Interpretasi Radiografik

Mixed lesions

Purbo Seputro drg.

Skills Lab Blok 6 RADIOLOGI KEDOKTERAN GIGI 3 ( RKG 3 )

PROGRAM STUDI PENDIDIKAN DOKTER GIGI FAKULTAS KEDOKTERAN UNIVERSITAS BRAWIJAYA

Mixed lesions
Periapical / Pericoronal mixed lesions

Periapical / Pericoronal mixed lesions

Cementoma (periapical cemento-osseous dysplasia) 2nd stage Odontoma (mixed lesion) Adenomatoid Odontogenic Tumor (AOT) (mixed)

Calcifying Epithelial Odontogenic Tumor (CEOT)

Calcifying odontogenic cyst (Gorlin cyst) Cementoblastoma

Cementoma

(periapical cemento-osseous dysplasia) 2nd stage

Features
Apices of several lower incisors Middle aged adults (typically black women). Round, monolocular, often multiple. Adjacent teeth: typically vital, not displaced, not resorbed. The periapical ligament space is intact.

Small, up to 1 cm in diameter.

Radiodensity Early stage: Radiolucent, not corticated Intermediate stage: Radiopacity within the apical radiolucencies Late stage: Densely radiopaque but surrounded by a thin radiolucent line.

Differential Diagnosis Odontoma (mixed lesion) Cementoblastoma

Odontoma (mixed lesion)

Features
Relatively common lesion. Two types: complex and compound odontoma. Complex odontoma is composed of haphazardly arranged dental hard and soft tissues. Compound odontoma is composed of many small "denticles" . It usually occurs in young patients. Usually asymptomatic. Failure of eruption of a permanent tooth may be the first presenting symptom.It is commonly found occlusal to the involved tooth. Well defined. The internal aspect is very radiopaque in comparison to bone

 Differential Diagnosis Cementoblastoma Adenomatoid Odontogenic Tumor (AOT) (mixed) Cementoma (periapical cemento-osseous dysplasia) 2nd stage

Adenomatoid Odontogenic Tumor (AOT) (mixed)

Features

Benign. Relatively rare. It occurs in young patients (70% of cases in patients younger than 20 years). Most common site: anterior maxilla. Often surrounds an entire unerupted tooth (most commonly the canine). Usually well defined, well corticated. Some tumors are totally radiolucent; others show evidence of internal classification (mixed radiolucency).

Differential Diagnosis Odontoma (mixed lesion) Calcifying odontogenic cyst (Gorlin cyst)

Calcifying Epithelial Odontogenic Tumor (CEOT)

Features Rare benign neoplasm. It occurs more often in middle-aged patients. Usually in mandible. Small lesions may be radiolucent. In advanced stages irregularly sized calcifications may be scattered in the radiolucency. It can cause displacement and impaction of teeth.

Differential Diagnosis Calcifying odontogenic cyst (Gorlin cyst) Adenomatoid Odontogenic Tumor (AOT) (mixed) Cemento-Ossifying fibroma (2nd stage)

Calcifying odontogenic cyst (Gorlin cyst)

Features Rare. Usually in young patients under 40 years old. More often in maxilla. Initially as well-defined radiolucency. In advanced stages irregularly sized calcifications may be scattered in the radiolucency. It can cause displacement of teeth and root resorption

Differential Diagnosis Calcifying Epithelial Odontogenic Tumor (CEOT) Adenomatoid Odontogenic Tumor (AOT) (mixed) Cemento-Ossifying fibroma (2nd stage)

Cementoblastoma

Features

Benign neoplasm. Most commonly in the second and third decade. Site: usually mandibular premolar and molar regions. Attached to the root of the affected tooth. Tooth displacement, resorption are common. Pain in 50% of the cases, swelling. Three stages of development: radiolucent mixed radiopaque. When radiopaque is usually surrounded by a thin radiolucent halo.

Differential Diagnosis Cementoma (periapical cemento-osseous dysplasia) 2nd stage Odontoma (mixed lesion) Cemento-Ossifying fibroma (2nd stage) Calcifying odontogenic cyst (Gorlin cyst) Calcifying Epithelial Odontogenic Tumor (CEOT)

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