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Hard Tissue Enlargements (Ch 17) - Coggle Diagram

- - - - Torus palatinus is found in midline of hard palate; growths may be large, lobulated, or subtle; mandibular tori develop along lingual aspect of mandible and are usually bilateral; do not appear suddenly; do not grow rapidly
    - - Possible interference with speech, eating, and toothbrushing; removal may be necessary for comfort, for dental appliances, or for the interferences mentioned above
    - - Not applicable
    - - May become traumatized, but normally pose no problem and treatment is not usually needed
    - - Appear to have genetic and ethnic predisposition; may involve masticatory stressors from bruxing and clenching
  - - - Tend to occur along the facial aspect of the maxilla and the mandible and manifest as lobulated, uneven solid bony growth; posterior region is most affected usually; tissue appears normal
    - - Determination of direct cause such as bruxism is important; removal may be necessary for dentures or Dental appliances
    - - Not applicable
    - - No treatment is recommended and less interference with dentures or continuous injury producing chronic inflammation; night guards might be necessary if bruxism is present
    - - Asymptomatic, exuberant growth of compact bone, along facial surfaces of Magilla and mandible; may be single or multiple nodules composed of dense compact bone; ideology is irritation and clues of forces
- - - - Not applicable
    - - Aggressive lesions may recur; complete removal as indicated; hyperparathyroidism should be ruled out where are the term brown tumor is used
    - - Can possibly affect small long bones, such as those of the hands and feet; intraorally usually manifests as a painless expansion of the jaw, usually anterior to the first molar; If penetrates through the cortical bone, appears as a soft tissue, flat based nodule with a blue to purple color; usually no pain; radiographic appearance is a radiolucent, multilocular, or less often unilocular lesion with scalloped and expanding margins
    - - CGCG thought to be a reactive lesion or a reparative response to trauma or other local factors; many feel that because of its unpredictable and often aggressive nature, it is a neoplasm; topic is controversial; considered and intraosseous lesion with an unknown at etiology
    - - Excision by curettage is the recommended treatment; reoccurrence occurs in 15 to 20%; prognosis is good with complete removal
  - - - Lung metastasis may occur; intraorally may present with symptoms of pain, swelling, loose teeth, or numbness; dysesthesia; taste sensationAnd tingling and numbness may occur; many cases show radiographic appearance described as a "sunburst" pattern; may see symmetrical widening of PDL space on one or several teeth and root resorption called "spiking" resorption because roots have a tapered appearance
    - - May exhibit tooth mobility, swelling, and pain; patient may complain of nasal obstruction and paresthesia; growth can affect trigeminal nerve; may see fractures and widened of the PDL space
    - - Not applicable
    - - Chemotherapy and surgical removal are the treatment of choice; poor rate of survival correlate with inability to obtain clear or negative margins during surgery; prognosis is not so good
    - - Most common primary malignant tumor found in bone and accounts for 20% of all bone tumors; malignancy of mesenchymal cells that produce osteoid or immature bone; osteoblasts become malignant; originates from gene mutation
  - - - Large OFs may cause swelling and facial asymmetry; intraorally often slow growing, painless, and expansile; radiographic appearance is a well circumscribed, unilocular, radiolucency with variable density; sclerotic borders may be evident as well as root resorption or root divergence
    - - Complete diagnosis is made after lesion is removed and viewed microscopically
    - - Not applicable
    - - Must be surgically removed; prognosis is excellent
    - - A true benign neoplasm, composed of cementum like calcifications and bony components; thought to originate from the PDL; from a collection of fibroosseous lesion of bone
  - - - May present with external swelling and asymmetry due to tumor growth; most common oral site is maxilla followed by mandible; maxillary involvement manifest as painless swelling with possible ulceration; patient may complain of a headache, nasal problems, vision problems, and separation or loosening of teeth; when found in mandible it is in premolar and molar regions; usually discovered radio graphically as multilocular or focal radiolucent lesion, sometimes a peek; widening of PDL space is common
    - - Because teeth to become mobile; monitoring for reoccurrence is crucial
    - - Not applicable
    - - Wide surgical excision is the treatment of choice; MRI scans are best for diagnosis; these tumors are radio resistant; five-year survival rate for patients with high-grade tumors is 15%
    - - Malignant tumor of cartilage; some evidence of genetic predisposition; post radiation chondrosarcomaseen an individuals receiving more than 7000 rad dosages during radiation treatment
  - - - A large CEOT may produce clinically observable facial asymmetry resulting; Intraorally manifests as slow growing, painless jaw expansion, usually an molars and premolars area; on Mozilla tends to grow more rapidly; lesions are often associated with impacted teeth; intraosseous usually involves mandible; extraosseous usually involves anterior gingival region; Radiographs show multilocular radiolucent lesion with variable amounts of calcification; a distinct entity, referred to as LIESEGANG rings may be visible microscopically when calcification is dense
    - - Usually discovered when patient notices and reports facial asymmetry or during routine radiographic examination
    - - Not applicable
    - - Surgical removal of the tumor with a wide margin of normal tissue is required; prognosis is excellent
    - - Benign epithelial tumor probably originating from enamel epithelium, but it's origin is unknown; Associated with unerupted teeth
  - - - Clinically affects long bones, pelvic area or femur; intraorally lesions involve pain, swelling, numbness, and tooth mobility; Ramus of mandible is most common location; usually find destruction of alveolar bone and ulceration of overlying gingiva; may cause facial asymmetry; radio graphically appears as mouth eaten radiolucency or infection in the bone with destruction or erosion of cortical bone; may also exhibit "onion skin" appearance
    - - Any hard tissue growth should be evaluated and diagnosed through biopsy
    - - Not applicable
    - - Surgery, radiation, and chemotherapy are the standard treatment; survival rate of 60 to 80% or more is usual; most common site for metastasis is lungs and bones
    - - Malignant bone neoplasm of unknown origin; neural or neuroectodermal origin is suspected; may share a link to Pastor radiation or chemo therapy from childhood
  - - - May cause facial asymmetrry; usually asymptomatic until discovered on radiographs; appears as painless, swelling, usually in post MD region; may see buccal and lingual expansion; may cause root resorption leading to tooth mobility; on radiographs appear as multilocular or unilocular radiolucencies with well-defined, scalloped margins; multilocular lesions will exhibit a "soap-bubble" or "honeycomb" appearance when small
    - - Lesion could break through the cranial cavity by expansion making it life-threatening; if they appear in the maxilla, they can result in death due to direct extension into vital structures
    - - Not applicable
    - - Excision is the treatment of choice; requires wide excision with clear margins; careful radiographic follow up is necessary; prognosis is good if treatment is timely
    - - A benign tumor of odontogenic epithelial origin; arising from epithelial or mesenchymal remnants of tooth forming tissues such as enamel organ, dental lamina Hertwig sheath, rests of Malassez, rest of Serres, basal cells or oral mucosa or reduced enamel epithelium
- - - - Not applicable
    - - May lead to tooth mobility depending on degree of advancement and stage of treatment; source of irritation must be removed; may require endodontic treatment or extraction
    - - Lesion appears as an asymptomatic, unilateral, Bonnie, hard protuberance with normal tissue covering the growth; usually occurs on posterior region of mandible; occlusal radiographic image shows onion skin pattern of bone growth, presence of a dental infection, and young age
    - - Identification of bacteria involved and subsequent removal of tooth or teeth or endodontic treatment; antibiotics are usually required; prognosis is good and bone will resolve overtime
    - - Proliferative inflammatory response of the periosteum to infection or other irritants; originates from odontogenic factors such as periapical abscess or periodontal infection, or from non-odontogenic factors such as bacteremia, oral surgery, or jaw fractures