[Oradlist] Differential Diagnosis for mandibularossifications/calcifications

[Johan Aps]

Dear Ramesh,

The first that comes to my mind is periapical osseous dysplasia, though the 
age of the patient is not typical.
On the other hand, in the late stage of the lesion, a radiopaque mass is 
seen with a thin radiolucent line...just like the image you sent.

Kind regards from Belgium,

Johan
______________________________________________________________________
Prof. Dr. Johan K.M. Aps
(DDS, MSc Paed. Dent. & Special Care, MSc DMFR (King's College London, UK), 
PhD)
Head of Dental & Maxillofacial Radiology
Coordinator Postgraduate Teaching in Dentistry Ghent University 
(accreditation system Belgium)
Senior Clinical Consultant Ghent University Hospital, Dental School
UZG, P8, Dental School, De Pintelaan 185, 9000 Gent, Belgium
tel; + 32 9 332 5102
fax; +32 9 332 3851
secretary; +32 9 332 3857
----- Original Message ----- 
From: "Ramesh, Aruna" <Aruna.Ramesh at tufts.edu>
To: <oradlist at lists.ucla.edu>
Sent: Tuesday, December 14, 2010 9:40 PM
Subject: [Oradlist] Differential Diagnosis for 
mandibularossifications/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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