Dentistry OMF

Differential Diagnosis of oral Maxillofacial Lesions PDF

Differential Diagnosis of oral Maxillofacial Lesions

1. PERIAPICAL RADIOLUCENCIES

·           Granuloma
·           Radicular cyst
·           Abscess
·           Apical scar
·           Surgical defect
·           Periodontal disease
·           Chronic suppurative osteomyelitis
·           Periapical cemental dysplasia (osteolytic stage)
·           Cementoblastoma (osteolytic stage)
·           Cementifying and ossifying fibromas (osteolytic stage)
·           Odontogenic and nonodontogenic cysts
·           Odontogenic and nonodontogenic benign tumors
·           Malignant tumors

2. PERIAPICAL RADIOPACITIES

·         Periapical cemental dysplasia (calcified stage)
·         Cementoblastoma (calcified stage)
·         Cementifying and ossifying fibromas (calcified stage)
·         Condensing osteitis
·         Osteosclerosis
·         Socket sclerosis
·         Florid osseous dysplasia (diffuse cementosis)
·         Tori
·         Hypercementosis

Differential Diagnosis of oral Maxillofacial Lesions

3. PERICORONAL RADIOLUCENCIES

Do NOT contain radiopacities:

·         Follicular space
·         Dentigerous cyst
·         Unicystic (mural) ameloblastoma
·         Odontogenic keratocyst
·         Ameloblastoma
·         Ameloblastic fibroma

MAY contain radiopacities:

·         Ameloblastic fibro-odontoma
·         Adenomatoid odontogenic tumor
·         Calcifying epithelial odontogenic tumor (Pindborg tumor)
·         Calcifying odontogenic cyst (Gorlin cyst)

4. SOLITARY CYSTLIKE RADIOLUCENCIES

Normal anatomy and Variations

·         Tooth follicle (early stage)
·         Large marrow space (wide inter-trabecular space)
·         Post extraction socket
·         Surgical defect

Odontogenic cysts:

·         Primordial
·         Lateral periodontal
·         Residual
·         Odontogenic keratocyst

Fissural cysts:

·         Incisive canal (nasopalatine)
·         Globulomaxillary
·         Median palatine
·         Median mandibular

False cysts:

·         Traumatic bone cyst
·         Stafne bone cavity

Odontogenic tumors:

·         Ameloblastoma
·         Odontogenic adenomatoid tumor
·         Calcified epithelial odontogenic tumor(Pindborg tumor)
·         Ameloblastic fibroma
·         Cementifying and ossifying fibromas (osteolytic stage)

Giant cell and nonodontogenic tumors:

·         Central giant cell granuloma
·         Giant cell lesion of hyperparathyroidism
·         Non-odontogenic benign tumors

5. SOLITARY RADIOLUCENCIES WITH DIFFUSE IRREGULAR BORDERS

·         Chronic alveolar abscess
·         Chronic osteomyelitis
·         Osteoradionecrosis
·         Squamous cell carcinoma
·         Metastatic tumors to the jaws
·         Fibrous dysplasia (early stage)
·         Histiocytosis X
·         Osteosarcoma and chondrosarcoma
·         Ewing’s sarcoma
·         Burkitt’s lymphoma

6. MULTILOCULAR RADIOLUCENCIES

Cysts:

·         Odontogenic keratocyst (basal cell nevus syndrome)
·         Aneurysmal bone cyst

Differential Diagnosis of oral Maxillofacial Lesions
Tumors:

·         Ameloblastoma
·         Odontogenic myxoma
·         Central hemangioma of bone
·         Metastatic tumors to the jaws

Others:

·         Cherubism
·         Central giant cell granuloma
·         Giant cell lesion of hyperparathyroidism

7. SOLITARY RADIOPACITIES

·         Exostoses and tori
·         Osteoma
·         Retained root
·         Osteosclerosis
·         Socket sclerosis
·         Mature cementoma
·         Complex composite odontoma
·         Compound composite odontoma
·         Calcifications in soft tissue
·         Foreign objects in the jaws
·         Fibrous dysplasia
·         Garré’s osteomyelitis

8. MIXED RADIOLUCENT – RADIOPAQUE LESIONS

Inflammatory:

·         Condensing osteitis

Osteomyelitis:

·         Chronic suppurative osteomyelitis
·         Tuberculous osteomyelitis
·         Syphilitic osteomyelitis
·         Actinomycotic osteomyelitis
·         Osteoradionecrosis

Cementomas (intermediate and calcified stages):

·         Periapical cemental dysplasia
·         Cementifying and ossifying fibroma
·         Cementoblastoma
·         Florid osseous dysplasia (diffuse cementosis)

Others:

·         Fibrous dysplasia
·         Paget’s disease
·         Osteosarcoma
·         Chondrosarcoma
·         Osteoblastic metastatic carcinoma

Pericoronal mixed lesions:

·         Ameloblastic fibro-odontoma
·         Odontogenic adenomatoid tumor
·         Calcifying epithelial odontogenic tumor (Pindborg tumor)
·         Calcifying odontogenic cyst (Gorlin cyst)

9. GENERALIZED RADIOPACITIES

·         Florid osseous dysplasia (diffuse cementosis, sclerotic cemental masses)
·         Paget’s disease
·         Osteopetrosis
·         Gardner’s syndrome
·         Infantile cortical hyperostosis
·         Albright’s syndrome

Differential Diagnosis of Oro Maxillofacial pain-Chart

Oro facial pain is one common cause patients seek dental treatments. It could be simply a local cause like dental caries or any other pathology involving adjacent structures. Other way it could be a psychogenic pain.

Causes for Oro-Facial pain

Local Causes
  • Dental caries (Reersible pulpitis, Irreversible pulpitis, Periapical periodontitis)
  • Periodontal disease
Neurological Disorders
  • Trigeminal neuralgia
  • Glosopharyngeal  neuralgia
  • Malignant neoplasams in volving trigeminal nerve
  • Herpes Zoster
Psychogenic causes
  • Atypical facial pain
Vascular Disorders
  • Migraine
  • Migranous neuralgia
  • Giant cell arteritis
Referred pain
  • Angina
  • Nasopharyngeal
  • Occular
  • Aural
  • Maxillary sinus
  • Chest disease ( Very rare)

This chart will help you to diagnose Oro Facial pain.

Differential Diagnosis of oral Maxillofacial Lesions

Diagnostic hierarchy for chronic headache and oro facial pain

Differential Diagnosis of oral Maxillofacial Lesions