Sol Rad

Question 1

what are the solitary and interradicular radiolucencies

Answer 1

• incisive canal cyst
• median mandibular cyst
• mid palatine cyst
• lateral periodontal cyst
• solitary bone cyst
• posterior lingual mandibular salivary gland depression (Stafne cyst)
• focal osteoporotic bone marrow defect
• residual cyst
• fibrous healing defect
• neuroma, neurofibroma

Question 2

do solitary and interraddicular radiolucencies form around apex

Answer 2

not typically

Question 3

what is the most common interradicular and solitary radiolucencies

Answer 3

incisive canal (nasopalatine) cyst

Question 4

what are the lines of embryonic fusion and sites of development cysts

Answer 4

• naso-labial
• naso-palatine duct
• median palatal

Question 5

what are the clinical features of incisive canal cysts

Answer 5

• painless swelling
• sinus tract may be present

Question 6

what are the radiographic features of the incisive canal cyst

Answer 6

• unilocular radiolucency in vicinity of maxillary midline
• cause of alterations to walls of incisive canals
• root divergence in cases of large cysts

Question 7

what is another way an incisive canal cyst is described and why

Answer 7

heart shaped because of the anterior nasal spine superimposing over the round radiolucency

Question 8

do incisive canal cysts displace teeth

Answer 8

no

Question 9

do incisive canal cysts usually get larger

Answer 9

not usually but it can

Question 10

what is the age, site and gender predilection of the incisive canal cyst

Answer 10

• 4th and 6th decades
• site: anterior maxilla; close to midline
• gender: male:female 3:1

Question 11

what is the management of incisive canal cysts and is there recurrence

Answer 11

• simple enucleated; degree of surgery is dependent on size of lesion
• recurrence is unusual

Question 12

what are the clinical features of median mandibular cysts

Answer 12

asymptomatic

Question 13

what are the radiographic features of the median mandibular cysts

Answer 13

unilocular radiolucency in the symphyseal region

Question 14

what are the clinical features of the mid palatine cyst

Answer 14

asymptomatic

Question 15

what are the radiographic features of the mid palatine cyst

Answer 15

• unilocular radiolucency
• palatal midline, posterior to papilla

Question 16

what is the age, site and gender predilection for the mid palatine cyst

Answer 16

• any age
• site: midpalate posterior to papila
• no gender predilection

Question 17

what is the management of mid- palatine cyst

Answer 17

• simple enulcelated; degree of surgery is dependent on size of lesion

Question 18

what is the clinical presentation of the lateral periodontal cyst

Answer 18

• asymptomatic, dome-shaped swellings of the interdental papilla, attached gingiva, or alveolar mucosa
• occurs in the mandible cuspid-PM region

Question 19

does the lateral periodontal cyst push teeth away

Answer 19

no

Question 20

what is the radiographic presentation of the lateral periodontal cyst

Answer 20

• well defined radiolucency
• round to ovoid
• normally in inter radicular areas between alveolar crest and apices
• may or may not come in contact with the tooth surface

Question 21

what is the age, site and gender predilection for the lateral periodontal cyst

Answer 21

• age: adult
• site mandible- canine-premolar region
• gender: male

Question 22

what is the management of lateral periodontal cysts and do they recur

Answer 22

• surgical enucleated
• does not recur

Question 23

what must lateral periodontal cysts be differentiated from

Answer 23

early stage OKCs and ameloblastomas

Question 24

what is the clinical presentation of solitary (traumatic) bone cysts

Answer 24

• normally asymptomatic
• may have swelling or pain

Question 25

what are the other names for the solitary bone cyst

Answer 25

- unicameral bone cyst - solitary bone cyst - hemorrhagic bone cyst - intravasational bone cyst - traumatic bone cyst - extravasational bone cyst

Question 26

what is the radiographic appearance of the solitary bone cyst

Answer 26

- unilocular radiolucency with interradicular scalloped superior margins - usually greater than 10mm and associated with more than 1 root apex - well demarcated but does not have corticated border - aggressive lesions can be expansive but most cases arent

Question 27

what is the age, site and gender predilection for solitary bone cyst

Answer 27

- age: second decade, usually less than 25 years but also seen in menopausal age women and same age in men - site: body and ramus of mandible - gender: no predilection

Question 28

what is the management of solitary bone cysts and is there recurrence

Answer 28

- initiate bleeding - recurrence is rare

Question 29

what is the clinical presentation of the posterior lingual mandibular salivary gland depression

Answer 29

- developmental lesion - asymptomatic - usually found in routine radiographic examinations - considered pathognomonic

Question 30

what is another name for the posterior lingual mandibular salivary gland depression

Answer 30

Stafne cyst

Question 31

what is the radiographic presentation of PLMSGD

Answer 31

-well circumscribed posterior radiolucency in molar region between mandibular canal and inferior border - can be found in antegonial notch - may or may not be corticated

Question 32

does the PLMSGD grow

Answer 32

yes

Question 33

what is the age, site and gender predilection of the PLMSGD

Answer 33

- age: adults; prominent over 50 years - site: between the mandibular canal and inferior border - gender: almost exclusively in men

Question 34

what is the management for PLMSGD

Answer 34

- positive diagnosis based on clinical and radiologic history negates the need for biopsy and histologic examination

Question 35

what is the clinical presentation of focal osteoporotic bone marrow defect of the jaws

Answer 35

asymptomatic

Question 36

what is the radiographic presentation of the focal osteoporotic bon marrow defect of the jaws

Answer 36

- unilocular, faint radiolucency - not ragged but difficult to discern as a separate entity - well demarcated, can be trabeculations, no expansion

Question 37

what is the age, site and gender predilection for focal osteoporotic bone marrow defect of the jaws

Answer 37

- age: all - site: mandible - gender: slightly higher in females but no predominant gender

Question 38

what is the management for focal osteoporotic bone marrow defect of the jaws

Answer 38

no treatment

Question 39

what is the pathophysiology of the residual/recurrent cyst

Answer 39

- results from incomplete removal or residual viable epithelial cystic lining following treatment of a cyst - previous history of periapical disease

Question 40

what is the clinical presentation of the residual cyst

Answer 40

- asymptomatic, normally found on radiographic examinations of edentulous areas - tooth or root may or may not be present

Question 41

what is the radiographic presentation of the residual cyst

Answer 41

- well defined radiolucency with smooth round corticated borderd - usually 5mm or less in diameter - may not be any root present if tooth was previously extracted

Question 42

what is the age, site and gender predilection for the residual cyst

Answer 42

- age: middle age or older - site: more common in maxilla - gender: more common in males

Question 43

what is the management of the residual/recurrent cyst

Answer 43

- same as PA cyst - requires removal of the cyst lining - enucleation if a large cyst

Question 44

what is the pathophysiology of the fibrous healing defect

Answer 44

- develops after inflammation that affects the integrity of the periosteum - once disease is eradicated the bone heals without a mineralized bony matrix - due to the loss of the periosteum only fibrous connective tissue fills the site of the previous disease

Question 45

what is another name for the fibrous healing defect

Answer 45

apical scar

Question 46

what is the clinical presentation of the fibrous healing defect

Answer 46

- asymptomatic - noted in areas with a history of disease or trauma

Question 47

what is the radiographic presentation of the fibrous healing defect

Answer 47

- well circumscribed radiolucent lesion at site of previous surgery - punched out or see through appearance - may resemble residual cysts in edentulous areas but lack of cortication

Question 48

fibrous healing defects are seen where:

Answer 48

there was trauma such as endo or mandibular fx

Question 49

what is the management for the fibrous healing defect

Answer 49

- no treatment indicated - a previous history of disease is critical in establishing the diagnosis

Question 50

what is the clinical presentation of the neuroma, neurofibroma

Answer 50

- expansion, pain or paresthesia - symptoms include complaints of burning, tingling and aching sensations

Question 51

what is the radiographic presentation of neuroma, neurofibroma

Answer 51

- well circumscribed radiolucency of various shapes - in the mandible it usually forms in the mandibular canal - benign

Question 52

what is the management of the neuroma, neurofibroma

Answer 52

- excision - recurrence is rare

Question 53

what are the other odontogenic cyst like radiolucencies

Answer 53

- ameloblastoma - central giant cell granuloma - cementoossifying fibroma

Question 54

what are the other non-odontogenic cyst like radiolucencies

Answer 54

-chronic localized langerhans cell disease - myeloma