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Lesion Radicular cyst (Periapical cyst) Description
Inflammatory cyst Originates from rests of Malassez

Clinical Features
Most common cyst Associated w/ non-vital teeth

Apex of non-vital teeth Encircles tooth apex

Radiographic Appearance
RADIOLUCENT unilocular Loss lamina dura Root resorption is common

Residual cyst

Inflammatory cyst Originates from rests of malassez

Remains after extraction of non-vital tooth Secondary to periodontal disease or pulpal necrosis spread through lateral canal Age 10-30 yrs Male predilection More prevalent in caucasians Asymptomatic Age > 30yrs Male predilection uncommon (<2%) Asymptomatic Age 10-40 yrs Male predilection Associated with NBCC SYNDROME 30 % recurrence 75% OKC- usually multiple (OKC occurs at average age of 19) Multiple BCC of skin Bifid rib/ kyphoscoliosis Calcification of falx cerebri

Any tooth-bearing area Along lateral aspect of tooth Evaluate periodontal status and vitality Mandibular 3rd molar area Surrounds crown of IMPACTED tooth Mandibular canine/ premolar area lateral to root of VITAL tooth Mandiblemolar/ramus area 25-40% associated w/impacted teeth Multiple sites May be associated w/impacted teeth

RADIOLUCENT unilocular round to oval shaped RADIOLUCENT Unilocular

Lateral radicular cyst

Inflammatory cyst Originates from Rests of Malassez

Dentigerous cyst

Developmental cyst Originates from reduced enamel epithelium

RADIOLUCENT unilocular well defined sclerotic border root resorption is common RADIOLUCENT unilocular * Botryoid variant is Multilocular RADIOLUCENT Unilocular or multilocular

Lateral periodontal cyst

Developmental cyst Originates from remnants of dental lamina

Odontogenic Keratocyst (OKC)

Developmental cyst Originates from remnants of dental lamina

Nevoid Basal Cell Inherited AD Carcinoma Syndrome (NBCC) Gorlin Syndrome

RADIOLUCENT Unilocular or multilocular

Calcifying Odontogenic Cyst (COC)

Developmental cyst Originates from epithelial remnants

Age 10-30 yrs (x 33yrs) Uncommon

Incisor/canine area Mandible=maxilla 33% associated w/impacted teeth

MIXED LUCENT-OPAQUE unilocular radiolucency with radiopaque flecks

Christel Haberland DDS, MS

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hamartoma? Compound: Anterior maxilla Complex: Posterior segments Mandible=maxilla RADIOPAQUE toothlets with radiolucent rim RADIOPAQUE mass surrounded by radiolucent rim Christel Haberland DDS.ODONTOGENIC TUMORS SUMMARY CHART Lesion Ameloblastoma Conventional Solid or Multicystic Description Benign odontogenic tumor originates from odontogenic epithelium w/o ectomesenchyme Clinical Features 20-60yrs (average 33 yrs) No sex predilection Painless swelling 55-90% recurrence Younger patients Average age 23 yrs Painless swelling Location mandible >maxilla Posterior regions Can be associated w/impacted teeth (Mand 3rd molar) mandible >maxilla Posterior regions *Associated with impacted teeth* Radiographic Appearance RADIOLUCENT Multilocular "soap bubble" Ameloblastoma Unicystic Benign odontogenic tumor Originates from odontogenic epithelium w/o ectomesenchyme RADIOLUCENT Unilocular Well defined borders Ameloblastic Fibroma Benign odontogenic tumor Originates from odontogenic epithelium WITH ectomesenchyme Age < 20yrs. MS Page 2 9/21/2013 . especially around crown of tooth MIXED LUCENT-OPAQUE Well defined unilocular radiolucency With radiopacities (snowflakes) Adenomatoid Odontogenic tumor (AOT) Benign odontogenic tumor Originates from odontogenic epithelium WITH ectomesenchyme Young patients 10-19 yrs rare in adults Female predilection (2:1) Asymptomatic Children. Average 14 Asymptomatic MOST COMMON ODONTOGENIC TUMOR Maxilla > mandible Anterior maxilla Associated with impacted teeth Mandible=maxilla Associated with impacted teeth Ameloblastic Fibro-Odontoma Benign odontogenic tumor Originates from odontogenic epithelium WITH ectomesenchyme MIXED LUCENT-OPAQUE Unilocular or multilocular radiolucency With radiopacities (flecks) similar to tooth structures Odontoma Types: Compound Complex Benign odontogenic tumor vs.uni or multilocular Contains calcified structures. average age 10 rare in adults No sex predilection Asymptomatic Age <20yrs. Average 14 20% recurrence Slight male predilection Asymptomatic Average age 25-30yrs No sex predilection Asymptomatic Larger lesions = painless expansion Mandible Posterior segments 50% Associated w/ impacted teeth mandible >maxilla RADIOLUCENT Unilocular or multilocular Myxoma Benign odontogenic tumor Originates from ectomesenchyme RADIOLUCENT Multilocular may have "soap bubble" appearance Calcifying Epithelial Benign odontogenic Age 30-50yrs Odontogenic Tumor tumor No sex predilection (CEOT) Pinborg Tumor Originates from odontogenic epithelium w/o ectomesenchyme mandible >maxilla Posterior regions Associated with impacted teeth (3rd molars) MIXED LUCENT-OPAQUE Radiolucency.

multifocal Expansile area-crosses midline Expansile Developmental disease Inherited AD Age 7yrs average Painless BILATERAL expansion Hyperparathyroidism (BROWN TUMORS) Endocrine disorder Elevated PTH levels Primary or Secondary Primary. females Stones. bones and groans Mandible > maxilla RADIOLUCENT Multifocal Unilocular or multilocular Other bony abnormalities: "Ground glass" appearance Loss of lamina dura Christel Haberland DDS. femur. vertebra 30% affects jaws Multiple sites RADIOLUCENT Multifocal Floating teeth.well defined attached to root with a radiolucent border ** diagnostic appearance Idiopathic Osteosclerosis Paget's Disease Areas of dense bone Unknown cause Chronic bone disease Unknown etiology Age 20-40yrs Female predilection Asymptomatic Adults > 40yrs. Male predilection (2:1) Bony enlargement w/pain "hat/dentures don't fit" 1% Osteosarcoma Mandible > maxilla First molar area Pelvis. hamartoma Age 10-20 yrs Female predilection May have pain/swelling Bruit/pulsations Mandible > maxilla RADIOLUCENT Mulitlocular "honeycomb" or "soap bubble" Benign bone lesion Most < 30yrs Recurrence 16% Mandible > maxilla Mandibular anterior Posterior mandible RADIOLUCENT Multilocular RADIOLUCENT Multilocular Bilateral.Craniofacial Fibrous Dysplasia Langerhan's Cell Disease Bone disease Neoplasm? Proliferation of Langerhan's cells Age. ribs.teens and older Loose teeth Pain Average age 70yrs Male predilection Blacks > whites Bone pain Mandible > maxilla Posterior mandible Skull.>60yrs.BONE PATHOLOGY SUMMARY CHART Lesion Osteoma Description Benign bone tumor Clinical Features Young adults < 20yrs Asymptomatic Solitary lesions Associated w/ GARDNER'S SYNDROME Location Maxilla = mandible Radiographic Appearance RADIOPAQUE well defined Cementoblastoma Benign bone tumor Adults 20-30 yrs Mandibular 1st molar RADIOPAQUE mass. MS Page 3 9/21/2013 .alveolar bone loss Punched-out radiolucency-skull film RADIOLUCENT Poorly defined Multifocal "Punched-out" appearance Multiple Myeloma Malignant tumor of plasma cells Hemangioma of Bone (Central Hemangioma) Central Giant Cell Granuloma Cherubism Benign tumor vs. skull Maxilla > mandible RADIOPAQUE well defined RADIOPAQUE.Multifocal "cotton wool" appearance HYPERCEMENTOSIS of teeth Fibrous Dysplasia Chronic bone disease Developmental Young adults <20yrs Unilateral enlargement Painless Recurrence 25-50% NO RADIATION Skull Maxilla > mandible RADIOPAQUE poorly defined "Ground glass" appearance Multifocal in.multifocal MIXED LUCENT-OPAQUE.

paresthesia. prostate. clinically a mass may be seen Age 20-30yrs Female predilection Larger lesions may cause painless expansion Mandible>maxilla RADIOLUCENT. Lesion Traumatic Bone Cyst Description Benign bone lesion Not a true cystno epithelium Clinical Features Age 10-20 yrs Adjacent teeth vital Painless expansion Children + adolescents Whites > blacks or asians Male predilection Pain and swelling Paresthesia. kidney) Older patients Pain.early MIXED LUCENT-OPAQUE (late) Florid CementoOsseous Dysplasia Benign bone lesion Female predilection Blacks > whites Asymptomatic May have fistulas Bilateral-symmetrical MIXED LUCENT-OPAQUE 4 quadrants may be involved Mandible = maxilla MIXED LUCENT-OPAQUE Ill-defined root resorption "sun-burst" pattern on occlusal Multifocal Osteosarcoma Malignant tumor of bone Average age 33yrs Male predilection Swelling. swelling.ill defined MIXED LUCENT-OPAQUE (breast or prostate ca) Cemento-Ossifying Fibroma (Ossyfing Fibroma) Benign bone tumor Mandible > maxilla Premolar area MIXED LUCENT-OPAQUE well defined unilocular radiolucency radiopaque flecks Never seen with impacted teeth Periapical CementoOsseous Dysplasia Benign bone lesion Age 30-50yrs Female predilection Blacks > whites Asymptomatic No expansion Vital teeth Mandible > maxilla Periapical area of mandibular anteriors RADIOLUCENT. pain. MS Page 4 9/21/2013 . loose teeth Location Mandible only Radiographic Appearance RADIOLUCENT poorly defined Scalloping around teeth Ewing's Sarcoma Malignant tumor of bone Mandible > maxilla RADIOLUCENT Ill-defined "onion skin" sometimes seen Metastatic Tumors to Jaws Metastatic carcinoma to jaws (breast.BONE PATHOLOGY SUMMARY CHART cont. lung. loose teeth. loose teeth paresthesia Christel Haberland DDS.early MIXED LUCENT-OPAQUE (late) Focal CementoOsseous Dysplasia Benign bone lesion Age 30-50yrs Female predilection Blacks < whites Asymptomatic No expansion Mandible > maxilla Posterior segments RADIOLUCENT.