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Focal Sclerosing Osteomyelitis, Cementoblastoma, Odontoma, Osteoma,…
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Cementoblastoma
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Oral Characteristics
IO: appears as a dense, radiopaque object around the apical area of the tooth. The tooth will remain vital but might test nonvital on electrical pulp tester due to disruption of normal neural impulse transmission.
A “halo effect” is characteristic of the lesion. This is the periodontal ligament space. Pain may or may not be present
Epidemiology
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Posterior MD is most common site and first molars is most commonly affected tooth but the MX is the most common site when multiple teeth are involved
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Odontoma
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Epidemiology
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Decrease risk for some cancers—maintain a healthy weight, healthy diet high in fiber and antioxidants, no tobacco, limit alcohol use, exercise, et
Oral characteristics
Complex Odontoma
Calcified collection of structures; may be enamel, dentin, cementum, and pulp
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Etiology
May be comprised of both epithelial and mesenchymal tissues. They are developmental anomalies and are hamartomas
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Osteoma
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Epidemiology
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Growths may occur in the MX, MD, the skull and the sinuses
Etiology
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Infections, trauma, and developmental defects have been suggested as possible causes
Oral characteristics
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IO: Radiographically appears dense opaque growth on the bone. Depending on size,
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Gardner Syndrome
Oral Characteristics
Sharply well-defined, clumped radiopaque structures
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Epidemiology
Polyposis coli occurs in 1 in 8,000 people and most common form of hereditary polyposis syndromes
Osteoperosis
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Oral Characteristics
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IO: Radiographically there is skeletal density due to diffusion sclerosing of all the bones. Bone appear dense but poor quality and will break easily with pressure. Delayed tooth eruption, enamel hyperplasia and thickening if the lamina dura.
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Etiology
Hereditary autosomal recessive and autosomal dominant disorder
Also called: Albers-Schönberg disease and "marble bone syrdome"
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Treatment
Best treated in a multispecialty facility so that other professionals can be involved in the treatment
Periapical Ganuloma
Etiology
Caused by caries, trauma, or necrotic pulp tissue and Periodontal disease may cause periapical granuloma as well
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Oral characteristics
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IO: accumulation of granulation tissue apically of the nonvital tooth; tooth may be asymptomatic but in most cases tooth sensitivity and pain occur until tooth becomes completely non-vital
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Radicular Cyst
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Etiology
Caused by caries, trauma, or necrotic pulp tissue and Periodontal disease may cause periapical granuloma as wel
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Oral Characteristics
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IO: MX anterior region is more common at the apex of the tooth, patient usually experience no pain and is usually not aware of the cyst. Radiographs can show root absorption; blunting of the root surface.
Well-circumscribed radiolucent lesion
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Aneurysmal Bone Cyst
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Oral characteristics
Benign lesion filled with blood; swelling found with or without pain. Unilocular or multilocular with soap bubble appearance.
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Traumatic Bone Cyst
Etiology
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Thought to be traumatic-hemorrhage theory but other factors are venous obstruction, local disturbance in bone growth, altered calcium metabolism, and ischemic marrow necrosis
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Oral characteristics
IO: Painless blood filled lesion increased swelling may occur but lesions are discovered with radiographs. Scalloping cyst with well-delineated radiolucency with sharp margins in some ares and ill defined in others. Honey comb appearance.
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Osteomyelitis
Epidemiology
Male prevalence and the MD is most often affected due to poor vascular supply and dense cortical bone that is most susceptible to infection
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Oral characteristics
EO: Lymphadenopathy, fever, and pain
IO: Acute infection usually don't produce as much destruction as chronic forms bc it hasn't been present long enough to create bone damage.
Chronic form: patches of necrotic bone and diffuses radiolucent lesions, lesions appear mottled with sclerotic appearance on radiograph
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Differential diagnosis
The pain, swollen lymph nodes, and radiographic appearance indicates Osteomyelitis
Lateral Periodontal Cyst
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Oral Characteristics
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IO: Asymptomatic in most cases and is noticed with radiograph, usually unilocular that is round or oval and is well-delineated
When found as a multilocular cyst, it is termed botryoid odontogenic cyst
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Gingival Cyst Adult
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Oral Characteristics
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Firm, flesh colored, nodular that is painless and nonmobile usually measuring 1-3 mm
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Dentigerous Cyst
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Etiology
A cystic change in the dental follicle following crown formation when follicle separates from the crown of the tooth
Unerupted, undeveloped tooth.
Oral characteristics
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IO: no symptoms or pain; a radiograph shows well-circumscribed, unilocular, and sometimes multilocular
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Eruption Cyst
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Oral Characteristics
Usually have a darker appearance due to blood accumulation, dome shaped on the crest of the alveolar ridge; usually painless
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Gingival Cyst Newborn
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Oral Characteristics
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Multiple (usually fewer than six), yellow-white sessile to pearl-like papules, 1 - 4 mm
Superficial (rupture easily)
Etiology
There are three types Epstein's pearls are cysts along the median palatal raphe or at the junction of the hard and soft palate that develop from remnants of epithelial tissue trapped along the raphe during palatal fusion. Bohn's nodules are cysts found along the facial and lingual surfaces of the alveolar ridges and on the palate away from the midline. They develop form heterotopic salivary gland tissue. Dental lamina cysts are found on the top of the alveolar ridges and are more common in the maxilla and mandible. They are thought to develop from remnants of the tooth bud
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Epidemiology
Gingival cysts of newborn arise after fourth month in utero, during tooth development
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Globulomaxillary Cyst
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Etiology
Multiple types of cyst may be present; Radicular cysts, central giant cell tumors, myxomas, and OKC
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Oral Characteristics
IO: Inverted pear shaped lesion because of the location, causing divergence of tooth roots. Circumscribed and radiolucent is vital pulp.
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Nasopalatine Canal Cyst
Etiology
epithelial remnants of the embryologic structure of the nasaopalatine ducts and the structure connects the oral and nasal cavities
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Oral Chacteristics
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IO: Pain, tenderness, swelling, and drainage in MX anterior region. Well-circumscribed and radiolucent. Clinically, the area may be dark red or bluish in color
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Median Palantine Cyst
Etiology
Same location as nasopalatine cyst but more towards midline of hard palate. Lined with stratified squamous epithelium
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Static Bone Cyst
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Oral Characteristics
Asymptomatic, sharply circumscribed
Treatment
Usually below the mandibular canal and found often when a Panorex is taken. If the lesion is above the mandibular canal, a biopsy should be taken and other cysts that are found in this region must be considered
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Ameloblastic Fibroma
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Oral Characteristics
IO: Usually no pain and no swelling; Jaw expansion, maybe calcified material containing enamel and dentin
Radiographically, lesion can be uniocular or multiocular well defined and usually associated with an unerupted tooth
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Langerhans Cell DIsease
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Oral Characteristics
EO: Poor healing is common, and all bone in body may be affected. Lymphadenopathy, cranial bones may be involved and the cutaneous areas may have rashes and erythematic lesions
IO: "floating teeth" appearance on radiograph. Tenderness, pain and swelling can occur
Treatment
Tx depends upon the involvement of disease Surgical t somteitmes is the only tx option but chemotherapy can be needed.
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Bengin rad. cyst
Slow growth
Expands into tissues, usually encapsulated
Cells are well differentiated
Do not metastasize
Mal. rad. cyst
Variable growth rate, depends on the level of cell differentiation
Invades surrounding tissues by infiltration, not encapsulated
Undifferentiated cells may not resemble cells of origin
Metastasizes to distant tissues
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