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HARD TISSUE LESIONS - Coggle Diagram
HARD TISSUE LESIONS
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Exostosis
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Dental implications: it’s is important to determine if there are any direct causes associated with the development of the excessive bone such as bruxism
Treatment and prognosis: there is no treatment recommended unless the growth interferes with anything.
Chronic osteomyelitis
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Characteristics: “onionskin” pattern of bone growth , presence of dental infection and young age
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Treatment and prognosis: identification of the bacteria involved and removal of the tooth or teeth in the area the prognosis is good
Ameloblastoma
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Characteristics: a soap bubble radiographic appearance and well defined as scalloped margins are characteristic of this lesion
Dental implications: these are localized non-encapsulated lesions and it can break through the cranial cavity by expansion making it life-threatening.
Treatment and prognosis: excision is the course of action. The tumor requires wide excision with clear margins to lessen the chance of reoccurrence the prognosis is good when timely treatment is rendered
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Ossifying fibroma
Etiology: A true benign neoplasm composed of cementum like calcifications and bony components the ossifying fibroma is thought to originate from the PDL
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Characteristics: radiographic lesions appear as well defined unilocular radiolucent lesions with radiopaque calcifications. Diverging roots may be evident or the lesion may appear dense and calcified
Dental implications: this lesion is removed, and a complete diagnosis is made after the specimen is viewed microscopically
Treatment and prognosis: ossifying fibroma‘s must be surgically removed. It is rare to have a reoccurrence and they do not become malignant. The prognosis is excellent
Osteosarcoma
Etiology: The most common primary malignant tumor found in bone and accounts for 20% of all bone tumors. It’s malignancy of mesenchymal cells that produce osteoid or immature bone
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Characteristics: symmetrical widening of the PDL of one or several teeth is often seen. Additionally the typical sunburst or spiking seen in radiographs are other distinguishing characteristics
Dental implications: the dental implications include tooth mobility swelling and pain. The patient may complain of nasal obstruction and paresthesia the growth can affect the trigeminal nerve causing paresthesia fractures may be observed as well
Treatment and prognosis: chemotherapy and surgical removal of the affected bone are the treatment of choice, with negative margins obtained around the periphery of the specimen. Poor rate of survival are correlated with the inability to obtain clear or negative margins
Chondrosarcoma
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Characteristics: the most common oral site for development of these lesions is the maxilla followed by the mandible. Maxillary involvement manifests as a painless swelling of the affected bone, with possible ulceration of the overlying mucosa. The patient may complain of a headache nasal problems vision problems and separation and or losing of teeth
Dental implications: Condrosarcoma’s may cause teeth become mobile. Monitoring the patient periodically for signs of reoccurrence is crucial
Treatment and prognosis: wide surgical excision which can be extensive depending upon the size of the lesion is the treatment of choice. The five-year survival rate for patients with high-grade tumors is 15%
Ewing sarcoma
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Characteristics: the most distinguishing feature of this is the unusually large mass of swelling that is usually present. This typically involves the long bones such as the femur, tibia, and humerus
Dental implications: any hard tissue growth should be evaluated and diagnosed through biopsy and additional warrant tests
Treatment and prognosis: surgery radiation and chemo therapy are the standard treatment. A survival rate of 60 to 80% has been reported approximately 20% of those affected will experience metastasis commonly involving the Lungs
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