Oral Medicine Case final Presentations Rasha Ahmed Badahdah 0931010

DEMOGRAPHIC DATA : Age : 19 years old. Nationality : Chadian. Gender : female.

CHIEF COMPLAINT : The patient wants to restore her upper anterior teeth.

HISTORY OF PRESENT ILLNESS : The caries started about one year ago. She did not seek any treatment for her teeth .

MEDICAL HISTORY : Not significant DENTAL HISTORY : Not significant FAMILY HISTORY :

SOCIAL HISTORY and HABITS: Marital status : Single . Occupation : student. There are no significant habits The patient brushes her teeth once per day , and she does not floss her teeth.

CLINICAL EXAMINATIONS : A-Extra-Oral Examination . B-Intra-Oral Examination.

A-EXTRA-ORAL EXAMINATION : Normal with Dark Pigmentation on the lip.

B-INTRA-ORAL EXAMINATION : *Pigmentation all around in the baccal and labial mucosa , gingiva and tongue. * Maxillary Lateral retained Deciduous teeth.

*Two lesions near the mucogingival junction related to upper central incisors #11 #21. Badly decayed teeth : #11,#21,#36,#46#47.

RADIOGRAPHIC FINDING : Periapical radiolucency related to #11,#21,#46,#47

DESCRIPTION OF LESIONS : Lesion one : Two round raised asymptomatic lesions located at the upper mucogingival junction, related to the upper central incisors #21,#11, with well demarcated margins, 1-2 mm in size, smooth and resilient on palpation . The lesion related to #21 appeared red in color , containing purulent material (pus).

Teeth Examination : Vitality test Thermal examination ( cold and hot and EPT) was done & showed that teeth #11,#21 did not respond Checking for periapical lesions: Done by percussion, showed there no response at teeth #11,#21 Periodontal examination Done with a graduated periodontal probe for pocket detection , no pockets were revealed

For lesion one : To diagnose the location of the problematic tooth, tracing done with a size #25 Gutta -Percha cone, threaded into the Opening of the sinus tract .

Lesion two : Generalized dark (brownish/bluish) pigmentation in the buccal and labial mucosae , upper and lower gingivae and tongue.

DIFFERENTIAL DIAGNOSIS : For lesion one : 1)Fistula 2)Periapical abscess. 3)Periodontal abscess 4)Periapical cyst . For lesion two : 1)Physiological pigmentation 2)Systemic disease :Addison's disease .

FINAL DIAGNOSIS: For lesion one: Fistulas

Management For lesion One : Consultation with the endodontic department for Root Canal Treatment.

FINAL DIAGNOSIS: For lesion two: Physiological pigmentation

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