1. Oral Medicine Case final Presentations
Rasha Ahmed Badahdah

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

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

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

5. MEDICAL HISTORY :
Not significant
DENTAL HISTORY :
Not significant
FAMILY HISTORY :

6. 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.

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

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

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

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

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

16. 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).

17. 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

18. 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 .

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

22. 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 .

23. FINAL DIAGNOSIS:
For lesion one:
Fistulas

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

26. FINAL DIAGNOSIS:
For lesion two:
Physiological pigmentation

27. FOLLOW UP :

28. THANK YOU FOR YOUR ATTENTION ,,,