chapter 8 oral path

What is dysplasia in bone?

Abnormal and disordered production of cementum and bone.

How is bone/cementum dysplasia different from epithelial dysplasia?

Bone/cementum dysplasia affects bone and cementum, while epithelial dysplasia affects squamous epithelium.

What are the main types of benign fibro-osseous lesions?

Periapical cemento-osseous dysplasia, focal cemento-osseous dysplasia, florid cemento-osseous dysplasia, fibrous dysplasia.

What is the typical location of Periapical Cemento-Osseous Dysplasia (PCOD)?

Anterior mandible.

What are the common patient demographics for PCOD? (Periapical cemento-osseous dysplasia)

Women over 30, more common in black women.

Are the teeth in the PCOD affected area vital?

Yes, teeth remain vital.

What is the radiographic progression of PCOD?

Early lesions are radiolucent, while older lesions are calcified.

What is the treatment for asymptomatic PCOD?

None required; biopsy only if diagnosis is unclear.

What is the typical patient for florid cemento-osseous dysplasia?

Black women over 40.

How many quadrants are usually involved in florid cemento-osseous dysplasia?

More than one quadrant.

Does florid cemento-osseous dysplasia require treatment if asymptomatic?

No.

What is the radiographic appearance of florid cemento-osseous dysplasia?

Masses of irregular opacification (dense sclerotic bone/cementum).

What is the typical location and size of focal cemento-osseous dysplasia?

Posterior mandible, less than 1.5 cm.

What are the typical patient demographics for focal cemento-osseous dysplasia?

Women 30-50, more common in white patients.

How is focal cemento-osseous dysplasia diagnosed?

Biopsy and histologic examination (fibrous tissue + bone/cementum).

What replaces normal bone in fibrous dysplasia?

Abnormal fibrous connective tissue with irregular bone trabeculae.

What are the two types of fibrous dysplasia?

Monostotic (single bone) and polyostotic (multiple bones).

What is the typical presentation of monostotic fibrous dysplasia?

Maxilla more than mandible, painless swelling, children/young adults, most common (~85%).

What is the typical presentation of polyostotic fibrous dysplasia?

Multiple bones, children under 10, female predilection, café au lait spots, ground glass radiographs.

What is the treatment for fibrous dysplasia?

Surgical recontouring for cosmetic reasons.

What is the typical patient for Paget disease of bone?

Men over 50.

Which jaw is most commonly affected by Paget disease?

Maxilla more than mandible.

What is the radiographic appearance of Paget disease?

Cotton-wool radiopacity, hypercementosis, loss of lamina dura.

What is a characteristic laboratory finding in Paget disease?

Elevated serum alkaline phosphatase.

What is the treatment for Paget disease?

Bisphosphonates; the disease is slowly progressive.

What is Central Giant Cell Granuloma (CGCG) composed of?

Vascular connective tissue with multinucleated giant cells.

What is the radiographic appearance of CGCG?

Unilocular or multilocular radiolucency, possible root divergence.

What is the treatment for CGCG?

Surgical excision.

What condition is associated with a presentation resembling CGCG?

Brown tumor of hyperparathyroidism.

What type of lesion is an Aneurysmal Bone Cyst (ABC)?

Pseudocyst filled with blood spaces, surrounded by multinucleated giant cells.

What is the radiographic appearance of an ABC?

Honeycomb or soap-bubble appearance.

What is the treatment for an ABC?

Surgical excision and cryotherapy.

What is the cause of osteomalacia and rickets?

Vitamin D deficiency; may also be caused by tumors, malabsorption, drugs, liver/kidney disease.

What are the clinical features of osteomalacia and rickets?

Delayed tooth eruption, periodontal disease, pathologic fractures.

What is the difference between rickets and osteomalacia?

Rickets occurs in children; osteomalacia occurs in adults.

Which condition presents with a ground glass radiographic appearance?

Fibrous dysplasia.

Which condition presents with a cotton-wool radiographic appearance?

Paget disease of bone.

Which condition presents with a soap-bubble or honeycomb radiographic appearance?

Aneurysmal bone cyst.