Fibro Osseous Lesions
Question. Classify fibro-osseous lesions. Discuss clinical features, radiographic features and radio-differential diagnosis of fibrous dysplasia.
Answer.
Radio-differential Diagnosis
- Osteolytic Stage of Fibrous Dysplasia
- Central giant cell granuloma: It shows faint wispy trabeculae while fibrous dysplasia show calcification or granular appearance.
- Traumatic bone cyst: Cortical bulging is absent along with displacement of involved teeth.
- Dental cyst: It shows well-defined cortex which is smooth whereas in fibrous dysplasia the cortex is wider and more granular.
- Chronic osteitis: In this, roots of pulpless teeth are involved.
Fibro-Osseous Lesions: Types, Causes, and Diagnosis
- Mottled Stage of Fibrous Dysplasia
- Lymphoma of bone: It is irregular and bizarre in its radiographic appearance whereas in fibrous dysplasia smooth and well-contoured external bony borders are maintained.
- Osteoblastic metastatic carcinoma: It does not show monotonous radiographic pattern-like fibrous dysplasia.
- Osteosarcoma: It shows sun-burst appearance. It also has Codman’s triangle while these features are absent in fibrous dysplasia.
- Cementifying and Ossifying fibroma: Margins are welldefined in cementifying and ossifying fibroma, while in fibrous dysplasia they are indistinct and also blends with surrounding normal bone.
Fibro-Osseous Lesions in Dentistry: Clinical Features and Treatment
- Mature Stage of Fibrous Dysplasia
- Paget’s disease: It produces lesions with ground glass appearance but overall effect is of rarefaction and not radiopacities.
- Giant cell lesion of hyperthyroidism: Due to change in normal trabecular pattern causes ground-glass appearance of numerous small and randomly oriented trabeculae. Demineralization and thinning of cortical boundaries is present.
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