Oral Pathology Quiz on Tumors and Cysts

Periapical Cyst or Granuloma

• Radiographic Appearance: Radiolucent, well-defined, unilocular
• Etiology: Infection or inflammation of the pulp
• Associated Features: Associated with apex, round and symmetrical
• Clinical Presentation: Painless (acute exacerbations), non-vital teeth, possible swelling, history of carious lesions, restorations, or trauma

Traumatic Bone Cyst

• Radiographic Appearance: Well-defined, unilocular radiolucency, located in body of mandible, often apical to several teeth. Scalloped corticated border around roots.
• Etiology: Trauma to the jaw (not a true cyst)
• Clinical Presentation: Painless, vital teeth, no swelling, typically an incidental finding

Nasopalatine Duct Cyst

• Radiographic Appearance: Well-defined, unilocular radiolucency, located on midline of anterior maxilla, heart-shaped
• Etiology: Developmental, arising from epithelial remnants
• Clinical Presentation: Painless, bony hard swelling typically on the incisive papilla

Dentigerous Cyst

• Radiographic Appearance: Radiolucent, well-defined, unilocular radiolucency, often located in posterior mandible or third molar region; associated with impacted or unerupted tooth, spans from cementoenamel junction (CEJ) to CEJ, doesn't typically cause root resorption but could displace teeth
• Etiology: Developmental, arising from epithelial remnants
• Clinical Presentation: If left untreated, can cause facial swelling.

Residual Cyst

• Radiographic Appearance: Well-defined, unilocular radiolucency, located in an edentulous space
• Etiology: Epithelial cells left behind after an extraction
• Clinical Presentation: Painless

Stafne Bone Defect

• Radiographic Appearance: Well-defined, unilocular radiolucency. Located below the inferior alveolar nerve.
• Etiology: Developmental anomaly, depression in the bone (not a true cyst)
• Clinical Presentation: Painless, incidental finding

Central Giant Cell Granuloma

• Radiographic Appearance: Well-defined, uni or multilocular radiolucency. Often located in anterior mandible and can cross midline.
• Etiology: Abnormal reaction of bone to stimuli
• Clinical Presentation: Painless, vital teeth, slow-growing, bony hard swelling, possible history of trauma

Odontogenic Myxoma

• Radiographic Appearance: Well-defined, multilocular radiolucency, often in posterior mandible or third molar region; "honeycomb" or "tennis racket" appearance with wispy trabeculae, destructive, causing root resorption
• Etiology: Uncontrolled cell growth
• Clinical Presentation: Painless, slow-growing, bony hard swelling, expansive

Odontogenic Keratocysts

• Radiographic Appearance: Well-defined, multilocular radiolucency. Located in posterior mandible; scalloped borders, locally invasive, and destructive.
• Etiology: Developmental, arising from epithelial remnants
• Clinical Presentation: Painless, slow growing, bony hard swelling, associated with nevoid basal cell carcinoma syndrome, risk of recurrence

Ameloblastoma

• Radiographic Appearance: Well-defined, uni or multilocular radiolucency, often located in posterior mandible, "soap bubble" appearance; expansion, locally destructive and invasive, tooth displacement and or root resorption.
• Etiology: Uncontrolled cell growth
• Clinical Presentation: Painless, vital teeth, slow-growing, bony hard swelling

Acute Osteomyelitis

• Radiographic Appearance: Ill-defined, non-corticated radiolucency, diffuse boundary. May have other radiographic findings.
• Etiology: Infection of bone from bacterial invasion (dental infections, procedures, trauma, etc).
• Clinical Presentation: Pain, vital teeth, rapidly progressive swelling, history of trauma, surgery or infection, erythema, edema, drainage, tooth mobility, possible history of fever or lymphadenopathy, and restricted mouth opening; pain and pus

Osteosarcoma

• Radiographic Appearance: III-defined radiolucency, "sunburst" appearance, potential opacities within the lesion, rapidly growing
• Etiology: Uncontrolled cell growth
• Clinical Presentation: Pain, paresthesia, mobile teeth, overlying mucosa disruption

Metastatic Carcinoma

• Radiographic Appearance: III-defined radiolucency, destructive, rapidly growing
• Etiology: Metastasis from primary cancer site to the jaw
• Clinical Presentation: Pain, paresthesia, mobile teeth, telangiectasias, history of previous cancer or evidence of recurrence or metastasis

Chronic Osteomyelitis

• Radiographic Appearance: Mixed radiolucent-radiopaque, "onion peel" appearance, sequestrum of bone.
• Etiology: Long-standing infection and inflammation
• Clinical Presentation: +/- Pain, swelling or cervical lymphadenopathy, history of acute episodes, trauma, or infection, tooth mobility, purulence, or bad taste.

Adenomatoid Odontogenic Tumor

• Radiographic Appearance: Well-corticated, mixed radiolucent-radiopaque, often located in anterior maxilla or canine/premolar region
• Etiology: Uncontrolled cell growth
• Clinical Presentation: Painless, slow-growing, bony hard swelling, retained primary tooth, unerupted permanent teeth

Periapical Cemento-Osseous Dysplasia

• Radiographic Appearance: Mixed radiolucent-radiopaque, often located in periapical mandibular incisor region
• Etiology: Disturbance in normal bone remodeling
• Clinical Presentation: Painless, vital teeth, no swelling, typically in African American females over 30, typically an incidental finding

Focal Cemento-Osseous Dysplasia

• Radiographic Appearance: Mixed radiolucent-radiopaque, often located in posterior mandible.
• Etiology: Disturbance in normal bone remodeling, replacing normal bone with fibrous bone.
• Clinical Presentation: Painless, vital teeth, possible swelling

Complex Odontoma

• Radiographic Appearance: Mixed radiolucent-radiopaque, resembles tooth density, commonly located in the posterior mandible,
• Etiology: Uncontrolled cell growth
• Clinical Presentation: Painless, slow-growing, bony hard swelling, unerupted or impacted teeth

Compound Odontoma

• Radiographic Appearance: Mixed radiolucent-radiopaque, multiple, small tooth-like structures. Most commonly located in the anterior maxilla.
• Etiology: Uncontrolled cell growth

Calcifying Odontogenic Cyst

• Radiographic Appearance: Mixed radiolucent-radiopaque, associated with impacted teeth
• Etiology: Developmental, arising from epithelial remnants
• Clinical Presentation: Painless, slow-growing, bony hard swelling, expansive

Ossifying Fibroma

• Radiographic Appearance: Mixed radiolucent/radiopaque, expansive.
• Etiology: Uncontrolled fibrous tissue growth.
• Clinical Presentation: Painless, vital teeth, slow-growing, bony hard swelling

Calcifying Epithelial Odontogenic Tumor (CEOT), Pindborg's Tumor

• Radiographic Appearance: Mixed radiolucent/radiopaque. Radiopaque flecks, typically in posterior mandible. Associated with unerupted or impacted teeth, expansive
• Etiology: Uncontrolled cell growth
• Clinical Presentation: Painless, slow-growing, bony hard swelling

Osteoma

• Radiographic Appearance: Radiopaque, Can have radiolucencies within.
• Etiology: Uncontrolled bone growth
• Clinical Presentation: Painless, vital teeth, slow-growing, bony hard swelling, possible history of Gardner syndrome

Fibrous Dysplasia

• Radiographic Appearance: Radiopaque, "ground glass" appearance, often located in the posterior mandible, blurred or smudgy with diffuse, blending borders, loss of lamina dura, increased trabeculation
• Etiology: Genetic mutation causing normal bone to be replaced by fibrous bone
• Clinical Presentation: Painless, vital teeth, slow-growing, bony hard swelling, normal intact mucosa, associated with McCune-Albright syndrome

Cementoblastoma

• Radiographic Appearance: Radiopaque mass with a thin radiolucent border, commonly associated with mandibular first molars, attached to root; root resorption
• Etiology: Uncontrolled cell growth
• Clinical Presentation: Pain, vital teeth, slow-growing bony hard swelling

Condensing Osteitis

• Radiographic Appearance: Radiopaque, irregular sclerosis adjacent to the apex of a root.
• Etiology: Fibro-osseous response of bone to chronic inflammation or infection
• Clinical Presentation: +/- Pain, involved with both vital and non-vital teeth, no swelling

Hypercementosis

• Radiographic Appearance: Radiopaque, bulbous, enlarged roots, thickened cementum.
• Etiology: Excessive deposition of cementum
• Clinical Presentation: Not painful, vital tooth, no swelling

Idiopathic Osteosclerosis (Dense Bone Island)

• Radiographic Appearance: Radiopaque, often in posterior mandible.
• Etiology: Benign growth of bone (no known reason)
• Clinical Presentation: Not painful, vital teeth, no signs or symptoms

Sickle Cell Disease

• Radiographic Appearance: Interproximal alveolar bone "step ladder" pattern, large trabecular spaces, increased medullary spaces, thinning of inferior mandibular border, thickening of lamina dura, "hair-on-end" striations on skull in cephalometric radiograph
• Etiology: Genetic blood disorder
• Clinical Presentation: Systemic features: low hemoglobin levels, fatigue, weakness, shortness of breath

Multiple Myeloma

• Radiographic Appearance: Multiple "punched out" osteolytic lesions
• Etiology: Uncontrolled growth of blood cells
• Clinical Presentation: Pain and paresthesia, systemic features: anemia, bleeding, infection, and fracture

Paget's Disease

• Radiographic Appearance: Sclerotic and radiolucent areas, widespread and multifocal, "cotton wool" appearance, tooth displacement
• Etiology: Chronic abnormal bone remodeling
• Clinical Presentation: Pain, swelling, systemic features: bone pain, headaches, altered vision or hearing, and increased alkaline phosphatase levels

Hyperparathyroidism

• Radiographic Appearance: Multiple radiolucent foci, loss of lamina dura, giant cell lesions (brown tumors).
• Etiology: Excessive production/secretion of parathyroid hormone.
• Clinical Presentation: Systemic features: kidney stones, metastatic calcification, osteoporosis, neurologic problems, arrhythmias, elevated PTH and alkaline phosphatase

Cherubism

• Radiographic Appearance: Uni- or multilocular radiolucencies, often posterior mandible, "soap bubble" appearance, thin cortical bone, displacement of teeth.
• Etiology: Genetic disorder, abnormal jawbone development and growth
• Clinical Presentation: Painless, bilateral, symmetrical jaw expansion, premature exfoliation of primary teeth

Langerhans Cell Histiocytosis

• Radiographic Appearance: Non-corticated radiolucencies, osseous lytic lesions with "punched out" appearance, "floating teeth"
• Etiology: Abnormal proliferation of immune cells
• Clinical Presentation: Tooth mobility, possible erythematous skin or mucosal lesions

Test your knowledge on the primary etiology, common locations, and clinical presentations of tumors and cysts. This quiz also covers types of cemento-osseous dysplasia and radiographic characteristics associated with these conditions. Perfect for dental students and practitioners!