Slide 1 1- Osteogenesis imperfecta 2y Thin translucent skin y Distortion of ear ossicles and deafness y Heart valve defects y Dentinogenesis

imperfecta Slide 2 1- Dentinogenesis imperfecta 2- They are carried on SEPARATE but related genes Slide 3 1- Osteopetrosis y There s an increased density of the whole skeleton with no distinction between cortical and medullary bone y The density of jaw bones makes the roots of the teeth almost invisible on radiographs 2y Delayed eruption of teeth y Osteomyelitis Slide 4 1- Cleidocranial dysplasia 2y Skull y Clavicle y Jaws 3y The fontanelles and the sutures tend to remain open y The skull appears flat with prominent frontal, parietal and occipital bones y The nasal bridge is also depressed

Slide 5 y The deciduous dentition tends to be retained y The permanent dentition tends to be delayed or non-eruptive because of multiple impactions y Supernumerary teeth and dentigerous cysts y The roots of the teeth tend to be thinner than normal y Secondary cellular cementum is either absent or sparsely present on both deciduous and permanent teeth Slide 6 1- Monostotic fibrous dysplasia 2- Maxilla 3- Craniofacial fibrous dysplasia Slide 7 1- Left side ill-defined radiopaque obliteration of maxillary sinus and involvement of orbital floor 2- Adulthood Slide 8 1- The lesions tend to expand mainly during the period of active skeletal growth and become quiescent in adult life treatment is delayed until phase of active growth subsides 2- COSMETIC SURGERY fibrous dysplasia is not radiosensitive and there s increased incidence of malignant transformation into fibrosarcoma among radiotherapy treated cases Slide 9 1- Ill-defined and blend with surrounding bone 2- 1

3- Radiopaque 4- Orange-peel or ground glass Slide 10 1- Polystotic fibrous dysplasia 2- caf au lait melanotic spots 3- McCune-Albright syndrome y Precocious puberty in females puberty occurring at early age y Other endocrine abnormalities y Pigmentation of the oral mucosa Slide 11 1- 1 2 immature woven bone fibrous cellular tissues

2y Fibrous dysplasia y Cemento-osseous dysplasia y Ossifying fibroma 3- Clinically and radiographically BUT NIT histologically Slide 12 1- Periapical cemental dysplasia well-defined lobular masses periapical to lower anterior teeth 2- Osteomyelitis due to decreased vascularity Slide 13 1- Cherubic appearance y Eyes upturned to heaven y Chubby face

2- A Normal at birth and begins between 2-4 years B Up to the age of 7 years C Regresses after 7 years of age with progressive reduction in asymmetry as patient passes from puberty into adult life Slide 14 1- Well-defined bilateral multilocular radiolucencies at the angle and ramus of the mandible Slide 15 1- 1 multinucleated giant cell 2 fibrous cellular tissues 2y y y y

Brown tumor of hyperparathyroidism Central giant cell granuloma Central giant cell tumor Peripheral giant cell granuloma giant cell epulis

Slide 17 12y y y y y Brown tumor of hyperparathyroidism Elevated parathormone level Increased serum calcium level Reduced serum phosphate level Increased urinary excretion of calcium and phosphate There may be elevated alkaline phosphatase

Slide 18 1- Rickets 2- Vitamin D deficiency

Slide 19 1- Acromegaly 2- Excessive secretion of growth hormone after closure of epiphyseal plates 3- Spaced teeth and class III skeletal relationship Slide 20 1- Chronic Suppurative osteomyelitis 2- Moth-eaten appearance Slide 21 1- Garre s osteomyelitis Chronic osteomyelitis with proliferative Periostitis 2- Onion-peel appearance Slide 22 1- Torus palatinus 2- NO 3- Cosmetic reasons or denture construction Slide 23 1- Dense bone Island Idiopathic osteosclerosis 2y Cemento-osseous dysplasia y Inflammatory osteosclerosis Slide 24 1- Buccal exostosis 2- Osteoma Slide 25 1- Paget s disease of bone 2- Reversal line 2nd active phase Mosaic appearance 3- 1st phase root resorption 2nd phase post extraction hemorrhage

3rd phase Hypercementosis, ankylosis, post extraction fracture and post extraction infections (osteomyelitis and dry socket) Slide 26 1- Cotton wool appearance 2- Osteosarcoma 3- Blood chemistry 4- A- Normal B- Normal C- Raised Slide 27 1- Osteosarcoma 2- Sun rays appearance only in 25% of patients 3- Localized symmetrical widening of PDL space Slide 28 1- Ossifying fibroma 2- Fibrous dysplasia and Cemento-osseous dysplasia Slide 29 1- Osteoma 2- Exostosis 3- Gardner syndrome  Multiple osteomas of the jaws  Polyposis coli which shows a marked tendency to undergo malignant changes  Multiple fibrous tumors  Epidermal/sebaceous cysts of the skin  Multiple impacted supernumerary and permanent teeth may be found as well

Slide 30

y 1- Langerhans cell histocytosis y 2- 1 Eosinophil y 2 Malignant langerhans cell

Slide 31 1- Birbeck granules Slide 32 1- Punched out appearance 2- Monoclonal Slide 33 1- Malignant plasma cells 2- M-Spike