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Non-Neoplastic diseases of bone (Paget Disease of Bone :star: (Chronic,…
Non-Neoplastic diseases of bone
Benign Fibro-Osseous Lesions
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Periapical Cemento-Osseous Lesions
Asymptomatic
Location: Anterior Mandible
Cause:Unknown
Diagnosis: Radiographic & Clinical
Appearance: resemble bone & cementum in X-ray, well circumscribed, radiolucent when new, radiopaque when old
Focal Cemento-Osseous Dysplasia
Asymptomatic
Women 30-50
White>Black
Diagnosis: Surgical & Radiographic
Appearance: numerous gritty pieces of soft & hard tissue, separates easily from adjacent normal bone
Location: Local
Florid Cemento-Osseous Dysplasia
Appearance: radiopaque masses of irregular opacification, no bone expansion
Location: multiple quads of Mandible & Maxilla
Black Women > 40 years of age
Treatment: antibiotics & surgery
Diagnosis: Historical / Clinical / Radiographic
Fibrous Dysplasia
Diagnosis:
Radiographic / Clinical / Microscopic
Treatment:
Surgical - recontouring of affected bone for cosmetic reasons
Clinical Appearance:
enlargement of involved bones (maxilla/mandible involved; malocclusion, tipping, or displacement of teeth
Radiographic Appearance:
diffuse "Ground Glass" radiolucency / abnormal bone blends into normal bone
Location:
Monostotic
Maxilla >Mandible; ribs, femur, tibia
Polyostotic
More than one bone involved; skull, clavicles, long bones / Craniofacial type maxilla & adjacent bones
Cause:
Unknown
Monostotic Fibrous Dysplasia (most common type)
Location: localized abnormality involving one bone in the Maxilla > Mandible (not as common) & Posterior > Anterior
Diagnosis: Clinical
Appearance: irregularly shaped trabeculae single bone
Treatment: Bony recontouring at the affected site to improve esthetics and function once they become dormant.
Cause: Normal bone is replaced with fibrous connective tissue
Polyostotic Fibrous Dysplasia
Asymptomatic
Appearance: skin lesions appear as light-brown macules "cafe au lait spots".
3 types:
Craniofacial
Jaffe type
Albright syndrome
Treatment: Clinical - painless enlargement of affected bone or bones / Microscopic - benign fibro-osseous lesion / Radiographic - diffuse radiopacity resembling "ground glass"
Paget Disease of Bone
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Chronic, metabolic bone disease
Appearance: resorption, osteoblastic repair, remineralization of involved bone / patchy radiolucency - radiopacity "cotton wool"
Cause: Unknown
Men (+50) > Women (+50)
Location:Maxilla > Mandible
Treatment: Experimental
Diagnosis: Radiographic / Clinical / Laboratory
Central Giant Cell Granuloma
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Diagnosis: Microscopic
Treatment: Surgical Excision
Asymptomatic
Appearance: Unilocular / Multilocular radiolucency / Divergence of tooth roots is a common feature
Location: within bone of Maxilla & Mandible
Female > Male
ages 30 and under
Osteomalacia
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Treatment:
Children: vitamin D and dietary calcium
Adults: dependent on cause
Radiographic Appearance: subtle changes in bone trabeculation
Clinical Features: Children, delayed tooth eruption / pathological fractures / Perio disease
Location: generalized bone disease
Type common in children: Rickets
Type common in Adults: Osteomalacia