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Radiopaque Lesions, Burkhart, N., Delong, L. (2020). Radiopaque Lesions.…
Radiopaque Lesions
Neoplasms and Tumors
Odontoma
Charcteristics: Complex is usually found in the posterior mandibular region, while compound is usually in maxilla. Compound may be evident when normal eruption patterns do not occur. Usually asymptomatic and found on radiographs.
Dental implications: May be seen in Gardner Syndrome along with osteoma. May impinge on teeth causing teeth to not erupt.
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Treatment/ Prognosis: Excision is the treatment of choice; prognosis is excellent without recurrence.
Etiology: Mixed odontogenic tumors comprised of both epithelial and mesenchymal tissues. Believed to be a disturbance in tooth development.
Osteoma
Characteristic: Appear radiographically as a dense radiopaque growth on the bone. Bony growths may be in the condyle, mandible, and macilla or even in the sinus region.
Dental implications: Differentiation of osteoma is important in early diagnosis of Gardner Syndrome. Presence of osteomas and odontomas may indicate Gardner Syndrome and thus further testing is necessary.
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Treatment/ Prognosis: Observation with careful monitoring for small osteomas. Surgery for the larger ones. Prognosis is excellent after surgical removal with recurrence not usually an issue. Referral to a medical doctor is needed when there is indication of Gardner syndrome.
Etiology: unknown but trauma, infections, and developmental defects have been suggested as possible causes.
Cementoblastoma
Characteristics: Will not test vital with an electric pulp tester but there may still be normal, vital pulp tissue.
Dental implications: Patient may present with pain only therefore the clinician will need to categorize the lesion including the stage of development, vitality of the tooth, and the factors that would indicate that the lesion is a cementoblastoma.
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Treatment/ Prognosis: Removal of the tooth is the usual treatment. Growth potential makes removal necessary.Reported potential for recurrence.
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Gardner Syndrome: An autosomal dominant disorder characterized by polyposis coli associated with multiple hard and soft tissue tumors. If left untreated or unrecognized, polyps usually develop into malignant invasive adenocarcinoma in the gastrointestinal tract and the stomach by the fourth decade. Madible is the favored location for osteomas and odontomas. Family members should be advised to have screenings as well.
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Burkhart, N., Delong, L. (2020). Radiopaque Lesions. In GENERAL AND ORAL PATHOLOGY FOR THE DENTAL HYGIENIST {450-458}. S.I.: JONES & BARTLETT LEARNING