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March 2015

A 16-year-old male reported to the dental clinic for a regular checkup. Radiographic examination revealed a well-defined, mixed density lesion, and a radiolucent margin in the left mandibular region is noted. The tooth #21 is impacted and a retained deciduous molar is noted as well. What is the most likely diagnosis?

 

INCORRECT.

A calcifying cystic odontogenic tumor appears as a unilocular, well-defined radiolucency, although the lesion may occasionally appear multilocular. Radiopaque structures within the lesion, either irregular calcifications or toothlike densities can be present as small flecks or smooth pebbles. In some cases, it may be associated with an odontoma.

 

 

INCORRECT.

An adenomatoid odontogenic tumor can appear as a circumscribed, unilocular radiolucency that involves the crown of an unerupted tooth or located between the roots of erupted teeth. The lesion is usually completely radiolucent; however, it can contain fine (snowflake) calcifications.

 

 

CORRECT.

Radiographically, a compound odontoma appears as multiple, tooth-like structures with varying dimensions and these structures are surrounded by a radiolucent rim.

 

 

INCORRECT.

Complex odontomas appear as an irregular calcified mass (no tooth-like structures are noted) on radiographs and are surrounded by a radiolucent rim.

 

 

INCORRECT.

Radiographically, a calcifying epithelial odontogenic tumor exhibits either a unilocular or a multilocular radiolucent defect usually associated with an impacted tooth. The margins of the lytic defect are often scalloped and usually relatively well-defined. However, in some cases they exhibit an ill-defined periphery. The lesion may be entirely radiolucent, but the defect usually contains scattered calcified structures of varying size and density. One of the characteristic features is appearance of radiopacities close to the crown of an embedded tooth.

 


March 2015 References

Neville B, Damm DD, Allen CM, Bouquot J. Oral and Maxillofacial Pathology, 3rd Edition, W.B. Saunders Co.; 2009

White SC, Pharoah MJ. Oral Radiology: Principles and Interpretation, 7th Edition, Mosby; 2014


February 2015

A 14-year-old male presents to the dental clinic with upper and lower lip swelling present for several days. The patient has noncontributory medical history. The incisional biopsy revealed chronic inflammatory infiltrate with formation of noncaseating granulomas. What is the diagnosis?

 

INCORRECT.

Angioedema is diffuse edematous swelling of the soft tissues that most commonly involves the subcutaneous and submucosal connective tissues. It is commonly caused by histamine release from mast cells due to presence of allergen.

 

 

INCORRECT.

 

 

 

CORRECT.

Orofacial granulomatosis is a term used to describe swelling of the orofacial area, mainly in the lips, due to an underlying granulomatous inflammatory process. It can be an oral manifestation of diseases like sarcoidosis and Crohn’s disease and possibly may be associated with a dietary trigger. It is also commonly seen as a sign of allergic reaction to common food allergens, such as cinnamon and benzoate. The labial tissues demonstrate a nontender, persistent swelling that may involve one or both lips. The diagnosis of orofacial granulomatosis is made on histopathologic demonstration of granulomatous inflammation that is associated with negative special stains for organisms and no foreign material.

 

 

INCORRECT.

 

 

 

INCORRECT.

 

 


February 2015 References

Neville B, Damm DD, Allen CM, Bouquot J. Oral and Maxillofacial Pathology, 3rd Edition, W.B. Saunders Co.; 2009


January 2015

A 40-year-old female presented to dental clinic with 0.5 x 0.5 cm mucosa colored, sessile gingival nodule. Upon histopathologic examination, the lesion showed bone formation surrounded by fibrous connective tissue. What is your diagnosis?

 

INCORRECT.

Peripheral odontogenic fibroma is a benign neoplasm of odontogenic ectomesenchymal origin. Histopathologically, it is characterized by relatively mature collagenous fibrous tissue with scattered odontogenic epithelium.

 

 

INCORRECT.

 

 

 

INCORRECT.

Peripheral giant cell granuloma represents a reactive lesion, not a true granuloma, caused by local irritation or trauma. Microscopic examination shows a proliferation of multinucleated giant cells. The clinical appearance is similar to pyogenic granuloma, where the peripheral giant cell granuloma often is more blue-purple compared with the bright red of a typical pyogenic granuloma

 

 

CORRECT.

Peripheral ossifying fibroma is a relatively common gingival growth that is considered to be reactive rather than neoplastic in nature. It occurs exclusively on the gingiva. The microscopic pattern of shows fibrous proliferation associated with the formation of a mineralized product. Excision is usually curative; however a recurrence rate of 8% to 16% has been reported.

 

 

INCORRECT.

Pyogenic granuloma is a common tumor-like growth considered to be reactive in nature. It is not a true granuloma but a tissue response to local irritation or trauma.

 


January 2015 References

Neville B, Damm DD, Allen CM, Bouquot J. Oral and Maxillofacial Pathology, 3rd Edition, W.B. Saunders Co.; 2009