ORAD800: Benign Fibro-osseous Lesions and Other Bone Pathology

Fibro-Osseous Lesions

lesions characterized by replacement of normal bone by fibrous connective and abnormal immature bone

What lesion is replaced by fibrous connective tissue?

Fibro-Osseous

What are the 4 categories that Fibro-Osseous Lesions can be??

Developmental

Reactive

Dysplastic

Neoplastic

Fibrous Dysplasia

localized change in normal bone metabolism, replacement of cancellous bone by fibrous tissue

What fibrous lesion is a change in the normal bone metabolism?

Fibrous Dysplasia

Solitary Type Fibrous Dysplasia

one bone involved

One bone involved

Solitary Type Fibrous Dysplasia

Jaffe Type Fibrous Dysplasia

multiple bones involved

Multiple bones involved

Jaffee Type Fibrous Dysplasia

McCune Albright Syndrome

polyostotic fibrous dysplasia, cutaneous pigmentation, hyperfunction of one or more adrenal glands

Clinical Features of Fibrous Dysplasia

young adults

posterior maxilla

enlargement of alveolar process

unilateral facial swelling

growth ceases after adolescence

T/F: Fibrous Dysplasia is common in younger people?

TRUE

T/F: Fibrous Dysplasia ceases after adolescence?

TRUE

Location of Fibrous Dysplasia

maxilla, posterior region, unilateral

Periphery of Fibrous Dysplasia

ill-defined

blended

normal trabeculae

Internal Structure of Fibrous Dysplasia

RI, RO, mixed, ground glass, cotton wool, orange peen

T/F: Fibrous Dysplasia can cause superior displacement of the IAN?

TRUE

Periapical Cemental Dysplasia

localized change of normal cancellous bone with fibrous tissue and cementum-like material

Clinical Features of Periapical Cemental Dysplasia?

middle aged woman

african american, asian

Vital Teeth

Large expansion of alveolar process

T/F: Periapical Cemental Dysplasia is common in white men

FALSE

T/F: Periapical Cemental Dysplasia is common in non-vital teeth

FALSE

Location of Periapical Cemental Dysplasia

Apex, mandibular anterior teeth

Periphery of Periapical Cemental Dysplasia

well defined,RL border

Internal structure of Periapical Cemental Dysplasia

early stage (apical RL), mixed stage, mature

Florid

widespread

Florid Osseous Dysplasia

widespread form of PCOD.

Normal bone replaced with dense, acellular cemento-ossoeus tissue in background of connective tissue.

poor vascular supply

Clinical Features of Florid Osseous Dysplasia

females

poorly localized

extensive lesions

Cementoosifying Fibroma

benign bone neoplasm

3-4th decade

mandible > maxilla

asymptomatic

Location of Cementoosifying Fibroma

mandible

maxilla

Periphery of Cementoosifying Fibroma

well defined, sclerotic border, RL capsule

Internal Structure of Cementoosifying Fibroma

mixed

T/F: Cementoosifying Fibroma has an intact lamina dura

FALSE

Juvenile Cementoosifying Fibroma

rapid growth and jaw deformity

30-58% recurrence rate

involves orbital, frontal bone and paranasla sinuses

maxilla common

Osteoma

benign tumor

asymptomatic

slow growing

mandibular body/condyle

paranasal sinus osteoma

Osteoblastoma

benign neoplasm of osteoblasts

common in vertebrae of young person

TMJ

Benign Cementoblastoma

slow growing, mesenchymal neoplasms composed of cementum primarily

bulbous growth around/ attached to apex of tooth root

Osteogenesis Imperfecta

autosomal dominant/ recessive an inherited disorder characterized by extreme fragility of the bones.

Focal Osteoporotic Marrow Defect

not a pathologic process but radiographic features can be confused with pathology

radiolucent area with fine central trabeculation within the lesion

Focal Idiopathic Osteosclerosis

asymptomatic, radiopaque, unknown origin, no inflam./dysp./neop. etiologies

Paget's Disease

abnormal resorption and deposition of osseous tissue

Paget's Disease has what levels elevated?

alkaline phosphatase

hydroxproline in urine

Central Giant Cell Granuloma

reactive lesion

multinucleated giant cells

What is a clinical feature of Central Giant Cell Granuloma?

purple overlying mucosa

Location of Central Giant Cell Granuloma

mandible

Periphery of Central Giant Cell Granuloma

well defined RL margin

Internal Structure of Central Giant Cell Granuloma

RL, granular pattern, wispy septae

Aneurysmal Bone Cyst

reactive lesion of bone

exaggerated, localized proliferative response of vascular tissue in bone

Clinical Features of Aneurysmal Bone Cyst

under 30

predilection females

rapid bone swelling

pain

tender on palpation

Location of Aneurysmal Bone Cyst

mandible

Periphery of Aneurysmal Bone Cyst

well-defined

Internal structure of Aneurysmal Bone Cyst

multilocular

Cherubism

inherited developmental abnormality

bilateral enlargement of jaws

Simple Bone Cavity

well-delineated, unilocular radiolucency