Radiographic interpretation of a lesion
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This document discusses radiographic interpretation and describes how to analyze lesions seen on radiographs. It explains that radiographs along with clinical information are used to formulate a differential diagnosis. It then describes the normal radiographic anatomy seen on x-rays. The document outlines a systematic process for interpreting periapical radiographs which involves describing the size, shape, location, density, borders, internal architecture, and effect on adjacent structures of any lesions. Specific examples are provided for analyzing each of these characteristics to determine possible diagnoses.
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The document summarizes key aspects of oral mucosa development and structure. It describes that the oral mucosa lines the oral cavity and has different types (masticatory, lining, specialized) according to function. The mucosa develops from the primitive oral cavity and includes structures from branchial arches. It matures through specific stages in utero, developing characteristic features like papillae. The mucosa has stratified squamous epithelium and contains minor salivary glands. It has specialized junctions like desmosomes that maintain the epithelial barrier and allow cell renewal processes.
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MPDS, or myofascial pain disorder syndrome, is a pain disorder characterized by unilateral pain referred from trigger points in muscles of the head and neck. These trigger points are localized tender areas within taut muscle bands caused by micro- or macro-trauma to the musculoskeletal system. Accumulation of chemicals like lactic acid and prostaglandins in the muscles lowers the pain threshold, leading to MPDS symptoms like pain, limited jaw motion, and joint noises. Diagnosis involves assessing range of motion, palpating muscles for tenderness, and grading joint clicks. Treatment aims to inactivate trigger points, prevent recurrence, and correct perpetuating factors through therapies like physical modalities, anesthesia, pharmacotherapy, and occasionally
Oral Mucous Membrane
The document summarizes the oral mucosa and its components. It describes that the oral mucosa lines the oral cavity and provides protection, sensation and secretion. It is made up of epithelium, lamina propria, submucosa and periosteum/bone. The document further describes the different types of oral epithelium and the layers that make up keratinized and non-keratinized oral epithelium. It also summarizes the different types of oral mucosa including lining mucosa and masticatory mucosa, as well as the structures they line.
Diseases of bone and its oral aspects
Dr. Gaurav S. Salunkhe presented on oral and maxillofacial pathology. The document discussed the classification, development, diseases and conditions that affect bone, including the alveolar bone. Specific conditions discussed in detail include cherubism, osteogenesis imperfecta, osteopetrosis, and cleidocranial dysplasia. Cherubism is a rare hereditary condition causing bilateral jaw swelling in children that typically resolves after puberty.
Diseases of oral cavity
This document provides an overview of oral manifestations of systemic diseases categorized into infectious diseases, collagen-vascular and granulomatous disorders, and fungal infections. Key points include:
- Common viral infections that can cause oral lesions include herpes simplex, herpes zoster, infectious mononucleosis, hand foot and mouth disease, measles, and mumps. Bacterial infections like tuberculosis, syphilis and leprosy can also manifest in the oral cavity.
- Collagen-vascular disorders such as Sjogren's syndrome, systemic lupus erythematosus, sarcoidosis and Wegener's granulomatosis can present with oral signs and symptoms.
- Op
Auto immune diseases
Autoimmune diseases occur when the immune system mistakenly attacks and damages healthy body tissues. There are over 80 types of autoimmune diseases, including rheumatoid arthritis, multiple sclerosis, and systemic lupus erythematosus. The causes are not fully understood but may involve genetic and environmental factors. Common treatments aim to suppress the immune system to reduce symptoms, though diagnosis and treatment can be challenging given the wide variation in symptoms and tissues affected across different autoimmune diseases.
Odontogenic cysts
A cyst is an epithelium-lined sac containing fluid or semisolid material. In the formation of a cyst, the epithelial cells first proliferate and later undergo degeneration and liquefaction. The liquefied material exerts equal pressure on the walls of the cyst from within. Cysts grow by expansion and thus displace the adjacent teeth by pressure. May can produce expansion of the cortical bone. On a radiograph, the radiolucency of a cyst is usually bordered by a radiopaque periphery of dense sclerotic bone. The radiolucency may be unilocular or multilocular. Odontogenic cysts are those which arise from the epithelium associated with the development of teeth. The source of epithelium is from the enamel organ, the reduced enamel epithelium, the cell rests of Malassez or the remnants of the dental lamina.
Cysts of oral region (5)
The document discusses different types of cysts that can occur in the oral region, dividing them into odontogenic cysts and non-odontogenic cysts. Odontogenic cysts include radicular, dentigerous, primordial, odontogenic keratocyst, and lateral periodontal cysts. Non-odontogenic cysts include globulomaxillary, nasolabial, median palatal, and nasopalatine canal cysts. Each cyst type is described in terms of etiology, clinical features, radiographic appearance, histology, and treatment.
Diseases of bone manifested in the jaws
This document discusses several diseases and conditions that affect bone in the jaws, including fibrous dysplasia, periapical cemental dysplasia, florid osseous dysplasia, cemento-ossifying fibroma, central giant cell granuloma, aneurysmal bone cyst, cherubism, Paget's disease, and Langerhans cell histiocytosis. For each condition, the document describes clinical features, radiographic features including location, periphery, internal structure and effects on surrounding structures. Differential diagnosis and management are also discussed.
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This document defines and classifies odontogenic cysts, which are epithelium-lined sacs that arise from odontogenic epithelium. It discusses the most common types, including periapical (radicular) cysts, dentigerous cysts, odontogenic keratocysts, glandular odontogenic cysts, and calcifying odontogenic cysts. For each cyst type, it describes characteristics such as prevalence, location, radiographic appearance, histopathology, treatment involving enucleation or marsupialization, and prognosis. It also discusses the basal cell nevus syndrome that can be associated with odontogenic keratocysts.
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Radiographic interpretation of a lesion
- 2. • Radiographs are often obtained as part of a complete examination. • Appropriate radiographic interpretation is used along with clinical information and other tests to formulate a differential diagnosis.
- 4. • ENAMEL Most radiopaque structure • DENTIN Slightly lighter than enamel • PULP CAVITY Radiolucent lines within the tooth
- 5. • ALVEOLAR CREST Gingival margin of the alveolar process appear as a radiopaque line • PDL SPACE Narrow radiolucent line around tooth surface • LAMINA DURA Radiopaque line representing tooth socket
- 6. Periapical radiograph interpretation of a lesion
- 7. 7 Interpretation is an orderly process Normal variation Abnormal Developmental abnormalities Acquired abnormalities Cyst Benign neoplasia Vascular anomaly MetabolicInflammatory lesion Malignant neoplasia Bone dysplasia Trauma
- 8. Describing the Lesion • 1. Size • 2. Shape • 3. Location • 4. Density • 5. Borders • 6. Internal Architecture • 7. Effect on adjacent structures
- 9. 1. Size • Measure the lesion with a ruler. If you must estimate, use surrounding structures as your guide • Measure in two dimensions, width and height in mm or cm, as appropriate
- 10. 2. Shape • Regular Round Triangular Rhomboid, etc. • Irregular shape
- 11. 3. Location • Is the lesion localized or generalized? • Unilateral or bilateral • Where is the lesion in relation to other structures and anatomic landmarks? • Use terms such as: Mesial, Distal Inferior, Superior Posterior, Anterior
- 12. • If the epicenter of the lesion is above the mandibular canal, the likelihood is that the lesion is odontogenic in origin. • Epicentre- below mandibular canal, non odontogenic(likely) • Cartilaginous lesions are found nearer the condyles. • If the epicenter of the lesion is in the sinus, it probably is not odontogenic in origin.
- 13. 4. Density • Is the lesion Radiopaque, Radiolucent,or Mixed Density • Remember that opacity is relative to the adjacent structures. • If the lesion is of mixed density, describe the appearance
- 14. 5. Borders • Well or poorly demarcated • Punched out (muliple myeloma) • Corticated (osteomyelitis) • Sclerotic (wide, uneven opaque border) • Hyperostotic (increased density of trabeculation)
- 15. 6. Internal architecture • Is the lesion uniform? • Internal structures such as septae or loculations • Use terms such as: soap bubble ,honey comb , cotton wool, ground glass, wispy, orange peel, etc.
- 17. 31-03-2017 Free PowerPoint Template from www.brainybetty.com 17
- 18. 7. Effect on adjacent structures Is the lesion causing: • Displacement ( such as teeth, maxillary sinus, inferior alveolar canal, etc.) • Scalloping • Root resorption • Destruction • Remodelling • Expansion(any benign lesion)
- 20. • Epicentre above crown of teeth-follicular cysts-teeth apically • Lesion-ramus of mandible-cherubism-anterior direction • Widening of PDL, broken lamina dura- periapical abscess • Reactive bone-periphery of lesion-benign slow growth