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Craniofacial Anomalies

20102050188

Segmental Odontomaxillary
Dysplasia
Hemimaxillofacial dysplasia
A developmental abnormalities of unknown etiology
that affects posterior alveolar process of one side of
maxilla, including teeth and attached gingiva
Ipsilateral hypertrichosis,hyper and
hypopigmentation,Beckers nevus, clefting in 23% of
cases
Most detected in childhood unerupted tooth, mild
facial asymmetry, missing PM

Large left max deciduous molars


Lack formation of bicuspid
Delayed eruption of 1st molar
Dense bone pattern of the left of max alveolar process

Delayed eruption of 1st


PM and molar

Coarse trabecular pattern of


right max alveolar process

CBCT
Increase width of alveolar
process
Reduced size of maxillary
sinus

Coronal

Axial

Multiple vertical RL
linear structurenutrient canal

Lingual Salivary Gland Depression


Stafne defect
Location :
*submandibular gland fossa, close to inf border of
mandible
*lingual anterior variant + sublingual gland
*rarely medial surface variant + Parotid gland

Age range : 11 to 30 y/o


Slowly growing in size
Asymptomatic, discovered on RG
M>F
Peak at fifth and sixth decade

well-defined round,ovoid
with 1-3 cm in diameter
Below mandibular canal,
near inf border of
mandible, can erode
Dense sclerotic RO
margin, thicker at
superior aspect

Unusual variant
with a superior
position above ID
canal

Anterior variant
which associated
with sublingual
gland

CT SCAN

Well-defined defect

RL fat tissue within


the defect

3D CT image revealing a
defect extending from
medial surface of mandible

DDx

Epicenter of Odontogenic lesion is located above inf.alveolar canal

When defect is related to sublingual gland and appear above the


canal,D/D could be odontogenic lesion

Management
recognition of lesion should preclude any treatment @ surgical
exploration @ need for advancing image e.g CT
Defect may increase with time
Destruction of well defined cortex of defect may indicate
neoplasm

Focal Osteoporotic Bone Marrow


Marrow space
Indicate RL defect within cancellous portion in jaws
Histologic : normal areas of hematopoietic or fatty
marrow
Unknown etiology but is belief to be due to:
*bone marrow hyperplasia
*persistent embryologic marrow remnants
*sites of abnormal healing after exo,trauma or local
inflammation
Variation of normal anatomy

Clinically:
*asymptomatic
*incidental RG finding
*middle-aged women

seen as
RL
Few internal
trabeculae may be
present
*Periphery varies from well-defined,
corticated to ill defined, blending
*Normal surrounding bone
Common site at mandibular MPM region
Others: max tuberosity, mand
retromolar area, edentulous
area, mand molar furcation
region, apex of tooth

At furcation of lower molar. Lamina dura


and PDL space are intact

DDx
Could have same appearance
*Simple bone cyst no bone reaction at periphery of it
*Early inflammatory lesion with not yet stimulated a visible
osteoblastic process
If occur in furcation region @ apex of tooth suspect
inflammatory lesion

Management
No treatment required

If in doubt , prescribe longitudinal study with films at 3-months


interval
*the bone marrow should not increase in size