DOCSLIB.ORG

Odontogenic Cysts and Periapical Periodontitis Associate Professor Elitsa Deliverska, Phd Department of Dental, Oral and Maxillofacial Surgery, FDM, MU- Sofia

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Odontogenic Cysts and Periapical Periodontitis Associate Professor Elitsa Deliverska, Phd Department of Dental, Oral and Maxillofacial Surgery, FDM, MU- Sofia Odontogenic cysts and periapical periodontitis Associate professor Elitsa Deliverska, PhD Department of Dental, Oral and Maxillofacial surgery, FDM, MU- Sofia Introduction The lesions most commonly found at the apices of non-vital teeth are the periapical granuloma and radicular cyst. The treatment and prognosis may differ according to the lesion. To decide treatment options of periapical lesion, whether surgery or not, necessitate precise diagnosis of the lesion as being granuloma, true cyst, or pocket cyst within granuloma mass. Periapical inflammation is usually due to spread of infection following death of the pulp and accumulation of inflammatory cells at the apex of a nonvital tooth. There is no evidence that necrotic pulp tissue can elicit periapical inflammation in the absence of bacteria. Tissue response to pulpal inflammation/necrosis caused by microorganism invasion from: Caries Trauma Medical induced Allergy In the beginning all intent to localize the infection within the confines of the root canal system, but the progression of inflammation can lead to Inflammation of PDL around apical portion of root. Cause: spread of infection following pulp necrosis, trauma (occlusal), inadvertent endodontic procedures etc. Types: 1. Acute Apical Periodontitis- serous or purulent 2. Chronic Apical Periodontitis Etiological factors Trauma Acute injury • Injury on tooth • Cavity preparation without water spray • Vigorous prolonged polishing • Root planning in PDL therapy • Restoration – improper insulation Chronic injury • Attrition, abrasion -abrasive food & bruxism • Abnormal tooth brushing Medication • Medicaments or materials applied to dentin diffuses through dentinal tubules. Microorganisms Bacterial invasion by: • Dental caries • Fractured tooth where exposed pulp • Anachoretic infection Anachoresis: In traumatized necrotic teeth with ‘intact’ crowns, microorganisms can reach the pulp through: • Microcracks • Accessory canals • Exposed dentinal tubules • due to presence of bacteria in circulating blood stream In contrast to pulp, periradicular tissues have an: • Unlimited source of undifferentiated cells • Rich collateral blood supply • Lymph drainage system Reaction of the bone provides a separation between the irritants and the bone, thereby preventing osteomyelitis. Depending on the: • severity of irritation • duration • host response Periradicular pathoses may range from slight inflammation to extensive tissue destruction. The ultimate biological aim of endodontic treatment is either to prevent or cure apical periodontitis and to preserve the tooth. Nonspecific mediators of inflammation are: Neuropeptides Fibrinolytic peptides Kinins Lysosomal enzymes Specific mediators of inflammation are: Antigen-presenting cells Immunoglobulins Mast cells Macrophage-like cells T cells B cells are rare Plasma cells are absent in normal pulp Pathophysiology of periapical lesion inflammatory lesions of dental origin which are the most common of all other periapical lesions, are differentiated by certain terminologies as “periapical lesions of endodontic origin” or “pulpoperiapical” lesions to indicate that the cause is infected or necrotic pulp. Inflammation of periapical membrane around the apex of the tooth is usually due to spread of infection following death of the pulp. In most cases inflammation remains localized to the periapical region. Diagnosis of the combined endodontic and periodontal lesions is often multifaceted and exasperating. A growing periapical lesion with secondary involvement of the periodontal tissue may have the similar radiographic appearance as a chronic periodontal lesion which has reached to the apex. An endodontically treated tooth or a nonvital tooth associated with periodontal lesion can pose greater diagnostic problem as in such cases pulpal inflammation is frequently associated with inflammation of periodontal tissue. Thus, a careful history taking, visual examination, diagnostic tests involving both pulpal and periodontal testing and radiographic examination are needed to diagnose such lesions. NORMAL PERIAPICAL TISSUES No pain Not abnormally sensitive to palpation and percussion Normal intact lamina dura Normal periodontal ligament With progression, the infection spreads along the path of least resistance. The purulence may extend through the medullary spaces away from the apical area, resulting in osteomyelitis, or it may perforate the cortex and spread diffusely through the overlying soft tissue (as abcess). It can starts as serous inflammation and to progress to purulent one. CLASSIFICATION of acute purulent periapical periodontitis- spreads along the path of least resistance Periodontal stage Endosteal stage Subperiosteal stage Submucosal stage Signs and symptoms- key features: Dull throbbing constant pain Pain on biting or percussion- most severe in subperiosteal stage Palpation – pain in subperiosteal and submucosal stage. Facial asymmetry- in subperiosteal and submucosal stage. Negative or delayed vitality test response Not associated with apical radiolucency Widening of PDL space could be detected The tooth should be non-vital to simple tests- it does not respond to cold and hot or electric pulp testing (as the periapical inflammation is usually provoked by a dead and/or infected pulp) although, particularly with multirooted teeth, some vital response may still be elicited. There is often a large carious cavity or filling in the affected tooth, or it may be discoloured due to death of the pulp earlier. The patient may give a history of pain due to previous pulpitis. Acute periapical periodontitis could be divided to serous and purolent. Diagnosis: according to: anamnesis, clinical and paraclinical examination. Important about case history: CHIEF COMPLAINT HISTORY OF PRESENT ILLNESS MEDICAL HISTORY DENTAL HISTORY DRUG HISTORY The patient complains of a pain and feeling that the tooth is elevated out of the socket. Intaoral examinnation- inspection, palpation, percussion Clinical features - PAIN, mobility of the tooth could be detected • Thermal changes do not induce pain. • Slight extrusion of tooth from socket. • Cause tenderness on mastication due to inflammatory edema collected in PDL. • Due to external pressure, forcing of edema fluid against already sensitized nerve endings results in severe pain. - PERCUSSION: can be checked by applying finger pressure on the tooth or tapping with tip end of handle of the mirror; if pain then periodontal ligament is inflamed. Lateral percussion is done to check for marginal periodontitis or periodontal pocket disease Apical / vertical percussion is done to check for apical periodontitis - PALPATION: simple test done with finger tips using light pressure to examine tissue consistency & pain response around the apex of the tooth RADIOGRAPHIC FEATURES: - Appear normal except for widening of PDL space Pulp sensitivity test In case of purulent periapical periodontitis, the tooth is nonvital. Extraoral examination- inspection, palpation (facial symmetry, lymph nodes) Elevated temperature and malaise may follow. The body responds to this insult by trying to isolate the abscess and/or establish drainage intraorally. If drainage is not effective, the abscess may spread into fascial planes or spaces of the head and neck. Differential diagnosis could be made with: pulpitis osteomyelitis of jaws, maxillary sinuitis, denticle, neuralgia, exacerbation of chronic periapical periodontitis. PHOENIX ABSCESS- If a periapical radiolucency is present and an acute inflammatory response is superimposed on this preexisting chronic lesion it is termed a phoenix abscess. Management If tooth is in hyper occlusion, relieve occlusion. follow up the case with Pulp sensitivity test for at least one year if the cause for serous acute periodontitis is trauma. If tooth is infected, initiate endodontic therapy or extraction (if the tooth is not prospective) Incision and drainage should be done in subperiosteal and submucosal stage Medication include pain killers/NAID and antibiotics (if needed in 3-rd or 4-th stage). Fill in! In contrast to pulp, periradicular tissues have an: • Unlimited source of undifferentiated cells • Rich collateral blood supply • Lymph drainage system Periapical bone destruction Resorption of the bone provides a separation between the irritants and the bone, thereby preventing osteomyelitis. Depending on the: severity of irritation duration host response ACUTE VS CHRONIC APICAL PERIODONTITIS Acute: rapid onset, spontaneous pain, tenderness of the tooth to pressure, pus formation, and eventual swelling of associated tissues Chronic: gradual onset, little or no discomfort, and the intermittent discharge of pus through an associated sinus tract. - Acute- Immediately round the apex the lamina dura may appear slightly hazy (loss of the lamina dura) and the periodontal space may be slightly widened. - Chromic- when there is acute periapical abscess due to exacerbation of a chronic infection, the original lesion can be seen as an area of radiolucency at the apex. Periradicular pathoses may range from slight inflammation to extensive tissue destruction Chronic periodontitis is a low-grade infection. It may follow an acute infection that has been inadequately drained and incompletely resolved. It can occure acute exacerbation of a pre- existing chronic periapical inflammatory lesion. Periodontitis chronica granulomatosa diffusa cum/ sine fistula Periododntitis chronica granulomatosa localisata: - Granuloma simplex - Granuloma
Load more

Recommended publications
  • Glossary for Narrative Writing
    Periodontal Assessment and Treatment Planning Gingival description Color: o pink o erythematous o cyanotic o racial pigmentation o metallic pigmentation o uniformity Contour: o recession o clefts o enlarged papillae o cratered papillae o blunted papillae o highly rolled o bulbous o knife-edged o scalloped o stippled Consistency: o firm o edematous o hyperplastic o fibrotic Band of gingiva: o amount o quality o location o treatability Bleeding tendency: o sulcus base, lining o gingival margins Suppuration Sinus tract formation Pocket depths Pseudopockets Frena Pain Other pathology Dental Description Defective restorations: o overhangs o open contacts o poor contours Fractured cusps 1 ww.links2success.biz [email protected] 914-303-6464 Caries Deposits: o Type . plaque . calculus . stain . matera alba o Location . supragingival . subgingival o Severity . mild . moderate . severe Wear facets Percussion sensitivity Tooth vitality Attrition, erosion, abrasion Occlusal plane level Occlusion findings Furcations Mobility Fremitus Radiographic findings Film dates Crown:root ratio Amount of bone loss o horizontal; vertical o localized; generalized Root length and shape Overhangs Bulbous crowns Fenestrations Dehiscences Tooth resorption Retained root tips Impacted teeth Root proximities Tilted teeth Radiolucencies/opacities Etiologic factors Local: o plaque o calculus o overhangs 2 ww.links2success.biz [email protected] 914-303-6464 o orthodontic apparatus o open margins o open contacts o improper
    [Show full text]
  • Small Dog, Big Smile
    Small Dog, Big Smile How to make sure your little dog has a happy, healthy mouth Christine Hawke Sydney Pet Dentistry INTRODUCTION Hello and thanks for downloading my book, ‘Small Dog, Big Smile – How to make sure your little dog has a happy, healthy mouth’. Small dogs are gorgeous, and deservedly very popular throughout the world. Centuries of careful and selective breeding has provided us with a huge range of small breeds to choose from, each with their own specific characteristics and charm. While good things certainly come in small packages, one of the drawbacks of their small size is that many of these dogs suffer silently from serious dental issues. While all dog breeds are susceptible to ‘teething problems’, periodontal infection and orthodontic disorders, dogs with small mouths have the added issue of overcrowded teeth to contend with. Similar to their larger ancestors, they have to find space for 42 teeth, which is sometimes no easy feat. As a result, things don’t always go according to plan…. My name is Christine Hawke, and I am a veterinarian with almost 20 years experience in small animal practice. After many years in general practice, I developed a passion for all things dental, and have been running a small animal dentistry-only practice in Sydney since 2007. I am a Member of the Australian and New Zealand College of Veterinary Scientists in the field of Veterinary Dentistry (this can only be attained through examination), and the American Veterinary Dental Society. I am currently the President of the Australian Veterinary Dental Society, and teach veterinary dentistry to vet students (at The University of Sydney), vets and nurses across Australia.
    [Show full text]
  • Oral Diagnosis: the Clinician's Guide
    Wright An imprint of Elsevier Science Limited Robert Stevenson House, 1-3 Baxter's Place, Leith Walk, Edinburgh EH I 3AF First published :WOO Reprinted 2002. 238 7X69. fax: (+ 1) 215 238 2239, e-mail: [email protected]. You may also complete your request on-line via the Elsevier Science homepage (http://www.elsevier.com). by selecting'Customer Support' and then 'Obtaining Permissions·. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book is available from the Library of Congress ISBN 0 7236 1040 I _ your source for books. journals and multimedia in the health sciences www.elsevierhealth.com Composition by Scribe Design, Gillingham, Kent Printed and bound in China Contents Preface vii Acknowledgements ix 1 The challenge of diagnosis 1 2 The history 4 3 Examination 11 4 Diagnostic tests 33 5 Pain of dental origin 71 6 Pain of non-dental origin 99 7 Trauma 124 8 Infection 140 9 Cysts 160 10 Ulcers 185 11 White patches 210 12 Bumps, lumps and swellings 226 13 Oral changes in systemic disease 263 14 Oral consequences of medication 290 Index 299 Preface The foundation of any form of successful treatment is accurate diagnosis. Though scientifically based, dentistry is also an art. This is evident in the provision of operative dental care and also in the diagnosis of oral and dental diseases. While diagnostic skills will be developed and enhanced by experience, it is essential that every prospective dentist is taught how to develop a structured and comprehensive approach to oral diagnosis.
    [Show full text]
  • June 18, 2013 8:30 Am – 11:30 Am
    Tuesday – June 18, 2013 8:30 am – 11:30 am Poster Abstracts – Tuesday, June 18, 2013 #1 ORAL LESIONS AS THE PRESENTING MANIFESTATION OF CROHN'S DISEASE V Woo, E Herschaft, J Wang U of Nevada, Las Vegas Crohn’s disease (CD) is an immune-mediated disorder of the gastrointestinal tract which together with ulcerative colitis, comprise the two major types of inflammatory bowel disease (IBD). The underlying etiology has been attributed to defects in mucosal immunity and the intestinal epithelial barrier in a genetically susceptible host, resulting in an inappropriate inflammatory response to intestinal microbes. The lesions of CD can affect any region of the alimentary tract as well as extraintestinal sites such as the skin, joints and eyes. The most common presenting symptoms are periumbilical pain and diarrhea associated with fevers, malaise and anemia. Oral involvement has been termed oral CD and may manifest as lip swelling, cobblestoned mucosa, mucogingivitis and linear ulcerations and fissures. Oral lesions may precede gastrointestinal involvement and can serve as early markers of CD. We describe a 6-year-old male who presented for evaluation of multifocal gingival erythema and swellings. His medical history was unremarkable for gastrointestinal disorders or distress. Histopathologic examination showed multiple well-formed granulomas that were negative for special stains and foreign body material. A diagnosis of granulomatous gingivitis was rendered. The patient was advised to seek consultation with a pediatric gastroenterologist and following colonoscopy, was diagnosed with early stage CD. Timely recognition of the oral manifestations of CD is critical because only a minority of patients will continue to exhibit CD-specific oral lesions at follow-up.
    [Show full text]
  • Dental & Oral Health
    Dental & Oral Health RESEARCH REVIEW™ Making Education Easy Issue 5 – 2016 to the fifth issue of Dental and Oral Health Research Review. In this issue: Welcome This issue begins with a review of the latest advances in saliva-related studies in which the potential value of Saliva in the diagnosis of saliva for early diagnosis of oral and systemic diseases is discussed. A meta-analysis of analgesics for pain of disease endodontic origin concludes that NSAIDs are the agents of choice (in the absence of contraindications). Colleagues from Australia have reviewed and provided guidelines for reducing the risks associated with radiation exposure in dental practices. The final issue for 2016 concludes with a report on the use of TCMs (traditional Chinese Treatment failure in medicines) by US-residing Chinese parents and their children for oral conditions. endodontics We hope you have enjoyed Dental and Oral Health Research Review this year, and we look forward to returning in 2017. Treating permanent teeth Kind regards with deep dentine caries Dr Colleen Murray Associate Professor Jonathan Leichter NSAIDs: first-line in [email protected] [email protected] endodontic pain relief? Management of dens Saliva in the diagnosis of diseases invaginatus Authors: Zhang C-Z et al. Summary: Saliva is a hypotonic solution of salivary acini, gingival crevicular fluid and oral mucosal exudates Oral care for pregnant with multiple functions: mouth cleaning, by washing away bacteria and food debris; digestion, as salivary patients amylase catalyses the hydrolysis of starch into maltose and sometimes glucose in the mouth; antibacterial effects provided by salivary lysozymes and thiocyanate ions; and saliva secretion contains risk factors for some diseases by excreting or transmitting potassium iodide, lead and mercury, and viruses such as rabies, polio and Hypophosphatasia in HIV infection.
    [Show full text]
  • The Role of Unfinished Root Canal Treatment in Odontogenic Maxillofacial Infections Requiring Hospital Care
    Clin Oral Invest (2013) 17:113–121 DOI 10.1007/s00784-012-0710-8 ORIGINAL ARTICLE The role of unfinished root canal treatment in odontogenic maxillofacial infections requiring hospital care L. Grönholm & K. K. Lemberg & L. Tjäderhane & A. Lauhio & C. Lindqvist & R. Rautemaa-Richardson Received: 16 November 2011 /Accepted: 4 March 2012 /Published online: 14 March 2012 # Springer-Verlag 2012 Abstract 60 % were males. Unfinished root canal treatment (RCT) was Objectives The aim of this study was to evaluate clinical the major risk factor for hospitalisation in 16 (27 %) of the 60 and radiological findings and the role of periapical infection cases (p0.0065). Completed RCT was the source only in 7 and antecedent dental treatment of infected focus teeth in (12 %) of the 60 cases. Two of these RCTs were adequate and odontogenic maxillofacial abscesses requiring hospital care. five inadequate. Materials and methods In this retrospective cohort study, we Conclusions The initiation of inadequate or incomplete pri- evaluated medical records and panoramic radiographs during mary RCT of acute periapical periodontitis appears to open a the hospital stay of patients (n060) admitted due to odonto- risk window for locally invasive spread of infection with local genic maxillofacial infection originating from periapical abscess formation and systemic symptoms. Thereafter, the periodontitis. quality of the completed RCT appears to have minor impact. Results Twenty-three (38 %) patients had received endodontic However, a considerable proportion of the patients had not treatment and ten (17 %) other acute dental treatment. Twenty- received any dental treatment confirming the importance of seven (45 %) had not visited the dentist in the near past.
    [Show full text]
  • Coding Guidelines for Dentists
    246 > COMMUNIQUE Coding guidelines for dentists SADJ July 2014, Vol 69 no 6 p246 - p248 M Khan ICD-10 coding remains confusing for some dentists and their persists for a very long time and seeks relief from the pain. personnel. We have recently heard from the administrators The patient agrees that you can take a periapical radiograph that they had to reject R18 000 worth of claims on one day of the tooth. The radiograph shows an interproximal cari- as a result of incorrect ICD-10 coding. This article attempts ous lesion on the distal of tooth 21, extending deep into the to provide some clarity on this issue. dentine, but not yet into the pulp. The lamina dura in rela- tion to the apex of the root appears to be normal. The tooth The biggest misconception about ICD-10 responds with a sharp pain following a percussion test. You The most common question asked about the system is: “What document the following diagnosis on your records: “21 se- is the ICD-10 code for this procedure code?” Please note that vere interproximal caries (distal) with an irreversible pulpitis ICD-10 coding does not work like this. There is no standard or and an acute periapical periodontitis”. You explain the diag- fixed ICD-10 code related to any procedure code. nosis, the required follow-up procedures and the estimated costs to the patient who agrees to a root canal treatment Basic principle of ICD-10 coding and further radiographs. ICD-10 coding is a diagnostic system and dental procedures The invoice after treatment is as follows: can be performed as result of various different diagnoses.
    [Show full text]
  • Anterior Mandibular Swelling – a Case Report Praveen B.N1, Amrutesh
    Case Report Anterior mandibular swelling – A Case Report 1 1 1 1 1 Praveen B.N , Amrutesh S , Vaseemuddin S , Shubhasini A.R. , Pal S. , 1Dept. of Oral Medicine and Radiology, KLE Society’s Institute of Dental Sciences, Bangalore. Praveen B.N, Amrutesh S, Vaseemuddin S, Shubhasini A.R., Pal S Anterior mandibular swelling – a case report. Tanz Dent J 2010, 16 (2):58-62 Abstract: Predilection of lesions to occur at certain specific sites is of great aid in arriving at a logical diagnosis. However tendency of lesions to appear at particular site does not follow a rule book. Enigmatic lesions like ameloblastomas have varied presentation. Here is an unusual case report of a patient who presented to us with an anterior mandibular swelling. Although clinical and radiographic features were suggestive of central giant cell granuloma, histopathological diagnosis was of ameloblastic carcinoma. Ameloblastomas are considered to be benign lesions; however, some can be reclassified as malignant when metastases occur or present with a very aggressive behavior. A detailed deliberation of differential diagnosis of anterior mandibular swellings is also done. Key words: ameloblastoma, anterior, carcinoma, giant cell granuloma, mandible Correspondence: Dr. Sumona Pal, Dept. of Oral Medicine and Radiology, KLE Society’s Institute of Dental Sciences, No. 20. Yeshwantpur Suburb, Opp. CMTI, Tumkur Road, Bangalore- 560022. India Phone no. +91-9164138993 Fax no: 080-23474305 E-mail address: [email protected] Introduction: swelling of the lower front region of the face since Predilection of lesions to occur at certain specific four months. The swelling was reported to be sites is of great aid in arriving at a logical diagnosis.
    [Show full text]
  • Volving Periodontal Attachment, the Apposition of Fire Or Severe Trauma, Physical Features Are Often Cementum at the Root Apex, the Amount of Apical Destroyed
    ISSN 0976-2256 E-ISSN: 2249-6653 The journal is indexed with ‘Indian Science Abstract’ (ISA) (Published by National Science Library), www.ebscohost.com, www.indianjournals.com JADCH is available (full text) online: Website- www.adc.org.in/html/viewJournal.php This journal is an official publication of Ahmedabad Dental College and Hospital, published bi-annually in the month of March and September. The journal is printed on ACID FREE paper. Editor - in - Chief Dr. Darshana Shah Co - Editor Dr. Rupal Vaidya DENTISTRY TODAY... Assistant Editor: We are living in an era in which community experience for Dr. Harsh Shah students is becoming a more essential component to the mission of dental education. Dental Public Health aims to improve the oral health of the population through preventive and curative services. The Editorial Board: introduction of mobile clinics into dentistry dates back to 1924. They have Dr. Mihir Shah been successfully used to provide dental treatment to schools, disabled patients, rural communities, industries and armed forces of various Dr. Vijay Bhaskar countries. Outreach programs using Mobile Dental Vans (MDV) are desirable model of clinical practice in a non-conventional setting, and help Dr. Monali Chalishazar the student to disassociate the image that best dentistry can only be Dr. A. R. Chaudhary practiced in conventional clinical settings. Confrontation with limited resources and economic barriers to Dr. Neha Vyas dental care for patients requiring more extensive procedures also serve as an additional learning experience in community-based programs. Unlike Dr. Sonali Mahadevia stationary dental clinics, mobile clinics provide greater physical access to dental care for medically underserved populations in poor urban and Dr.
    [Show full text]
  • Odontogenic Cysts II [PDF]
    Odontogenic cysts II Prof. Shaleen Chandra 1 • Classification • Historical aspects • Odontogenic keratocyst • Gingival cyst of infants & mid palatal cysts • Gingival cyst of adults • Lateral periodontal cyst • Botroyoid odontogenic cyst • Galandular odontogenic cyst Prof. Shaleen Chandra 2 • Dentigerous cyst • Eruption cyst • COC • Radicular cyst • Paradental cyst • Mandibular infected buccal cyst • Cystic fluid and its role in diagnosis Prof. Shaleen Chandra 3 Gingival cyst and midpalatal cyst of infants Prof. Shaleen Chandra 4 Clinical features • Frequently seen in new born infants • Rare after 3 months of age • Undergo involution and disappear • Rupture through the surface epithelium and exfoliate • Along the mid palatine raphe Epstein’s pearls • Buccal or lingual aspect of dental ridges Bohn’s nodules Prof. Shaleen Chandra 5 • 2-3 mm in diameter • White or cream coloured • Single or multiple (usually 5 or 6) Prof. Shaleen Chandra 6 Pathogenesis Gingival cyst of infants • Arise from epithelial remnants of dental lamina (cell rests of Serre) • These rests have the capacity to proliferate, keratinize and form small cysts Prof. Shaleen Chandra 7 Midpalatal raphe cyst • Arise from epithelial inclusions along the line of fusion of palatal folds and the nasal process • Usually atrophy and get resorbed after birth • May persist to form keratin filled cysts Prof. Shaleen Chandra 8 Histopathology • Round or ovoid • Smooth or undulating outline • Thin lining of stratified squamous epithelium with parakeratotic surface • Cyst cavity filled with keratin (concentric laminations with flat nuclei) • Flat basal cells • Epithelium lined clefts between cyst and oral epithelium • Oral epithelium may be atrpohic Prof. Shaleen Chandra 9 Gingival cyst of adults Prof. Shaleen Chandra 10 Clinical features • Frequency • 0.5% • May be higher as all cases may not be submitted to histopathological examination • Age • 5th and 6th decade • Sex • No predilection • Site • Much more frequent in mandible • Premolar-canine region Prof.
    [Show full text]
  • Pdf 461.11 K
    http:// ijp.mums.ac.ir Original Article (Pages: 381-39 0) Clinical and Histopathological Profiles of Pediatric and Adolescent Oral and Maxillofacial Biopsies in a Persian Population Shirin Saravani1, *Hamideh Kadeh1, Foroogh Amirabadi2, Narges Keramati3 1 Dental Research Center, Department of Oral & Maxillofacial Pathology, Faculty of Dentistry, Zahedan University of Medical Science, Zahedan, Iran. 2 Dental Research Center, Department of Pediatric dentistry, Faculty of Dentistry, Zahedan University of Medical Science, Zahedan, Iran. 3 Department of Oral & Maxillofacial Pathology, Faculty of Dentistry, Zahedan University of Medical Science, Zahedan, Iran. Abstract Introduction The frequency of pediatric and adolescent oral and maxillofacial lesions is various in different societies. The present study was aimed at investigating the frequency of oral and maxillofacial pediatric and adolescent biopsies in Zahedan, Southeastern Iran, and compare the results with other epidemiologic studies. Methods and Materials This retrospective study reviewed oral and maxillofacial lesions in patients aged 0-18 years old referring to the treatment centers of Zahedan University of Medical Sciences, during 12-years period. Patients’ demographic information including age, gender and location of the lesion were collected and statistically analyzed with SPSS software, version 19. Results In general, among 1112 oral and maxillofacial lesions, 154 (13.9%) cases were related to children and adolescents younger than 18 years old. The average age of patients was 11.4 ± 4.9, 53.2% and 46.8% of them were boys and girls, respectively. The most frequent sites of lesions were the gingiva and lip. The most prevalent lesions included inflammatory/reactive, cystic and neoplastic lesions, respectively. Benign and malignant tumors comprised 12.3% and 4.5% of cases.
    [Show full text]
  • Six Cases Report of Differential Diagnosis of Periapical Diseases
    Int J Oral Sci (2011) 3: 153-159. www.ijos.org.cn CLINICAL ARTICLE Six cases report of differential diagnosis of periapical diseases Wen-wei Xia, Ya-qin Zhu, Xiao-yi Wang* Department of Endodontics and Operative Dentistry, Shanghai Ninth People’s Hospital Affiliated Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China The distinction of some particular forms of periapical area, involving diseases from regular periapical disease, is a matter of considerable importance when choosing a correct treatment. The aim of this study is to describe the differential diagnosis of periapical diseases from six rare cases in clinical practice. The six rare cases are examples of situations where it is difficult to make a differential diagnosis in clinical practice. By retrospective surveys on the clinical examination, radiographs and pathological results, six patients referred to endodontic treatment in our department were analyzed for the accuracy of diagnosis and therapy. The pathoses of the six cases included two atypical radical cysts, periapical cemental dysplasia, cemento-ossifying fibroma, thymus cancer metastasis in the periapical site and tuberculosis. This report indicates that endodontists should be cognizant of a few particular circumstances when clinically treating periapical diseases. Keywords: periapical diseases; differential diagnosis; endodontic International Journal of Oral Science (2011) 3: 153-159. doi: 10.4248/IJOS11055 Introduction appear initially as periapical signs. Thus, early correct diagnosis of such patients was crucial for treatment and The periapical disease is one of the most prevalent subsequent prevention of advanced pathological process. diseases in general dental practice. However, because the The aim of this study is to describe the differential clinical diagnosis and treatment of periapical diseases is diagnosis on periapical diseases based on six rare cases.
    [Show full text]