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8/3/2019 Lab 6 Paget`s Disease and Bone Tumors2010 Shorter
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Lab Paget`s Disease
and Bone TumorsDr. Rima Safadi
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Torus palatinusEtiology: genetic versus environmentalArises at the midline of the hard palate
Can slowly increase in size
Peak prevalence is in adult- dynamic
Nodular torus Lobular torusSpindle torus and flat torus
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Torus mandibularis
At the lingual aspectPresent above themylohyoid line90% bilateralVaries in sizeCan correlate with
bruxismTrt: surgical removalfor dentureconstruction
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Exostoses
Buccalexostosis
Subpontine exostosis
Palatal exostosis
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Exostosis
Histopathology
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Dense Bone Island
IdiopathicosteosclerosisSclerotic bone
Premolar regionof the mandibleWell defined notsurrounded byradiolucent lineSeparated orattached to root
apex
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12 Well defined radiolucent radioopaque
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Ossifying fibroma
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Ossifying fibroma
Fibrous stroma
Bone trabeculae
Osteoblastic rimming
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Psammomatoid ossifying fibroma
Cementum like bodies
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Ossifying fibroma
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Loose teeth
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Also gingival swelling
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Differential diagnosis??
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Floating in air teeth
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Biopsy
Langehrans cell-malignanteosinophils
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Diagnosis?
Langerhans cell histiocytosis
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74 yr old hospitalized for low backpain
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Punched out radiolucencies
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Also present is gingival swelling
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Malignant plasmacells
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Malignant plasmacells
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Immunohistochemistrykappa light chain (positive)
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Immunohistochemistrylambda light chain(negative)
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Diagnosis:
Multiple myeloma
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Malignant osteoid
Malignantosteoblasts
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Hemangioma
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Central hemangioma
Cavernous blood spaces
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Ill defined RL in anterior maxilla
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Chondrosarcoma
Malignant chondroi
Malignant chondroblasts
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Hard swelling at right angle ofmandible
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Compact osteoma
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Colonic biopsy
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Adenoma
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Diagnosis
Gardner Syndrome
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Paget`s Disease of Bone
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Paget`s Disease of Bone
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Paget`s Disease of Bone
P ’ Di
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Paget’s Disease Oral Features
When teeth areinvolved:Ankylosis
HypercementosisRoot resorption inosteolytic phase
Postextractionhemorrhage in activephaseMore prone to infectionin sclerotic phase
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Paget`s Disease of Bone
Loss of diploeDense bone
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Paget`s Disease of Bone
Reversal lines ciss-cross lines
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Osteosarcoma
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Metastatic carcinoma
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Metastatic disease
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Mts