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Hard Tissue Enlargements - Coggle Diagram
Hard Tissue Enlargements
Variations of Normal
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Exostosis:
etiology: irritation and occlusal forces. usually due to frictional causes such as an ill-fitting dental prosthesis or bruxism.
Characteristics: lobulated , uneven solid bony growths. The posterior region is affected most often. The tissue appears a normal color unless the area has been traumatized.
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Dental Implications: if the cause is bruxism you should limit the excessive occlusal forces through the use of appliances or behavior modification would be optimal. Growths may need to be removed if dentures or other dental appliances are required.
Treatment and Prognosis: no treatment recommended. night guards my be fabricated for the patient if bruxism is a factor.
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Neoplasms
Ameloblastoma
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Characteristics: painless swelling, usually in the posterior mandibular region. may cause facial asymmetry. may cause root resorption and teeth may become mobile as the neoplasm expands.
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Dental Implications: it can break through the cranial cavity by expansion, making it life threatening. Can result in death due to direct extension into vital structures. The lesions also become more difficult to manage when they spread through the bone into soft tissues.
Treatment and Prognosis: excision is the treatment of choice. the prognosis is good when timely treatment is rendered, but ameloblastomas may recur, and untreated ameloblastomas can result in death due to the expansion and tissue destruction.
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Ossifying Fibroma
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Characteristics: larger ossifying fibromas may cause swelling and facial asymmetry. Slow growing, painless, and expansile.
Dental Implications: the lesion is removed, and a complete diagnosis is made after the specimen is viewed microscopically.
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Treatment and Prognosis:esion is removed surgically. recurrence is rare, and they do not become malignant. Prognosis is excellent.
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Osteosarcoma
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Characteristics: pain, swelling, loose teeth or numbness. Dysesthesia is also reported. when neoplasms involve teeth a widened PDL space and root resorption is observed.
Dental Implications: tooth mobility, swelling, pain.The patient may complain of nasal obstruction and paresthesia. growth can affect the trigeminal nerve, causing paresthesia.
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Treatment and Prognosis: chemo and surgical removal of the affected bone are the treatments of choice, with negative margins obtain around the periphery of the specimen.
Chondrosarcoma
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Characteristics: external swelling and asymmetry may be visible due to the growth of the tumor. swelling, painless with possible ulceration of the overlying mucosa. may cause teeth to become mobile
Dental Implications: may cause teeth to become mobile. Monitoring the patient periodically for signs of a recurrence is crucial.
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Treatment and Prognosis: wide surgical excision is the treatment depending on the size of the lesion. The 5 year survival rate for patients with high grade tumors is 15% but the outlook for patients with low grade tumors is more favorable. If the tumor recurs, it is usually found 5 to 10 years postsurgery. :
Ewing Sarcoma
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Characteristics: the lesions usually involve pain, swelling, numbness, and often tooth mobility. lesion appears radiographically as the motheaten radiolucency or as an infection in the bone, with destruction or erosion of the cortical bone.
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Citations:
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Delong, L & Burkhart, N. (2019). General and Oral Pathology for the Dental
Hygienist. Third Edition. Philadelphia: Wolter Kluwer.
Langlais, R, Miller, C., & Gehrig, J. (2017). Color Atlas of Common Oral
Diseases. Fifth Edition. Philadelphia: Wolter Kluwer