[Oradlist] Differential Diagnosis for mandibular ossifications/calcifications

[Mansur Ahmad]

Dear Aruna;

This is quite interesting. To me this lesion appears to be melorheostosis.
This condition is rare in jaws, more common in long bones. The radiopacity
in long bones look like dripping candle wax by cortical walls. The
literature reports only a few cases in the jaws. Your case has similar bumpy
appearance. Mostly an incidental finding, as in your case. 

>From my collection, I am attaching images from long bones. In my patient,
jaws were normal. 

Thanks

Mansur Ahmad

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Mansur Ahmad, BDS PhD, 
Associate Professor and Director, Oral and Maxillofacial Radiology,
University of Minnesota School of Dentistry
Director and Secretary/Treasurer: American Board of Oral and Maxillofacial
Radiology
7-536 Moos Tower, 515 Delaware Street SE, Minneapolis, MN 55455
Phone 612-625-6147, Fax 612-624-0477

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-----Original Message-----
From: oradlist-bounces at lists.ucla.edu
[mailto:oradlist-bounces at lists.ucla.edu] On Behalf Of Ramesh, Aruna
Sent: Tuesday, December 14, 2010 2:40 PM
To: oradlist at lists.ucla.edu
Subject: [Oradlist] Differential Diagnosis for mandibular
ossifications/calcifications

 Hello all,

This case was referred to our oral path department for a consult, and sent
to me by them. 

This panoramic is of a 24 year old asymptomatic female involved in a MVA two
weeks ago, with some soft tissue injuries but no facial bone fractures.  The
radiopacities in the anterior mandible and very thick inferior cortex of the
mandible were incidental findings.  She denies any history/clinical
diagnosis.

My thoughts: idiopathic osteosclerotic islands/enostoses/osteomas as the
patient does not report any existing diagnosis. However as many of the
cortical osseous landmarks, like external oblique ridge, zygomatic process
of maxilla, posterior Wall of the maxillary sinus, inferior mandibular
cortex, all show thicker than typical borders, hypercorticalis generalisata
is a possibility, if the same features are present in rest of the skeleton.
Craniofacial fibrous dysplasia, juvenile pagets would not be included, as
these areas are focal with defined borders, no teeth displacement or other
effects in the trabecular bone noted. 


In the absence of any clinical symptoms, I am unsure if prescribing a CBCT
scan would help in any way, other than help us better characterize these
areas.

I would appreciate your thoughts/input. 

Thanks
Aruna Ramesh
Tufts University School of Dental Medicine
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