Subpontic osseous hyperplasia: a case series and literature review

Self-Instruction Exercise No. 352
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Exercise No. 352
Subject Code: 610
Prosthodontics/Fixed

The 15 questions for this exercise are based on the article, “Subpontic osseous hyperplasia: a case series and literature review”, on pages 46-52. This exercise was developed by Charles Martello, DDS, FAGD, in association with the General Dentistry Self-Instruction committee.

Reading the article and completing the exercise will enable the reader to:

  • define subpontic osseous hyperplasia (SOH);
  • recognize the significant periodontal and restorative complications of SOH; and
  • understand SOH management.

Answers for this exercise must be received by June 30, 2015.

  1. A review of the literature indicates that SOH

    A. presents almost exclusively in the maxilla.
    B. is gender specific.
    C. can result in periodontal complications if left untreated.
    D. is a neoplastic osseous lesion.

  2. SOH is described as a/an

    A. slow-growing lesion.
    B. osseous growth associated with maxillary teeth.
    C. fibro-osseous growth associated with mandibular teeth.
    D. osseous overgrowth associated with an impinging pontic.

  3. The types of treatment required to manage SOH may include procedures related to all the following except one. Which is the exception?

    A. oral surgery
    B. restoration
    C. endodontics
    D. periodontics

  4. Most patients express pain in the area of the SOH. The increasing size of the SOH may limit access for hygiene to the fixed partial denture abutment teeth.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  5. The size and shape of an SOH lesion is dependent upon

    A. its histologic variant.
    B. the dimension of the edentulous space.
    C. the exact etiology of the SOH.
    D. the position and shape of the superior border of the pontic.

  6. Which of the following conditions could be considered specific to edentulous ridges?

    A. lack of gingival/keratinized tissue
    B. gingival tissue enlargement
    C. ridge deficiency
    D. decreased vestibular depth

  7. According to Calman et al, SOH is a

    A. secondary metastatic lesion.
    B. non-neoplastic growth.
    C. keratinized soft tissue enlargement.
    D. fibrous hyperplastic lesion.

  8. All of the following characteristics of SOH have been reported except one. Which is the exception?

    A. lesion typically presents bilaterally
    B. histologic features similar to other exostoses
    C. predilection for the mandible
    D. etiology unknown

  9. Which of the following is true regarding the clinical findings, or treatment, for the case study involving the 79-year-old woman?

    A. The medical history indicated a systemically healthy patient.
    B. Piezoelectric instrumentation was used to resect the lesion.
    C. No tori were present.
    D. The space under the bar-like pontic was obliterated.

  10. SOH is usually associated with tori or other exostoses in _____% of cases.

    A. 62
    B. 73
    C. 86
    D. 90

  11. The average patient diagnosed is Caucasian and 56.6 years old. SOH manifests equally in both genders, mostly as a bilateral lesion.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  12. SOH, first described by Calman in 1971, has been reported in the literature under all of the following names except one. Which is the exception?

    A. nonreactive subpontine exostosis
    B. plateauization
    C. subpontic hyperostosis
    D. subpontine tissue enlargement

  13. Which of the following is true regarding the clinical findings, or treatment, for the case study involving the 64-year-old woman?

    A. No tori were present.
    B. The SOH lesion was removed using rotary and hand instruments.
    C. The lower left first molar was extracted when the patient was 16 years old.
    D. Focal cemento-osseous dysplasia was an incidental finding.

  14. SOH almost overwhelmingly manifests in the mandibular second bicuspid region. SOH recurrence after excision is quite common.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  15. An analysis by Ralph & Caputo demonstrated which of the following?

    A. The role of genetics contributing to SOH development.
    B. Stress patterns are concentrated on the mandibular cortical plates with vertical loading.
    C. The difference between cortical bone content in the maxilla and the mandible.
    D. The shape and dimensions of the mandible change during opening and closing.


Evaluation

Please respond to the statements below, using the following scale:
1 Poor; 2 Below average; 3 Average; 4 Above average; 5 Excellent

Practicality of the content 1 2 3 4 5
Benefit to your clinical practice 1 2 3 4 5
Quality of illustrations 1 2 3 4 5
Clarity of objectives 1 2 3 4 5
Clarity of exercise questions 1 2 3 4 5
Relevance of exercise questions 1 2 3 4 5
 
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