Oral Maxillofacial Surgery #2

Notes

Diseases of Bone

Fibrous Dysplasia

• normal bone replaced with fibrous tissue undergoes gradual calcification
• poorly defined margins
• painless expansion, neurological signs
• Mx > Mb
• Albright's syndrome - multiple bones affected, café-au-lait spots, precocious puberty, hyperthyroidism, hyperparathyroidism

Cemento-ossifying Fibroma

• young adult females
• Mb > Mx
• slow growing swelling, firm to touch, painless
• well demarcated from surrounding normal bone

Paget's Disease

• abnormal formation and resorption of bone
• middle and old  age
• M > F
• Mx > Mb
• enlargement and weakening of bone
• slow growing swelling of bones
• bowing of legs, spinal curvature
• bone pain
• hypercementosis and ankylosis
• ↑ alkaline phosphatase, normal serum calcium and phosphate levels

Giant Cell Granuloma (Central)

• non-neoplastic lesion of bone
• 1st to 3rd decades
• F > M
• Mb > Mx
• painless swelling, displacement of teeth
• well-defined, non-corticated margin

Hyperparathyroidism

• excessive amount of parathyroid hormone (PTH)
• middle age
• F > M
• renal calculi, peptic ulceration, bone pain, psychiatric problems, loose teeth
• cortical bone more severely affected
• brown tumors
• ↑ serum and urinary calcium, PTH, alkaline phosphatase levels
• ↓ phosphate levels

Osteogenesis Imperfecta

• multiple bone fractures after minor trauma
• soft tissue typically lax
• hernia
• blue sclera
• dentinogenesis imperfecta
• short stature

Osteopetrosis

• marble bone disease
• medullary cavity infills with dense bone
• maxillary sinus may fail to pneumatise
• partial fail of tooth eruption

Maxillofacial Trauma

Skin Sensations Changes :

supraorbital and supratrochlear - forehead

zygomaticofacial and temporal - lateral face and temporal region

infraorbital - cheek, lateral nose, upper lip, teeth / gingiva of maxilla

mental - lower lip and chin

Facial Skeleton Fractures :

Mandibular Fractures

• coronoid
• condyle
• ramus
• angle
• body
• parasymphysis
• symphysis
• dentoalveolar

Maxillary Fractures

Zygomatic Complex Fractures

• Arch
• Zygomatico-orbital
• Orbital

Nasal Fractures

• cartilaginous
• cartilage + nasal bones
• complex naso-orbital-ethmoidal