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Benign tumors of the bone

1- Torus / Exostosis / Osteoma . 1- Torus : rounded, smooth surfaced, non-neoplastic growth of nodular dense bone found in the midline of the palate

Faraday
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Benign tumors of the bone

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    1. Benign tumors of the bone

    3. Treatment: lesions are only treated if the patient encounters problems or a prosthetic appliance is necessary. The treatment is done by surgery Histopathology: Each of the lesions is composed of dense cortical bone with a lamellar pattern. The cortical bone is sclerotic & relatively avascular, & the medullary bone is denser than normal with reduced marrow spaces.

    4. 1-Torus,exostosis,osteoma

    5. 2- Osteoid osteoma / osteoblastoma: Benign intraosseous lesions with similar clinical, radiographic, & histopathologic features. Clinically: 1- the lesion produce swelling & pain on palpation. 2- occur in young patients. 3- osteoid osteoma is small (0.5-2 cm ), while osteoblastoma are larger (< 2 cm).

    6. Radiographically: Are distinctive & pathognomonic, they are round, with a well defined central radiolucency (nidus) surrounded by a zone of radiopacity.

    7. Histopathology: The lesion consist of osteoid bone, then become well calcified with small focus of active osteoblasts. The center usually remain vascular with increased number of osteoblasts & osteoclasts. Treatment: Surgical removal. Osteoid osteoma by curettage or block resection, while osteoblastoma requires large surgical block resection.

    8. 3- Cemento-Ossifying fibroma: A well-demarcated, encapsulated, expansile intraosseous lesion of the jaws composed of cellular fibrous tissue containing spherical calcifications & irregular, randomly oriented bony structures Clinically: 1- Most often located in the mandible posterior to the canines & occasionally occurs in max. 2- it occurs twice as often in females & mainly in the 20-30 years age group. 3- the lesion is usually painless & grow slowly, show marked buccal & lingual bone expansion. Radiographically: It may be either unilocular or multilocular. In early stage the lesion is small & completely radiolucent. As they enlarge, amounts of irregular shaped radiopacities appear within the radiolucent area. In the later stage, the lesion often forming a nearly radiopaque with a thin radiolucency separating it from the surrounding normal bone.

    9. Treatment: by surgical removal, the extent depending on the size & location of the lesion. Histopathology: Composed of cellular fibrous tissue, with spherical amorphous calcifications (cementicle) as well as irregular small bone trabeculae. A thin outer fibrous C.T. separating the lesion from surrounding normal bone.

    10. 4-Central giant cell granuloma (CGCG): An intraosseous destructive lesion of the anterior mand. & max., cause movement of the teeth, & produce root resorption; composed of multinucleated giant cell in a background of mononuclear fibrohistocytic cells & RBC. Clinically: Mostly occurs between 10-30 years of age. It occur in the anterior mand. & max, but 75% in the mand. & crossing the midline. Expansion of the buccal & lingual cortical plates is common, & sometime the lesion perforate the cortex & resorption of the root apices.

    11. Radiographically: is not specific, but show diffuse radiolucency (relatively large), with resorption of tooth roots

    12. Treatment: are successfully treated by curettage, but sometime will recur & require one or more retreatments. Block resection is done in large lesions. Histopathology: The lesion is composed of giant cells, usually containing 5-10 nuclei, in a background of mononuclear cells & fibrous tissue.

    13. 5-Peripheral giant cell granuloma(PGCG): Most common of the giant cell lesions of the jaws, arising from the periosteum or periodontal membrane as a purplish-red nodular consisting of multinucleated giant cells in a background of mononuclear cells & RBCs. Clinically: Is the most common giant cell lesion occurring in the jaws. Occurs at any age, with peaks in the incidence during the mixed dentition years & 30-40 year old age group. & mostly affect the females. Mostly appear as a sessile focal purplish nodule on the gingiva, may reach 2 cm in size. Spreading through penetration of the PdL.

    14. Radiographically: small lesions show little radiographic changes, while larger one show superficial erosion of the cortical bone, & some widening of the PdL. Histopathology: Composed of multinucleated giant cells in a background of mononuclear cells & extravasated RBCs ., the lesion are surrounded by bands of fibrous C.T. stroma. Osteoid deposits or speckles of new bone are often present in the base of the lesion.

    15. Treatment: By surgical removal, & when PdL is involved, the associated teeth may need to be extracted.

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