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Non-Neoplasia -1, Fibrous Dysplasia, Periapical, Florid, Focal, Paget…
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Paget Disease of Bone
Cotton wool radiographic appearance. 
The maxilla is more commonly affected than the mandible, but this condition usually affects the pelvis, femur, spinal column, tibia, and skull. The serum alkaline phosphatase level is significantly elevated in active disease.
Frequently affects males over the age of 50. As the involved bone enlarges the edentulous patient will need another denture. Dizziness, deafness, and severe headaches are clinical manifestations of nerve impingement.
Chronic metabolic bone disease of unknown cause. Abnormal bone metabolism. Bone enlargement and pain are common symptoms. Spacing between teeth are signs of bone enlargement.
Complications include fracture of the involved bone and development of malignant tumors,
(osteosarcoma). Heart disease is a rare complication. The most commonly used treatment is bisphosphonate, but the disease is slowly progressive and other treatments include osteoclast inhibitors.
Unclear cause
Made of well vascularized fibrous CT
Occurs within gingival and alveolar soft tissue and bone of the maxilla and mandible
Children and young adults under 30
Females more common than males
Nonaggressive/aggressive
Discomfort, no pain
Radiographically
Surgical removal
Occasionally reoccurs
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Aneurysmal Bone Cyst
Mostly affects long bones. Jaw involvement is rare.
Mandible is more commonly affected than the maxilla.
Appears as a radiolucent lesion that is multilocular and resembles soap bubbles or honeycomb.
Expansion and enlargement of the involved bone.
It is a pseudocyst that consists of blood-filled spaces and lacks an epithelial lining. It is surrounded by multinucleated giant cells and fibrous connective tissue. Usually occurs in individuals younger than 30 years old. Affects females slightly more commonly than males.
Although the cause is unknown, it has been associated to a change in vascularity caused by fibrous dysplasia, central giant cell granuloma, chondroblastoma, and other
primary bone lesions as well as a previous history of trauma
Tx is complete removal by surgical excision and supplemental cryotherapy
Osteomalacia
Total mass of bone may be normal but it is not properly mineralized and is soft and weak
Delayed tooth eruption and periodontal disease are associated to this disease. It is commonly caused by a severe vitamin D deficiency, but can also occur as a result of phosphorus or calcium deficiency (rare in Western countries) Can also be induced by certain tumors.
Soft bones is the most common sign. Symptoms include pain, muscle spasms, muscle weakness,difficulty walking. The prognosis is good but bones are susceptible to fracture.
Tx is based on the identification of the cause and includes nutritional supplementation with vitamin D and dietary calcium.
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Definition: a developmental disease characterized by the replacement of bone with abnormal fibrous connective tissue interspersed with varying amounts of calcified material
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Definition: “Dysplasia” in this chapter refers to abnormal and disordered production of cementum and bone
-Unknown cause
-F>M
-Age >30
-Anterior Mandible
-Asymtomatic, vital teeth
-Well defined radiolucent you to radio parity at apex of tooth
-Benign fibro-osseous lesion
-Fibrous conn. Tissue w/ dense sclerotic masses of bone, cementum or both
-No treatment
-Historical, clinical (pulp test for tooth vitality), radiographic
Examples: Periapical granuloma, Periapical cyst, ossifying fibroma
-Unknown cause
-F>M
-Age 30-50
-Whites
-Posterior mandible
-asymptomatic
-Well defined radiolucent to radiopacity
-Fibrous conn. Tissue w/ round globular calcification and bone trabeculae
-Numerous gritty pieces of soft/hard tissue
-No treatment
-Radiographic, clinical (unilateral expansion), Microscopic
-Unknown cause
-F>M
-Age >40
-Multiple areas of maxilla and mandible
-asymtomatic
-multiple areas of radiolucency to radiopacity
-benign fibro-osseous lesion
-fibrous conn. Tissue w/ dense sclerotic masses of bone, cementum or both
- Non treatment unless complicated by osteomyelitis
-historical, clinical (no expansion), radiographic