Слайд 3Pericoronitis
Erupting or partially impacted third molars
Inflamed gingiva
Trismus
Cellulitis
Слайд 4Pericoronitis (R/F)
In early stages, minimal radiographic changes
Radiolucency adjacent to the crown
Ill-defined
periphery
Sclerotic border in late stage
Osteomyelitis, in sever cases
Слайд 9Acute Suppurative Osteomyelitis
Слайд 10Acute Suppurative Osteomyelitis
Dental infection – most common cause
Other causes: fracture, wound, hematogenous
spread
Common organisms: Staph. aureus, Staph. albus, tuberculosis, actinomycosis, syphilis, mixed organisms
Слайд 11Suppurative Osteomyelitis
May involve either jaw
Localized in maxilla, diffuse in mandible
Severe pain
temperature,
WBC count
Слайд 12Suppurative Osteomyelitis (R/F)
Early stages: no radiographic changes
Ill-defined periphery
Decrease in the density of
bone
Followed by increased radiolucency
Sclerosis at later stages
Sequestra: nonvital bone
Слайд 13Suppurative Osteomyelitis (R/F)
Resorption
Periosteal new bone formation
Proliferative periostitis
Fistula formation
Radiographic features similar to malignant
lesions
Слайд 32Chronic Focal Sclerosing Osteomyelitis
Слайд 33Chr. Focal Sclerosing Osteomyelitis
Sclerosing or condensing osteitis
Younger, < 20 yrs
Mostly mandibular first
molar
Large carious lesion
Слайд 34Focal Sclerosing Osteomyelitis (R/F)
Initial stage – no radiographic signs
Rarefying osteitis – radiolucent
area
Sclerosing osteitis – dense sclerotic bone, trabeculation difficult to identify
Difference with idiopathic osteosclerosis
Слайд 39Chronic Diffuse Sclerosing Osteomyelitis
Слайд 40Chr. Diffuse Sclerosing Osteomyelitis
May not be associated with carious teeth
Intermittent, recurrent episodes
of swelling, pain, fever
Any age, mostly elderly patients
Prevalence in African American
Chronic low grade infection
Pain, if present, is often mild
Acute exacerbation
Слайд 42Chronic Osteomyelitis With Proliferative Periostitis
Garre’s Periostitis
Слайд 43Chronic Osteomyelitis With Proliferative Periostitis
Garre’s Periostitis (1893)
Younger, <25 yrs
Mostly mandible
Слайд 44Garre’s Periostitis (R/F)
Often associated with a carious tooth
Mottled, predominantly lucent
Focal overgrowth of
bone
“Onion-skin” appearance : layering of cortical bone
Слайд 52Osteoradionecrosis
Radiotherapy (40 to 80 Gy)
Decreased vascularity
Low defense
High susceptibility to extraction, perio, pulpal
disease, denture sore
Слайд 53Osteoradionecrosis (R/F)
Similar to osteomyelitis
Diagnosis established by history
Слайд 57Florid Cemento-osseous Dysplasia
Слайд 58Florid Cemento-osseous Dysplasia
Wide-spread form of periapical cemental dysplasia
Mostly female, middle-aged, African, Asian
May
not be symptomatic
Слайд 59Florid Cemento-osseous Dysplasia
Poor vascular supply – prone to infection
Osteomyelitis, if infected
Preventive management
Слайд 60Florid C-O Dysplasia (R/F)
Usually bilateral, both jaws
Well-defined sclerotic border
Internal content of mixed
density
Large irregular masses
Hypercementosis