opath

8/2/2019 Opath

1/69

3/4/12

Oral Pathology

8/2/2019 Opath

2/69

3/4/12

Definitions of the

following words:v Pericoronal, Periapical, Non-Periapical/Non-Pericoronal

8/2/2019 Opath

3/69

3/4/12

v PERICORONAL: lucency aroundcrown of impacted tooth

v PERIAPICAL: lucency where rests of

dental lamina expectedv (bottom 1/5 of root)

v NON-PERIAPICAL/NON-PERICORONAL: lucency not

associated w/ impacted tooth; area

8/2/2019 Opath

4/69

3/4/12

Bone pathology of

Inflammatory Origin

8/2/2019 Opath

5/69

3/4/12

8/2/2019 Opath

6/69

3/4/12

v Apical Periodontal Cyst: Lucency @ apex ofpotentially non-vital tooth

v Residual apical perio cyst (in previous extractionsite)

v Lateral Radicular Cyst/l inflamed rest of Mal. Onside of root

8/2/2019 Opath

7/69

3/4/12

8/2/2019 Opath

8/69

3/4/12

Periapical Granulomav Lucency adjacent to apex of potentially non-vitaltooth

8/2/2019 Opath

9/69

3/4/12

8/2/2019 Opath

10/69

3/4/12

Periapical Abscessv Radiolucency adjacent to apex of potentially non-vital tooth

vPain to percussion + Sinus tract MUST BEPRESENT

8/2/2019 Opath

11/69

3/4/12

8/2/2019 Opath

12/69

3/4/12

Fibrous Scarv Persistent Lucency from fibrous repair in areawhere cortical plate has been lost; associatedwith endo tooth or extraction site.

8/2/2019 Opath

13/69

3/4/12

8/2/2019 Opath

14/69

3/4/12

Osteomyelitisv Lucency with ill-defined lucency and w/ or w/oradiopacities

v Associated w/ percussion sensitivity

8/2/2019 Opath

15/69

3/4/12

v Apical Periodontal Cyst

v Periapical Granuloma

v Periapical Abscess

v Fibrous Scar

8/2/2019 Opath

16/69

3/4/12

Non-Odontogenic

Developmental Cysts

8/2/2019 Opath

17/69

3/4/12

8/2/2019 Opath

18/69

3/4/12

Stafne Defect:submandibular gland;common lucency at angleof the mandible; not

intraosseous.Median Palatal Cyst: raremidline lucency; posterior todentitionl clinical swelling ofpalate posterior to rugae.

Sublingual Defect: uncommon

apical to mand cuspidStafne

Nasopalatine duct cyst:lucency of midlinemandible

8/2/2019 Opath

19/69

3/4/12

Non-OdontogenicDevelopmental Cysts:

Nasopalatine Duct Cyst

Median Palatal CystStafne DefectSublingual Gland defect

8/2/2019 Opath

20/69

3/4/12

Odontogenic Cysts &

Tumors

8/2/2019 Opath

21/69

3/4/12

8/2/2019 Opath

22/69

3/4/12

Apical Perio Cyst, Lateral Radicular, ResidualCyst

Lateral Perio Cyst: lucency not associatedwith impacted tooth; no relationship to PDL.Teeth may or may not be present

Variants:-Glandular odontogenic: clusters of mucouscells.

-Botryoid cyst: polycystic; looks like grapecluster (in gross appearance)

Dentigerous Cyst: lucencyassociated w/ impacted tooth

8/2/2019 Opath

23/69

3/4/12

8/2/2019 Opath

24/69

3/4/12

Primordial Cystv Lucency which arises in site where expectedtooth did not develop

v Almost all are ODONTOGENIC KERATOCYTS(OKCs)

8/2/2019 Opath

25/69

3/4/12

Odontogenic Cysts &

Tumorsv Apical Periodontal Cysts, Residual, LateralRadicular Cysts

v Dentigerous Cyst

v Lateral Periodonal Cyst

v Primordial Cyst

8/2/2019 Opath

26/69

3/4/12

Odontogenic Lesions of

Epithelial Origin

8/2/2019 Opath

27/69

3/4/12

8/2/2019 Opath

28/69

3/4/12

Ameloblastomav Any Jaw; Any Age; Posterior or Anteriorv (ALWAYS INCLUDE THIS IN DIFFERENTIAL

FOR RADIOLUCENCY)

8/2/2019 Opath

29/69

3/4/12

8/2/2019 Opath

30/69

3/4/12

Odontogenic

Keratocystv Any jaw; any age; posterior or anterior

v Multiple OKCs associated with Gorlin Syndrome(Nevoid Basal Cell Carcinoma)

v Associated symptoms: multiple basal cell

carcinomas, OKCs, palmar pits, calcified falx,enlarged head circumference, rib anomalies

8/2/2019 Opath

31/69

3/4/12

8/2/2019 Opath

32/69

3/4/12

Calcifying Epithelial

Odontogenic TumorCEOT (Pindborg Tumor)v Wide Age Range; Majority in Adults with avgage of 40 yo.

v 90% posterior region (premolars/molars)

8/2/2019 Opath

33/69

3/4/12

8/2/2019 Opath

34/69

3/4/12

Squamous Cell

Carcinoma Associatedw/ impacted toothv Pericoronal radiolucency in patient olderthan 50 yo.

8/2/2019 Opath

35/69

3/4/12

Squamous OdontogenicTumor:Too rare to include indifferential

Clear Cell OdontogenicTumor:Too rare to include in

8/2/2019 Opath

36/69

3/4/12


Epithelial Originv Ameloblastoma

v Odontogenic Keratocyst (OKC)

v Calcifying Epithelial Odontogenic Cyst (CEOT;Pindborg)

v Squamous Cell Carcinoma associated w/impacted tooth

v Squamous Odontogenic Tumor (SOT)

v Clear Cell Odontogenic Carcinoma

8/2/2019 Opath

37/69

3/4/12


Epithelial Origin w/ectomesenchyme

8/2/2019 Opath

38/69

3/4/12

8/2/2019 Opath

39/69

3/4/12

Ameloblastic Fibromav Very Rare in Adults; usually first twodecades of life

8/2/2019 Opath

40/69

3/4/12

8/2/2019 Opath

41/69

3/4/12

Ameloblastic Fibro-

Odontomav Very rare in adults; majority first twodecades of life

8/2/2019 Opath

42/69

3/4/12

8/2/2019 Opath

43/69

3/4/12

Adenomatoid

Odontogenic Tumor(AOT)v Most in people age 15-25v Extremely rare in molar region

8/2/2019 Opath

44/69

3/4/12

8/2/2019 Opath

45/69

3/4/12

Calcifying Odontogenic

Cyst- Gorlin Cystv Any jaw; any age; posterior/anterior

8/2/2019 Opath

46/69

3/4/12

8/2/2019 Opath

47/69

3/4/12 Complex Odontoma: 90 % radiopaque; bag of multiple toothlets

Compound Odontoma: 90 % radiopaque; single radiopacity w/ radiolucent rim

8/2/2019 Opath

48/69

3/4/12


Epithelial Origin w/ectomesenchymev Ameloblastic Fibromav Ameloblastic Fibro-Odontoma (AFO)

v Adenomatoid Odontogenic Tumor (AOT)

v Calcifying Odontogenic Cyst (Gorlin Cyst)

v Odontoma

8/2/2019 Opath

49/69

3/4/12


Ectomesenchymalorigin

8/2/2019 Opath

50/69

3/4/12

8/2/2019 Opath

51/69

3/4/12

Odontogenic Fibromav Can be pericoronal or located in alveolar ridge inany area where dental lamina is expected.Pericoronal lesion must be much larger than theexpected follicle

8/2/2019 Opath

52/69

3/4/12

8/2/2019 Opath

53/69

3/4/12

Odontogenic Myxomav Pericoronal or located in alveolarridge anywhere dental lamina is

expected; pericoronal lesionmust be much larger thanexpected follicle

8/2/2019 Opath

54/69

3/4/12


EctomesenchymalOriginv Odontogenic Fibromav Odontogenic Myxoma

8/2/2019 Opath

55/69

3/4/12

Fibro-Osseous Lesions

8/2/2019 Opath

56/69

3/4/12

8/2/2019 Opath

57/69

3/4/12

Central Ossifying

Fibromav Single lucency that may or may not containradiopacities

v Can be 90% radiopaque with think radiolucent

line

v usually this pattern is in old lesions

v Lesions tend to hang together and come out inone piece

8/2/2019 Opath

58/69

8/2/2019 Opath

59/69

3/4/12

Fibro-Osseous Lesionsv Central Ossifying Fibromav Cementoblastoma

v Cemento-osseous dysplasia (OsseousDysplasia)

v Periapical cemento-osseous dysplasia

8/2/2019 Opath

60/69

3/4/12

Miscellaneous Lesion

8/2/2019 Opath

61/69

3/4/12

8/2/2019 Opath

62/69

3/4/12

Simple/Traumatic Bone

CystMany are kids with mandibularprominence; any jaw; any age;posterior/anterior

Classically scallops between teeth

8/2/2019 Opath

63/69

3/4/12

8/2/2019 Opath

64/69

3/4/12

Central Giant Cell

granulomav Many in anterior regions but can be any jaw; anyage; ant or post

v RULE OUT OTHER DISEASES:

v CHERUBISM: kids w/ bilateral multilocular lesionsof poster mandible

8/2/2019 Opath

65/69

3/4/12

v Hemangioma

Aneurysmal bone cyst

AV Malformation

DONT FORGET TO ASPIRATEYOUR BIOPSY:

COULD BE VASCULARLESION

8/2/2019 Opath

66/69

3/4/12

8/2/2019 Opath

67/69

3/4/12

Osteosarcoma: ill defined lucent, mixed/radiopaque; any age/location usually

early 30s

Chondrosarcoma: ill defined lucent, mixed or radiopaque; wide age

Metastatic Cancer to the oral

8/2/2019 Opath

68/69

3/4/12

Metastatic Cancer to the oralcavity

Resembles Pyogenic GranulomaorPeripheral Giant Cell Granuloma

Ill defined lucent, mixed orradiopaque

Most in older adults.

8/2/2019 Opath

69/69

opath

Documents