Podcast
Questions and Answers
A 25-year-old patient presents with a unilocular radiolucency associated with an unerupted mandibular third molar. Radiographic examination reveals no root resorption of adjacent teeth and a well-defined border. Which of the following is the MOST likely diagnosis?
A 25-year-old patient presents with a unilocular radiolucency associated with an unerupted mandibular third molar. Radiographic examination reveals no root resorption of adjacent teeth and a well-defined border. Which of the following is the MOST likely diagnosis?
- Unicystic ameloblastoma
- Ameloblastic fibroma
- Dentigerous cyst (correct)
- Odontogenic keratocyst (OKC)
Which odontogenic lesion, known for its aggressive growth and potential association with Nevoid Basal Cell Carcinoma Syndrome, is often characterized by a multilocular radiolucency and a high recurrence rate if not adequately treated?
Which odontogenic lesion, known for its aggressive growth and potential association with Nevoid Basal Cell Carcinoma Syndrome, is often characterized by a multilocular radiolucency and a high recurrence rate if not adequately treated?
- Odontogenic keratocyst (OKC) (correct)
- Dentigerous cyst
- Central giant cell granuloma (CGCG)
- Odontogenic myxoma
A 15-year-old patient presents with a painless, expansile lesion in the posterior mandible. Radiographic examination reveals a multilocular 'soap bubble' appearance. Which of the following is the MOST likely diagnosis?
A 15-year-old patient presents with a painless, expansile lesion in the posterior mandible. Radiographic examination reveals a multilocular 'soap bubble' appearance. Which of the following is the MOST likely diagnosis?
- Ameloblastoma (correct)
- Central odontogenic fibroma
- Ameloblastic fibroma
- Adenomatoid odontogenic tumor (AOT)
Which of the following odontogenic lesions is MOST likely to be associated with 'spiking root resorption' of adjacent teeth and may radiographically resemble a 'blood-soaked sponge' upon aspiration?
Which of the following odontogenic lesions is MOST likely to be associated with 'spiking root resorption' of adjacent teeth and may radiographically resemble a 'blood-soaked sponge' upon aspiration?
A 12-year-old patient presents with a radiopaque lesion in the anterior maxilla, composed of numerous small tooth-like structures. Which of the following is the MOST probable diagnosis?
A 12-year-old patient presents with a radiopaque lesion in the anterior maxilla, composed of numerous small tooth-like structures. Which of the following is the MOST probable diagnosis?
Which of the following odontogenic lesions is typically treated with resection due to its locally aggressive nature and potential for recurrence?
Which of the following odontogenic lesions is typically treated with resection due to its locally aggressive nature and potential for recurrence?
A 45-year-old patient presents with a radiolucent lesion at the apex of a non-vital maxillary central incisor. Which of the following is the MOST likely diagnosis?
A 45-year-old patient presents with a radiolucent lesion at the apex of a non-vital maxillary central incisor. Which of the following is the MOST likely diagnosis?
Which cyst is characterized by its location along the lateral root surface of a vital tooth, commonly in the mandibular canine-premolar region, and often presents as a small, teardrop-shaped radiolucency?
Which cyst is characterized by its location along the lateral root surface of a vital tooth, commonly in the mandibular canine-premolar region, and often presents as a small, teardrop-shaped radiolucency?
Decompression followed by enucleation is a common treatment approach for which of the following odontogenic cysts, particularly when large?
Decompression followed by enucleation is a common treatment approach for which of the following odontogenic cysts, particularly when large?
A 'scalloped' radiolucency around the roots of vital teeth, often associated with orthodontic treatment, is characteristic of which lesion?
A 'scalloped' radiolucency around the roots of vital teeth, often associated with orthodontic treatment, is characteristic of which lesion?
A 7-year-old patient presents with a unilocular radiolucency in the posterior mandible associated with an unerupted permanent molar. Which of the following is the MOST likely diagnosis, considering the patient's age?
A 7-year-old patient presents with a unilocular radiolucency in the posterior mandible associated with an unerupted permanent molar. Which of the following is the MOST likely diagnosis, considering the patient's age?
Which of the following non-odontogenic lesions is characterized by a focal concavity of the cortical bone on the lingual aspect of the mandible below the inferior alveolar nerve canal?
Which of the following non-odontogenic lesions is characterized by a focal concavity of the cortical bone on the lingual aspect of the mandible below the inferior alveolar nerve canal?
A patient presents with a multilocular radiolucency in the anterior mandible that crosses the midline. Which of the following should be HIGHLY considered in the differential diagnosis due to its tendency to cross the midline?
A patient presents with a multilocular radiolucency in the anterior mandible that crosses the midline. Which of the following should be HIGHLY considered in the differential diagnosis due to its tendency to cross the midline?
Which of the following lesions requires aspiration prior to biopsy or surgical intervention due to its potential vascular nature and risk of significant bleeding?
Which of the following lesions requires aspiration prior to biopsy or surgical intervention due to its potential vascular nature and risk of significant bleeding?
A 'sunburst' periosteal reaction is MOST commonly associated with which of the following bone lesions?
A 'sunburst' periosteal reaction is MOST commonly associated with which of the following bone lesions?
Which radiopaque lesion is characterized by being fused to the root of a vital tooth, often a mandibular molar, and radiographically presents with a thin radiolucent halo?
Which radiopaque lesion is characterized by being fused to the root of a vital tooth, often a mandibular molar, and radiographically presents with a thin radiolucent halo?
Florid cemento-osseous dysplasia (FCOD) is typically characterized by which radiographic presentation?
Florid cemento-osseous dysplasia (FCOD) is typically characterized by which radiographic presentation?
Downward bowing of the mandible is a clinical feature that can be associated with which fibro-osseous lesion?
Downward bowing of the mandible is a clinical feature that can be associated with which fibro-osseous lesion?
Which of the following is a benign, non-odontogenic tumor composed of mature bone and is often associated with Gardner's Syndrome?
Which of the following is a benign, non-odontogenic tumor composed of mature bone and is often associated with Gardner's Syndrome?
Which malignant tumor, common in young adults, is characterized by 'punched-out' radiolucencies on radiographs and may present with 'teeth floating in air' appearance?
Which malignant tumor, common in young adults, is characterized by 'punched-out' radiolucencies on radiographs and may present with 'teeth floating in air' appearance?
Elevated Bence-Jones proteins in urine and 'punched-out' radiolucencies in the jaws are suggestive of which malignancy?
Elevated Bence-Jones proteins in urine and 'punched-out' radiolucencies in the jaws are suggestive of which malignancy?
A 'moth-eaten' radiolucency in the mandible, especially in a patient with a known history of primary malignancy elsewhere in the body, should raise suspicion for:
A 'moth-eaten' radiolucency in the mandible, especially in a patient with a known history of primary malignancy elsewhere in the body, should raise suspicion for:
Which of the following benign lesions is MOST likely to present with pain that is relieved by aspirin?
Which of the following benign lesions is MOST likely to present with pain that is relieved by aspirin?
Which of the following developmental cysts, commonly found in newborns, are small, white or yellowish nodules located along the median palatal raphe?
Which of the following developmental cysts, commonly found in newborns, are small, white or yellowish nodules located along the median palatal raphe?
A dome-shaped swelling on the gingiva overlying an erupting tooth in a child is MOST likely a(n):
A dome-shaped swelling on the gingiva overlying an erupting tooth in a child is MOST likely a(n):
Which soft tissue cyst, located in the midline of the floor of the mouth, is described as doughy or rubbery upon palpation?
Which soft tissue cyst, located in the midline of the floor of the mouth, is described as doughy or rubbery upon palpation?
A soft fluctuant swelling in the lateral neck is MOST suggestive of which soft tissue cyst?
A soft fluctuant swelling in the lateral neck is MOST suggestive of which soft tissue cyst?
Which soft tissue lesion, often seen on the gingiva of children and young adults, is characterized by proliferation of connective tissue and is NOT a true granuloma?
Which soft tissue lesion, often seen on the gingiva of children and young adults, is characterized by proliferation of connective tissue and is NOT a true granuloma?
A 35-year-old patient presents with a painful, expansile lesion in the posterior mandible. Radiographic examination reveals a multilocular 'soap bubble' appearance and root resorption. Biopsy shows palisading columnar ameloblast-like cells. What is the MOST likely diagnosis?
A 35-year-old patient presents with a painful, expansile lesion in the posterior mandible. Radiographic examination reveals a multilocular 'soap bubble' appearance and root resorption. Biopsy shows palisading columnar ameloblast-like cells. What is the MOST likely diagnosis?
A radiopaque lesion in the posterior mandible is noted to be asymptomatic and composed of poorly defined calcified deposits. What is the MOST probable diagnosis?
A radiopaque lesion in the posterior mandible is noted to be asymptomatic and composed of poorly defined calcified deposits. What is the MOST probable diagnosis?
Which odontogenic tumor is known to exhibit 'internal calcifications around the crown' of an unerupted tooth and may present with a 'driven snow' appearance histologically?
Which odontogenic tumor is known to exhibit 'internal calcifications around the crown' of an unerupted tooth and may present with a 'driven snow' appearance histologically?
Which of the following lesions is LEAST likely to be associated with an unerupted tooth?
Which of the following lesions is LEAST likely to be associated with an unerupted tooth?
Orthodontic treatment is sometimes considered as part of the management of which of the following lesions?
Orthodontic treatment is sometimes considered as part of the management of which of the following lesions?
Which of the following lesions is characterized by 'soap bubble' appearance, straight septa, and scalloping borders (not always present) and is known for its myxomatous stroma?
Which of the following lesions is characterized by 'soap bubble' appearance, straight septa, and scalloping borders (not always present) and is known for its myxomatous stroma?
A patient presents with 'cafe au lait' spots, polyostotic fibrous dysplasia, and endocrine abnormalities. This clinical presentation is MOST consistent with:
A patient presents with 'cafe au lait' spots, polyostotic fibrous dysplasia, and endocrine abnormalities. This clinical presentation is MOST consistent with:
Which of the following is a benign odontogenic tumor that is almost exclusively found in the anterior maxilla, frequently associated with impacted canines, and often demonstrates a 'duct-like' histologic pattern?
Which of the following is a benign odontogenic tumor that is almost exclusively found in the anterior maxilla, frequently associated with impacted canines, and often demonstrates a 'duct-like' histologic pattern?
Which lesion is described as a 'ghost cell tumor' due to the presence of ghost cells histologically and may be associated with Calcifying Odontogenic Cyst?
Which lesion is described as a 'ghost cell tumor' due to the presence of ghost cells histologically and may be associated with Calcifying Odontogenic Cyst?
Which of the following lesions is treated with 'extraction or root amputation with RCT' due to its intimate association with the root of a vital tooth?
Which of the following lesions is treated with 'extraction or root amputation with RCT' due to its intimate association with the root of a vital tooth?
Flashcards
Ameloblastic Fibroma (AF)
Ameloblastic Fibroma (AF)
Benign, bone expansion; associated with unerupted teeth.
Unicystic Ameloblastoma
Unicystic Ameloblastoma
Arises in dentigerous cysts, RL around the crown of unerupted tooth.
Dentigerous Cyst
Dentigerous Cyst
Attached to CEJ of unerupted 3rd molars.
Odontogenic Keratocyst (OKC)
Odontogenic Keratocyst (OKC)
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Lateral Periodontal Cyst
Lateral Periodontal Cyst
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Squamous Odontogenic Tumor (SOT)
Squamous Odontogenic Tumor (SOT)
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ABC
ABC
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Odontogenic Myxoma
Odontogenic Myxoma
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Ameloblastic Fibro-Odontoma (AFO)
Ameloblastic Fibro-Odontoma (AFO)
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Adenomatoid Odontogenic Tumor (AOT)
Adenomatoid Odontogenic Tumor (AOT)
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Calcifying Odontogenic Cyst (COC)
Calcifying Odontogenic Cyst (COC)
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Calcifying Epithelial Odontogenic Tumor (CEOT)
Calcifying Epithelial Odontogenic Tumor (CEOT)
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Central Odontogenic Fibroma
Central Odontogenic Fibroma
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Compound Odontoma
Compound Odontoma
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Complex Odontoma
Complex Odontoma
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Stafne Bone Cyst
Stafne Bone Cyst
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Central Giant Cell Granuloma (CGCG)
Central Giant Cell Granuloma (CGCG)
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Central Hemangioma
Central Hemangioma
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Osteoma
Osteoma
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Osteoid Osteoma
Osteoid Osteoma
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Fibrous Dysplasia
Fibrous Dysplasia
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Ameloblastic Fibrosarcoma
Ameloblastic Fibrosarcoma
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Langerhans Cell Histiocytosis
Langerhans Cell Histiocytosis
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Chondrosarcoma
Chondrosarcoma
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Study Notes
- These notes cover various odontogenic and non-odontogenic cysts and tumors, focusing on their classification, location, radiographic features (unilocular, multilocular, mixed, radiopaque), and key characteristics.
Unilocular Radiolucent Lesions
- Ameloblastic Fibroma (AF):
- Typically found in individuals aged 0-20
- Located in the posterior mandible
- Treatment involves surgical excision or curettage
- Characterized by bone expansion.
- Often associated with unerupted teeth
- Can be multilocular
- Unicystic Ameloblastoma:
- Occurs in individuals aged 10-20
- Located in the mandible
- Treated by enucleation or excision
- Can arise within a dentigerous cyst
- Presents as a radiolucency around the crown of an unerupted tooth
- Simple Bone Cyst:
- Affects individuals aged 10-20
- Found in the mandible
- Treatment involves curettage
- Associated with scalloping around roots of teeth
- Teeth are vital
- Orthodontic treatment may be considered
- Dentigerous Cyst:
- Occurs in individuals aged 10-30
- Located in the mandible around an unerupted third molar
- Initial treatment involves decompression, followed by excision
- Attached to the cementoenamel junction (CEJ) of the tooth
- Associated with impacted teeth
- Odontogenic Keratocyst (OKC):
- Occurs in individuals aged 20-30
- Located in the posterior mandible and ramus area, often associated with unerupted teeth
- Treatment involves decompression followed by extraction of the affected tooth
- Does not cause root resorption
- Exhibits anterior-posterior (AP) growth before lateral expansion
- Multiple OKCs may indicate Nevoid Basal Cell Carcinoma Syndrome (NBCCS)
- Can be multilocular
- Periapical Cyst/Radicular Cyst:
- Affects individuals in their 20s to 50s
- Located in the anterior maxilla, more common than in the mandible
- Treatment involves root canal therapy (RCT)
- Teeth are non-vital and painless
- Causes blunt root resorption
- Lateral Periodontal Cyst:
- Occurs in individuals aged 30+
- Located in the mandibular lateral incisor/canine/premolar region
- Treatment involves enucleation
- Teeth are vital
- Presents as a teardrop-shaped radiolucency
- Asymptomatic
- Does not cause root resorption
Multilocular Radiolucent Lesions
- Squamous Odontogenic Tumor (SOT):
- Affects individuals in their 10s to 60s
- Located in the anterior alveolar ridge
- Treated via excision
- Causes tooth mobility
- Appears as a semilunar radiolucency
- Can resemble periodontal disease
- May present in multiple quadrants
- Aneurysmal Bone Cyst (ABC):
- Occurs in individuals aged 0-20
- Located more commonly in the mandible
- Treatment involves enucleation with curettage
- Causes swelling, pain, and paresthesia
- Characterized by rapid growth/swelling
- Can cause spiking root resorption
- Described as a "blood-soaked sponge"
- Odontogenic Myxoma:
- Affects individuals in their 20s
- Found more often in the mandible
- Located anywhere within the jaws
- Undergoes excision
- Exhibits a soap bubble appearance with straight septa
- Has scalloping borders
- Leads to expansion of the mandible
- Ameloblastoma:
- Occurs in individuals aged 30-40
- Located in the mandibular ramus area, associated with unerupted teeth
- Treatment involves resection
- Typically painless
- Causes expansion of the mandible
- Blunt root resorption
Mixed (Radiolucent and Radiopaque) Lesions
- Ameloblastic Fibro-Odontoma (AFO):
- Affects individuals aged 0-20
- Located in the posterior mandible
- Treated via excision
- Odontoma is often associated
- Adenomatoid Odontogenic Tumor (AOT):
- Occurs in individuals aged 10-20
- More common in the anterior jaw (2/3) and maxilla (2/3)
- Frequently associated with canines
- Treatment involves enucleation
- Associated with impacted teeth, usually canines
- Causes expansion of bone and displacement of teeth
- Appears as 75% unilocular radiolucency
Radiopaque Lesions
- Calcifying Odontogenic Cyst (COC):
- Occurs in individuals aged 10-20
- Located in the maxilla, anterior to molars, or near canines
- Treated via enucleation with peripheral ostectomy
- Often associated with unerupted teeth, especially canines
- May display ghost cell tumor characteristics
- Can cause root resorption and displacement
- Calcifying Epithelial Odontogenic Tumor (CEOT):
- Occurs in individuals aged 30-40
- Post mandible
- Maxilla
- Resection
- Central Odontogenic Fibroma:
- Affects individuals aged 20-30
- Located in the maxilla or mandible
- Treated via enucleation with curettage
- Usually rare
- Located peri-radicularly
- RO (radiopaque) flecks within RL (radiolucent)
- Associated with unerupted teeth
- Causes root resorption or divergence
- Compound Odontoma:
- Affects individuals aged 0-20
- Located in the anterior jaw
- Treated via excision
- Asymptomatic
- Structures resemble rudimentary teeth
- Complex Odontoma:
- Occurs in the posterior jaw
- Mostly asymptomatic
- Consists of poorly defined calcified deposits
- Cementoblastoma:
- Affects individuals in their 10s to 30s
- Located in the mandible near molars/premolars
- Treatment involves extraction or root amputation with root canal therapy (RCT)
- Patient experiences pain and swelling
- Attached to a vital tooth
- Radiopaque with a thin radiolucent halo, fused to the root of the tooth
Non-Odontogenic Cysts and Tumors
- Stafne Bone Cyst:
- Affects adults
- Located below the mandibular canal at the angle of the mandible
- Monitor the lesion
- Causes a focal concavity of cortical bone on the lingual aspect of the mandible
Multilocular Non-Odontogenic Lesions
- Central Giant Cell Granuloma (CGCG):
- Affects individuals aged 0-30
- Located in the anterior mandible, crossing the midline
- Treatment involves curettage with intralesional corticosteroid injection or bisphosphonates
- Rule out brown tumor of hyperparathyroidism
- Soap bubble appearance
- Causes multiplanar root resorption and displaces teeth
- Central Hemangioma:
- Affects individuals aged 10-20
- Located in the mandible
- Requires aspiration before biopsy
- Cauterize and sclerose to stop blood supply, followed by resection
- Causes soap bubble appearance, bleeding in the sulcus, pain, swelling, and bruits
- AV malformation causes a "wiggly" radiolucency and tooth mobility
Mixed Non-Odontogenic Lesions
- Hyperparathyroidism / Brown Tumor:
- Affects individuals aged 30-60
- Located in the anterior mandible
- Treatment involves treating HPT
- Osteoma:
- Affects individuals aged 10-20
- Located at the mandibular angle and condyle
- Multiple osteomas may indicate Gardner's Syndrome
- Osteoid Osteoma/Osteoblastoma:
- Affects individuals before age 30
- Located in the posterior mandible
- Treatment includes Excision, curettage, and monitoring
Radiopaque Non-Odontogenic Lesions
- Cemento-Osseous Dysplasia (COD):
- Occurs in individuals aged 30+
- Periapical COD occurs in anterior mandible, Focal COD in posterior mandible, Florid COD in multiple quadrants
- Vital Teeth
- FCOD: Contraindicated for implants
- FCOD: Ground glass
- Ossifying Fibroma:
- Occurs in young female adults aged 20-30
- Located in the posterior mandible
- Treated with surgical removal
- Downward Bowing,Unilocular at first- Mixed RL
- Vital teeth, Round
- FCOD: Ground glass
- Juvenile Ossifying Fibroma:
- Occurs in individuals aged <15
- Found in the Mx>MD
- Aggressive rapid growth
- Needs bone
- FCOD: Ground glass
Radiopaque Non-Odontogenic Lesions
- Dense Bone Island:
- Located in the MD
- No tx
- No RL rim
- Fibrous Dysplasia:
- Occurs in young patients
- Located in the Mx>MD
- No tx
- Unilateral Swelling
- FCOD: Ground glass
Malignancy
- More common in younger patients
Malignant Tumors
- Ameloblastic Fibrosarcoma:
- Located in the mandible
- Treated via excision
- Rapid Growth
- Langerhans Cell Histiocytosis:
- Occurs 0-10 yo
- Located in the MD (Skull, rib)
- Teeth floating in the air
- Ewing Sarcoma:
- Occurs 5-30yo
- Located on the MD
- Chemo, RT, Surgery
- Chondrosarcoma:
- Occurs in individuals in their 20s
- Excision is not responsive to RT or chemo
- Painless swelling, loose teeth
- Osteosarcoma:
- Occurs in individuals 30 yo
- Chemo, then surgery
- Ewing Sarcoma: Similar to above
Older population-Malignant Tumors
- Multiple Myeloma:
-Occurs in individuals 40+
- Ramus location
- Macroglossia, Punched Out RL
- Metastasis to the jaw:
- Occurs in individuals 40+
- Check history
- SCC:
- Occurs in individuals 40+
- Tongue location most common
- Vasculature
Infant Cysts
- Bohn Nodules:
- Benign and usually resolve on their own
- Newborns tend to have this cysts
- Over the HP junction
- Epstein Pearls:
- Most likely located along median palatal raphae
- Typically occurs in newborns
- Congenital epulis:
- Most likely located on anterior gingiva at birth
- Tx: Excision
- Melanotic Neuroectodermal tumor of infancy:
- Most likely located on Anterior MX
- Tx: Excision
Soft tissue cysts
- Dermoid cyst:
- Ant FOM Location most common
- Doughy, rubbery
Eruption Cyst
- dome shaped swelling
This is a more detailed version, including key words from the original summary as well as common treatments.
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