final year BDS

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3. CONTEN
TS
 D E F I N I T I O N
 R A D I O L U C E N T L E S I O N S O F
M A N D I B L E
1 . R A D I C U L E R C Y S T
2 . D E N T I G E R O U S C Y S T
3 . O D O N T O G E N I C
K E R AT O C Y S T
4 . R E S I D U A L C Y S T
5 . A M E L O B L A S T O M A
6 . S I M P L E B O N E C Y S T
7 . C E N T R A L G A I N T C E L L
G R A N U L O M A
 D I F F E R E N T I A L D I A G N O S I S
&
M A N A G E M E N T 3

4. Greater transparency or "trans
radiancy" to X-ray photons .
RADIOLUCENT LESIONS: Those lesions
which allow radiations to pass through
them are called radiolucent lesions.
They appear relatively darker as compared
to the appearance of more dense
materials.
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6. CONT…
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7. LESION :
o Any pathological or traumatic
discontinuity of tissues or loss of
function of a part of body .
o Cyst is a pathological cavity lined by
epithelium containing fluid or semi solid
material .
o Every cyst is a lesion but every lesion is
not supposed to present as a cyst
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8.  Radicular cyst
 Dentigeriuous
cyst
 Odontogenic
keratocyst
 Residual cyst
 Ameloblastoma
 Simple bone cyst
 Central giant cell
granuloma
 Osteomyelitis
 Bisphosphonate
osteonecrosis
 Osteoradionecro
sis
 Osteoblastoma
Metastases
etc….
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RADIOLUCENT LESIONS OF THE MANDIBLE

9. • Arise from epithelial cell rests of the
periodontal ligament.
• stimulated by the inflammatory
products.
• Mostly asymptomatic.
• seen in all age groups,
• often between 30 and 60 years of age
• typically associated with a non-vital
tooth
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10. • Unilocular periapical
lesion
• with well-defined,
sclerotic borders
• in close vicinity of
the apical portion of
the root of a non-
vital tooth.
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11. D/D:
Periapical granuloma
Central gaint cell granuloma
Periapical abcess
Trauamatic bone cyst etc
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12. apical surgery
tooth extraction
endodontic treatment.
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13. periapical cysts retained
in the jaw after surgical
removal of a non-vital
tooth.
• Similar clinical and
radiological features as
radicular cysts.
• However, there is always
a missing tooth.
• less than 1 cm in size.
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14. D/D :
Primordial cyst
Lateral periodontal cyst,
Odontogenic keratocyst.
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15. Enucleation
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16. • Also called pericoronal cyst
• Second most common odontogenic
mandibular cyst
• Seen in patients of age 20 ----- 40 yr
• Fluid accomolates b/w enamel organ and
the tooth crown resulting in cystic lesion
around crown of uneruped tooth
typically mandibular 3rd molar
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17. Adenomatoitd odontogenic tumour
Compound odontome
Odontogenic keratocyst
Ameloblastic fibroma
Calcyfying epithelial odontogenic cyst
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18. • Unilocular well-defined radiolucent
lesion (black arrows)
• surrounding an unerupted tooth.
Immediate vicinity of the mandibular
canal (red arrow) to the impacted
tooth. ...
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20. • Enucleation in smaller lesions
• Marsupialisation in larger cysts.
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21. • A cyst derived from the remnants of
dental lamina,with biological behaviour
similar to benign neoplasm
• they have a high recurrence rate after
surgery (up to 60 %).
• are often asymptomatic.
• Multiple cysts are seen in the nevoid
basal cell carcinoma syndrome (Gorlin-
Goltz syndrome), the oral-facial-digital
syndrome, the Ehlers Danlos and in the
Noonan syndrome.
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22. D/D:
Ameloblastoma
Dentigerous cyst
Aneurysmal bone cyst
Lateral periodontal cyst
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23. • Well defined
• Soliatry lesion with
smooth or scalloped
margins OR
• Multilocular polycystic
radiolucent lesions
with thin corticated
margins,
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24. o Wide (local) surgical excision
o Marsupialization - the surgical opening of
the cystic cavity and a creation of
a marsupial-like pouch, so that the cavity is
in contact with the outside for an extended
period, e.g. three months etc ..
o Curettage (simple excision & scrape-out of
cavity)
o Peripheral ostectomy after curettage and/or
enucleation.
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25. • Arising from remnants of the dental
lamina and dental organ or less
frequently from the epithelial lining of
an odontogenic cyst.
• Benign but locally invasive, slowly
growing
• Occur during the 4th–6th decade .
• C/F are non-specific and patients may
complain of unilateral painless
swelling.
• Do not have distant metastases.
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26. • four histological types:
1. unicystic,
2. multicystic,
3. extraosseous,
4. desmoplastic .
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27. • The radiological appearance
depends on the histological type
and includes unilocular or
multilocular radiolucent lesions
(“soap bubble” or “honeycomb”
appearance)
• with sclerotic borders, displaced
adjacent teeth with root resorption
• And/or extensive bone expansion
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28. Dentigerous cyst
Globulomaxillary cyst
Lateral periodontal cyst
Odontome
Ossifying fibroma
Calcifying epithelial odontogenic cyst
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29. o Radiograph showing a well-
defined, uni /multilocular
radiolucency (arrows)
o with sclerotic borders.
o bony expansion,
o destruction of the alveolar
ridge
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31. o Bone cavity is filled with serous or
haemorrhagic fluid and is characterised
by the absence of an epithelial lining.
o occurs in close proximity to a vital tooth
and is not associated with bone swelling
unless there is associated infection.
o Most lesions are asymptomatic
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32. Aneurysmal bone cyst
Central giant cell granuloma
Ameloblastoma
Ameloblastic fibroma
Central ossifying fibroma
Calcifying epitheilial odontogenic
cyst
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33. well-defined radiolucent lesion (arrows)
located in the angle of the mandible mostly.
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34. Surgical exploration of the cyst which
causes further hamorrhage in the area
and subsequent healing.
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35. o Benign but occasionally aggressive
proliferative intraosseous lesion with
fibrous tissue, haemorrhage and
haemosiderin deposits, as well as
characteristic osteoclast-like giant cells
o posterior mandible is affected more often
than the anterior mandible
o Most common clinical features are pain,
swelling, facial asymmetry and paresthesia
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36. o The typical radiological appearance
is that of a multilocular (less often
unilocular), well-defined radiolucent
lesion
o However, ill-defined lesions have
also been reported.
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38. giant cell tumour,
• radicular cyst,
• ameloblastoma,
• odontogenic tumour
• fibrous dysplasia.
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39. • Osteomyelitis
• Bisphosphonate
osteonecrosis
• Osteoradionecrosis
• Osteoblastoma
• Metastases etc….
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