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Case project By: brittany horrigan
Oral pathology Case project By: brittany horrigan
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Patient personal data Age: 39 Gender: male
Race: white Caucasian with small percentage of native American Country of origin: united states of America
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Patient information historical data
Family history: Mother has diabetes type 2 Sister has cerebral palsy Dental history: Most recent dental exam 1 year ago Most recent dental Hygiene appointment October 2014 Adequate oral hygiene Most recent dental x-rays Fmx in May 2014 Medical history: History of Acl injury, treated with surgery, currently has no residual effects Occasional drinker Non-smoker Baseline vitals Bp 122/58 , Pulse , Respiration 16 Drug ingestion: - Patient is not prescribed any medications History pertaining to specific lesion: Present for entire life Has not increased or decreased in size
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Intra-oral examination clinical features
Clinical Appearance: Lobulated bilateral Consistency: -Firm to palpation Color: Generalized pink w/ localized areas of redness due to irritation of toothbrush- as stated by patient Size: -patients left side is moderate in size- 2cm by 3cm -patients Right side is small in size – 1cm by 3cm Surface texture: Smooth
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Patient information signs and symptoms
Overgrowths of dense bone Bilateral Lobulated Present for as long as patient can remember lingual aspect of the mandible in the premolar region Symptoms: No reported pain No dysphagia Wnl- oropharynx, salivary glands, larynx, lymphnodes, mucousa
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Patient information radiographic data
Radiopaque Anatomical landmarks also within this region Mental foramen, Mylohyoid ridge, External oblique ridge, Fossa or depression
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Whats next…? Measurements Intraoral photographs
Continued with treatment as planned Dental hygiene report was completed and given to patient Keep a watchful eye at re-care appointments
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Differential diagnosis 1)mandibular tori , 2)peripheral osteoma, 3) exostoses
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Differential diagnosis (1) Mandibularus torus/ Mandibular tori
Etiology: genetics Description: Variant of normal, typically bilateral and lobulated, can appear fused together. symptomless Composition: Outgrowths of dense bone Location: mandible, lingual aspect, premolar area, above mylohyoid ridge Diagnosis: clinical appearance, historical data- has the condition changed in size over time
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Diagnostic process and Diagnosis
Clinical: Eoe Observation Palpation ioe Clinical appearance Color, shape, location, size, texture consistency Firm, soft, semifirm, fluid filled Historical: Important component to any diagnosis Personal, family, past plus present medical or dental histories, past drug ingestion, history pertaining to specific lesion in question
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Health promotion methods treatment, prognosis, prevention
- not required unless patient is and the tori interfere with in need of a prosthodontic appliance fabrication or placement - I expect that the Short term prognosis will be good. - I expect that the long term prognosis will be dependent upon the need for a prosthodontic device later in life the presence of such large tori may become an issue -No prevention technique - A patient can only maintain meticulous OHI to decrease the bacteria accumulation
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Differential diagnosis (2)Peripherial osteoma
Etiology: numerous neoplastic cells Description: benign- raised, rounded, well circumscribed margins. Slow growing and painless. Beyond confines of parent bone Composition: benign- neoplastic cells, grows slowly, less aggressive. Compact or cancellous bone Location: posterior mandible or condyle Diagnosis: clinical appearance, historical data- help to find causative factors, laboratory culture, microscopic biopsy
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Differential diagnosis (3)exstoses
Etiology: genetics Description: single, multiple, unilateral, bilateral Composition: overgrowth of bone Location: buccal aspect, maxillae, alveolar ridge, molar/premolar region Diagnosis: clinical appearance, historical data- has the condition changed over time
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bibliography Langlais, Robert E., Craig S. Miller, and Jill S. Nield Gehrig. Color Atlas of Common Oral Diseases. 4th ed. Philadelphia: lipcott Williams and Wilkins, Print. Ibsen, Olga A.C., and Joan A. Phelan. Oral Pathology for the Dental Hygienist. 6th ed. St. Louis: Linda Duncan, Print. "What Are Tori, And Why Do I Have Them? « Julie M. Gillis, DDS." Julie M Gillis DDS. N.p., n.d. Web. 01 oct
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