HEAD AND NECK FOR DENTISTRY LECTURE 3, DISEASES OF THE JAW

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Presentation transcript:

HEAD AND NECK FOR DENTISTRY LECTURE 3, DISEASES OF THE JAW DR HEYAM AWAD FRCPATH

INFLAMMATORY LESIONS OF THE JAW DENTAL GRANULOMAS. HYALINE RING LIKE STRUCTURS. OSTEOMYELITIS.

DENTAL

EPITHELIAL CYSTS EPITHELIAL CYSTS OF THE MANDIBLE AND MAXILLA ARE COMMON DISEASES. CLINICO- RADIOLOGICAL AND PATHOLOGICAL CORRELATION IS ESSENTIAL TO REACH A SPECIFIC DIAGNOSIS.

EPITHELIAL CYSTS TWO TYPES: ODONTOGENIC CYSTS : ARISE FROM ODONTOGENIC EPITHELIUM AND LOCATED IN THE JAW. NONODONTOGENIC CYSTS: ARISE FROM EPITHELIAL INCLUSIONS IN SOFT TISSUE OR BONY PORTIONS OF THE REGION ALONG EMBRYONAL FISSURE LINES.

ODONTOGENIC CYSTS DENTIGEROUS CYSTS. ERUPTION CYSTS. GINGIVAL CYSTS. KERATOCYSTS. RADICULAR CYSTS.

DENTIGEROUS CYST THESE CYSTS SURROUND OR ARE ASSOCIATED WITH UNERUPTED TEETH. YOUNG ADULTS. ARISE FROM ENAMEL EPITHELIUM. SWELLING AND PAIN.

DENTIGEROUS CYST THIN FIBROUS WALL LINED BY KERATINIZED STRATIFIED SQUAMOUS EPITHELIUM. SECONDARY CHANGES: INFLAMMATION, ULCERATION, HYPERPLASIA, METAPLASIA, CALCIFICATION AND CLUSTERS OF HISTIOCYTES.

DENTIGEROUS CYSTS DYSPLASIA AND CARCINOMA CAN ARISE IN THESE CYSTS. SURGICAL EXCISION IS THE TREATMENT OF CHOICE. RECURRENCE IS UNUSUAL.

ERUPTION CYSTS A SUBTYPE OF DENTIGEROUS CYSTS. ABOVE ERUPTING PRIMARY TEETH OR RARELY ABOVE PERMANENT TEETH. GENGIVAL SWELLING. INFLAMED, HEMORRHAGIC CYST WALL LINED BY THIN NONKERATINISING STRATIFIED SQUAMOUS EPITHELIUM.

GINGIVAL CYST IN NEWBORN INFANTS. MINUTE CYSTIC FORMATIONS. SEEN IN MOST NEONATES AND GRADUALLY DISAPPEAR WITHIN WEEKS.

RADICULAR OR PERIAPICAL CYSTS THE MOST COMMON JAW CYST. DUE TO INFLAMMATION. MORE IN THE THIRD AND FOURTH DECADES. IF SEEN AFTER TOOTH EXTRACTION = RESIDUAL CYSTS.

LINED BY STRATIFIED SQUAMOUS EPITHELIUM. ULCARATION IS COMMON. METAPLASIA AND CALCIFICATIONS CAN OCCUR.

KERATOCYSTS 10% OF THE JAW CYSTS. SOLITARI IN 90% OF CASES. MULTIPLE IN 10% OF CASES; ASSOCIATED WITH GORLIN’S SYNDROME. MOST COMMON SITE: THIRD MOLAR REGION OF THE MANDIBLE. PRESENT AS PAINFUL SWELLINGS. HIGH RATE OF RECURRENCE.

NONODONTOGENIC CYSTS NASOALVEOLAR CYSTS. NASOPALATINE DERMOID CYSTS PALATAL CYSTS

NASOPALATINE CYST IS THE MOST COMMON NONODONTOGENIC CYST AND IS LINED BY SQUAMOUS OR RESPIRATORY EPITHELIUM.

ODONTOGENIC TUMOURS TUMOURS OF THE JAW WHICH DIFFERENTIATE TOWARDS TOOTH STRUCTURS. RARE TUMOURS. BENIGN, BORDERLINE OR MALIGNANT TUMOURS.

BENIGN ODONTOGENIC TUMOURS SQUAMOUS ODONTOGENIC TUMOUR. ADENOMATOID ODONTOGENIC TUMOUR. AND OTHERS!

BORDERLINE TUMOUR AMELOBLASTOMA THE MOST COMMON EPITHELIAL ODONTOGENIC TUMOUR. THIRD TO FIFTH DECADES OF LIFE. 80% IN THE MANDIBLE. RADIOGRAPHY: LYTIC EXPANSILE LESION.

AMELOBLASTOMA SEVERAL HISTOLOGICAL PATTERNS. MOST COMMON PATTERNS ARE FOLLICULAR AND PLEXIFORM. FOLLICULAR SUBTYPE: NESTS OF LOOSE NETWORK OF CELLS RESEMBLING STELLATE RETICULUM, SURROUNDED BY AN OUTER PALISADED LAYER OF TALL COLUMNER EPITHELIUM.

MALIGNANT TUMOURS AMELOBLASTIC CARCINOMA IS A TUMOUR THAT HAS HISTOLOGICAL FEATURES SIMILAR TO AMELOBLASTOMA BUT ALSO SHOW MALIGNANT FEATURES SUCH AS NUCLEAR ATYPIA AND INCREASED MITOTIC RATE.