© Copyright 2022, Booster Prep Inc.

INBDEBooster Booster Cheat Sheets™ Bone Lesions All Rights Reserved.

Oral Pathology Image Type Treatment Hallmark Features

- Composed fibroblastic stroma and mineralized products
Central Ossifying Fibroma Fibro-Osseous Surgical Excision - Commonly found between mandibular premolar and molar region
(COF) - Two forms:
- Central: Lesion in bone with well circumscribed radiolucency and
ossifying product in the center
- Peripheral: Lesion in gum tissue with no radiographic evidence
- Juvenile variant characterized by rapid aggressive growth

Fibrous Dysplasia Fibro-Osseous Surgical recontouring when lesion stops - Scar-like fibrous tissue growing in place of bone
growing (typically post puberty) - Stops after puberty
- Radiographic ground glass appearance with soft radiopaque areas
within lesion
- McCune-Albright Syndrome characterized by polyostotic fibrous
dysplasia, cafe au lait spots, and endocrine abnormalities

Fibro-Osseous - Circumscribed radiopaque mass of osteoblasts and bone

Osteoblastoma Surgical Excision

Fibro-Osseous None - Reactive process replacing normal bone with fibrous tissue
Periapical Cemento-
Osseous Dysplasia (PCOD) - Commonly seen at apices of mandibular anteriors
- Affected teeth are vital despite necrotic radiographic appearance
- Prevalent in middle aged woman of African descent

Giant Cell - Benign blood-filled pseudocyst that expands

Aneurysmal Bone Cyst Surgical excision - Multilocular radiolucency present in posterior mandible
- Aspiration biopsy initial step
 © Copyright 2022, Booster Prep Inc.
INBDEBooster Booster Cheat Sheets™ Bone Lesions All Rights Reserved.

Oral Pathology Image Type Treatment Hallmark Features

Central Giant Cell
Granuloma (CGCG)
- Osteolytic neoplasm composed of fibroblasts and multinucleated giant
Giant Cell Surgical excision cells
- Most common in the anterior mandible
- Two forms:
- Central: occurs in the bone with radiolucency having thin wispy
separations
- Peripheral: occurs in gums, presents as red/purple gingival mass

Cherubism Giant Cell Curettage of lesions, corticosteroids, jaw - Autosomal dominant disorder characterized by enlargement and
recontouring prominence of mandible and maxilla
- Stops growing after puberty
- Symmetrical bilateral swollen appearance
- Upturned eyes
- Bone replaced by fibrous granuloma containing multinucleated giant
cells
- Soap bubble appearance

Giant Cell - Excess levels of parathyroid hormone resulting in increased osteoclast

Hyperparathyroidism Surgical intervention, hormone adjustments activity and elevated alkaline phosphatase levels
- Similar appearance to CGCG
- Lesions known as Brown tumor
- Can lead to Von Recklinghausen’s disease of bone

Giant Cell Surgical excision, radiation, chemotherapy - Idiopathic histiocytosis due to abnormal buildup of Langerhans cells
Langerhans cell disease
- Discrete scooped out radiolucencies with appearance of floating teeth

Giant Cell - Progressive metabolic disturbance of bones resulting in symmetrical

Paget’s Disease Bisphosphonate, calcitonin enlargement
- Radiographic cotton wool appearance
- Observe elevated alkaline phosphatase levels due to increased bone
breakdown
- Hats and dentures become too tight
- Patients with this condition have an increased risk of developing
osteosarcoma
 © Copyright 2022, Booster Prep Inc.
INBDEBooster Booster Cheat Sheets™ Bone Lesions All Rights Reserved.

Oral Pathology Image Type Treatment Hallmark Features

- Infection in bone due to odontogenic infection and trauma
Acute Osteomyelitis Bone Inflammatory Antibiotics, drainage - S/S include: Deep pain, high or intermittent fever, and paresthesia or
anesthesia of IAN

Medication related
Osteonecrosis of Jaw
Bone Inflammatory Chlorhexidine rinse, antibiotics, conservative - Patients treated with bisphosphonates or usage in the past are at risk
surgery - Higher risk associated with IV administered bisphosphonates
- Medications related to this condition include: Alendronic acid,
Ibandronate, Zoledronic acid, Denosumab, Methotrexate, and
Adalimumab

Bone Inflammatory - Chronic bone infection that recurs with drainage and intense pain
Chronic Osteomyelitis Antibiotics, debridement - Diffuse mottled radiolucency
- Garre’s osteomyelitis condition involves chronic osteomyelitis and
proliferative periostitis
- Onion skin appearance

Bone Inflammatory - Low-grade inflammation causing periapical lesion

Focal Sclerosing Address cause of infection
Osteomyelitis (Condensing - Typically due to chronic pulpitis
Osteitis) - Diffuse dense bone walls off the infection
- Radiopaque
- Non-vital teeth
- Mandibular premolar region

Bone Inflammatory - Larger scale version of condensing osteitis

Diffuse Sclerosing Address cause of infection - May lead to jaw fracture, osteomyelitis
Osteomyelitis
 © Copyright 2022, Booster Prep Inc.
INBDEBooster Booster Cheat Sheets™ Bone Lesions All Rights Reserved.

Oral Pathology Image Type Treatment Hallmark Features

- Sarcoma of jaws when tumor cells produce new cartilage
Chondrosarcoma Bone Malignancy Surgical intervention, chemotherapy, radiation - Commonly involves condyle due to cartilaginous origin
therapy - Characteristic radiographic sunburst appearance

Ewing’s Sarcoma Bone Malignancy Surgical intervention, chemotherapy, radiation - Sarcoma of long bones involving round cells
therapy - Rarely affects jaws
- Most commonly seen in children

Bone Malignancy - Orally see pain, swelling, and paresthesia

Metastatic carcinoma Resection, chemotherapy - Diffuse and ill-defined changes such as eroding bone observed
radiographically
- Carcinoma metastasis from other parts of body
- Most likely to least likely from: breast > lung > kidney > colon >
prostate

Bone Malignancy - Sarcoma of jaws when tumor cells produce new bone
Osteosarcoma Resection, chemotherapy
- New bone deposition presents sunburst pattern radiopacity
- Patient suffering from Paget’s Disease have an increased risk for
acquiring this form of cancer