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Radiolucent Lesions - Coggle Diagram
Radiolucent Lesions
Infections:
Osteomyelitis
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Characteristics: lymphadenopathy, fever, and pain are symptoms. in chronic form, more evident patches of necrotic bone and diffuse radiolucent lesions are seen.
Dental Implications: patient may have pain and lymphadenopathy. Try to assess the cause of this lesion.
Method of Transmission: the acute form of this lesion may have several infectious organisms involved in the disease process.
Treatment and Prognosis: Drainage and antibiotics are needed to treat the acute form of this lesion. The chronic form of this lesion is more difficult to treat due to the necrosis. Surgery would then be recommended, with antibiotic coverage.
Lateral Periodontal Cyst
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Characteristics: this is asymptomatic and is usually not seen on a radiograph. The cyst is usually unilocular, is round or oval, and is well delineated.
Dental Implications: should be diagnosed as a lateral periodontal cyst, and rule out any other more serious type of cyst or tumor.
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Treatment and Prognosis: surgery is recommended and pathologic review are treatments of choice. test the vitality of the tooth. Prognosis is excellent.
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Dentigerous Cyst:
Etiology: odontogenic in development. arise from a cystic change in the dental follicle following frown formation when the follicle separates from the crown of the tooth.
Characteristics: found around the crown of the unerupted third molars, canines, and unerupted teeth. usually only evident on radiographs, with no symptoms of pain or discomfort reported.
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Treatment and Prognosis: complete removal of this lesion is recommended. Since the recurrence is high when this is not fully accomplished.
Dental Implications: delayed tooth eruption is a common theme. early diagnosis is very important because they will continue to grow and spread if not.
Eruption Cyst
Etiology: variant of the dentigerous cyst and is caused by the accumulation of fluid or blood between the crown of an erupting tooth and the reduced enamel organ, due to trauma.
Characteristics: bluish cast due to the inflammatory inner core and blood accumulation. The blue hue of the lesion is present. The radiographic finding of an eruption cyst is an enlarged follicular space.
Dental Implications: failure of the tooth to erupt, therefore the cyst may be opened to hasten the event. Most eruption cyst are left to dissipate on their own.
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Treatment and Prognosis: no treatment required. Sometimes, the removal of the overlying tissue could facilitate a quicker eruption. The tooth eventually erupts through the tissue, and the cyst disappears.
Odontogenic Keratocyst
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Characteristics: occurs most often in the posterior mandibular region. can be multilocular, unilocular, well circumscribed on the radiograph and radiolucent, with a scalloped appearance.
Dental Implications:prompt treatment is required. Multiple OKCs should alert the practitioner to the possibility of neviod basal cell carcinoma.
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Treatment and Prognosis: removal of the entire lesion is crucial. Many OKCs today are treated by decompression, allowing the cyst to shrink before definitive surgical removal.
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Globulomaxillary cyst:
Etiology: fissural cyst that arose from the epithelium that was thought to be trapped when the globular portion of the median nasal process fused with the maxillary process.
Characteristics: cyst may be inverted pear-shaped lesion because of the location, causing divergence of the tooth roots. Vitality of the pulp provides some evidence about the type of cyst.
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Dental Implications: vitality of the teeth involved, such as the lateral and cuspid, must be evaluated. Endodontic therapy should be administered when necessary.
Treatment and Prognosis: surgical removal is the treatment of choice, and the prognosis is good, depending upon the type of cyst. Recurrence is rare.
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Nasopalatine duct cyst:
Etiology: developmental cyst. arises from the epithelial remnants of the embryologic structure of the nasopalatine ducts, and the structures connects the oral and nasal cavities in the area of the incisive canal, probably because of infection or some stimulation.
Characteristics: occurs in about 1% of the population. most commonly seen in the fourth to sixth decades, and most commonly found in males. Patient may complain with pain, tenderness, and swelling, and drainage may be noted in the maxillary incisor region.
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Dental Implications: cyst is not radiographically diagnostic and must be removed and biopsied for definitive microscopic evaluation.
Treatment and Prognosis: complete surgical removal is needed. prognosis is good, recurrence rate is low with complete removal
Static Bone Cyst
Etiology: defect in the mandible that surrounds salivary gland tissue. it is believed to be an entrapment of the salivary gland tissue.
Characteristics: asymptomatic. usually discovered when a panoramic is taken. usually found at the angle of the mandible. sharply circumscribed, oral, radiolucent lesion with a sclerotic border.
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Dental Implications: when the location is superior to the mandibular canal, a biopsy may be needed to rule out pathology.
Treatment and Prognosis: this lesion is noted and followed long term and if any changes occur, they are noted in the patients records. Other cyst should be considered if the cyst is occuring above the mandibular canal.
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Neoplasms
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Odontogenic Myxoma
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Characteristics: swelling may occur in isolated areas. radiographically, the tumors can be unilocular or multilocular, and the radiolucencies may have scalloped appearance.
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Dental Implications: enlarged dental follicles or the dental papilla of the developing tooth may be mistaken for the myxomas upon microscopic exam. The tumors can become quite large, causing tooth displacement.
Treatment and Prognosis: Myxoma is removed surgically, usually with a wide margin of normal bone. Recurrence rate can be as high as 25%. Fragments are hard to remove.
Ameloblastic Fibroma
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Characteristics: these lesions are rare. slow growing and small in size, although large tumors have been reported. Posterior mandible is the most common site where this lesion can occur. There is no gender preference. Some external swelling may be present. Patient usually experiences no pain with any swelling that may occur.
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Treatment and Prognosis: conservative excision is the treatment of choice. Recurrence occurs in 20% of cases.
Langerhas Cell Disease:
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Dental Implications: lesions that occur periapically can be confused with periapical cyst or granulomas. Tooth vitality would still be present.
Treatment and Prognosis: conservative surgical treatment is sometimes the only treatment. In more extensive disease involvement, chemotherapy many be needed as well. Bone marrow transplant may be done as well.
Characteristics: lymphadenopathy may be present, cranial bones may be involved, and the cutaneous areas may involve rashes and erythematic lesions.