomaxillary cyst

what is the histology and radiography of a globulomaxillary cyst

histology: OKC, periapical cyst, lateral periodontal cyst

radio: well-defined radiolucency bt the maxillary lateral incisor/canine

list the nonodontogenic extraosseous cysts (6)

1. nasolabial cyst

2. branchial cleft cyst / cervical lymphoepithelial cyst - oral lymphoepithelial cyst

3. thyroglossal tract cyst

4. epidermoid cyst

5. dermoid cyst

6. stafne bone cyst

why is a stafne bone cyst not a real cyst

it is not a real cyst. it is a radiolucent lesion that has no epithelium lining and it is asymptomatic

stafne bone cyst / stafne defect / static bone cyst (+ common location, radiographic appearance, tx, population)

common locations: posterior mandible and inferior the mandibular canal

radio: uniocular lucency / well-defined cyst like radiolucency

TX: none

population: men 80-90%

little notes abt non-odontogenic developmental cysts - intraosseous (3) + extraosseous (6)

-nasopalatine duct cyst + stafne duct cyst affect males. nasolabial cyst affect females

-their populations are almost paired:

--middle aged+men

--any age

--middle age

--YA

--YA

--any age

--birth/young

--men

list the bone diseases (4)

1. osteogenesis imperfecta

2. paget disease

3. fibrous dysplasia

4. cherubism

what is osteogenesis imperfecta

it is a group of inherited disorders where an abnormal or deficient amount of collagen produces insufficient bone

osteogenesis imperfecta (+clinical features, population

genetic

• blue sclera of eyes + multiple bone fractures + joint hyperextension

• teeth = dentinogenesis imperfecta

• population: children

what is another name for pagets disease and what is it

osteitis deformans. it is chronic benign disease that is usually polyostotic

pagets disease / osteitis deformans

-cause

-clinical features

-oral features

-radiographic

-prognosis

-population

cause: unknown

clinical features: painful gradual enlargement of bones; a positive alkalaine phosphatase in blood is dx

oral features: jaws are mostly affected esp the MAXILLA; dentures appear too tight

radiographic: extensive hypercementosis; mixed lesion w cotton wool opacities and round lucencies

prognosis: guarded bc of risk of osteosarcoma

population: adults >40; males

what is fibrous dysplasia

it is an uncommon chronic benign bone disease where bone is replaced w CT; it is usually monostotic but it may be polyostotic

fibrous dysplasia

-cause

-clinical features

-oral features

-radiographic

-prognosis

-population

cause: unknown

clinical features: painless gradual enlargment of bone replaced by fibrous CT (paget's is gradual enlargement presenting w pain)

oral features: maxilla is affected (like paget's); bone expansion/displacement

radiographic: ground glass/orange peel appearance

prognosis: guarded bc of 25-50% recurrence

population: teens/YA <20s

what is cherubism

it is a rare genetic disorder named for the appearance of plump cheeks

cherubism

-cause

-clinical features

-oral features

-radiographic

-population

cause: inherited autosomal dominant

clinical features: plump cheeks; upturned eyes; histologically GIANT CELL LESIONS

oral features: posterior mndible; usually symmetric

radiographic: bilateral multiocular lucencies

population: children

bone disease are the only section that ask for specifically abt clinical features and [ ]

[ ]

oral features

list bone lesions (4)

1. central giant cell granuloma

2. traumatic bone cyst

3. periapical c-o dysplasia

4. idiopathic sclerosis / dense bone island

central giant cell granuloma

-common locations

-clinical features

-radiographic

-population

common locations: anterior jaws and mostly the mandible; cross the midline from canine to canine

clinical features: it is a slow growing expansion; histologically we see giant cells similar to hyperparathyroidism/browns tumors

radio: it starts as a uniocular lesion, then develops into a multilocular lucency; it may cause expansion+divergence

population: YA <30s

why is a traumatic bone cyst not a true cyst

there is no epithelial lining

traumatic bone cyst / solitary bone cyst

-common locations

-radiographic

-population

common locations: mandible only

radiographic: well-defined uniocular radiolucency which scallops bt roots of adjacent vital teeth; surgery reveals an empty cavity

population: children

periapical cemento-osseous dysplasia (periapical C-O dysplasia)

-common locations

-clinical features

-radiographic

-population

common locations: anterior mandible of periapical region

clinical features: asymptomatic; vital teeth

radiographic: early lesions are radiolucent, then they become mixed, then they become radiopaque; the PDL is still intact

population: middle aged adults; females 14:1; black females

what is idiopathic osteosclerosis / dense bone island

it is an isolated area of lamellar bone within a medullary space

idiopathic osteosclerosis / dense bone island

-common locations

-radiographic

-population

common locations: posterior mandible 90%

radiographic: it is a focal area of radiopacity which often affects PA/interradicular bone; involves vital teeth

population: arises in children 10-20yrs

list the bone tumors (6)

1. osteoma

2. cementoblastoma

3. ossifying fibroma

4. osteosarcoma

5. chondrosarcoma

6. metastatic disease

which of the bone tumors are from benign neoplasms (3)

1. osteoma

2. cementoblastoma

3. ossifying fibroma

which of the bone tumors are from malignant neoplasms (3)

1. osteosarcoma

2. chondrosarcoma

3. metastatic disease

osteoma

-clinical features

-radiographic

-population

it is a neoplasia; ass w/ gardners sx (multiple osteomas, intestinal polyps, supernumerary teeth)

common locations: mandible

radiographic: a well-defined radiopaque mass

population: YA

cementoblastoma

-common locations

-clinical features

-radiographic

-population

common locations: mand 1st molar

clinical features: it presents w pain

radiographic: it is a dense radiopaque mass that binds w the apex; it is a sclerotic mass w a thin radiolucent rim; vital teeth are involved

population: children + YA <30s

ossifying fibroma

-common locations

-clinical features

-radiographic

-population

common locations: posterior mandible

clinical features: expansion + divergence

radiographic: well-defined unilocular radiolucency w opaque flecks

population: YA 20-30s

what is an osteosarcoma

it is a malignancy of bone producing cells

osteosarcoma (+location, features, radio, prognosis, population)

common locations: head and jaws 8%

clinical features: there is usually pain at first

radiographic: mixed opaque lesion w ill-defined borders; symmetrical widening of the PDL; sunburst pattern of bone growth above the crestal bone

TX: it metastasizes to the lung/brain

prognosis: death

population: YA; males

what is chondrosarcoma

it is magignancy of cartilage

chondrosarcoma (features, population)

a slow growing painless cancer characterized by loose teeth, ill-defined lucency + opacities
• population: older adults (60-70); males

what is metastatic disease

it is a tumor which arises from the distant site of a metastasis of a carcinoma of another organ

what is the most common malignancy of bone

metastatic disease

metastatic disease (features, population)

moth-eaten, bone expansion cancer found on the gingiva and posterior mandible

• population: older adults (60-70s)