Oral Pathology I Third Year

1. Cyst of Jaws and Osteomylitis
:Done By
Tariq Al Mutair
Khalid Al Ahmary

2. Periapical cyst
 Etiology
 Periapical
grunoloma
 Clincal feature
 X-ray
 Histopathology
 Treatment

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. 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. 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. 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. 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. 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 .

10. Treatment
 Extraction
 RCT
with curettage .
.
 RCT with apicoetomy .

11. .Cont
IF NOT TREATED :
 Bone
resorpion
 Weekness of the jaw

12. Osteomylitis
 Can
be classified to :
 Acute
 chronic

13. 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 .

14. .Cont
Clinical features :
-
Pain
pyrexia
Painful lymphadenopathy
Leukocytosis
Parasthesia of lower lip

15. .Cont
Radiography :
Lesion must have resorb or demineralize
approximately 60% of the bone to be shown
in a radiograph .

16. .Cont
Histopathologically :
-Purulent exudates occupies the marrow spaces.
-Bony trabeculae show reduced octeoblastic
activity and increased octeoclastic resorbtion.

18. .Cont
:Treatment
Antibiotics- 1
Drainage- 2
Surgery- 3

19. Chronic Osteomylitis
Def. : continuation of acute osteomylitis
:Etiology
.Previous acute osteomylitis.Long term low grade inflammatory reaction .Bone irradiated susceptible to infection-

20. .Cont
:Predisposing factors
.Anatomical location.Immunological status.Nutritional status.Patient age.Pre-existing systemic factor-

21. .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

22. .Cont
:Radiography
Chronic osteomylitis appear primarily
radiolucent lesion , that may show focal
.zones of opacification

23. .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 -

25. .Cont
:Treatment
Antibiotics, combination may be relatively- 1
.extended
.Surigical removal- 2