Lesions of the Jaw
Introduction
Imaging of lesions within the maxilla and mandible is often fraught with difficulty owing to the similarity in the imaging appearance of a diverse array of pathologic processes. Principally, lesions arise from either odontogenic sources (lesions arising from tooth forming epithelium) or primarily from bone. The response of the cancellous and cortical bone to pathologic insult can be expressed either through an osteolytic or an osteoblastic response; thus, most lesions within the jaws can be classified as cystic or lytic appearing, sclerotic, or a mixture of the two. This article will review the imaging features of the most common cysts, fibro-osseous lesions, benign and malignant neoplasms, and highlight those features key to the differential diagnosis.
Section snippets
Cystic Lesions: Cysts and Benign Tumors
Most lesions arising within the jaws present with some form of osseous demineralization, rarefaction, or remodeling rendering them lytic or cystic appearing on imaging. The degree of osseous rarefaction and remodeling will differ among inflammatory, benign, and malignant lesions, and it is this feature, along with location of the lesion, which allows for differentiation.
The most common odontogenic cyst is the radicular cyst, which arises secondary to pulpal necrosis of a tooth following
Mixed Cystic and Sclerotic Lesions: Benign Fibro-Osseous Lesions
Bony expansion and septation of the alveolus represents the osteolysis, replacement and or remodeling of the cancellous trabeculation by a neoplastic mass and as such these findings are relatively nonspecific to the odontogenic neoplasms. Nonodontogenic neoplasms will similarly expand bone and may be septated. Ossifying fibromas (Cemento-ossifying fibromas) are among the most common nonodontogenic neoplasms to arise within the alveolus, but as their tissue of origin is not odontogenic, they are
Mixed Cystic and Sclerotic or Sclerotic Lesions: Benign and Malignant Tumors
The mixture of soft tissue neoplastic elements and cartilaginous or ossified neoplastic elements, or the osseous destruction of bone, will generate the appearance of lesions having a mixed cystic and sclerotic composition. Although the most common benign odontogenic neoplasms are typically cystic in appearance, more uncommon or rare lesions including the odontogenic myxoma, and the calcifying epithelial odontogenic cyst and calcifying epithelial odontogenic tumor will appear mildly dense or
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Cysts and Benign Odontogenic Tumors of the Jaws
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2023, Dental Clinics of North AmericaCitation Excerpt :Radiographically, ameloblastoma and KCOT may present as unilocular or multilocular radiolucency predominantly in the posterior mandible and ramus.54 Clinical signs and symptoms of malignant jaw tumors may include pain, paresthesia or anesthesia, a rapidly expanding swelling, and mobility of teeth within the field of disease.54 The primary malignant jaw tumor, osteosarcoma of the jaw, is rare (primarily accounting for approximately 4% of all the primary malignant jaw lesions and 7% of all osteosarcomas) and commonly occurs in the fourth decade of life.55
A possible case of ameloblastoma in an adult male from the early 20th century Coimbra, Portugal
2021, International Journal of PaleopathologyCitation Excerpt :Ameloblastoma is a slowly growing, locally invasive, benign epithelial neoplasm. It is the second most common benign odontogenic tumour, only next to odontoma, sharing with it a tendency for being locally aggressive and having a relatively high recurrence rate (Mosier, 2015). In most cases, it affects the ramus and posterior body of the mandible (Giraddi et al., 2017).
Guided biopsy of osseous pathologies in the jaw bone using a 3D-printed, tooth-supported drilling template
2019, International Journal of Oral and Maxillofacial SurgeryIs it a cystic or a cyst-like condition? Discussing the etiology of an unusual large mandibular lesion in a Roman skeleton from Quinta da Torrinha/Quinta de Santo António (Almada, Portugal)
2018, International Journal of PaleopathologyCitation Excerpt :In fact, any lytic radiolucent lesion detected on conventional radiography may suggest different conditions, not always easy to identify. This occurs because different conditions may produce similar imaging appearances (Dunfee et al., 2006; Mosier, 2015). Histopathological typing of teeth and adjacent soft tissues is crucial to understand the origin and interactions of the tissues seen in jaw lesions (Kramer et al., 1992).