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Radiopaque Lesions, Citation: pg. 450-58 Delong, L & Burkhart, N.…
Radiopaque Lesions
Neoplasms and Tumors
Cementoblastoma
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Characteristics: may be normal pulp tissue that is vital but may not test vital because of disruption of normal neural impulse transmission, calcified mass has a radiolucent halo around outer perimeter (PD space), pt may be with or without pain, swelling usually present
Dental Implications: pt may only present with symptom of pain clinician required to categorize characteristics of lesion involved including the stage of development; vitality of tooth; and factors that indicate lesion is a cementoblastoma
Treatment/Prognosis: usual protocol is removal of tooth because of unlimited growth potential related to attached calcified mass, excellent prognosis, potential recurrence due to poor removal
Odontoma
Etiology: developmental anomalies and are hamartomas (abnormal mixture of tissue elements) in both epithelial and mesenchymal tissues
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Characteristics: usually found in posterior mandible region, compound of odontoma is most often seen in anterior maxilla, compound may be evident when normal eruption patterns do not occur and may block the permanent tooth from erupting (noticeable when failure to erupt is unilateral), usually asymptomatic and discovered on routine radiographs
Dental Implications: may be seen in Gardner syndrome along with osteoma, may impinge on teeth causing failure to erupt, may grow in size which can cause facial asymmetry
Treatment/Prognosis: excision, prognosis excellent
Osteoma
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Characteristics: some swelling may be noticed extraorally depending on size, lesion is slow growing, bony growths may be in the condyle; mandible; and maxilla, pt may experience headaches; sinusitis; or vague-related symptoms depending on size
Dental Implications: differentiation of an osteoma important in early diagnosis of Gardner syndrome, presence of lesions may indicate Gardner syndrome so further testing is necessary
Treatment/Prognosis: observation, careful monitoring, surgery for the larger and more extensive lesions, prognosis excellent when osteoma is removed
Gardner Syndrome: Inherited as an autosomal dominant disorder, characterized by polyposis coli associated with multiple hard and soft tissue tumors, caused by mutations of the APC gene, if left untreated or unrecognized then the polyps associated with condition usually develop into malignant invasive adenocarcinoma in gastrointestinal tract
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Citation: pg. 450-58 Delong, L & Burkhart, N. (2019). General and Oral Pathology for the Dental Hygienist. Third Edition. Philadelphia: Wolter Kluwer.