INBDE Bootcamp High-Yield Oral Radiology (Bone Lesions) PDF

f INBDE Bootcamp High-Yield Oral Radiology (Bone Lesions) | Bootcamp.com Structure Radiograph Key Facts Radiolucent, well-defined...

f INBDE Bootcamp High-Yield Oral Radiology (Bone Lesions) | Bootcamp.com Structure Radiograph Key Facts Radiolucent, well-defined, unilocular Periapical cyst or granuloma Etiology: Infection or inflammation of the pulp Radiographic appearance: Well-defined, unilocular radiolucency Associated with apex Round and symmetrical Clinical presentation: Painless (in acute exacerbations) Non-vital teeth +/- history of swelling History of carious lesions, restorations, or trauma Traumatic bone cyst Etiology: Trauma to jaw (not a true cyst) Radiographic appearance: Well-defined, unilocular radiolucency Located in body of mandible, apical to several teeth Scalloped corticated border around roots Clinical presentation: Painless Vital teeth No swelling Typically an incidental finding Nasopalatine duct cyst Etiology: Developmental, arising from epithelial remnants Radiographic appearance: Well-defined, unilocular radiolucency Located on midline of anterior maxilla Heart shaped Clinical presentation: Painless Bony hard swelling typically on the incisive papilla © Bootcamp.com  INBDE Bootcamp High-Yield Oral Radiology (Bone Lesions) | Bootcamp.com Structure Radiograph Key Facts Radiolucent, well-defined, unilocular Dentigerous cyst Etiology: Developmental, arising from epithelial remnants Radiographic appearance: Well-defined, unilocular radiolucency Often located in posterior mandible or third molar region Associated with an impacted or unerupted tooth Spans CEJ to CEJ No root resorption but can displace teeth Clinical presentation: If left untreated, can cause facial swelling Residual cyst Etiology: Epithelial cells left behind after an extraction Radiographic appearance: Well-defined, unilocular radiolucency Located in an edentulous space Clinical presentation: Painless Stafne bone defect Etiology: Developmental anomaly, depression in the bone (not a true cyst) Radiographic appearance: Well-defined, unilocular radiolucency Below the inferior alveolar nerve Clinical presentation: Painless Incidental finding © Bootcamp.com  INBDE Bootcamp Radiographic Bone Lesions | Bootcamp.com Structure Radiograph Key Facts Radiolucent, well-defined, multilocular Central giant cell granuloma Etiology: Abnormal reaction of bone to stimuli Radiographic appearance: Well-defined, uni or multilocular radiolucency Often located in anterior mandible that crosses midline Clinical presentation: Painless Vital teeth Slow-growing, bony hard swelling +/- history of trauma Expansile Odontogenic myxoma Etiology: Uncontrolled cell growth Radiographic appearance: Well-defined, multilocular radiolucency Often located in posterior mandible or third molar region “Honeycomb” or “tennis racket” appearance Wispy trabeculae Destructive, causes root resorption Clinical presentation: Painless Slow growing, bony hard swelling Expansile Odontogenic keratocyst Etiology: Developmental, arising from epithelial remnants Radiographic appearance: Well-defined, multilocular radiolucency Often located in posterior mandible Scalloped borders Locally invasive and destructive Clinical presentation: Painless, slow growing, bony hard swelling Associated with nevoid basal cell carcinoma syndrome Risk of recurrence © Bootcamp.com  INBDE Bootcamp Radiographic Bone Lesions | Bootcamp.com Structure Radiograph Key Facts Radiolucent, well-defined, multilocular Ameloblastoma Etiology: Uncontrolled cell growth Radiographic appearance: Well-defined, uni or multilocular radiolucency Often located in the posterior mandible “Soap bubble” appearance Expansile Locally destructive and invasive Tooth displacement and/or root resorption Clinical presentation: Painless Vital teeth Slow-growing, bony hard swelling Radiolucent, ill-defined Acute osteomyelitis Etiology: Infection of bone attributed to bacterial invasion from dental infections, procedures, trauma, blood, or other structures Radiographic appearance: Ill-defined, non-corticated radiolucency Diffuse boundary May also have no radiographic findings Clinical presentation: Pain Vital teeth Rapidly progressive swelling History of trauma, surgery or infection Erythema, edema, and drainage Tooth mobility +/- history of fever or lymphadenopathy Restricted mouth opening, pain, and pus © Bootcamp.com  INBDE Bootcamp Radiographic Bone Lesions | Bootcamp.com Structure Radiograph Key Facts Radiolucent, ill-defined Osteosarcoma Etiology Uncontrolled cell growth Radiographic appearance: Ill-defined radiolucency “Sunburst” appearance Potential opacities within the lesion Rapidly growing Clinical presentation: Pain Paresthesia Mobile teeth Overlying mucosa is disrupted Metastatic carcinoma Etiology: Metastasis from primary cancer site to the jaw Radiographic appearance: Ill-defined radiolucency Destructive Rapidly growing Clinical presentation: Pain Paresthesia Mobile teeth Telangiectasias History of previous cancer or evidence of recurrence or metastasis © Bootcamp.com  INBDE Bootcamp Radiographic Bone Lesions | Bootcamp.com Structure Radiograph Key Facts Mixed radiolucent/radiopaque Chronic osteomyelitis Etiology: Long standing infection and inflammation of the jaw due to dental infections, procedures, trauma, systemic infections, compromised immunity, or poor blood supply Radiographic appearance: Mixed radiolucent-radiopaque “Onion peel” appearance Sequestrum of bone Clinical presentation: +/- Pain Swelling or cervical lymphadenopathy History of acute episodes, trauma, or infection Tooth mobility Purulence or bad taste Adenomatoid odontogenic Etiology: tumor Uncontrolled cell growth Radiographic appearance: Well-corticated, mixed radiolucent-radiopaque Often located in anterior maxilla or canine/premolar region Clinical presentation: Painless Slow-growing, bony hard swelling Retained primary tooth Unerupted permanent teeth Periapical cemento-osseous Etiology: dysplasia Disturbance in normal bone remodeling process in which normal bone is replaced by fibrous bone Radiographic appearance: Mixed radiolucent-radiopaque Often located in periapical mandibular incisor region Clinical presentation: Painless Vital teeth No swelling Typically occurs in African American adult females over the age of 30 Typically an incidental finding © Bootcamp.com  INBDE Bootcamp Radiographic Bone Lesions | Bootcamp.com Structure Radiograph Key Facts Mixed radiolucent/radiopaque Focal cemento-osseous Etiology: dysplasia Disturbance in normal bone remodeling process in which normal bone is replaced by fibrous bone Radiographic appearance: Mixed radiolucent-radiopaque Often located in posterior mandible Clinical presentation: Painless Vital teeth +/- swelling Complex odontoma Etiology: Uncontrolled cell growth Radiographic appearance: Mixed radiolucent-radiopaque Ill-formed mass resembles tooth density Most commonly located in the posterior mandible Clinical presentation: Painless Slow-growing, bony hard swelling Unerupted or impacted teeth Compound odontoma Etiology: Uncontrolled cell growth Radiographic appearance: Mixed radiolucent-radiopaque Multiple, small tooth-like structures Tooth-bearing areas of the jaw Most commonly located in the anterior maxilla Clinical presentation: Painless Slow-growing, bony hard swelling Unerupted or impacted teeth Typically an incidental finding © Bootcamp.com  INBDE Bootcamp Radiographic Bone Lesions | Bootcamp.com Structure Radiograph Key Facts Mixed radiolucent/radiopaque Calcifying odontogenic cyst Etiology: Developmental, arising from epithelial remnants Radiographic appearance: Mixed radiolucent-radiopaque Associated with impacted teeth Clinical presentation: Painless Slow-growing, bony hard swelling Expansile Ossifying fibroma Etiology: Uncontrolled fibrous tissue growth Radiographic appearance: Mixed radiolucent/radiopaque Expansile Clinical presentation: Painless Vital-teeth Slow-growing, bony hard swelling Calcifying epithelial Etiology: odontogenic tumor (CEOT), Uncontrolled cell growth Pindborg’s tumor Radiographic appearance: Mixed radiolucent/radiopaque Radiopaque flecks Often located in posterior mandible Associated with unerupted or impacted teeth Expansile Clinical presentation: Painless Slow-growing, bony hard swelling © Bootcamp.com  INBDE Bootcamp Radiographic Bone Lesions | Bootcamp.com Structure Radiograph Key Facts Radiopaque Osteoma Etiology: Uncontrolled growth of bone Radiographic appearance: Radiopaque Can have radiolucencies within Clinical presentation: Painless Vital teeth Slow-growing, bony hard swelling Expansile History of Gardner syndrome Fibrous dysplasia Etiology: Genetic mutation causing normal bone to be replaced by fibrous bone Radiographic appearance: Radiopaque “Ground glass” appearance Often located in the posterior Smudgy with diffuse, blending borders Loss of lamina dura Increased trabeculation Clinical presentation: Painless Vital teeth Slow-growing, bony hard swelling Normal intact mucosa Associated with McCune-Albright syndrome Cementoblastoma Etiology: Uncontrolled cell growth Radiographic appearance: Radiopaque mass with thin radiolucent border Commonly associated with mandibular first molars Attached to root Root resorption Clinical presentation: Pain Vital teeth Slow-growing, bony hard swelling © Bootcamp.com  INBDE Bootcamp Radiographic Bone Lesions | Bootcamp.com Structure Radiograph Key Facts Radiopaque Condensing osteitis Etiology: Fibro-osseous response of bone to chronic inflammation or infectious Radiographic appearance: Radiopaque Irregular sclerosis adjacent to the apex of a root Clinical presentation: +/- Pain Involved with both vital and non-vital teeth No swelling Hypercementosis Etiology: Excessive deposition of cementum Radiographic appearance: Radiopaque Bulbous, enlarged roots Thickened cementum Clinical presentation: Not painful Vital tooth No swelling Idiopathic osteosclerosis Etiology: (dense bone island) Benign growth of bone with no exact reason Radiographic appearance: Radiopaque Often located in posterior mandible Not associated with teeth Clinical presentation: Not painful Vital teeth No signs or symptoms © Bootcamp.com  INBDE Bootcamp Radiographic Bone Lesions | Bootcamp.com Structure Radiograph Key Facts Systemic Diseases Sickle cell disease Etiology: Genetic blood disorder 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 Clinical presentation: Systemic features: low hemoglobin levels, fatigue, weakness, shortness of breath Multiple myeloma Etiology: Uncontrolled growth of blood cells Radiographic appearance: Multiple “punched out” osteolytic lesions Clinical presentation: Pain and paresthesia Systemic features: anemia, bleeding, infection, and fracture Paget’s disease Etiology: Chronic abnormal bone remodeling Radiographic appearance: Sclerotic and radiolucent areas Widespread and multifocal “Cotton wool” appearance Tooth displacement Clinical presentation: Pain Swelling Systemic features: bone pain, headaches, altered vision or hearing, and increased alkaline phosphatase levels © Bootcamp.com  INBDE Bootcamp Radiographic Bone Lesions | Bootcamp.com Structure Radiograph Key Facts Systemic Diseases Hyperparathyroidism Etiology: Excessive production and secretion of parathyroid hormone Radiographic appearance: Multiple radiolucent foci Loss of lamina dura Giant cell lesions aka “Brown tumors” Clinical presentation: Systemic features: kidney stones, metastatic calcification, osteoporosis, neurologic problems, arrhythmias, elevated PTH and alkaline phosphatase Cherubism Etiology: Genetic disorder resulting in abnormal development and growth of the jawbones Radiographic appearance: Uni- or multilocular radiolucencies Often located in posterior mandible but also frequently in maxilla “Soap bubble” appearance Thin cortical bone Displacement of teeth Clinical presentation: Painless Bilateral, symmetrical jaw expansion Premature exfoliation of primary teeth Langerhans cell histiocytosis Etiology: Abnormal proliferation of immune cells Radiographic appearance: Non-corticated radiolucencies Osseous lytic lesions with “punched out” appearance “Floating teeth” Clinical presentation: Tooth mobility +/- erythematous skin or mucosal lesions © Bootcamp.com