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Case 1

Antral Pseudocyst

A 52-year-old male presents to the dental clinic for an admitting visit. Radiographic examination revealed a dome shaped radiopacity in the right sinus. What is the most likely diagnosis?

 

INCORRECT.

True sinus mucocele is an accumulation of mucin that is completely encased by epithelial lining. It can occur by trauma (such as sinus surgery) or it can arise from an obstruction of the sinus ostium, thereby blocking normal drainage.

 

 

INCORRECT.

Periapical cysts and granuloma cannot be differentiated by radiographic examination alone. Both lesions are related to non-vital tooth and radiographically appear radiolucent with absence of lamina dura at the apical area.

 

 

INCORRECT.

Periapical cysts and granuloma cannot be differentiated by radiographic examination alone. Both lesions are related to non-vital tooth and radiographically appear radiolucent with absence of lamina dura at the apical area.

 

 

CORRECT.

Antral Pseudocyst is a retention pseudocyst, where the process consists of inflammatory exudate primarily serum. It accumulates under the maxillary sinus mucosa and causes a dome shaped elevation. It is asymptomatic and the patient is usually unaware of the lesion. The lesion does not require treatment because they can resolve spontaneously without any residual effect on antral mucosa.

 

 

INCORRECT.

Odontogenic cysts, such as keratocystic odontogenic tumors, displace the floor of the antrum and the border of the cyst becomes coincident with the bony sinus floor.

 


Case 1 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, 6th Edition, Mosby; 2009

 

Case 2

A 77-year-old female presented to the dental clinic for a routine visit. Upon radiographic examination, a linear radiopacity near the spinal column was noted. During extra-oral examination, patient was asymptomatic. What is the most likely diagnosis?

 

INCORRECT.

 

 

CORRECT.

The styloid process is a long cartilaginous bone located on the temporal bone. The muscles and ligaments which have a role in mastication and swallowing are attached to the styloid process. Ossification of stylohyoid ligament can be detected on panoramic radiographs as linear radiopacity extending from posteroinferior aspect of the ramus toward the hyoid bone. Symptoms, such as neck and cervicofacial pain, related to elongated stylohyoid process or ossification of stylohyoid ligament is called Eagle Syndrome. For asymptomatic individuals, no treatment is required. For symptomatic patients, recommended treatment can include steroid or lidocaine injections into tonsillar fossa or amputation of stylohyoid process.

 

 

INCORRECT.

 

 

INCORRECT.

Arterial calcifications can be seen in facial artery and are less commonly in the carotid artery. Calcified vessels appear as a parallel pair of thin, radiopaque lines that follow the anatomy of the artery (straight or tortuous).

 

 

INCORRECT.

Sialolith involving the parotid gland appears as a round to cylindrical in shape radiopacity and will superimpose on the body of the ramus radiographically.

 


Case 2 References

White SC, Pharoah MJ. Oral Radiology: Principles and Interpretation, 6th Edition, Mosby; 2009

 

Case 3

A 13-year-old female presents to the dental clinic for routine care. Upon radiographic examination, a teardrop-shaped, well-defined radiolucency is noted between the right mandibular lateral incisor and canine, causing displacement of teeth. Both teeth were vital. What is the most likely diagnosis?

 

INCORRECT.

Dentigerous cysts are related exclusively to impacted teeth in coronal position.

 

 

INCORRECT.

Lateral radicular cysts appear to be laterally positioned to the tooth mimicking lateral periodontal cysts, however, the associated tooth will be non-vital.

 

 

CORRECT.

Lateral periodontal cyst is thought to arise from epithelial rests entrapped in the lateral periodontium of the tooth. The lesion is asymptomatic and found mostly in the region extending from the lateral incisor to second premolar. It appears as a well-defined radiolucency with prominent cortical boundary and round or oval shape. The radiographic differential diagnosis of such lesions includes keratocystic odontogenic tumor (KOT) or radicular cyst (related to non-vital tooth) at foramen of lateral or accessory pulp canal. The treatment includes excisional biopsy or simple enucleation. There is no recurrence.

 

 

INCORRECT.

Gingival cyst of adult is the soft tissue counterpart of a lateral periodontal cyst. It usually does not demonstrate any bony involvement.

 

 

INCORRECT.

Radicular (periapical) cyst is associated to the root of non-vital tooth.

 


Case 3 References

White SC, Pharoah MJ. Oral Radiology: Principles and Interpretation, 6th Edition, Mosby; 2009