1. Case project By: brittany horrigan
Oral pathology
Case project
By: brittany horrigan

2. Patient personal data Age: 39 Gender: male
Race: white Caucasian with small percentage of native American
Country of origin: united states of America

3. 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

4. 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

5. 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

6. Patient information radiographic data
Radiopaque
Anatomical landmarks also within this region
Mental foramen, Mylohyoid ridge, External oblique ridge, Fossa or depression

7. 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

8. Differential diagnosis 1)mandibular tori , 2)peripheral osteoma, 3) exostoses

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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