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Nasopalatine Duct Cyst

Pear/Heart shaped RL between Max. central incisors.
Teeth are vital
May perforate labial plate
List 3 pathologies that present with RL lesions in the posterior mandible, are associated with an unerupted tooth and have painless expansion.
1. Ameloblastoma
2. Ameloblastic Fibroma
3. Dentigerious Cyst

NOTE: AOT presents in a similar fashion but in the ant. canine region, usually maxilla
Odontogenic Keratocyst

Agressive
Uni or Multilocular RL
Unerupted tooth
Painful expansion, soft tissue swelling, drainage.
High recurrence
Assoc. with Nevus Basal Cell Syndrome
List 5 key features of Nevus Basal Cell Syndrome
1. Frontal Bossing
2. Calcification of the falx cerebri
3. OKC's
4. Multiple Basal cell carcinomas
5. Palmar/plantar pitting
Traumatic bone cyst

Trauma, hemorrage and fluid build up
RL that scallops between roots of vital teeth
Asymtomatic, no expasion
Stafne Bone Cyst

Pseudo cyst
inferior to mandibular canal
well defined RL
indentation of bone containing submandibular gland.
Asymptomatic
Globulomaxillary Cyst

RL pear shaped lesion between max. laterals and canines

DDx: AOT
Median Palatal Cyst

Firm or fluctulant swelling in the midline of hard palate.

Central well defined RL

DDx: Nasopalatine cyst (note MPC occur more posteriorly, where as nasopalatine cyst arise right between roots of centrals).
What is an aneurysmal bone cyst (ABC)?
Benign osteolytic lesion that may affect any bone.

multilocular RL

50% cause pain
Ballooning of mandible
CGCG lesions are found more commonly in the anterior of the maxilla and the mandible in younger people (before age 20).

reabsorb roots and/ or move teeth.
Composed of multi-nucleated giant cells
multilocular RL of bone.

DDx: OKC, ameloblastoma, odontogenic myxoma, hemangioma, central odontogenic fibroma, hyperparathyroid tumor, and cherubism.
Odontogenic Myxoma

Benign odontogenic tumor

multilocular RL, soap bubble, step ladder trabeculae

Young adults, post. mandible

painless expansion, diplaces/resorbs teeth

Cherubism

AD
caused by a loss of bone in the mandible which the body replaces with excessive amounts of fibrous tissue

hypertelorism with upward gaze
multilocular RL in all 4 quads

causes premature loss of the primary teeth and uneruption of the permanent teeth.

resolves over time
Ameloblastic Fibro-odontoma (AFO)

Avg. age 10 y/o
assoc. with a tooth that fails to erupt
RL, calcifications may be present
most in ant. region
painless swelling, may expand
Calcifying Odontogenic Cyst AKA Gorlin Cyst
Ant. jaws
2md to 3rd decade
unilocular RL containing scattered radiopacities
painless swelling, may expand
May be assoc. with unerupted tooth or odontoma
Histology: Ghost Cells
The odontoma is a hamartoma of odontogenic origin average age  is 14
frequently associated with an unerupted tooth.

May be Compound (toothlets) or Complex (undistinguishable tooth structure)

S/S: delayed tooth eruption, +/-expansion
A patient presents with cafe au lait spots, abnormal skin pigmentation, precocious puberty and polyostotic fibrous dysplasia. What is your diagnosis?
Albright Syndrome
Albright Syndrome

Seen here is Fibrous dysplasia (Bone replaced with fibrous tissue) in the skull give "ground glass appearance"

Precocious puberty
Cafe au lait pigmentation
Cementoblastoma

uncommon, children/ young adults
benign neoplasm of the cementum of the teeth.

Mand. molars or premolars. 
vital pulp

Pain, expansion, diplaced teeth

Progresses from RL to RO
Osteoblastoma

Benign bone tumor
post. mand
prgresses from RL to RO
pain, swelling.
vital tooth; may have root resorptions
"sunburst" appearance
may undergo malignant transformation
What is a benign tumor of mature bone and is associated with Gardner's Syndrome.
Osteoma
Ewing's Sarcoma

malignant tumor of bone
post. mand
painful expansion
"moth eaten" appearance on x-ray (mixed RL RO)
febrile, leukocytosis
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