The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Occlusion in prosthodontics (Revision for 5th year students)Amal Kaddah
The document discusses key concepts related to occlusion and prosthodontics. It defines important occlusion terms like centric relation, centric occlusion, maximum intercuspation, vertical dimension of occlusion, and vertical dimension of rest. It describes the stomatognathic system including muscles of mastication and temporomandibular joint anatomy. It also discusses factors that affect balanced occlusion and the importance of recording occlusion for removable prosthodontics.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
benign tumors of oral cavity including epithelial, connective tissue. muscle tissue and nerve tissue tumors.. hemangiomas included.. beautiful high def histopathological pictures included
Biomechanics in orthodontics / /certified fixed orthodontic courses by Indian...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
“Perio-Implant Synergy”- Two lectures on “Lost Buccal Plate- Complications and Management” and “Failing to Plan is Planning to Fail”. Organized by the Society of Periodontists and Implantologists of Kerala” at PMS Dental College, Trivandrum, India on 17/9/2018.
This document discusses cancer metastasis, specifically metastasis to the jaw. It begins by defining cancer metastasis as the process where tumor cells invade nearby tissues and spread via the lymphatic system or bloodstream to form tumors in other parts of the body. The jaw is a relatively rare site of metastasis, accounting for around 1-1.5% of oral malignant tumors. The most common primary sites that metastasize to the jaw are the lungs, breast, kidneys, and bone. Metastasis to the jaw usually presents with pain, difficulty chewing, swelling, and pathological fractures. Radiographs may show osteolytic or osteoblastic lesions depending on the primary tumor type. Histopathological examination is needed for definitive diagnosis of metastatic
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Cases in Prosthodontics - Wiley-Blackwell; 1 edition (October 26, 2010).pdfNguyenThiHanh16
This document provides biographical information about the authors of the book "Clinical Cases in Prosthodontics". It lists Leila Jahangiri, Marjan Moghadam, Mijin Choi, and Michael Ferguson as authors and clinical professors in the Department of Prosthodontics at New York University College of Dentistry. It also acknowledges their contributions in developing this collection of clinical cases focused on prosthodontic treatment planning and decision making.
Occlusion in prosthodontics (Revision for 5th year students)Amal Kaddah
The document discusses key concepts related to occlusion and prosthodontics. It defines important occlusion terms like centric relation, centric occlusion, maximum intercuspation, vertical dimension of occlusion, and vertical dimension of rest. It describes the stomatognathic system including muscles of mastication and temporomandibular joint anatomy. It also discusses factors that affect balanced occlusion and the importance of recording occlusion for removable prosthodontics.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
benign tumors of oral cavity including epithelial, connective tissue. muscle tissue and nerve tissue tumors.. hemangiomas included.. beautiful high def histopathological pictures included
Biomechanics in orthodontics / /certified fixed orthodontic courses by Indian...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
“Perio-Implant Synergy”- Two lectures on “Lost Buccal Plate- Complications and Management” and “Failing to Plan is Planning to Fail”. Organized by the Society of Periodontists and Implantologists of Kerala” at PMS Dental College, Trivandrum, India on 17/9/2018.
This document discusses cancer metastasis, specifically metastasis to the jaw. It begins by defining cancer metastasis as the process where tumor cells invade nearby tissues and spread via the lymphatic system or bloodstream to form tumors in other parts of the body. The jaw is a relatively rare site of metastasis, accounting for around 1-1.5% of oral malignant tumors. The most common primary sites that metastasize to the jaw are the lungs, breast, kidneys, and bone. Metastasis to the jaw usually presents with pain, difficulty chewing, swelling, and pathological fractures. Radiographs may show osteolytic or osteoblastic lesions depending on the primary tumor type. Histopathological examination is needed for definitive diagnosis of metastatic
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Cases in Prosthodontics - Wiley-Blackwell; 1 edition (October 26, 2010).pdfNguyenThiHanh16
This document provides biographical information about the authors of the book "Clinical Cases in Prosthodontics". It lists Leila Jahangiri, Marjan Moghadam, Mijin Choi, and Michael Ferguson as authors and clinical professors in the Department of Prosthodontics at New York University College of Dentistry. It also acknowledges their contributions in developing this collection of clinical cases focused on prosthodontic treatment planning and decision making.
In prosthodontics, replacing the missing, without affecting the other components of the masticatory system has two main reference the maximum intercupation and the centric relation.
In this lecture discussion of centric relation as reference is exposed.
Prenatal and postnatal development of mandible /certified fixed orthodontic c...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This document discusses various methods of mixed dentition analysis used to predict the size and space needed for unerupted permanent teeth based on measurements of erupted primary and permanent teeth. It describes Nance analysis, Huckaba's method, Moyer's analysis, Tanaka Johnston analysis, Hixon-Oldfather prediction method, and Staley and Kerber method. The document emphasizes that mixed dentition analysis helps evaluate space availability and plan treatment during the transition from primary to permanent dentition.
This document discusses different types of anchorage in orthodontics. Anchorage is defined as the resistance to tooth movement provided by anatomical units. There are different classifications of anchorage based on the manner of force application, location, and number of teeth providing resistance. Intra-oral sources include teeth and bone, while extra-oral includes occipital bone and muscles. Anchorage requirements depend on factors like number of teeth moving, type of movement, treatment duration, and occlusal interlock. Anchorage loss can be prevented by reinforcing the anchorage unit, subdividing tooth movement, using tipping movements, controlling forces, and using temporary skeletal anchorage.
This document discusses the management of craniofacial syndromes and developmental anomalies. It begins by defining syndromes and anomalies, and describes how Ibn Sina pioneered the idea of classifying syndromes. It then discusses various craniofacial development stages and factors that can affect them, including teratogens, radiation, genes, and more. Finally, it outlines different syndromes and anomalies that occur at each development stage, and how orthodontists are involved in managing craniofacial disorders through diagnostic considerations, various treatment approaches, and understanding surgical correction methods.
The document discusses making impressions for removable partial dentures. It defines an impression as a negative likeness made of elastic material. An accurate impression is vital for removable partial denture success. Materials used include reversible and irreversible hydrocolloids and elastomers. Steps include tray selection, mixing, loading the tray, making the impression, and inspecting. Types of impressions include diagnostic, one-stage, and two-stage techniques. Control of problems like gagging is also covered.
This document describes a study on the socket shield technique for tooth replacement with dental implants. The socket shield technique involves retaining part of the facial root when extracting a tooth and immediately placing a dental implant. The study examined 15 patients treated with this technique between 2011-2018. Volumetric analysis using CT scans found that the socket shield technique helped maintain hard and soft tissue volumes compared to traditional immediate implant placement. The technique is described as an effective way to preserve alveolar bone and provide esthetic outcomes for dental implant treatment.
Orthognathic treatment for skeletal class iii malocclusion nehal fouad copynehal albelasy
Orthognathic surgery involves combined orthodontic and surgical treatment for dentofacial deformities. It can correct skeletal imbalances and improve facial aesthetics. Careful planning is required between the orthodontist and surgeon to move the teeth into optimal positions before surgery and refine the bite afterwards. The document discusses patient evaluation, treatment planning, the roles of orthodontics and surgery, and ensuring stability after treatment.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
1) The document discusses different types of occlusion including mutually protected occlusion, group function occlusion, balanced occlusion, and occlusion for complete dentures, removable partial dentures, fixed partial dentures, and osseointegrated prostheses.
2) It describes the desirable characteristics of occlusion for each type of prosthesis, such as bilateral simultaneous contacts, anterior guidance, disclusion of posterior teeth on protrusion, and distribution of forces.
3) The key advantages of different occlusal schemes like mutually protected occlusion and group function occlusion are minimizing tooth contacts and distributing lateral pressures.
Muscle deprogramming /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The document discusses guidelines for selecting artificial teeth, including anterior and posterior teeth. It covers factors like tooth size, shape, color, material selection, and occlusion schemes. The goal is to select teeth that allow proper function, speech, and aesthetics while protecting natural tissues. Anterior tooth selection considers size, shape, color, and material. Posterior teeth are chosen based on color, size, cuspal morphology, and material to aid mastication and denture stability.
10 post insertion problems and complaints.Amal Kaddah
The document discusses common post-insertion problems with dentures including pain, poor fit, looseness, speech difficulties, and inability to eat. Potential causes are outlined such as overextension of borders, improper occlusion, cuspal interference, unstable dentures, and flat teeth. Treatment options provided include relining dentures, adjusting occlusion, constructing new dentures, and altering vertical dimension.
This document discusses occlusion in complete dentures. It begins by defining occlusion and describing different types of natural tooth occlusion compared to complete denture occlusion. Key differences are that incising with front teeth can dislodge dentures, interferences cannot be avoided due to lack of proprioception, and malocclusion causes immediate damage in dentures. The document then outlines requirements for complete denture occlusion including stability, minimal contacts, and directing forces vertically. It describes balanced, monoplane, and lingualized occlusal schemes for dentures and factors that affect achieving balanced occlusion such as condylar guidance, incisal guidance, and compensating curves. Monoplane occlusion lacks cusps for only vertical forces while lingualized
The content covers majority of the aspect of immediate implant placement - why immediate implants?, case selection, decision making, classifications, surgical technique, healing following immediate implant placement, immediate implants in infected sockets/periapical infections, literature reviews and recommendations for clinical practice.
This document discusses implant biomechanics and osseointegration. It notes that osseointegration occurs when an implant bonds to living bone, providing long term stability. Biomechanics involves the interaction between forces and tissues in the body. Key factors for implants include force magnitude and direction, as well as moment arms related to implant location and design. Proper implant selection, placement, and occlusion are important to minimize these forces and moments to prevent implant failure.
Four-handed dentistry involves the dental assistant assisting the dentist by handling instruments and equipment to reduce strain on the dentist and increase efficiency. It is based on principles like minimizing unnecessary motions, positioning equipment ergonomically, and having the assistant and dentist work closely together in designated zones. Following concepts such as four-handed dentistry can help reduce strain, improve productivity, and make the dental team more comfortable.
1. There are several methods for predicting outcomes of orthognathic surgery, including manual tracings, computer programs, and 3D modeling.
2. Accuracy of prediction varies depending on the method and software used, with 3D modeling generally providing the most accurate predictions but manual methods still common.
3. Studies have found most software to be reasonably accurate for hard tissue predictions but with more variability for soft tissues like lips and less ability to account for individual patient differences.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Soft tissue calcifications and ossifications / oral surgery courses Indian dental academy
This document discusses various types of soft tissue calcification and ossification that can occur in the oral cavity. It describes two main types of pathologic calcification: dystrophic calcification, which occurs in dead or degenerated tissues with normal calcium metabolism, and metastatic calcification, which occurs in normal tissues associated with abnormal calcium metabolism. Specific examples of soft tissue calcifications discussed in detail include calcified lymph nodes, tonsilloliths, cysticercosis lesions, arterial calcification, sialoliths, and phleboliths. The document also covers heterotopic ossification and provides examples such as osteoma cutis and myositis ossificans.
Pathologic calcification occurs when calcium salts abnormally deposit in tissues. There are two types: dystrophic calcification occurs in dead or dying tissues with normal calcium levels, while metastatic calcification deposits calcium in healthy tissues due to problems that cause high blood calcium levels. Dystrophic calcification is seen in areas of tissue damage like atherosclerosis or valve stenosis. Metastatic calcification's main causes include parathyroid hormone increases, bone destruction, vitamin D disorders, and kidney failure, and it notably affects lungs, kidneys, and blood vessels. Both types appear as basophilic calcium deposits that can impact organ function.
In prosthodontics, replacing the missing, without affecting the other components of the masticatory system has two main reference the maximum intercupation and the centric relation.
In this lecture discussion of centric relation as reference is exposed.
Prenatal and postnatal development of mandible /certified fixed orthodontic c...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This document discusses various methods of mixed dentition analysis used to predict the size and space needed for unerupted permanent teeth based on measurements of erupted primary and permanent teeth. It describes Nance analysis, Huckaba's method, Moyer's analysis, Tanaka Johnston analysis, Hixon-Oldfather prediction method, and Staley and Kerber method. The document emphasizes that mixed dentition analysis helps evaluate space availability and plan treatment during the transition from primary to permanent dentition.
This document discusses different types of anchorage in orthodontics. Anchorage is defined as the resistance to tooth movement provided by anatomical units. There are different classifications of anchorage based on the manner of force application, location, and number of teeth providing resistance. Intra-oral sources include teeth and bone, while extra-oral includes occipital bone and muscles. Anchorage requirements depend on factors like number of teeth moving, type of movement, treatment duration, and occlusal interlock. Anchorage loss can be prevented by reinforcing the anchorage unit, subdividing tooth movement, using tipping movements, controlling forces, and using temporary skeletal anchorage.
This document discusses the management of craniofacial syndromes and developmental anomalies. It begins by defining syndromes and anomalies, and describes how Ibn Sina pioneered the idea of classifying syndromes. It then discusses various craniofacial development stages and factors that can affect them, including teratogens, radiation, genes, and more. Finally, it outlines different syndromes and anomalies that occur at each development stage, and how orthodontists are involved in managing craniofacial disorders through diagnostic considerations, various treatment approaches, and understanding surgical correction methods.
The document discusses making impressions for removable partial dentures. It defines an impression as a negative likeness made of elastic material. An accurate impression is vital for removable partial denture success. Materials used include reversible and irreversible hydrocolloids and elastomers. Steps include tray selection, mixing, loading the tray, making the impression, and inspecting. Types of impressions include diagnostic, one-stage, and two-stage techniques. Control of problems like gagging is also covered.
This document describes a study on the socket shield technique for tooth replacement with dental implants. The socket shield technique involves retaining part of the facial root when extracting a tooth and immediately placing a dental implant. The study examined 15 patients treated with this technique between 2011-2018. Volumetric analysis using CT scans found that the socket shield technique helped maintain hard and soft tissue volumes compared to traditional immediate implant placement. The technique is described as an effective way to preserve alveolar bone and provide esthetic outcomes for dental implant treatment.
Orthognathic treatment for skeletal class iii malocclusion nehal fouad copynehal albelasy
Orthognathic surgery involves combined orthodontic and surgical treatment for dentofacial deformities. It can correct skeletal imbalances and improve facial aesthetics. Careful planning is required between the orthodontist and surgeon to move the teeth into optimal positions before surgery and refine the bite afterwards. The document discusses patient evaluation, treatment planning, the roles of orthodontics and surgery, and ensuring stability after treatment.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
1) The document discusses different types of occlusion including mutually protected occlusion, group function occlusion, balanced occlusion, and occlusion for complete dentures, removable partial dentures, fixed partial dentures, and osseointegrated prostheses.
2) It describes the desirable characteristics of occlusion for each type of prosthesis, such as bilateral simultaneous contacts, anterior guidance, disclusion of posterior teeth on protrusion, and distribution of forces.
3) The key advantages of different occlusal schemes like mutually protected occlusion and group function occlusion are minimizing tooth contacts and distributing lateral pressures.
Muscle deprogramming /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The document discusses guidelines for selecting artificial teeth, including anterior and posterior teeth. It covers factors like tooth size, shape, color, material selection, and occlusion schemes. The goal is to select teeth that allow proper function, speech, and aesthetics while protecting natural tissues. Anterior tooth selection considers size, shape, color, and material. Posterior teeth are chosen based on color, size, cuspal morphology, and material to aid mastication and denture stability.
10 post insertion problems and complaints.Amal Kaddah
The document discusses common post-insertion problems with dentures including pain, poor fit, looseness, speech difficulties, and inability to eat. Potential causes are outlined such as overextension of borders, improper occlusion, cuspal interference, unstable dentures, and flat teeth. Treatment options provided include relining dentures, adjusting occlusion, constructing new dentures, and altering vertical dimension.
This document discusses occlusion in complete dentures. It begins by defining occlusion and describing different types of natural tooth occlusion compared to complete denture occlusion. Key differences are that incising with front teeth can dislodge dentures, interferences cannot be avoided due to lack of proprioception, and malocclusion causes immediate damage in dentures. The document then outlines requirements for complete denture occlusion including stability, minimal contacts, and directing forces vertically. It describes balanced, monoplane, and lingualized occlusal schemes for dentures and factors that affect achieving balanced occlusion such as condylar guidance, incisal guidance, and compensating curves. Monoplane occlusion lacks cusps for only vertical forces while lingualized
The content covers majority of the aspect of immediate implant placement - why immediate implants?, case selection, decision making, classifications, surgical technique, healing following immediate implant placement, immediate implants in infected sockets/periapical infections, literature reviews and recommendations for clinical practice.
This document discusses implant biomechanics and osseointegration. It notes that osseointegration occurs when an implant bonds to living bone, providing long term stability. Biomechanics involves the interaction between forces and tissues in the body. Key factors for implants include force magnitude and direction, as well as moment arms related to implant location and design. Proper implant selection, placement, and occlusion are important to minimize these forces and moments to prevent implant failure.
Four-handed dentistry involves the dental assistant assisting the dentist by handling instruments and equipment to reduce strain on the dentist and increase efficiency. It is based on principles like minimizing unnecessary motions, positioning equipment ergonomically, and having the assistant and dentist work closely together in designated zones. Following concepts such as four-handed dentistry can help reduce strain, improve productivity, and make the dental team more comfortable.
1. There are several methods for predicting outcomes of orthognathic surgery, including manual tracings, computer programs, and 3D modeling.
2. Accuracy of prediction varies depending on the method and software used, with 3D modeling generally providing the most accurate predictions but manual methods still common.
3. Studies have found most software to be reasonably accurate for hard tissue predictions but with more variability for soft tissues like lips and less ability to account for individual patient differences.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Soft tissue calcifications and ossifications / oral surgery courses Indian dental academy
This document discusses various types of soft tissue calcification and ossification that can occur in the oral cavity. It describes two main types of pathologic calcification: dystrophic calcification, which occurs in dead or degenerated tissues with normal calcium metabolism, and metastatic calcification, which occurs in normal tissues associated with abnormal calcium metabolism. Specific examples of soft tissue calcifications discussed in detail include calcified lymph nodes, tonsilloliths, cysticercosis lesions, arterial calcification, sialoliths, and phleboliths. The document also covers heterotopic ossification and provides examples such as osteoma cutis and myositis ossificans.
Pathologic calcification occurs when calcium salts abnormally deposit in tissues. There are two types: dystrophic calcification occurs in dead or dying tissues with normal calcium levels, while metastatic calcification deposits calcium in healthy tissues due to problems that cause high blood calcium levels. Dystrophic calcification is seen in areas of tissue damage like atherosclerosis or valve stenosis. Metastatic calcification's main causes include parathyroid hormone increases, bone destruction, vitamin D disorders, and kidney failure, and it notably affects lungs, kidneys, and blood vessels. Both types appear as basophilic calcium deposits that can impact organ function.
Fibro-osseous lesions (FOLs) are characterized by replacement of normal bone by collagenous fibrous connective tissue mixed with mineralized material. They include developmental, reactive, dysplastic, and neoplastic conditions. Fibrous dysplasia is a common FOL that results from a genetic mutation affecting bone formation. It can be monostotic (single bone) or polyostotic (multiple bones). Radiographically, fibrous dysplasia appears as a "ground-glass" or "orange peel" pattern with indistinct borders. Differential diagnosis includes cemento-ossifying fibroma and chronic osteomyelitis.
This document provides information about heterotrophic calcification and ossification. It discusses dystrophic, idiopathic, and metastatic types of calcification, as well as heterotopic ossification. Specific examples of dystrophic calcification are also described, including pulp stones, calcified lymph nodes, tonsilloliths, and cysticercosis. Monckeberg's medial calcinosis, an example of arterial calcification, is also summarized. Clinical features, imaging characteristics, and management are discussed for each condition.
The document discusses imaging features of malignant bone tumors. It notes that plain radiographs are important for initial diagnosis and can show features like patterns of bone destruction, mineralization, and periosteal reactions that help differentiate benign from malignant lesions. Osteosarcoma is discussed in detail, with its common locations in long bones of adolescents and association with sunburst periosteal reactions and soft tissue masses. Telangiectatic and secondary osteosarcomas are also summarized.
This document describes different types of calcification that can occur in soft tissues and arteries. It discusses metastatic calcification caused by abnormal calcium metabolism, dystrophic calcification related to tissue damage, and calcinosis which occurs with normal calcium metabolism. Specific types of soft tissue calcification are described associated with parasites, hematomas, necrosis, metabolic disorders, and various conditions like dermatomyositis. Calcification patterns in arteries, veins, tendons and various structures are also outlined. Different types of ossification including myositis ossificans, post-traumatic myositis ossificans, and paraplegic myositis ossificans are summarized.
Intracranial Calcification in Cone Beam CT & Medical CTJudy Oh, D.D.S.
This document discusses intracranial calcifications seen on cone beam CT and medical CT scans. It begins by comparing CBCT and medical CT, noting CBCT has lower radiation dose. It then reviews common sites of physiological intracranial calcification including pineal gland, choroid plexus, habenular commissure, and dura. Pathological causes of calcification are also discussed, such as infections from TORCH agents, sarcoidosis, neurofibromatosis, and Fahr disease. The document provides images to illustrate various anatomical structures and calcification patterns.
1. The document discusses various types of soft tissue calcification that can be seen in the neck on CBCT imaging, including calcification of the carotid artery, stylohyoid ligament, triticeous cartilage, tonsils, thyroid cartilage, salivary glands, lymph nodes, and veins.
2. It provides the locations, appearances, and frequencies of each type of calcification based on reviews of 380 CBCT scans. Common sites include the stylohyoid ligament, triticeous cartilage, and tonsils.
3. The causes of soft tissue calcification include dystrophic calcification from chronic inflammation or injury, idiopathic calcification, and metastatic calcification from high
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.
Benign tumors of the jaw were discussed. Key points include:
- Benign tumors are slow-growing, do not metastasize or invade surrounding tissues, and have well-defined borders on radiographs.
- Common benign jaw tumors discussed include ameloblastoma, calcifying epithelial odontogenic tumor (Pindborg tumor), odontoma, and ameloblastic fibroma.
- Radiographic features help differentiate benign tumors and include location, well-defined or corticated borders, internal structure patterns like septa, and effects on surrounding structures like tooth displacement.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
This document discusses chondrosarcoma, a type of bone cancer. It is a malignant tumor originating from cartilage that makes up 9% of primary bone cancers. The document covers the classification, most common sites in the body, clinical features, diagnosis using imaging like CT and MRI, histological examination, treatment including wide resection or amputation, and prognosis which depends on grade and size of the tumor. Chondrosarcoma can be primary, arising directly in bone, or secondary from pre-existing benign cartilage lesions. Low-grade lesions have over 90% 10-year survival while high-grade have 20-40% 10-year survival.
Bone tumors can be benign or malignant, arising from different cell types. The most common benign tumors are osteochondroma and fibrous cortical defect. Osteosarcoma is the most frequent malignant tumor. Bone tumors present with pain, swelling or fracture. Diagnosis involves clinical history, imaging and histopathology. Many factors influence tumor type, location, progression and treatment approach. The document provides detailed information on characteristics, classification and features of various bone tumors.
This document summarizes various cartilage forming tumors including:
1. Chondrosarcoma, which is the third most common malignant bone tumor arising in adults. The main subtypes are conventional, dedifferentiated, clear cell, and mesenchymal chondrosarcoma.
2. Osteochondroma, which is a benign cartilage-capped outgrowth most commonly affecting adolescents and young adults.
3. Chondroma, which is a benign tumor composed of hyaline cartilage that can occur intraosseously as enchondromas or juxtacortically.
4. Other rare tumors discussed include chondroblastoma and chondromyxoid fibroma.
This document discusses imaging patterns of cystic bone tumors. Plain radiography is usually the initial imaging modality used. CT and MRI help further characterize lesions by assessing extraosseous extension, tumor relationships and content. Eosinophilic granuloma commonly appears lytic under 30 years of age. Enchondromas typically contain punctate calcification except in the hands/feet. Fibrous dysplasia has a ground glass appearance with no periostitis or pain unless fractured. Differential diagnoses are considered based on location, margins, expansion and other characteristics.
The document discusses osteosarcoma, the most common primary malignant bone tumor. It begins by classifying bone tumors and their histological types. Osteosarcoma is characterized by malignant mesenchymal cells producing osteoid. Risk factors include rapid bone growth, genetics, radiation exposure, and pre-existing bone conditions. Symptoms include pain and swelling. Diagnosis involves imaging like X-ray, CT, MRI and biopsy. Prognosis depends on factors like tumor grade, size, and presence of metastases. Treatment involves preoperative chemotherapy followed by surgery and additional chemotherapy.
this ppt is about malignant tumours of connective tissue origin. classifications, clinical features, radiological features and histological features of all tumors are discussed with pictures.
This document discusses bone tumors, including:
- Types of bone tumors include benign (e.g. osteochondroma) and malignant (e.g. osteosarcoma, chondrosarcoma).
- Risk factors, signs/symptoms, diagnostic tests (e.g. x-rays, biopsy), TNM classification, and management approaches are described.
- Management may involve chemotherapy, radiation therapy, surgery, and targeted therapy depending on the type and stage of bone tumor. The goal is to remove the tumor while minimizing damage to healthy tissue.
This document discusses different types of bone tumors including giant cell tumors, bone cysts, and osteosarcoma. Giant cell tumors are benign but aggressive tumors that typically occur in the long bones of young adults. Bone cysts include unicameral bone cysts, which appear as fluid-filled lesions in children, and aneurysmal bone cysts, which are more expansive lesions. Osteosarcoma is the second most common primary malignant bone tumor that produces new bone and commonly affects the distal femur or proximal tibia in teenagers and young adults.
Odontogenic tumors / dental implant courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Presentation on bone tumors for undergraduate 2nd year MBBS medical students. The information for this presentation has been taken from texbook of Robbins & Cotran Pathologic Basis of Disease 8th ed.
1. Congenital neck masses are abnormal growths present from birth between the clavicles and mandible. The most common congenital neck mass is a thyroglossal cyst, which forms from a persistent thyroglossal duct during development.
2. Other congenital neck masses include branchial cysts, dermoid cysts, cystic hygromas, hamartomas, and teratomas.
3. Evaluation of congenital neck masses involves inspection, imaging like ultrasound or CT to determine if the mass is solid or cystic in nature, and biopsy if needed to arrive at a definitive diagnosis. Surgical excision is usually the treatment for congenital neck masses.
- Bone tumors range from benign to malignant and require accurate diagnosis and treatment.
- The most common benign bone tumors are osteochondroma and fibrous cortical defect. The most common malignant bone tumor is osteosarcoma.
- Diagnosis of bone tumors requires integrating clinical history, radiographic appearance, and histopathology. Location and imaging studies also provide important diagnostic information.
- Many bone tumors are classified based on the normal cell/tissue type they arise from, such as bone-forming tumors (e.g. osteosarcoma), cartilage-forming tumors (e.g. chondrosarcoma), and others.
The document discusses various giant cell lesions of bone, including their pathogenesis, classification, clinical features, radiological appearance, histopathological characteristics, differential diagnosis, and key distinguishing features. Reactive and benign giant cell lesions are covered such as giant cell tumor, aneurysmal bone cyst, giant cell reparative granuloma, brown tumor, and chondroblastoma. Differential diagnoses and distinguishing characteristics of different lesions are also provided.
This document discusses bone tumors, including:
- Risk factors include genetic syndromes, radiation exposure, and injuries.
- Types include benign (osteochondroma, bone cysts) and malignant (osteosarcoma, chondrosarcoma, Ewing's sarcoma) tumors.
- Diagnosis involves imaging (X-rays, CT, MRI), biopsy, and TNM staging.
- Treatment depends on tumor type but may include chemotherapy, radiation therapy, surgery, and targeted therapy.
This document discusses bone tumors, including:
- Bone tumors can be benign or malignant and develop from uncontrolled cell division in bones. Common types include osteosarcoma, chondrosarcoma, and Ewing's sarcoma.
- Risk factors include genetic disorders, radiation exposure, and other cancers. Symptoms include bone pain, swelling, limited mobility, and pathological fractures.
- Diagnosis involves imaging like X-rays, CT, MRI and PET scans. Biopsies are also used to identify the tumor type and stage. Staging uses the TNM classification system to assess tumor size, spread to lymph nodes and distant organs.
Osteosarcoma is a malignant bone tumor that arises from primitive bone-forming cells. It most commonly occurs in adolescents and young adults. The most frequent sites are the distal femur, proximal tibia, and proximal humerus. Treatment involves preoperative chemotherapy, surgical resection with wide margins, and postoperative chemotherapy. Prognosis depends on the stage, with 5-year survival rates of 60-80% for localized tumors and 15-30% for those that have metastasized.
benign and malignant tumors of connective tissue originmadhusudhan reddy
This document discusses various connective tissue tumors that can occur in the oral cavity. It describes benign fibrous lesions like fibroma and giant cell fibroma. It also discusses benign adipose tissue lesions like lipoma. Various benign vascular lesions are described, including hemangiomas and lymphangiomas. Finally, it summarizes benign bone tissue tumors like osteoma and osteoid osteoma. For each lesion, the clinical features, histopathology, radiographic appearance, and treatment are summarized.
Similar to Sarcomas clinical and radiographic features /prosthodontic courses (20)
Opportunity for Dentists (BDS/MDS )to relocate to United kingdom -Register as a DENTAL HYGIENIST/ DENTAL THERAPIST without Board exams and after approval you can register in GDC as a DH/DT and start working as a DH/DT Immediately and get paid.
You can complete the whole process in 3-4 months.Salary range for DH/DT is around 2500-3500 Pounds per month.
Eligibility / requirements-
1. An International English Language Testing System (IELTS) certificate
at the appropriate level.(Within 2 yrs of application date )
2: A recent primary dental qualification that has been taught and examined in English..(Within 2 yrs of application date )
3: A recent pass in a language test for registration with a regulatory authority in a country where the first language is English.
If you are interested Please contact us for more details.
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals
who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry,
Periodontics and General Dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
I –Aligners are made with FDA approved transparent thermoplastic materials using 3D scanning, 3D Printing and finally Trays with Pressure vacuum formers.
Dear Doctor,
Indian Dental Academy Now offers comprehensive online Orthodontics course.
Course includes:
1.whiteboard lecture presentations
2.Case Discussions
3.with hundreds of pictures.
4.Demo on Models
5.Demo on Patients
6. subtitles in your own language
12 months unlimited access and support @350 USD only.
For Demo please visit :www.idalectures.com/preview/
For more details visit: www.idalectures.com
Please contact us for any clarifications:
idalectures@gmail.com
indiandentalacademy@gmail.com
Thanks & Regards
Indian Dental Academy
--
Indian Dental Academy
Leader in continuing dental education
www.indiandentalacademy.com
skype:indiandentalacademy
+919248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Diagnosis and treatment planning in completely endntulous arches/dental coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Properties of Denture base materials /rotary endodontic coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Use of modified tooth forms in complete denture occlusion / dental implant...Indian dental academy
This document discusses dental occlusion concepts and philosophies for complete dentures. It introduces key terms like physiologic occlusion and defines different occlusion schemes like balanced articulation and monoplane articulation. The document discusses advantages and disadvantages of using anatomic versus non-anatomic teeth for complete dentures. It also outlines requirements for maintaining denture stability, such as balanced occlusal contacts and control of horizontal forces. The goal of occlusion for complete dentures is to re-establish the homeostasis of the masticatory system disrupted by edentulism.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document discusses dental casting investment materials. It describes the three main types of investments - gypsum bonded, phosphate bonded, and ethyl silicate bonded investments. For gypsum bonded investments specifically, it details their classification, composition including the roles of gypsum, silica, and modifiers, setting time, normal and hygroscopic setting expansion, and thermal expansion. It provides information on how the properties of gypsum bonded investments are affected by their composition. The document serves as a comprehensive overview of dental casting investment materials.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
-------------------------------------------------------------------------------
Find out more about ISO training and certification services
Training: ISO/IEC 27001 Information Security Management System - EN | PECB
ISO/IEC 42001 Artificial Intelligence Management System - EN | PECB
General Data Protection Regulation (GDPR) - Training Courses - EN | PECB
Webinars: https://pecb.com/webinars
Article: https://pecb.com/article
-------------------------------------------------------------------------------
For more information about PECB:
Website: https://pecb.com/
LinkedIn: https://www.linkedin.com/company/pecb/
Facebook: https://www.facebook.com/PECBInternational/
Slideshare: http://www.slideshare.net/PECBCERTIFICATION
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
2. HISTORY
• cancer is found among fossilized bone tumors,
human mummies in ancient Egypt, and ancient
manuscripts.
• Growths suggestive of the bone cancer called
osteosarcoma have been seen in mummies.
• Oldest description of cancer dates back to about
3000 BC in egyptian Papyrus. writing says about the
• disease, “There is no treatment.”
www.indiandentalacademy.com
3. • Origin of the word cancer is credited to the Greek
physician Hippocrates (460-370 BC), “Father of Medicine.”
• He used the terms carcinos - non-ulcer forming
• carcinoma - ulcer-forming tumors.( refers to crab in greek)
• Roman physician, Celsus (28-50 BC), later translated the
Greek term into cancer, the Latin word for crab
• Galen (130-200 AD), Roman physician, used the word
oncos (Greek for swelling) to describe tumors
www.indiandentalacademy.com
4. • Hyperplasias may produce tissue masses
referred to as tumors
• Neoplasm or tumor is “ a mass of tissue
formed as a result of abnormal, excessive,
uncoordinated, autonomous, purposeless
proliferation of cells”.
www.indiandentalacademy.com
6. BENIGN NEOPLASMS
• Dysmorphic proliferations of tissues
• They have the capacity for continuous autonomous
growth.
• They donot elaborate the enzymes and growth
factors necessary for metastasis
www.indiandentalacademy.com
7. Hamaratoma
• Dysmorphic proliferation of tissue that is native to
the area
• It does not have the capacity for continuous growth
but merely parallels that of the host
• They cease grow at some point in their course and
they do not infiltrate into surrounding tissues.
• E.g: hemangioma , pigmented nevi, odontoma,
ameloblastic fibro odontoma.
www.indiandentalacademy.com
8. Choriostoma
• Dysmorphic proliferations of tissue that are not
native to the site. They have a limited proliferation.
• Heterotopic GI cyst, may be found in the tongue or
floor of the mouth contains GI glandular structures;
• Bone or cartilage in the tongue
• Development of thyroid tissue in the posterior
tongue
• Ectopic sebaceous glands known as Fordyce
granules
• salivary gland tissue within lymph nodeswww.indiandentalacademy.com
9. TERATOMA
• Neoplasias that arise from multiple germ layers
• Produce tissues that are foreign to the part in which
they develop.
• They are distinct from other neoplasias that may also
show tissue diversity
www.indiandentalacademy.com
10. • Carcinoma: malignant tumors of epithelial origin
• Sarcoma: (sarcos- fleshy)
Malignant tumors of mesenchymal origin.
www.indiandentalacademy.com
11. Grading of sarcomas
• FNCLCC( FEDERATION NATIONAL DE CENTRES
DE LUTTE CONTRE LE CANCER)
• Based on tumor differentiation
• Mitosis count
• Tumor necrosis
www.indiandentalacademy.com
12. TUMOR DIFFERENTION
• Score 1 : sa closely resembling normal adult
mesenchymal tisssue ( well differentiated)
• Score 2 : sa for which hp typing is certain
• Score 3 : embryonal & undifferentiated
www.indiandentalacademy.com
14. HISTOLOGIC GRADE
• Grade 1 : total score 2/3
• Grade 2 : total score 4/5
• Grade 3 : total score 6/7/8
www.indiandentalacademy.com
15. American Joint Committee on Cancer (AJCC) and
International Union Against Cancer (UICC) staging
system for soft tissue sarcomas
• Primary tumor
• Tx - Primary tumor cannot be assessed
• T0 - No evidence of primary tumor
• T1 - Tumor less than 5 cm in greatest dimension
(T1a, superficial; T1b, deep)
• T2 - Tumor greater than 5 cm in greatest
dimension (T2a, superficial; T2b, deep)
www.indiandentalacademy.com
26. MISCELLANEOUS:
• SYNOVIAL SARCOMA
• ALVEOLAR SOFT PART SARCOMA
• EPITHELOID SARCOMA
• DESMOPLASTIC SMALL ROUND CELL TUMOR
• MALIGNANT EXTRA RENAL RHABDOID TUMOR
www.indiandentalacademy.com
27. FIBROSARCOMA
• Malignant tumor of fibroblasts
• Most common soft tissue sarcoma
• Most common in extremities
• Only 10% occurs in h & n. m > f
• May arise from pre-exisisting lesions such as fibrous
dysplasia, chronic osteomyelitis, bone infarcts,
pagets disease.
www.indiandentalacademy.com
28. • Occur anywhere in h & n, & at any age
• Most common in children, young adults
• Can also occur in bone as primary or secondary forms
• Primary occurs centrally within medullary canal,
peripheral arise from periosteum.
• Produce variable amount of collagen
• Secondary arise from pre-exsisting lesion or after
radiotherapy to bone or soft tissue
• More aggressive tumor with poorer prognosis
www.indiandentalacademy.com
29. • Painless fibrous, fleshy masses that are destructive
of bone
• Peripheral lesions may invade local soft tissues
causing bulky clinically obvious lesion
• If involve course of nerve…neural abnormalities
• Involvement of tmj causes trismus
• Cause mobility of teeth if they are located in alveolar
bone
www.indiandentalacademy.com
30. • Hp: well differntiated fibrosarcomas consists of
spindle cels that classically form a “herring bone
pattern”
• Poorly differentiated tumors, cells are less organised
& may appear rounder/ovoid
• Produce less collagen when compared to well
differentiated.
www.indiandentalacademy.com
31. PARALLEL SHEETS OF CELLS ARRANGED IN
INTERTWINING WHORLS
Herring bone pattern
www.indiandentalacademy.com
32. • Radiology:
• Mostly in mandible
• Premolar-molar area is common
• Poorly demarcated, non corticated
• If soft tissue lesions occur adjacent to bone
they may cause saucer like depression similar
to scc
• Sclerosis may occur in adjacent normal bone
www.indiandentalacademy.com
33. • Internal structure: little
• Entirely radiolucent
• If lesion is not aggressive either residual jaw bone/
reactive osseous bone may be present
• Surrounding strctures:
• Alveolar process, inferior border, nv canals are lost
• Floor of sinus, wall of maxilla can be destroyed
• Loss of supporting bone around tooth.
www.indiandentalacademy.com
34. Dd :
• Fibrous dysplasia
• Osteosarcoma
• Fibrous histiocytoma
• Neurofibromas ,
• Malignant peripheral nerve sheath tumors.
“Each one must be distinguished by its unique
histopathologic features.”
www.indiandentalacademy.com
36. MALIGNANT FIBROUS HISTIOCYTOMA
• Sarcoma with both fibroblastic & histiocytic features
• Most common soft tissue sarcoma of late adult life.
• Many were previously diagnosed as fibrosarcomas,
malignant peripheral nerve sheath tumors, and
pleomorphic rhabdomyosarcomas.
• Its overlap with fibrosarcomas is because both arise
from a similar precursor cell within a maturation
sequence beginning with the pluripotential mesenchymal
stem cell and ending with the mature fibrocyte
www.indiandentalacademy.com
37. • Men> women
• Occurs mostly in extremities
• Occur in soft tissue or bone
• Rare in maxillofacial region
• Common complaint is expanding mass that may/
maynot be painful
www.indiandentalacademy.com
38. • Hp :
• Most lesional cells are spindled fibroblasts like cells
• Arranged in storiform pattern
• Some areas contain histiocyte like cells
• Which have eosinophilic cytoplasm/ pale foamy
cytoplasm
• Sub classified into
• Myxoid, pleomorphic-storiform, angiomatoid(
aneurysmal), giant cell
www.indiandentalacademy.com
39. Spindle cells may be arranged randomly. But most commonly usually
present as streaming in interlacing fascicles from a central nidus and
intersecting with cells from adjacent aggregates….storiform/ criss
crossing patternwww.indiandentalacademy.com
40. Dd:
• Malignant fibrous histiocytomas must be distinguished
from the benign fibrous histiocytoma( rl expansion of
jaw)
• fibrosarcomas, malignant peripheral nerve sheath
tumors & rhabdomyosarcomas
• Clinical presentation of all these lesions is similar
• Distinction is mainly histopathologic, most true
fibrosarcomas and rhabdomyosarcomas occur at
younger ages.
www.indiandentalacademy.com
41. LIPOSARCOMA
• Liposarcomas are very rare tumors in the oral and
maxillofacial area( if occurs- neck)
• Thigh, retroperitoneum
• Present as a slow‐growing mass from a deep origin
• Liposarcomas originate from primitive mesenchymal
cells rather than from mature fat cells
www.indiandentalacademy.com
42. • liposarcomas are rare in subcutaneous areas;
they most commonly arise in intermuscular
fascial planes, which contain residual
mesenchymal stem cells.
• Liposarcomas do not develop from pre‐existing
benign lipomas. All are malignant from their
inception.
www.indiandentalacademy.com
43. RHABDOMYOSARCOMA
• Rhabdomyosarcomas are malignant tumors of
primitive mesenchymal cells that undergo partial
rhabdomyoblast differentiation
• Unlike other sts which occur in adults
• 44% occurs in omf regions
• the orbit is the most common location, followed by
the nasal cavity, mouth, sinuses, cheek, and neck.
www.indiandentalacademy.com
44. • Three basic histologic types: embryonal, alveolar,
and pleomorphic
• embryonal- best prognosis
• most common type found in omf
• Males > f (1.5:1).
• Tumors have a peak incidence at age 4 years and
another at age 17 years
www.indiandentalacademy.com
45. • The tumor presents as a rapidly growing, fleshy
mass, which readily invades and destroys bone.
• Rhabdomyosarcomas are not radiographically
distinctive but will show primarily the anticipated
soft tissue mass and bony destruction
www.indiandentalacademy.com
46. • Dd:
• A tumor with rapid growth and destructiveness in a child
or young adult should suggest a rhabdomyosarcoma.
• Other rapidly destructive lesions in this age group are
Ewing sarcoma, neuroblastoma & acute Langerhans cell
• histiocytosis, and less commonly, a malignant peripheral
T‐cell lymphoma. All of these are also known
to invade bone in a destructive manner.
www.indiandentalacademy.com
47. Leiomyosarcoma
• Leiomyosarcomas are a relatively uncommon type of sarcoma
• 7% of all soft tissue sarcomas.
• Most occur in the retroperitoneum and within the abdomen;
• others are associated with large blood vessels, such as the
inferior vena cava and pulmonary artery, and are often
referred to as leiomyosarcomas of vascular origin.
• Intraoral leiomyosarcomas are extremely rare because of the
paucity of smooth muscle in oral tissues
www.indiandentalacademy.com
48. ANGIOSARCOMA
• Angiosarcomas are malignant tumors that arise from either
vascular or lymphatic endothelium
• malignant hemangioendotheliomas/lymphangiosarcomas
• Rarest , accounting for 1% of h& n sts
• Can occur at any age, more common in elderly
• Males> females
• Skin of maxillofacial area, scalp
• Io lesions lips, palate, gingiva, tongue, centrally with in maxilla,
mandible.
www.indiandentalacademy.com
49. • 10% of angiosarcomas develop in chronic
lymphedematous tissues
• 10% are believed to be late effects of radiotherapy
for previous malignancies of other types.
www.indiandentalacademy.com
50. • Induration and ulceration of angiosarcomas lead to a
suspicion of malignancy.
• rarity makes them an unusual consideration on a
differential list.
• More common ulcerating malignant lesions that can
occur on facial and forehead skin as well as scalp
• primarily basal cell carcinoma, melanoma, skin squamous
cell carcinoma, and eccrine tumors of sweat gland origin.
• If the tumor is nodular and bulky, a so‐called turban
tumor/ cylindroma of the scalp, is another possibility.
www.indiandentalacademy.com
51. • Begin as a flat, ecchymotic‐looking area dark red or
bluish red with a firm, indurated edge.
• associated with facial edema and are presumably of
lymphatic endothelial origin.
• As the lesions mature, they become nodular and fleshy
and will ulcerate.
• Most are painless, but secondary infection of ulcerated
lesions may produce pain.
• They are not vascular lesions, per se, and therefore do
not pose a bleeding risk. Instead, they are of vascular
cellular origin
www.indiandentalacademy.com
52. • Hp: Angiosarcomas are infiltrating tumors that
usually form irregular vascular channels that often
intercommunicate to form a network.
• The endothelial cells lining the channels are plump
and hyperchromatic and may proliferate to form
papillary projections.
• Nuclear irregularities
• atypical mitoses are usually present
www.indiandentalacademy.com
54. KAPOSI SARCOMA
• Angioreticuloendothelioma
• Multiple idiopathic hemorrhagic sarcoma of kaposi
• Multicentric proliferation of vascular & spindle
components.
• Etiology is unknown
• Co factor model : host factor- immunosuppression
• Infectious agent – human herpes virus 8/KSHV
• Environmental: overall geographic distribution
www.indiandentalacademy.com
55. • Classic:
• Occurs in late adult life. 70 to 90% occurs in males
• It forms violaceous macules, papules, and nodules often
symmetrically on the skin of the lower extremities.
• It is chronic and slowly progresses through an early patch
stage and into plaque and nodular stages
• The lesions increase slowly in size and number, spreading
proximally and emerging into plaques or vascular
nodules.
• Oral involvement is unusual. If occurs palatal
mucosa/gingiva.
www.indiandentalacademy.com
56. • Endemic/ lymphadenopathic/ african:
• Present as localised/ generalised enlargement of
lymphnodes
• Including cervical
• Mainly visceral involvement
• Less skin & mucous membrane involvement
• Salivary glands are affected
www.indiandentalacademy.com
57. • Transplantation associated:
• Seen in renal transplant patients
• Manifest 1 or 2yrs after transplantation
• Due to loss of cellular immunity
• Sarcomatous involvement of skin, internal organs
• Oral involvement is rare.
www.indiandentalacademy.com
59. • Aids related:
• 40% homosexual aids pts develop disease as early
sign
• Lesions occur in many cutaneous locations, along
lines of cleavage
• Tip of nose
• Oral lesions occur on any mucosal surface
• Commonly gingival & palatal mucosa
www.indiandentalacademy.com
60. • HP:
• PATCH STAGE: In the early patch stage, changes may
be extremely subtle and show only a proliferation of
both small and dilated vessels.
• A mild infiltrate of lymphocytes and plasma cells may
be seen at the periphery.
• PLAQUE: Vascular proliferation continues in the
plaque stage, and foci of spindle cells, typically
related to the vascular component, develop
www.indiandentalacademy.com
61. • NODULAR :
• nodular stage, the spindle cell component
dominates, encroaching on the previously obvious
vascular spaces
• picture resembles fibrosarcoma
• but Kaposi sarcoma will show the presence of slit‐like
spaces between the spindle cells,which contain
varying numbers of erythrocytes and some
hemosiderin
• hyaline globules are seen.www.indiandentalacademy.com
63. • DD : oral & skin lesions resemble bruising
(ecchymosis) or a deeply located low‐grade
mucoepidermoid carcinoma.
• Papular and nodular lesions appear like
hemangiomas, lymphangiomas & hemangiomas.
• Even though it is uncommon, bacillary epithelioid
angiomatosis may appear ks
• On the alveolar ridge, they may resemble a pyogenic
granuloma, or a peripheral giant cell proliferation
www.indiandentalacademy.com
64. Hemangiopericytoma
• Oral hpc is typically rapidly enlarged
red/bluish mass which arises in all age groups.
• Soft, rubbery, painless, well demarcatedcfrom
surrounding mucosa
• Sessile/pedunculated
• Surface lobularity/ telengiectasis
www.indiandentalacademy.com
65. • Hp: well circumscribed, greyish white
• Less hemorrhagic than vascular tumors
• Numerous branching vascular channels
• Plump endothelial nuclei
• Tightly packed oval & spindle cells
• Branching vascular channels are in form of stag horn
pattern.
www.indiandentalacademy.com
67. SYNOVIAL SARCOMA
• Un common form
• Represents 5 to 10% of all soft tissue
neoplasms
• Occurs near large joints/bursae
• Commonly involves extremities
• Rare in h&n
• Occurs in parapharyngeal/paravertebral areas
• Causing dyspnoea, dysphagia, hoarsness,
headache.
www.indiandentalacademy.com
68. • It so named because of its resemblance to
developing synovial tissue
• Arise from pleuripotent mesenchymal stem cells
near joint surface, tendon, tendon sheats, juxta
articular membranes, fascial aponeurosis
www.indiandentalacademy.com
69. • Radiograhic findings:
• Plain radiographs aid in diagnosis
• Produce spotty calcification ( snow
www.indiandentalacademy.com
70. WHO CLASSIFICATION OF
BONE SARCOMAS
Louis B Harrison, Roy B Sessions, Waun Ki Hong
Head & Neck Cancer- A Multidisciplinary
Approach
2nd Edition Lippincott Williams & Wilkins Usa
1998
www.indiandentalacademy.com
71. BONE FORMING TUMORS
OSTEOSARCOMA
• CONVENTIONAL CENTRAL OSTEOSARCOMA
Osteoblastic, chondroblastic, fibroblastic
• TELANGIECTATIC
• INTRAOSSEOUS WELL DIFF LOW GRADE
• ROUND CELL
• PAROSTEAL
• PERIOSTEAL
www.indiandentalacademy.com
73. MARROW TUMORS
• EWINGS SARCOMA
• PNET OF BONE
VASCULAR TUMOR OF BONE
• ANGIOSARCOMA OF BONE
• MALIGNANT HEMANGIOPERICYTOMA
www.indiandentalacademy.com
74. Osteosarcoma
• Malignancy of mesenchymal cells that have ability to
produce osteoid or immature bone.
• Most common primary tumor to orginate in bone
after multiple myeloma
• arises from undifferentiated cells &
www.indiandentalacademy.com
75. Etiology
• UNKNOWN
• Risk factors are radiation exposure
• Genetic predisposition( 13q14) causing inactivation
of RB gene leding to dev of retinoblastoma, os
• Bone dysplasias fibrous dysplasia, pagets disease
increase risk
• Li-fraumeni syndrome ( germline t53 mutation)
predispose to os
www.indiandentalacademy.com
76. • Can occur in any bone
• Common in long bones
• Extragnathic os shows bimodal age distribution
• 10-20yrs( period of active growth) & >50yrs
• Site: distal femoral & proximal tibial metaphyses.
• Older pts axial skeleton & flat bones are involved
www.indiandentalacademy.com
78. • Os of jaws 6 to 8% of all os.
• Occurs mostly in 3rd & 4th decade of life
• Slight male predominance.
• Maxilla < mandible
• Mandible: posterior body, hori.ramus > ascending ramus
• Maxilla : inferior portion( alveolar ridge, sinus
floor,palate) > superior( zygoma, orbital rim)
• Os of jaws are better differentited , better prognosis, less
metastasis, than extragnathic os
www.indiandentalacademy.com
79. Clinical features:
• Pain, swelling of involved area – facial deformity
• Pt c/o sprain,arthritis or so called growing pain
• Loosening of teeth
• Paresthesia
• Nasal obstruction in max. tumors
• Epistaxis, hemorrhage
• h/o recent tooth extraction with a nodular/polypoid
some what reddish granuloma like growth growing from
tooth socket.
www.indiandentalacademy.com
80. • As tumor grows, eroding cortical plates expansion is
very firm because of dense fibrous tumor tissue
produced.
• Initially swelling is smoothly contoured, covered with
normal appearing mucosa
• When expansion becomes chronically traumatised
mucositis develops on surface
• Surface ulcerates and grayish white necrotic surface
results which can be removed with tongue blade.
www.indiandentalacademy.com
81. juxta cortical os
• Paraosteal: lobulated nodule
attached to cortex by a stalk
• No elevation of periosteum/its reaction
• Hp: mass contain spindle cell fibroblast like
proliferation
• Well dev trabeculae of bone
• They coalesce and form large solid mass of
bone
www.indiandentalacademy.com
82. • Periosteal :
• Sessile lesion
• Arise with in cortex
• Elevates overlying periosteum
• Provokes production peripheral periosteal bone
• Leading edge of tumor mass perforates periosteum
extends into soft tissue
www.indiandentalacademy.com
83. Histopathology
• Cells of tumor may producoe osteoid, chondriod, or
fibrous connective tissue
• Vary in shape uniform round/ spindle shaped to
highly pleomorphic
• Depending on relative amounts of osteoid,
cartilage/collagen os is div into osteoblastic( 50%),
chondroblastic, fibroblastic
www.indiandentalacademy.com
84. • Chondroblastic os are more common
• Composed entirely of malignant cartilage growing lobules
with only small foci of direct osteoid production by tumor
cells
• Other less common histologic variants are
• Malignant histiocytoma like
• Smallcell, epitheloid, telangiectatic, giant cell rich
• Low grade well differentiated os – minimal cellular atypia ,
abundant bone formation.
• May be misdiagnosed as fibrous dysplasia/ fibro osseous
lesion
www.indiandentalacademy.com
86. Telangiectatic
• Seen in adolescence & early adulthood
• rare variant of central highgrade
• Gross examination reveals a blood-filled cavity
• Hemorrhagic & necrotic areas are seen in tumor
• Microscopically dilated vascular channels lined with
multinucleated giant cells and an anaplastic
sarcomatous stroma with evident bone formation
www.indiandentalacademy.com
87. • Radiographically : large lytic defect,
• usually expansile and accompanied by an extensive
soft tissue component.
• Mri- fluid levels similar to those seen in an
aneurysmal bone cyst
• Occasionally, this lesion may be very difficult to
distinguish from an aneurysmal bone cyst.
www.indiandentalacademy.com
88. Radiology
Internal structure:
• Entirely rl/ osteolytic
• Mixed rl-ro
• Quite ro/ osteoblastic
• Osseous structure may be granular/sclerotic apparing bone
• In form of cotton balls, wisps, honey coomb internal structure
with adjacent destruction of pre-exisisting osseous
architecture.
• What ever may be presentation, normal trabecular pattern is
lost.
www.indiandentalacademy.com
89. Osteolytic:
• Unicentric, ill defined borders
• Moth eaten appearance
• Perforation & expansion of cortical margins into sub
periosteal bone
www.indiandentalacademy.com
90. Mixed
• Ragged, ill defined borders
• Ro due to excess bone formation intermingled with
resorption leading to rl areas
• In some sequestra appear , appear as well defined ro
• Rl destruction may be in form of strands…honey comb
appearance
• Sun burst appearance
• Cumulus cloud
• Codmans triangle are seen
www.indiandentalacademy.com
91. Periphery and shape
• ragged, Ill defined border
• When viewed against normal bone Lesion is usually rl
• No peripheral sclerosis / encapsulation
• If it involves periosteum:
• Typical sun ray spicules/hair on end trabeculae are
seen
• This occurs when periosteum is displaced, partially
destroyed & disorganised.
www.indiandentalacademy.com
96. Effects on surrounding tissues
• Widening of pdl space occurs ( garrington sign)
• Band like widening along complete length of pdl
space unilaterally/bilaterally
• Also seen in other malignancies, osteoblastoma,
• Pts undergoing ortodontic treatment
• Unilateral bone resorption seen in periodontal
disease.
www.indiandentalacademy.com
97. • Antral/nasal wall cortices are lost in maxillary
lesions
• Mand lesions destroy cortex of neurovascular
canal, nv canal is symmetically widened &
enlarged
• Lamina dura of involved tooth is completely
destroyed.
www.indiandentalacademy.com
98. • Dd:
• If internal structure is minimal
fibrosarcoma/ osteoblastic metastatic ca
• Osseous structure visible
Chondrosarcoma (affects older age group, more often
involves maxilla)
• Spiculated periosteal reaction
Prostate/breast metastasis
• Benign tumors & conditions like ossifying fibroma, fo
lesioms mimic os radiographically.
www.indiandentalacademy.com
99. • Ossifying subperiosteal hematoma( a h/o recent
trauma to the bone)
• Peripheral fibroma with calcification( slow, benign
growth)
• Chronic osteomyelitis ( but infection is absent in os)
• An important clinical differential feature is
neurosensory loss.
• rare osteomyelitis or neural loss from a previous
biopsy or surgery, only malignancies can produce
objective paresthesias.
www.indiandentalacademy.com
100. • radiographs or CT scans at right angles to the cortex
should show extracortical bone and a destroyed cortex.
• Fibrous dysplasia and ossifying fibroma will not have
extracortical bone. The
• extracortical bone seen in osteomyelitis with proliferative
periostitis will be associated with an intact
• cortex.
• Even when other osteomyelitides produce extracortical
bone, it is parallel to the cortex rather
• than at right angles as is seen in osteosarcoma
www.indiandentalacademy.com
101. Chondrosarcoma
• Malignant tumor characterised by formation of cartilage
by tumor cells
• Comprise 10% of all tumors of skeleton
• Rare in jaws( 3% of all cs)
• Extragnathic it is primarily neoplasm of adulthood with
peak prevalance in 6th, 7th decades of life
• Tumors arising in younger age group is uncommon
• No sex or race predilection
• Site: ileum, femur, humerus
www.indiandentalacademy.com
102. • In h& n : cs common in maxilla ( anterior areas where
cartilage tissue is present.
• mandible: ccoronoid process, condylar h& n, symphyseal
region.less common in body, ramus, nasal septum, pns
• Chondrosarcomas most often develop in osseous
locations
• But 1/3rd originate in laryngeal cartilage/soft tissue
• Cs arise directly from cartilage or may occur within
benign cartilagenous tumors….secondary cs
www.indiandentalacademy.com
103. • A painless mass, swelling
• Associated with separation or loosening of teeth
• Pain is unusual
• Maxillary tumors may cause nasal obstruction,
congestion, epistaxis, photophobia, or visual loss.
• If cs occur near tmj trismus, abnormal joint function
occurs.
• When metastasis occurs lung is organ most
commonly involved.
www.indiandentalacademy.com
104. • Hp: composed of cartilage with varying degrees of
maturation & cellularity
• Lobular pattern with lobules separated by thin fibrous
connective tissue
• Central area demonstrates lobules with greatest degree
of maturity
• Peripheral area contains immature cartilage &
mesenchymal tissue consisting of round/spindle cells
• Calcification/ossification may occur in chondroid matrix
www.indiandentalacademy.com
105. • Some times at periphery of lobules of high grade cs,
a few fs like spindling tumor cells are present
• Osseous trabeculae when present are seen at
periphery of lobules & appears to be rimmed by
osteoblasts.
• When malignant cells produce osteoid lacework or
trabeculae even in small foci, tumor is graded as os
www.indiandentalacademy.com
106. • Four histological subtypes:
• Clear cell
• Dedifferentiated
• Myxoid
• Mesenchymal
• Occur centrally within bone or less commonly
in soft tissue.
www.indiandentalacademy.com
107. Variants :
• Clear cell cs:
cells with abundant clear cytoplasm
• Dedifferentiated cs:
high grade malignancy that show admixture of well
differentiated cs & malignnat mesenchymal tumor
resembling fibrosarcoma.
• Myxoid cs: soft tissue tumor. io variant is seen,
characterised by clear, vacuolated, eosinophilic
cytoplasm with a background of mucoid material.www.indiandentalacademy.com
108. • Mesenchymal cs: uncommon tumor of soft tissue &
bone
• Shows biphasic hp
• More common in soft tissue than bone
• Chondroid tissue is well differentiated, degree of
cellularity & atypia varies from benign chondroma to
well differentiated chindrosarcoma
• If cartilagenous foci is sparse, tumor may be
misdiagnosed as hemangiopericytoma
www.indiandentalacademy.com
109. • Radiographically….internal structure:
• radiolucent area with poorly defined borders
• Rl area contains scattered ro foci caused by
ossification of cartilage matrix
• Mixed rl- ro appearance
• Some times it appears as moth eaten bone
alternating with islands of residual bone unaffected
by tumor
www.indiandentalacademy.com
110. • Central ro structure appear as flocculent implying
snow like features
• Diffuse calcification may be superimposed on a bony
background that resembles granular/ground glass
appearing normal bone
• Examination of this flocculence may reveal central rl
nidus which is probably cartilage surrounded by
calcification.
www.indiandentalacademy.com
111. • Periphery :
• Generally roun/ovoid/lobulated
• Well defined corticated borders
• Occasionally peripheral periosteal reaction in form of
sunray, hair on end appearance is seen
• Uncommonly aggressive lesions ill defined, invasive ,
non corticated borders seen
www.indiandentalacademy.com
112. Effect on surrounding tissues:
• Relatively slow growing so expands cortex, rather
than rapidly destroying them
• Mand cases, ian expanded still maintaining corical
covering
• Maxillary lesions push wall of sinus or nasal fossa &
impinge on infratemporal fossa
• Lesions of condyle cause expansion, remodelling of
articular fossa & eminence.
www.indiandentalacademy.com
113. • If lesion is in articular disk region, widening of joint
space, remodelling of condylar neck occurs.
• Erosion of articular fossa occurs
• If lesion occurs near tooth, root resorption, widening
of pdl space, tooth displacement may occur.
www.indiandentalacademy.com
114. • Dd;
• Os : typical calcifications of cs are absent
• Fibrous dysplasia: periphery is well defined. ro
portion of fibrous dysplasia is abnormal bone & not
the calcifications
• Because of their slow growth and especially their
intact overlying mucosa, most cases will initially
resemble a benign odontogenic tumor or a benign
tumor of bone
www.indiandentalacademy.com
115. • Some punctate radiopacities are identifiable, the lesion
will resemble a
• calcifying epithelial odontogenic tumor
• an ossifying fibroma
• an immature osteoblastoma
• a cavernous hemangioma of bone.
• The more obviously aggressive presentations with
irregular radiolucencies and perhaps neurosensory loss
would be consistent with an intraosseous carcinoma, an
osteosarcoma, and a malignant fibrous histiocytoma
www.indiandentalacademy.com
116. Ewings sarcoma
• Notoriously aggressive and destructive malignancy
of bone arising from marrow mesenchymal stem cells
• Genetically and histologically distinctive small round
cell sarcoma of bone
• 85% to 90% cases, tumor cells show reciprocal
translocation b/n chromosomes 11 & 22. (q24;q12)
• Third most common osseous neoplasm than os, cs
• It was first described by James Ewing in 1920 as a
"diffuse endothelioma of bone.“www.indiandentalacademy.com
117. • In both the jaws and long bones,peak age of
occurrence is in the teenage years (50%). Young men
slightly > young women
• mandible's posterior body, the angle and ramus
regions are common. Cause bony expansion , mobile
teeth, extensive destruction of bone and
necrosis…fever occurs
• present a picture similar to that of an osteomyelitis.
• rapid growth rate. Metastasis is common.www.indiandentalacademy.com
118. • Hp : Ewing sarcomas are composed of densely packed,
rather uniform cells with little intercellular stroma
• The nuclei are rounded to oval with defined nuclear
borders and a
• finely granular chromatin pattern
• The cytoplasm is indistinct and may be vacuolated.
• The cells are two to three times the size of a lymphocyte.
• Mitoses are infrequent.
• Rapid growth, undergo considerable necrosis, sometimes
resulting in a perivascular pattern of viable tumor cells
www.indiandentalacademy.com
119. Tumor cells are arranged in broad sheets…filigree pattern in
which infiltratin strands of tumor cells are separated by thin
fibrovascular septae
Well defined nuclei
Indistinct
cytoplasm
www.indiandentalacademy.com
120. • Hp dd: includes other small round cell tumors,
including
• neuroblastoma,lymphoma, small cell
osteosarcoma& embryonal rhabdomyosarcoma.
• Ewing sarcoma will usually have intracytoplasmic
glycogen granules demonstrated by periodic
acid‐Schiff (PAS) and diastase staining.
• neuroblastoma and embryonal rhabdomyosarcomas
may also yield positive staining.( for glycogen)
www.indiandentalacademy.com
121. Rf:
• Internal structure:
• Es is a destructive process with little unduction of bone.
• It commences on internal aspect of bone & involves
endosteal & periosteal surfaces later , usually entirely rl.
• Periphery: rl poorly demarcated & never corticated.
• Advancing end destroys bone in an uneven fashion.
• May cause pathological fractures.
• Extends into adjacent soft tissue.
www.indiandentalacademy.com
122. Effect on surrounding tissues:
• adjacent normal structures ian canal, lower border
of mandible, alveolar cortical plates are destroyed.
• It doesnot characteristically cause root resorption, it
destroys supporting bone adjacent to tooth.
www.indiandentalacademy.com
123. • Panoramic radiographs and a CT scan
• an ill‐defined, irregular resorption of bone with focal
areas of residual bone resembling sequestra.
• Pathologic fractures are common, attesting to the degree
of bone destruction.
• Multilayered periosteal reaction that has been described
as an "onion skin" appearance,
• (Similar to proliferative periostitis in osteomyelitis)
• such a radiographic appearance is almost never seen
when Ewing sarcoma arises in the jaws.
www.indiandentalacademy.com
124. • Ewing sarcoma in the jaws will produce a destructive
radiolucency with resorbed tooth roots and
displaced teeth.
• On rare occasions, a Ewing sarcoma may produce a
periosteal new bone formation perpendicular to the
cortex and thereby create the "sun‐ray" appearance
more frequently seen in osteosarcomas
www.indiandentalacademy.com
125. • Dd :
• Pain , fever, leukocytosis suggest a suppurative
osteomyelitis.
• Reinforced by radiographs showing destructive
bone pattern , bone foci resembling a sequestrum,
layered periosteal "onion skin“
appearance…resembling proliferative periostitis.
www.indiandentalacademy.com
126. • Other aggressive malignancies that occur in this
young age group include
• Rhabdomyosarcoma ,
• Osteosarcoma, fibrosarcoma, and neuroblastoma
• Eosinophilic granuloma of jaw is also a destructive
process, but is associated with laminar periosteal
reaction, where as in jaws ewings sarcoma doesnot
produce.
www.indiandentalacademy.com
128. • periosteum is a membrane several cell layers thick that
covers almost all of every bone.
• only parts not covered by this membrane are the parts
covered by cartilage.
• Besides covering the bone and sharing some of its blood
supply with the bone,
• it also produces bone when it is stimulated
appropriately.
• Practically anything that breaks, tears, stretches,
inflames, or even touches the periosteum.
www.indiandentalacademy.com
129. •With slow-growing processes, the
periosteum has plenty of time to
respond to the process.
•It can produce new bone just as fast
as the lesion is growing.
• solid, uninterrupted periosteal new
bone along the margin of the affected
bone.
www.indiandentalacademy.com
130. •In case of rapid growing tumors,
new bone is not formed at the rate
of tumor.
•An interrupted pattern is formed
•This may result in a pattern of one
or more concentric shells of new
bone over the lesion. This pattern is
sometimes called lamellated or
"onion-skin" periosteal reaction.
www.indiandentalacademy.com
131. •If the lesion grows rapidly but steadily, the
periosteum will not have enough time to
lay down even a thin shell of bone,
•In such cases, the tiny fibers that connect
the periosteum to the bone (Sharpey's
fibers) become stretched out
perpendicular to the bone.
•When these fibers ossify, they produce a
pattern sometimes called "sunburst" or
"hair-on-end" periosteal reaction,
depending of how much of the bone is
involved by the proceswww.indiandentalacademy.com
132. • Codmans triangle :
• When a process is growing too fast, it
penetrate through the cortex causing
separation of the periosteum and formation of
lamellated new bone. If the periosteum
elevates to a significant degree, it can break
forming an acute angle
www.indiandentalacademy.com
133. • When this little bit of ossification is seen tangentially
on a radiograph, it forms a small angle with the
surface of the bone, but not a complete triangle..
www.indiandentalacademy.com
134. • References
1. Robert E Marx, Diane Stern Oral And Maxillofacial
Pathology: A Rationale For diagnosis & Treatment.
1st edition, Quintessence.2003.
2. Stuart C White , Michael J Pharoah , Textbook Of
Oral Radiology Principles And Interpretation
3. Norman k wood paul w goaz. Dd of oral and
maxilllofacial lesions. 5th edition elsevier 2007
www.indiandentalacademy.com
135. • R Rajendran B Sivapathasundharam Shafer’s
Textbook Of Oral Pathology. 5th Edition, Elsevier,
2008
• Brad W Neville Douglas D Damm Carl M Allen Jerry
E Bouquot. Oral And Maxillofacial Pathology. 3rd
Edition Elsevier, 2009
www.indiandentalacademy.com
finger-like spreading projections from a cancer is similar to shape of a crab.
similar to hamartomas
Another was given by us national cancer institute
more immature cell in this sequence and therefore have a more aggressive behavior
second most common sarcoma in adults (after the malignant fibrous histiocytoma) when all areas are considered
Per se…by itself……..
Moritz Kaposi first described this form in five individuals in 1872
Characteristically, individuals live with these lesions and die of unrelated causes years later
Benign tumor….but has definite malignant counterpart…telengiectasia/angioectasias (also known as spider veins) are small dilated blood vessels[1] near the surface of the skin or mucous membranes, measuring between 0.5 and 1 millimeter in diameter.[2]
Spindle cells are of mesenchymal origin, and form the body's connective tissue, fat, muscle, bone, cartilage and blood vessels
Osteolytic type is least differentiated and carries poor prognosis….
Sun ray not seen….
If periosteum is elevated, maintains its osteogenic potential, but is breached in centre, codmans triangle is formed
Due to infiltration of tumor mass into pdl space……….
Ossifying fibroma is better demarcated and it has uniform internal architecture.
translocation of chromosomes 11 and 22 at their respective q24 and q12 loci…..tumor of long bones…relatively rare in jaws…
It is rare in the mandible in general and even more rare in the maxilla
Filigree… ornamental work of fine (typically gold or silver) wire formed into delicate tracery.
seen occasionally when Ewing sarcoma arises within the diaphysis of long bones.
This interrupted pattern can manifest itself in several ways, depending on just how steadily the lesion grows. If the lesion grows unevenly in fits and starts, then the periosteum may have time to lay down a thin shell of calcified new bone before the lesion takes off again on its next growth spurt.
pattern may appear quite different.
Codmans triangle : another pattern in rapidly growing tumors
a bit of a misnomer ( not complete triangle)
When a process is growing too fast for the periosteum to respond with even thin shells of new bone, sometimes only the edges of the raised periosteum will ossify.
When this little bit of ossification is seen tangentially on a radiograph, it forms a small angle with the surface of the bone, but not a complete triangle.. a bit of a misnomer ( not complete triangle)