Cyst of jaws and osteomylitis

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Oral Pathology I
Third Year

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Cyst of jaws and osteomylitis

  1. 1. Cyst of Jaws and Osteomylitis :Done By Tariq Al Mutair Khalid Al Ahmary
  2. 2. Periapical cyst  Etiology  Periapical grunoloma  Clincal feature  X-ray  Histopathology  Treatment
  3. 3. (Odontogenic cyst (periapical :Etiology .Periapical cyst develops from a preexisting granulomaIt is a focus of chronically inflamed granulation tissue.in apex of non vital tooth Cyst formation occurs as result of epithelial.proliferation
  4. 4. Peiapical granuloma It is initiated and maintained by the degradation products of necrotic pulp tissue stimulation of the resident epithelial rest of Malassez occurs in response to the products of inflammation
  5. 5. Developing of preiapical cyst  Caries ,trauma,periapical disuse   Death of dental pulp   Apical bone inflammation   Dental granuloma   Stimulation of epithelial rest of Malassez   Epithelial proliferation   Periapical cyst 
  6. 6. Clinical feature      Most common cyst of the jaw . Age 3-6 decades . More located in maxilla , ant. then post. then mand. post, finally lower ant. Asymptomatic . Non vital tooth .
  7. 7. X-ray  Radiolucency with a narrow opaque margin  It can not be differentiated  Round or oval shape  Cyst range from mm to 1.5cm
  8. 8. Histopathology  Lined by non keratinized stratified squamus epithilum .  Polymorphonuclear transmigrated through the epithelium .  Connective tissue with mixed inflammatory cell population .  Foci of dystrophic calcification, cholesterol and giant cell .
  9. 9. Treatment  Extraction  RCT with curettage . .  RCT with apicoetomy .
  10. 10. .Cont IF NOT TREATED :  Bone resorpion  Weekness of the jaw
  11. 11. Osteomylitis  Can be classified to :  Acute  chronic
  12. 12. Acute osteomylitis Def. : acute inflammation of the bone and bone marrow of the mandible and maxilla. infectious Etiology : - extension of periapical abscess . - Physical injury - Bacteremia .
  13. 13. .Cont Clinical features : - Pain pyrexia Painful lymphadenopathy Leukocytosis Parasthesia of lower lip
  14. 14. .Cont Radiography : Lesion must have resorb or demineralize approximately 60% of the bone to be shown in a radiograph .
  15. 15. .Cont Histopathologically : -Purulent exudates occupies the marrow spaces. -Bony trabeculae show reduced octeoblastic activity and increased octeoclastic resorbtion.
  16. 16. .Cont :Treatment Antibiotics- 1 Drainage- 2 Surgery- 3
  17. 17. Chronic Osteomylitis Def. : continuation of acute osteomylitis :Etiology .Previous acute osteomylitis.Long term low grade inflammatory reaction .Bone irradiated susceptible to infection-
  18. 18. .Cont :Predisposing factors .Anatomical location.Immunological status.Nutritional status.Patient age.Pre-existing systemic factor-
  19. 19. .Cont :Clinical features .Mandible > Maxilla(.Pain ( varies in intensity, not related to the extent Duration of the symptoms is generally .proportional to the extent of the disease Swelling
  20. 20. .Cont :Radiography Chronic osteomylitis appear primarily radiolucent lesion , that may show focal .zones of opacification
  21. 21. .Cont :Histopathologicaly : In mild cases .similarities to fibrousseous lesion.Few Infiltration of chronic inflammatory cells : In advanced cases .necrotic bone.reversal lines of deposition and resorption -
  22. 22. .Cont :Treatment Antibiotics, combination may be relatively- 1 .extended .Surigical removal- 2

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