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Radiolucent Lesions - Coggle Diagram
Radiolucent Lesions
Developmental Cysts
Lateral Periodontal Cyst
Etiology = Odontogenic, non-keratinized development or cyst, believed to develop from the dental lamina remnants from within bone; most often unilocular, radioLucent, and lateral to the root of a vital mandibular cuspid were premolar tooth
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PO and IO =. Asymptomatic and not usually noticed until seen on a radiograph; usually unilocular, round or oval, and as well delineated
Distinguishing = Teeth associated are vital; when a multilocular cyst is present, it is called a variant of the lateral periodontal cyst and is known as the botryoid odontogenic cyst; have a grape like appearance; well circumscribed radioLucent area located laterally to the roots of vital teeth
Dental Implications = Should be identified since it is necessary to rule out an inflammatory type of lesion
Tx and Prognosis = surgical excision and pathologic review; but vitality testing is important to avoid unnecessary endodontic treatment; maybe a higher rate of recurrence when the cyst is a botryoid odontogenic cyst; periodic radiographic follow up as needed; the prognosis is excellent
Dentiogerous Cyst
Etiology = Odontogenic in development; dentigerous cyst change in the dental follicle following crown formation when the follicle separates from the crown of the tooth; Reduced enamel epithelium forms from the original ameloblast of the enamel organ
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PO and IO = Are usually only evidence on radiographs, with no symptoms of pain or discomfort; well circumscribed, unilocular, and sometimes multilocular
Distinguishing = Radiographically, well circumscribed, unilocular, and sometimes multilocular; appears completely radioLucent; always associated with the crown of an impacted or unerupted tooth, supernumerary tooth, or odontoma; fluid between the crown of the unerupted tooth in the epithelium
Dental Implications = Delayed tooth eruption; can become quite large and has the potential to displace teeth and resorb roots; continue to grow and expand, therefore, early diagnosis is imperative
Tx and Prognosis = Complete removal of the cyst; recurrence is hard when this is not fully accomplished
Eruption Cyst
Etiology = Considered a variant of the dentigerous, caused by the accumulation of fluid or blood between the crown of an on erupturing tooth and the reduced enamel Organ, due to trauma
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PO and IO = Tissue of the eruption cyst may have a darker appearance and appear elevated; seen as a smooth bluish swelling on the crest of the alveolar ridge; radiographically is an enlarged follicular space
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Dental Implications = Failure of the tooth to erupt; cyst may be opened to hasten the event; most eruption cyst are left to dissipate on their own
Tx and Prognosis = No treatment is necessary; however removal of the overlying tissue could facilitate a quicker eruption; tooth eventually erupts through the tissue in the cyst disappears
Odontogenic Keratocyst
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PO and IO = Occurs most often in the posterior mandibular region; cyst may become large enough to displace teeth and extend through the cancellous bone into the oral cavity; as the jaw becomes weekend, a fracture is more likely to occur
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Dental Implications = Microscopic interpretation is unique once a specimen is submitted; the association with nevoid bcc syndrome is especially important; prompt treatment is required
Tx and Prognosis = Since recurrence is hard, careful removal of the entire cyst is crucial, and the capsule must be removed intact so that daughter cells do not remain; treated by decompression, allowing the cyst to shrink before definitive surgical removal; thin wall is often difficult to separate from bone and remove in one piece, often allowing daughter cells to remain an increase in occurrence
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Globulomaxillary Cyst
Etiology = Represents a fissural cyst that arose from the epithelium that was felt to be trapped when the globular portion of the median nasal process fused with the maxillary process
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PO and IO = Inverted pear-shaped lesion because of the location, causing divergence of the tooth roots; circumscribed and radioLucent; but Vitality of the pulp provide some evidence
Distinguishing = Location and pear-shaped configuration of the globulomaxillary cyst; biopsy is needed
Dental Implications = Vitality of the teeth involved must be evaluated; endodontic therapy should be administered when necessary
Tx and Prognosis = Surgical removal; prognosis is good; recurrence is rare; treatment would depend upon microscopic evaluation
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Nasopalatine Duct Cyst
Etiology = Considered a developmental cyst, located in the nasopalatine canal; arises from epithelial remnants of the embryologic structure of the nasopalatine, and the structure connects the oral and nasal cavities in the area of the incisive canal
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EO = Size and extent of the cyst determine any extraoral characteristics such as swelling in her elevation around the nose and lip areas
PO and IO = Patient may complain of pain, tenderness, and swelling, and drainage of the maxillary incisors region; seen between the maxillary central incisors radiographically; well circumscribed radioLucent lesion which may have a sclerotic border
Distinguishing = When drainage occurs, patient may complain of foul, salty taste; pain, discomfort, and burning
Dental Implications = Not radiographically diagnostic and must be removed and biopsied for a definitive microscopic evaluation
Tx and Prognosis = Complete surgical removal is needed; prognosis is good; recurrence rate is low with complete removal
Static Bone Cyst
Etiology = Not a true cyst, although radiographically it appears as a cyst; a defect in the mandible that surrounds salivary gland tissue; entrapment of the salivary gland issue and is not lined by epithelium
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PO and IO = Asymptomatic and discovered when PAN film is taking; seen radiographically as a radiolucency in the posterior mandible below the mandibular canal; sharply circumscribed, oval, radioLucent lesion with a sclerotic border
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Dental Implications = Usually diagnosed clinically by using radiographs; when the location is superior to the mandible canal, a biopsy is needed
Tx and Prognosis = Noted and followed long-term, if any changes occur, they are noted in the patient’s record
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Neoplasms
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Odontogenic Myxoma
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PO and IO = Radiographically, can be unilocular or multilocular and have a scalloped appearance; also been described as having a step ladder or honeycombed appearance; margins well-defined or they may be diffuse
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Dental Implications = Enlarged dental follicles or the dental papilla of a developing tooth may be mistaken; also can be confused with other jaw neoplasms; tumors can become quite large, causing to displacement
Tx and Prognosis = Removed surgically, usually with wide margin of normal bone; Highly gelatinous material makes removal difficult with curettage, and the recurrence rate is as high as 25%; fragments are difficult to remove
Ameloblastic Fibroma
Etiology = Mixed odontogenic tumor that is believed to originate from odontogenic ectomesenchyme and odontogenic epithelium; nonencapsulated resembling dental papilla and small islands of odontogenic epithelium resembling dental lamina
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EO = Depending upon the expansion, some external swelling may be present
PO and IO = Usually experiences no pain with any swelling; has potential for extensive growth causing jaw expansion; maybe calcified material containing enamel and dentin; radiographically, can be unilocular or multilocular; normally well-defined and usually associated with an unerupted tooth
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