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Radiology Revision Disease D.D 1) Caries 1. Abrasion, Attrition 2. Cervical burn out 3. Internal resoption 4.

Anterior fillings & older Rl silicate restoration 2) Rl with non vital 1. Periapical Cyst tooth 2. Abscess 3. Granuloma (most common) 4. apical scar 5. Surgical defect 3) Osteosclerosis 1. Hypercementosis (vital tooth) 2. Condensing osteitis (non-vital tooth) 3. Periapical cemental dysplasia 4. retained tooth 5. odontoma, unerupted tooth have their own chch. 6. Exostosis , enostosis, tori, peripheral osteoma 7. Diffuse sclerosing osteomylitis 8. Osteoblastic malignancy 9. Cementobalstoma 4) Osteomylitis Mixed+ill defined margins Osteosarcoma +chondrosarcoma Paget's disease Eosinophilic granuloma (D.D): ( 1.Oral carcinoma 2.central bony pathosis 3.Inflammatory condition 4.Cherubism) 5) Mixed Rl & RP 1. Chronic osteomylitis lesions 2. Diffuse sclerosing osteomylitis 3. Garre's osteomyleitis 4. Florid osseous dysplasia 5. PCD (periapical cemental dysplasia 6. Paget's disease(cotton wool) 7. Fibrous dysplasia 8. Ossifying fibroma 9. Osteosarcoma 10. Osteoblastic carcinoma 11. chondrosarcoma 12. Odontoms AOT- late stage bindborg tumor- chondromaosteoid osteoma- (sometimes)osteoblastoma 6) SCC Osteomylitis Osteoradionecrosis Histocytosis-X In general (all malignat carcinoma) 7) Metastasis Advanced perio disease 8) multiple myloma Metastatic carcinoma 9) Fibrosarcoma Osteolytic stage of osteosarcoma 10) early ossifying 1. Cyst(calcifying cyst) fibroma(well 2. small ameloblastoma defined, resorption, 3. Myxoma

soap bubbles) 11) Giant cell granuloma

12) Anurysmal bone cyst

4. 5. 1. 2. 3. 4. 5. 6. 1. 2.

Giant cell granuloma cementoma Ameloblastoma Myxoma Anurysmal bone cyst ossifying fibroma Brown tumor ( PTH) Traumatic bone cyst central hemangioma Giant cell granuloma Disease Globulomaxillary cyst Nasopalatine cyst (incisive canal cyst) 1- Central hemangioma 2- Ameloblastoma (late stage) 3- Odontogenic myxoma 4- Chondrosarcoma 5- Ossifying fibroma 6- Giant cell granuloma 7- Multiocular aneurismal bone cyst MOST OF the benign tumors 1. Fibrous dysplasia 2. Paget's disease (late stage) PSS

Characteristic Appearance Pear or tearshaped Rl Heart shape Rl HONEY COMB appearance(early) & Soap bubble appearance(late)

Obliteration of maxillary sinus Bone erosion near the mandibular angels (bilateral , symmetrical) & the coronoid resorbed & amputated, smooth sharply defined Moth eaten appearance Onion skin appearance Ground glass appearance

An open bite skeletal pattern Floating teeth Teeth standing in space) Hair on end Step ladder appearance Punched out appearance Rootless tooth Ghost teeth

Chronic suppurative osteomylitis 1. Garre's osteomylitis 2. Ewing's sarcoma 1. Paget's disease 2. Fibrous dysplasia 3. PTH 4. Ricketts 5. Chondrosarcoma 6. Anemia (thalessemia) Thyroid hormone 1. Eosinophilic granuloma (histocyosis-X) 2. SCC 3. Extensive periodontal diseases 1. Thalassemia 2. Sickle cell anemia 1.Sickle cell anemia in interdental area 2.Thalessemia 2. multiple myloma 3. esionophilic granuloma (histocytosis_x) Dentin dysplasia Odontogenesis imperfecta = odontodysplasia

Blue sclera Inverted Y shape Sunray appearance (sunburst)

Cotton wool Eyes raised to the heaven Tennis Racket appearance Scalloped Large pulp

Delayed apical closure Acromegaly: Hypopituitarism: Phleboliths Gardner's syndrome:

Osteogenesis imperfecta Union between floor of the nasal cavity with floor of maxillary sinus in the canine area 1. Myloma 2. Metastatic carcinoma 3. central hemangioma 4. Osteosarcoma 5. salivary gland tumor 6. Osteoblastoma (esp. in mandibular region) 7. Central Hemangioma 8. TB 9. advanced Ewing's sarcoma 10. Chondrosarcoma25% 11. other inflammatory disease 1. Florid osseous dysplasia 2. Paget's disease Cheruism Myxoma 1. Traumatic bone cyst (superior or occlusal margin) 2. mucoepidermoid tumors 3. sometime (large keratocytes) 1. Hypophosphatasia 2. hypophosphatemia 3. Odontodysplasia (odontogenesis imperfecta) 4. taurodontism 5. Inernal resoption Hypophosphatemia

class III skeletal malocclusion class I skeletal malocclusion are commonly found in central hemangioma 1. multiple osteomas 2. Cutaneous sebaceous cysts 3. subcutaneous fibromas 4. multiple small & large intestinal polyposis Fibro-osseous disease (Paget's disease, fibrous dysplasia, & may be traumatic bone cyst ) Systemic diseases( PTH, Ricketts, osteomalasia, any disease causes osteoporosis, Cushing's syndrome, D.M, Renal osteodystrophy, Anemia) Tumors (myloma metastasis, leukemia, lymphoma (Hodgeken's & non Hodgeken's , osteosarcoma, chondrosarcoma, lymphosarcoma, metastatic carcinoma) Cyst(localized action) Occlusal trauma (loss of LD definition) Generally found below the mandibular canal & above the inferior

Lesions causing loss of lamina dura (final Q):

Developmental S.G. defect

PDL space:

border of the mandible, anterior to the angel & behind the 3rd molar.. 1. PSS (progressive systemic sclerosis) 2. Osteosarcoma 3. Chondrosarcoma 4. Traumatic occlusion & periapical infection (localized) ex.Periapical abscess & Periapical granuloma @ the rot apex Separate condition or associated with other diseases, may be generalized or localized: a. Traumatic occlusion (hyperocclusion) b. Loss of antagonist , supereruption of a tooth c. Inflammation from apical infection d. Fractured teeth e. Hyperpituitarism (acromegaly , gigantism) f. Paget's disease 1. Pituitary dwarfism 2. hypoparathyroidism 3. Churbism 4. Deficiency vit.D (rickets' and osteomalasia) 5. Hypothyroidism a. Dens in dente (dens invaginatus) b. Dentin dysplasia c. Dens evagenatus if its fracted 1. Neuroma 2. Schwannoma 3. Neurofibroma 4. Myxoma 5. Osteoid osteoma 6. Osteoblastoma a. Schwannoma b. Neurofibroma N.B: Facial neuralgia , lip paresthesia are frequent complication of the sarcoma 1. Ameloblastoma 2. CEOT 3. Chondroma(locally) a. Odontoma b. Adenomatoid odontogenic tumors 1. Neurofibroma 2. Chondroma 1. Skin lesion (multiple bsal cell carcinoma) esp. face, neck, trunk 2. Jaw lesion ( multiple jaw cysts) esp. multiple odontogenic keratocytes (primordial, dentigrous,radicular) 3. Skeletal abnormalities a. Peio D. b. Present of 1 or few adjacent loose teeth when the rest the mouth shows no sings of perio D. c. SCC of the alveolar process


Delayed root formation

Periapical inflammatory lesion associated with: Benign tumors that cause pain:

Benign tumors that cause parathesia: Invasive benign tumors: Hamartomas benign tumors: Benign tumors that have malignant changes: Basal cell nevus Syndrome (Gorlin's syndrome)

Diseases causing bony destruction around roots:

d. Langerhan's cell histocytosis (eosinophilic granuloma)

Root resoption External root resoption Displacement of tooth Asso. e unerupted tooth Bone expansion Asso. e missi ng teeth


*cemento*Aneurysmal bone ossifying fibroma cyst *paget's disease *CGCG *Fibrous dysplasia *traumatic bone cyst *Hyperparathyroi dism *Ameloblastoma *pindporg tumor *odontogenic myxoma *cementoblastoma *dentinoma *Shwannoma *chondroma *central hemangioma *Ameloblastic odontoma *Chondrosarcoma *SCC *metastatic carcinoma *Dentigerous cyst * Long standing radicular cyst *(sometimes) Globulomaxillary cyst . *(sometimes)Gorli n's cyst. *Hypoparathyroid ism *Hypothyroidism

*Fibrous dysplasia *Ossifying fibroma *Cherubism *Aneurymal bone cyst *Paget's disease

* Fibrous dysplasia * Ossifying fibroma *Paget's disease * Osteopetrosis


*Central hemangioma *Ameloblastoma *AOT *Ameloblastic odontoma *Myxoma

*Ameloblasto ma *Myxoma *AOT *PIndporg tumor *Adontoma (complex) *Ameloblastic fibroma (may be) *dentinoma *Gardner's syndrome

* Ameloblastoma *Pindborg tumor * Ameloblastic odontoma *myxoma Osteoid osteoma


*Fibrosarcoma *multiple myloma * Nasopalatine cyst (sometimes) * Radicular cyst * Dentigrous cyst * Enlarged odonto. Keratocystes * Primordial cyst * dentigrous cyst * Primordial (sometimes) * Gorlin's cyst (someties) * Radicular (rarly) * Dentigrous * Keratocyte



* Garr's osteomyelitis

* myxoma*Ameloblastic fibroma


KODAKROOM (2001-2002): 1. Rolling system with developer (faulty radiograph) 2. Cherubism 3. Maxillary sinus 4. Sickle cell anemia 5. Transposition 6. Impaction surrounded by radiolucency D.D # 2) 7. Dens invagenatis 8. Florid osseous dysplasia 9. Horizontal bone loss 10. Filtration (fig.6 in dr.sa7ar sheet ) 11. Static bone cyst 12. Type of trabeculation in the lower jaw 13. How do you know that the pic is inverted? 14. Pulp stone 15. 2 films upon each other, when is light, why?