disease of bone manifested in the jaws
TRANSCRIPT
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RADIOGRAPHIC INTERPRETATION OF
DISEASE OF BONE MANIFESTED IN
THE JAWS
DRG. SHANTY CHAIRANI
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FIBRO-OSSEUS LESION
• In fibro-oss!s "sion# nor$%" bon &%sbn r'"%() b* bni+n fibro!s ,iss!(on,%inin+ %ri%b" %$o!n,s of
$inr%"i%,ion.• T&r %r / (%,%+oris of ,&s "sion 0
,&os %r no, of 'rio)on,%" "i+%$n,
ori+in 1fibro!s )*s'"%si%2 %n) ,&os,&%, $%* b of 'rio)on,%" "i+%$n,ori+in 1'ri%'i(%" ($n,%" )*s'"%si%#ossif*in+ or ($n,if*in+ fibro$%2.
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FIBROUS DYSPLASIA
• An i)io'%,&i( r+ion%" %",r%,ion of bon in3&i(& ,& nor$%" %r(&i,(,!r is r'"%() b*fibro!s ,iss! %n) nonf!n(,ion%" ,r%b(!"%-"i4osso!s s,r!(,!rs5 3i,& or 3i,&o!, %sso(i%,)n)o(rin )is,!rb%n(s.
•
C"ini(%" F%,!rs0 – Mos, of,n 6!ni"s %n) *o!n+ %)!",s – I, (%n %ff(, 6!s, on bon 1$onos,o,i(2 or
$!",i'" bons 1'o"*os,o,i(2. J%3 ino"$n, is(o$$on 1s'(i%""* ,& $%7i""%2.
–Sin+!"%r# s"o3-+ro3in+# '%in"ss s3""in+ of ,&%ff(,) bon.
– Or+ro3,& of ,iss! ,&%, o((!rs (n,r%""* in ,& 6%3s
– M%* ino" i$'%(,) or !nr!',) ,,& – In(r%s) "" of sr!$ %"4%"in '&os'&%,%s
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• R%)io+r%'&i( F%,!rs0
–
M!",i"o(!"%r r%)io"!(n(* or $i7)r%)io"!(n, %n) r%)io'%8! %''%r%n(
– Ini,i%""* i""-)fin) r%)io"!(n(*# +r%)!%""*
fin ,r%b(!"% b(o$ i)n, ,o 'ro)!(
,& ,*'i(%" 9+ro!n) +"%ss: or 9or%n+'": %''%r%n(.
– L%$in% )!r% is !s!%""* obs(!r) %n) ,&
(or,i(%" '"%,s ,&inn). – M%* )is'"%() ,& %)6%(n, ,,&# rsorb)
roo,s %n) )s,r!(,) ,& )"o'in+ ,,&.
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CEMENTO-OSSEUS DYSPLASIA
• A )is%s 'ro(ss of ,& 6%3 3&i(& is
("%ssifi) %s fibroso!s "sions
• In("!)s 'ri%'i(%" ($n,oosso!s)*s'"%si%# fo(%" ($n,oosso!s
)*s'"%si%# %n) f"ori)
($n,oosso!s )*s'"%si%
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PERIAPICAL CEMENTAL DYSPLASIA
•
A"so 4no3n %s C$n,o$%# Pri%'i(%" C$n,o-Osso!s D*s'"%si%# Pri%'i(%" Fibro!sD*s'"%si% %n) Pri%'i(%" Os,ofibrosis
• As*$',o$%,i( )iff!s 'ri%'i(%" r%)io"!(n, %n)r%)io'%8! %r%s# 'ri$%ri"* of ,& %n,rior
$%n)ib"# in 3&i(& ($n,o-osso!s ,iss!r'"%(s ,& nor$%" %r(&i,(,!r of bon.
• C"ini(%" F%,!rs0 – Pr)i"(,ion for b"%(4 3o$n –
Mi))" %+) %)!",s# ;,& ,o <,& )(%) of "if – As*$',o$%,i( – Us!%""* o((!r in %'i(s of $%n)ib!"%r %n,rior
r+ion – T& ino") ,,& %r i,%"
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• R%)io+r%'&i( f%,!rs 0 – Ro!n)# $ono"o(!"%r# of,n $!",i'".
– A)6%(n, ,,&0 ,*'i(%""* i,%"# no, )is'"%()# no,rsorb).
– T& 'ri%'i(%" "i+%$n, s'%( is in,%(,. L%$in%)!r% $%* "os, or in,%(,
– S$%""# !' ,o = ($ in )i%$,r.
• R%)io)nsi,* – S,%+ = 1os,o"*,i( s,%+2 0 R%)io"!(n,# no,
(or,i(%,)
– S,%+ / 1($n,ob"%s,i( s,%+2 0 R%)io'%(i,*3i,&in ,& %'i(%" r%)io"!(n(is
– S,%+ > 1$%,!r s,%+2 0 Dns"* r%)io'%8! b!,s!rro!n)) b* % ,&in r%)io"!(n, "in.
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C$n,o$% =s, s,%+ C$n,o$% /n) s,%+
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C$n,o$% >r) s,%+
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CEMENTO-OSSIFYING FIBROMA
• A"so 4no3n %s Ossif*in+ Fibro$%• Bni+n fibro-osso!s no'"%s$. I, is )iffi(!",
,o )iffrn,i%, ,& (%"(ifi) ,iss! 3i,&in ,&"sion b,3n bon %n) ($n,!$.
• C"ini(%" F%,!rs0 – S"o3 +ro3in+ no'"%s,i( "sion
– An* %+ b!, $or (o$$on in (&i")rn %n) *o!n+%)!",s
– Mor of,n in ,& 'r$o"%r?$o"%r %r% in ,&$%n)ib".
– Gnr%""* %s*$',o$%,i(# !n"ss ,&* b(o$"%r+ no!+&.
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• R%)io+r%'&i( F%,!rs0 – W"" )fin) r%)io"!(n(*# $i7) r%)io"!(n,-
r%)io'%8!# %n) r%)io'%8!. – Cor,i(%" 7'%nsion 3i,&o!, 'rfor%,ion – T&r s,%+s of )"o'$n, 0 r%)io"!(n, @
$i7) @ r%)io'%8!.
• In %r"* s,%+ i, %''%rs %s !ni"o(!"%r# 3""-)fin) r%)io"!(n(*.
• Wi,& ,i$ r%)io'%8! fo(i )"o' 3i,&in ,&"sion.
• W&n r%)io'%8! is !s!%""* s!rro!n)) b* %
,&in r%)io"!(n, &%"o. – I, (%n (%!s )is'"%($n, of ,& %)6%(n,
,,&. Roo, rsor',ion $%* r%n+ fro$ $i") ,osr.
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FLORID OSSEOUS DYSPLASIA
•
A"so 4no3n %s F"ori) C$n,o-Osso!s D*s'"%si%1FCOD2• Diff!s %s*$',o$%,i( r%)io'%8! %n) r%)io"!(n,
in,r%osso!s %r%s of ($n,o-osso!s ,iss! ,&%,ino" on or bo,& %r(&s.
•
I, is % bni+n (on)i,ion ,&%, !s!%""* ino"s $!",i'"8!%)r%n,s of ,& 6%3s.• C"ini(%" F%,!rs0
– Un(o$$on in $%"s# $os, of,n in Afri(%n A$ri(%n3o$n
– Mos, '%,in,s %r $i))" %+). – Lo(%,) in ,& $%n)ib" or $%7i""% – No 7,rn%" si+ns or s*$',o$s – Us!%""* '%in"ss – T& "sions %r of,n bi"%,r%""* %n) s*$$,ri(%""*
'osi,ion) in )n,!"o!s %r%s.
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• R%)io+r%'&i( F%,!rs0 – M!",i'" r%)io"!(n, (%i,* '%r,i%""* fi"") 3i,& on or $or
)ns# r%)io'%8! $%sss
– E%r"* s,%+ (o$'","* r%)io"!(n, – Rs$b"s ("o!) "i4 $%sss 3&i(& %r* in si %n) s&%'
– Co,,on 3oo" %''%r%n(
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CHERUBISM
•
A!,oso$%" )o$in%n, fibro-osso!s "sion of ,& 6%3s ino"in+ $or ,&%n on 8!%)r%n, ,&%,s,%bi"is %f,r ,& +ro3,& 'rio)# !s!%""* "%in+so$ f%(i%" )for$i,* %n) $%"o(("!sion.
• C"ini(%" F%,!rs0
– Nor$%" %''%r%n( %, bir,& – S,%r,s in %r"* (&i")&oo)# 'ro+rss r%'i)"* in ,& ,&
,& *%r of "if# s"o3s )!rin+ '!br,* %n) s,%bi"is%f,r '!br,*
– C&!bb* (&4 %''%r%n( – Mor (o$$on in $%n)ib" ,&%n $%7i""% – Bi"%,r%"# s*$$,ri(%" n"%r+$n, of %"o"%r ri)+ – P%in"ss – Pr$%,!r 7fo"i%,ion of 'ri$%r* ,,& %n) f%i"!r of
'r$%nn, ,,& ,o r!',
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• R%)io+r%'&i( F%,!rs0
– Uni"o(!"%r or $or (o$$on"* $!",i"o(!"%r
s*$$,ri(%" bi"%,r%" 7'%nsi" r%)io"!(n(is in
$%n)ib". O((%sion%""* 'os,rior $%7i""%.
– T*'i(%""* ,& ini,%,ion of bon )s,r!(,ion is n%r
,& %n+"s of $%n)ib"# 3i,& "%,r 7'%nsion of
,& "sions 'os,rior"* in,o ,& r%$i %n) %n,rior"*in,o ,& $%n)ib!"%r bo)*.
– W""-)fin)# 3""-(or,i(%,) bor)r.
– E7'%nsion of ,& b!((%" %n) "in+!%" (or,i(%"
'"%,s.
– A)6%(n, ,,&0 $%r4) )is'"%($n,# i$'%(,ion#
roo, rsor',ion.
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CENTRAL GIANT CELL GRANULOMA
•
An in,r%osso!s )s,r!(,i "sion of ,&%n,rior $%n)ib" %n) $%7i""%# 'rob%b"*r%(,i ,o so$ !n4no3n s,i$!"!s5(o$'os) of $!",in!("%,) +i%n, (""s in %b%(4+ro!n) of $onon!("%r fibro-&is,io(*,i(
(""s %n) r) b"oo) (""s.• C"ini(%" F%,!rs0
– Co$$on in (&i")rn %n) *o!n+ %)!",s – Mor of,n in f$%"s ,&%n $%"s –
M%n)ib" $or of,n ,&%n $%7i""%# !s!%""* o((!rin %n,rior ,o ,& firs, $o"%r. – S"o3 +ro3in+ 3i"" b %s*$',o$%,i( s3""in+#
'ro)!(in+ %n %s*$$,r* of f%(i%". – R%'i) +ro3in+ 3i"" b '%inf!" %n) )n,i,ion 3i"" b
"oos
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• R%)io+r%'&i( F%,!rs0
– Uni"o(!"%r 1%r"* s,%+s2# $!",i"o(!"%r
1in,rn%" s',%# &on*(o$b %''%r%n(2
r%)io"!(n(is
–W"" )fin) or irr+!"%r bor)rs
– I, (%n (%!s (onsi)r%b" 7'%nsion
– Possib" ff(,s on %)6%(n, ,,&0
)is'"%($n,# rsor',ion# )s,r!(,ion of"%$in% )!r%.
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PAGETS DISEASE
•
A"so 4no3n %s Os,i,is Dfor$%ns• I)io'%,&i(# (&roni(# s"o3"* 'ro+rssi
)is%s of bon in ,& ")r"*.• Abnor$%" rsor',ion %n) )'osi,ion of bon#
"%)in+ n,!%""* ,o s("rosis %n) 7'%nsionof ,& ff(,) bon.• I, is 'ro)!(s "%r+r b!, 3%4r bons#
7,nsi '%in# &i+& ""s of sr!$ %"4%"in'&os'&%,%s %n) !rin%r* &*)ro7*'ro"in# %n)
%n in(r%s) ,n)n(* ,o )"o' $%"i+n%n,bon no'"%s$s.
• T& 6%3s %r ino") in %''ro7i$%,"* /of ,& (%ss.
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• C"ini(%" F%,!rs0
– Mor (o$$on in $%"s
– R%r"* o((!rs bfor ,& %+ of ;
– In(r%s) sr!$ %"4%"in '&os'&%,%s# nor$%"
(%"(i!$ %n) '&os'&or!s
– N!ro"o+i( (o$'"%in,s in("!) &%)%(&# %!)i,or*
or is!%" )is,!rb%n(s# f%(i%" '%r%"*sis# r,i+o#
%n) 3%4nss
– Bon '%in %n) n"%r+$n,# )for$i,* %n)
in(r%s) ris4 of bon fr%(,!r %n) os,os%r(o$%
– M%7i""% is $or of,n ino") ,&%n $%n)ib".
– T,&0 in(r%s) s'%(in+ %s 3"" %s "oosnin+ is
no,)
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• R%)io+r%'&i( F%,!rs0
– I, (%n b )ii)) in,o ,&r s,%+s0
•=s, s,%+ - Bon rsor',ion0 Gnr%""*r%)io"!(n(*? os,o'orosis2
• /n) s,%+ @ Os,ob"%s,i( r'%ir 1$i7)r%)io"!(n(*? r%)io'%(i,*2 0 +r%n!"%r or 9+ro!n)+"%ss: %''%r%n(
• >r) s,%+ @ S("rosin+ '&%s 1&%'&%%r))'osi,ion of s("ro,i( bon2 0 9(o,,on 3oo":%''%r%n(.
– H*'r($n,osis of roo,s
– O,&r r%)io+r%'&i( f%,!rs0 "oss of "%$in%)!r% %n) ob"i,r%,ion of ,& 'ri%'i(%" "i+%$n,s'%(srs!",in+ in %n4*"osis of ,,&# 7,rn%"roo, rsor',ion.
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OSTEOPETROSIS
•
A"so 4no3n %s M%rb" Bon Dis%s• Gnr%"i) &r)i,%r* (on)i,ion (onsis,in+ of
7(ssi bon $inr%"i%,ion# rs!",in+ in%",r) s,%,!r# fr8!n, fr%(,!rs# "%(4 of bon
$%rro3 &$%,o'oi,i( f!n(,ion# %n) %,n)n(* for sr os,o$*"i,is of ,& 6%3s.
• I, is +nr%""* s!b)ii)) in ,3o $%in ,*'s#,& ("ini(%""* bni+n %n) ,& ("ini(%""*
$%"i+n%n, for$s.• I, is (&%r%(,ri) b* or+ro3,& %n) s("rosis
of bon 3i,& rs!",%n, ,&i(4nin+ of ,& bon*(or,i(s %n) n%rro3in+ of ,& $%rro3 (%i,is.
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• C"ini(%" F%,!rs0 – B+ins in inf%n(* 3i,& br%,&in+ %n) &%rin+
)iffi(!",is
– r* )ns bon# fr%+i" bon. – S,!n,) +ro3,&# no 'ro'r $)!""%r* s'%(# %n)
bon $%rro3. S&or, "if s'%n. – H*)ro('&%"!s# %bnor$%" )n,%" )"o'$n,
1o"i+o)on,i%2 – An$i%# n!,ro'ni%# in(r%s) r%, of inf(,ion#
in(r%s) r%, of b")in+# &'%,os'"no$+%"*. – P%in# )%fnss# b"in)nss# s,ro4# (%r)i%( )is%s.
• R%)io+r%'&i( F%,!rs0 –
Gnr%"i) in(r%s in bon )nsi,* – Cr%ni%" '"%,s %r ,&i(4n) – Sin!s (%i,is %r r)!() in si – E$b))) or !nr!',) ,,& %r (o$$on
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INFANTILE CORTICAL
HYPEROSTOSIS
• A"so 4no3n %s C%ff*s )is%s.• Abnor$%"i,* of bon 3i,&o!, % 4no3n (%!s
or % )fini, '%,&o+nsis.• T& f%,!r of ,&is )is%s is !n!s!%"
(or,i(%" ,&i(4nin+ in (r,%in bons# s!(& %s,& $%n)ib" 1$or fr8!n,2# ,& ("%i("%n) ,& !"n%
• C"ini(%" f%,!rs 0 –
O((!rs in firs, *%r of "if# !s!%""* !n)r < $on,&sof %+ – Sof, ,iss! s3""in+s in ,& %r%s 3&r bons
3i"" "%,r b ,&i(4n). – Inf%n, &% fr %n) %r irri,%b"
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• R%)io+r%'&i( f%,!rs 0 – S*$$,ri(%"# bi"%,r%" ino"$n, of ,&
$%n)ib". –
En"%r+$n, or ,&i(4nin+ of ,& "o3r bor)r of,& $%n)ib" %n) ,&i(4nin+ of ,& (or,7 of ,&o,&r %ff(,) bons.
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OSTEOGENESIS IMPERFECTA
• A s'(,r!$ of )is%ss of bon )! ,o %b%si( %",r%,ion in ,& for$%,ion of bon(onn(,i ,iss! $%,ri7# rs!",in+ in %n
in%bi"i,* of ,& $%,ri7 ,o f!""* $inr%"i#% ,n)n(* for $!",i'" bro4n bons#b"! s("r% of ,& *s# %n) %sso(i%,))n,ino+nsis i$'rf(,%.
•
Os,o+nsis i$'rf(,% is % srio!s)is%s of !n4no3n ,io"o+*.
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• C"ini(%" F%,!rs0 – I, is !s!%""* 'rsn, %, bir,&# %",&o!+& so$ (%ss
%r no, r(o+ni) !n,i" "%,r in (&i")&oo). – Fr%+i" bons rs!",in+ in $!",i'" fr%(,!r %n)
)fo$i,* of "on+ bons – M%* b born 3i,& $!",i'" fr%(,!rs 6!s, fro$ bir,&
'ro(ss
– B"! s("r%# &%rin+ "oss# &*'r,&r$i% – O'%"s(n, )n,in
• R%)io+r%'&i( F%,!rs0 – M!",i'" fr%(,!rs %n) &%") fr%(,!rs –
B!"bo!s (ro3ns of ,,&# ob"i,r%,ion of '!"'%"(&%$brs %n) s&or,n) roo,s – Uni"o(!"%r r%)io"!(n(is on bo,& si)s of ,&
$%n)ib" – Wor$i%n bons in ,& s4!""
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