A 45-year-old female presented with a painful swelling in her upper left jaw. Imaging and biopsy revealed an odontogenic fibromyxoma, a rare benign tumor. The tumor was surgically excised via partial maxillectomy. Histopathological examination of the specimen confirmed the diagnosis. The patient recovered well without complications and follow-up scans showed no recurrence of the tumor.
The document summarizes the anatomy, development, and relationships between the maxillary sinus and dental structures. It discusses how dental procedures can affect the sinus, such as occasionally perforating the sinus membrane during tooth extraction. It also covers maxillary sinus infections of dental origin, implants in the maxilla, cysts and tumors that can involve the sinus, and radiographs used to image the sinus and related structures.
This document presents a case study of ameloblastoma, a benign odontogenic tumor. It defines ameloblastoma, discusses its epidemiology and classifications. The document describes the clinical features, radiological findings, differential diagnosis, management and prognosis of ameloblastoma. It then presents clinical case examples, including details of patients' examinations, radiographs, surgical procedures and histopathology reports. The conclusion emphasizes the need for long-term follow-up due to the high recurrence rate of ameloblastoma.
Nonsurgical management of large periapical lesionsdrnoronhagoa
This document discusses the pathophysiological relationship between the dental pulp and periapical tissues, which can trigger an inflammatory response and resorptive process leading to abscesses, granulomas or cysts. It then presents the case of an 18-year old female with pain and swelling in her upper left molar region after a root canal treatment. Clinical and radiographic examination revealed a periapical lesion resembling a cyst. She was treated through non-surgical decompression of the lesion using calcium hydroxide dressings over 12 months, resulting in resolution of the lesion.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Dr Rahul Katyayan. Odontogenic Keratocyst in Child Head &Neck RegionRahulKatyayan2
This case report describes the diagnosis and management of a keratocystic odontogenic tumor (KCOT), formerly known as an odontogenic keratocyst, in an 11-year-old female patient. Examination revealed a swelling in the left upper back tooth region that was gradually increasing in size. Imaging showed a unilocular radiolucency and impacted tooth. Biopsy via fine needle aspiration confirmed the diagnosis of KCOT. Under local anesthesia, the cyst was surgically removed along with the impacted tooth. Hydroxyapatite bone graft material was placed and the defect healed well over 2 months with no recurrence. KCOTs can occur in children and should prompt evaluation for nevoid
TMJ ANKYLOSIS of the Jaw and its clinical significanciesVamshi392572
This document provides an overview of temporomandibular joint (TMJ) ankylosis, including its embryology, anatomy, causes, pathogenesis, classification systems, clinical features, investigations, and management. Some key points:
- TMJ ankylosis is a bony or fibrous adhesion of the joint components that limits mouth opening. It is commonly caused by trauma or infection.
- Following trauma, haemarthrosis leads to organization of the intra-capsular hematoma and bone formation, resulting in ankylosis.
- Classification systems describe the extent of ankylosis based on the area of bony fusion. Management involves aggressive resection, coronoidectomy, inter
The document summarizes the anatomy, development, and relationships between the maxillary sinus and dental structures. It discusses how dental procedures can affect the sinus, such as occasionally perforating the sinus membrane during tooth extraction. It also covers maxillary sinus infections of dental origin, implants in the maxilla, cysts and tumors that can involve the sinus, and radiographs used to image the sinus and related structures.
This document presents a case study of ameloblastoma, a benign odontogenic tumor. It defines ameloblastoma, discusses its epidemiology and classifications. The document describes the clinical features, radiological findings, differential diagnosis, management and prognosis of ameloblastoma. It then presents clinical case examples, including details of patients' examinations, radiographs, surgical procedures and histopathology reports. The conclusion emphasizes the need for long-term follow-up due to the high recurrence rate of ameloblastoma.
Nonsurgical management of large periapical lesionsdrnoronhagoa
This document discusses the pathophysiological relationship between the dental pulp and periapical tissues, which can trigger an inflammatory response and resorptive process leading to abscesses, granulomas or cysts. It then presents the case of an 18-year old female with pain and swelling in her upper left molar region after a root canal treatment. Clinical and radiographic examination revealed a periapical lesion resembling a cyst. She was treated through non-surgical decompression of the lesion using calcium hydroxide dressings over 12 months, resulting in resolution of the lesion.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Dr Rahul Katyayan. Odontogenic Keratocyst in Child Head &Neck RegionRahulKatyayan2
This case report describes the diagnosis and management of a keratocystic odontogenic tumor (KCOT), formerly known as an odontogenic keratocyst, in an 11-year-old female patient. Examination revealed a swelling in the left upper back tooth region that was gradually increasing in size. Imaging showed a unilocular radiolucency and impacted tooth. Biopsy via fine needle aspiration confirmed the diagnosis of KCOT. Under local anesthesia, the cyst was surgically removed along with the impacted tooth. Hydroxyapatite bone graft material was placed and the defect healed well over 2 months with no recurrence. KCOTs can occur in children and should prompt evaluation for nevoid
TMJ ANKYLOSIS of the Jaw and its clinical significanciesVamshi392572
This document provides an overview of temporomandibular joint (TMJ) ankylosis, including its embryology, anatomy, causes, pathogenesis, classification systems, clinical features, investigations, and management. Some key points:
- TMJ ankylosis is a bony or fibrous adhesion of the joint components that limits mouth opening. It is commonly caused by trauma or infection.
- Following trauma, haemarthrosis leads to organization of the intra-capsular hematoma and bone formation, resulting in ankylosis.
- Classification systems describe the extent of ankylosis based on the area of bony fusion. Management involves aggressive resection, coronoidectomy, inter
This case report describes the surgical treatment of a 36-year-old male patient with an ameloblastoma tumor in the right side of the lower jaw. The tumor was excised via a trapezoidal flap surgery under general anesthesia. Histopathological examination found it to be an acanthomatous ameloblastoma. A reconstruction plate was fixed to prevent mandible fracture. The patient recovered well after surgery and was discharged after 3 days. Ameloblastomas are odontogenic tumors that commonly affect young people and have varying presentations depending on location and histological subtype.
Traditionally, obtaining tissue diagnosis from the Temporomandibular Joint (TMJ) has required invasive open techniques. In this case-series, the authors demonstrate a minimally invasive technique using arthroscopy to diagnose and treat Pigmented Villonodular Synovitis (PVNS) and pseudogout of the TMJ, followed by a review of the literature.
Peripheral Ossifying Fibroma: A Case Reportiosrjce
This case report describes a peripheral ossifying fibroma (POF) in a 50-year-old male patient. The patient presented with a 3x3 cm swelling in the mandibular left posterior region. Radiographs showed well-marginated radiopaque lesions with radiolucent foci suggestive of calcifications. Histopathological examination revealed variable thickness stratified squamous epithelium with fibrovascular connective tissue containing dense collagen fibers, compressed blood vessels, chronic inflammatory cells, and osseous-like structures, confirming the diagnosis of POF. POF is a benign reactive gingival lesion that is commonly mistaken for other lesions clinically. Complete surgical excision is the recommended treatment due to the lesion's recurrence
Ameloblastoma is a benign, locally invasive odontogenic tumor that arises from epithelial remnants of the tooth-forming organ. It is most commonly found in the mandible of young to middle-aged adults and can be central, unicystic, or peripheral in location. Treatment involves surgical resection with tumor-free margins of at least 1-2 cm due to high recurrence risk with more conservative approaches. Long-term follow up is needed due to possibility of late recurrence or rare malignant transformation.
Dept of Oral Medicine & Radiology
Ameloblastoma A case report
Dhananjay Singh
CHIEF COMPLAINT
HISTORY OF PRESENT ILLNESS
dental history
medical history
diagnosis
investigation
final diagnosis
treatment
clinical features
oral medicine
radiology
xray
oral diagnosis
This document discusses osteomas, which are benign bone tumors that commonly arise in the skull. It provides details on the typical presentation, locations, demographic factors, investigations and surgical approaches for osteomas. It then presents a case of a 10-year-old girl who presented with slow-growing swellings in her right eyebrow and hairline that were found to be osteomas on CT scan. She underwent a bicoronal surgical approach to completely excise the osteomas due to their size and location, with an excellent postoperative outcome and no recurrence.
Introduction
Portals of entry to the pulp
Concepts of infection
Focus of infection
Zones of Fish
Kronfeld’s mountain pass theory
Older v/s Newer Concepts in endodontics
Endodontics: When to do and When not to do?
Vital pulp therapy
Rationale of Pulpotomy
Vital pulp therapy over root canal therapy
Root canal therapy over vital pulp therapy
Rationale of Apexification
Conclusion
References
This case report describes a 19-year-old female patient with a central giant cell granuloma in the left mandibular condyle, treated with en bloc resection and reconstruction with fibula graft. This occurrence is considered very unusual. The lesion was removed surgically and reconstruction was performed using a fibula graft to restore function and anatomy. At a 24 month follow up there was no recurrence of the lesion and normal joint function had returned.
A case report of a rare Head & Neck Tumor, presented at Pakistan Institute of Medical Sciences, Islamabad. A 3 year old girl presented with a progressively enlarging swelling over the chin for 2months.
O/E: A huge swelling in the region of symphysis menti ,extending to involve the floor of the mouth , pushing the tongue upwards and backwards
No clinically palpable neck nodes. All baseline investigations were within normal range. After a proper Diagnosis made on Ct Scans and Histopathology, A Midline Mandibulectomy by vertical median lip splitting by an inverted T shaped incision was done.Titanium plates were used to stabilize the free edges of the mandible on both sides
Soft tissue reconstruction was done by primary closure.
Wound healed within 2 weeks post-operatively without any complications.
Journal of Pathology & Microbiology is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Pathology & Microbiology.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all areas of Pathology & Microbiology. Journal of Pathology & Microbiology accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of pathology & microbiology.
Journal of Pathology & Microbiology strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
This case report describes a 34-year-old male patient who presented with pain and pus discharge from a recently extracted tooth. Radiographs revealed two distinct radiolucencies - a large cyst in the left mandible and a smaller cyst in the right mandible. Histological examination found the left cyst to be a radicular cyst and the right cyst to be a dentigerous cyst. This presented a diagnostic dilemma due to the unusual presentation of multiple cysts occurring bilaterally and with atypical features for the cyst types.
A 34-year-old male presented with pain and pus discharge from a recently extracted tooth. Radiographs showed two distinct radiolucencies - a large cyst in the left mandible and a smaller cyst in the right mandible. Histological examination found the left cyst to be a radicular cyst and the right cyst to be a dentigerous cyst. This presented a diagnostic dilemma as it is uncommon to have multiple cyst types occurring bilaterally in the mandible without an associated syndrome. Careful radiographic and histological analysis was needed to arrive at the accurate diagnosis and appropriate treatment.
A 34-year-old male presented with pain and pus discharge from a recently extracted tooth. Radiographs showed two distinct radiolucencies - a large cyst in the left mandible and a smaller cyst in the right mandible. Histological examination found the left cyst to be a radicular cyst and the right cyst to be a dentigerous cyst. This presented a diagnostic dilemma as it is uncommon to have multiple cyst types occurring bilaterally in the mandible without an associated syndrome. Careful radiographic and histological analysis was needed to arrive at the accurate diagnosis and appropriate treatment.
Maxillary canine impaction occurs when the canine tooth fails to erupt into its proper position. This document discusses the development, eruption process and factors that can cause impaction of the canine tooth. It also covers methods for diagnosing impaction including various radiographic techniques and indices. The prognosis depends on the severity of impaction, as determined by radiographic evaluation, with more severe impactions requiring more complex treatment such as surgical exposure or extraction.
Abstract—This study was aimed to present a case report of a case of peripheral ossifying fibroma which is a rare case. This case was a 30 years non smoker male with the chief complaint of growth of gum tissue, moderately large in the mandibular posterior region. On intraoral examination, a peduncalated growth of 17 x 12 x 6 mm on marginal and attached gingiva with respect to tooth number 47 considerably hard in consistency and movable was seen. The lesion was erythmatous having a smooth non ulcerated surface. It was asymptomatic with no sign of pain. Intra oral periapical radiograph was taken which revealed slight erosion of crest of bone which was later confirmed during surgical excision. The possible reason of crestal bone erosion may be constant pressure of the growth. Differential diagnosis of irritation fibroma, pyogenic granuloma and peripheral giant cell granuloma was considered. However, clinical appearance and consistency was of a hard fibrous growth, which therefore led to a provisional diagnosis of peripheral ossifying fibroma or peripheral odontogenic fibroma.
This case report describes a rare case of synovial chondromatosis in the temporomandibular joint of a 36-year-old male patient who presented with a history of difficulty opening his mouth and pain in the left temporomandibular joint region. Imaging and histopathological examination confirmed the diagnosis of synovial chondromatosis. The lesion was surgically excised and the patient's symptoms were relieved post-operatively. Synovial chondromatosis is a benign tumor-like disorder involving the formation of loose cartilaginous nodules in the synovial membrane of joints.
This document discusses TMJ ankylosis, including classifications, causes, diagnosis, and surgical treatment. It begins by classifying TMJ disorders into organic, non-organic functional, and non-organic with secondary organic changes. Ankylosis is discussed as an organic articular disturbance that can be fibrous, bony, unilateral, or bilateral. Common causes are trauma, infection, and inflammation. Diagnosis involves limited or no mouth opening and radiographic findings. Surgical treatment aims to create a gap, improve function and nutrition, and sometimes uses costochondral grafts or temporalis fascia. The Popowich modification of preauricular surgical approach is described as advantageous for reducing facial nerve injury and improving visibility
This case report describes the surgical treatment of a 36-year-old male patient with an ameloblastoma tumor in the right side of the lower jaw. The tumor was excised via a trapezoidal flap surgery under general anesthesia. Histopathological examination found it to be an acanthomatous ameloblastoma. A reconstruction plate was fixed to prevent mandible fracture. The patient recovered well after surgery and was discharged after 3 days. Ameloblastomas are odontogenic tumors that commonly affect young people and have varying presentations depending on location and histological subtype.
Traditionally, obtaining tissue diagnosis from the Temporomandibular Joint (TMJ) has required invasive open techniques. In this case-series, the authors demonstrate a minimally invasive technique using arthroscopy to diagnose and treat Pigmented Villonodular Synovitis (PVNS) and pseudogout of the TMJ, followed by a review of the literature.
Peripheral Ossifying Fibroma: A Case Reportiosrjce
This case report describes a peripheral ossifying fibroma (POF) in a 50-year-old male patient. The patient presented with a 3x3 cm swelling in the mandibular left posterior region. Radiographs showed well-marginated radiopaque lesions with radiolucent foci suggestive of calcifications. Histopathological examination revealed variable thickness stratified squamous epithelium with fibrovascular connective tissue containing dense collagen fibers, compressed blood vessels, chronic inflammatory cells, and osseous-like structures, confirming the diagnosis of POF. POF is a benign reactive gingival lesion that is commonly mistaken for other lesions clinically. Complete surgical excision is the recommended treatment due to the lesion's recurrence
Ameloblastoma is a benign, locally invasive odontogenic tumor that arises from epithelial remnants of the tooth-forming organ. It is most commonly found in the mandible of young to middle-aged adults and can be central, unicystic, or peripheral in location. Treatment involves surgical resection with tumor-free margins of at least 1-2 cm due to high recurrence risk with more conservative approaches. Long-term follow up is needed due to possibility of late recurrence or rare malignant transformation.
Dept of Oral Medicine & Radiology
Ameloblastoma A case report
Dhananjay Singh
CHIEF COMPLAINT
HISTORY OF PRESENT ILLNESS
dental history
medical history
diagnosis
investigation
final diagnosis
treatment
clinical features
oral medicine
radiology
xray
oral diagnosis
This document discusses osteomas, which are benign bone tumors that commonly arise in the skull. It provides details on the typical presentation, locations, demographic factors, investigations and surgical approaches for osteomas. It then presents a case of a 10-year-old girl who presented with slow-growing swellings in her right eyebrow and hairline that were found to be osteomas on CT scan. She underwent a bicoronal surgical approach to completely excise the osteomas due to their size and location, with an excellent postoperative outcome and no recurrence.
Introduction
Portals of entry to the pulp
Concepts of infection
Focus of infection
Zones of Fish
Kronfeld’s mountain pass theory
Older v/s Newer Concepts in endodontics
Endodontics: When to do and When not to do?
Vital pulp therapy
Rationale of Pulpotomy
Vital pulp therapy over root canal therapy
Root canal therapy over vital pulp therapy
Rationale of Apexification
Conclusion
References
This case report describes a 19-year-old female patient with a central giant cell granuloma in the left mandibular condyle, treated with en bloc resection and reconstruction with fibula graft. This occurrence is considered very unusual. The lesion was removed surgically and reconstruction was performed using a fibula graft to restore function and anatomy. At a 24 month follow up there was no recurrence of the lesion and normal joint function had returned.
A case report of a rare Head & Neck Tumor, presented at Pakistan Institute of Medical Sciences, Islamabad. A 3 year old girl presented with a progressively enlarging swelling over the chin for 2months.
O/E: A huge swelling in the region of symphysis menti ,extending to involve the floor of the mouth , pushing the tongue upwards and backwards
No clinically palpable neck nodes. All baseline investigations were within normal range. After a proper Diagnosis made on Ct Scans and Histopathology, A Midline Mandibulectomy by vertical median lip splitting by an inverted T shaped incision was done.Titanium plates were used to stabilize the free edges of the mandible on both sides
Soft tissue reconstruction was done by primary closure.
Wound healed within 2 weeks post-operatively without any complications.
Journal of Pathology & Microbiology is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Pathology & Microbiology.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all areas of Pathology & Microbiology. Journal of Pathology & Microbiology accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of pathology & microbiology.
Journal of Pathology & Microbiology strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
This case report describes a 34-year-old male patient who presented with pain and pus discharge from a recently extracted tooth. Radiographs revealed two distinct radiolucencies - a large cyst in the left mandible and a smaller cyst in the right mandible. Histological examination found the left cyst to be a radicular cyst and the right cyst to be a dentigerous cyst. This presented a diagnostic dilemma due to the unusual presentation of multiple cysts occurring bilaterally and with atypical features for the cyst types.
A 34-year-old male presented with pain and pus discharge from a recently extracted tooth. Radiographs showed two distinct radiolucencies - a large cyst in the left mandible and a smaller cyst in the right mandible. Histological examination found the left cyst to be a radicular cyst and the right cyst to be a dentigerous cyst. This presented a diagnostic dilemma as it is uncommon to have multiple cyst types occurring bilaterally in the mandible without an associated syndrome. Careful radiographic and histological analysis was needed to arrive at the accurate diagnosis and appropriate treatment.
A 34-year-old male presented with pain and pus discharge from a recently extracted tooth. Radiographs showed two distinct radiolucencies - a large cyst in the left mandible and a smaller cyst in the right mandible. Histological examination found the left cyst to be a radicular cyst and the right cyst to be a dentigerous cyst. This presented a diagnostic dilemma as it is uncommon to have multiple cyst types occurring bilaterally in the mandible without an associated syndrome. Careful radiographic and histological analysis was needed to arrive at the accurate diagnosis and appropriate treatment.
Maxillary canine impaction occurs when the canine tooth fails to erupt into its proper position. This document discusses the development, eruption process and factors that can cause impaction of the canine tooth. It also covers methods for diagnosing impaction including various radiographic techniques and indices. The prognosis depends on the severity of impaction, as determined by radiographic evaluation, with more severe impactions requiring more complex treatment such as surgical exposure or extraction.
Abstract—This study was aimed to present a case report of a case of peripheral ossifying fibroma which is a rare case. This case was a 30 years non smoker male with the chief complaint of growth of gum tissue, moderately large in the mandibular posterior region. On intraoral examination, a peduncalated growth of 17 x 12 x 6 mm on marginal and attached gingiva with respect to tooth number 47 considerably hard in consistency and movable was seen. The lesion was erythmatous having a smooth non ulcerated surface. It was asymptomatic with no sign of pain. Intra oral periapical radiograph was taken which revealed slight erosion of crest of bone which was later confirmed during surgical excision. The possible reason of crestal bone erosion may be constant pressure of the growth. Differential diagnosis of irritation fibroma, pyogenic granuloma and peripheral giant cell granuloma was considered. However, clinical appearance and consistency was of a hard fibrous growth, which therefore led to a provisional diagnosis of peripheral ossifying fibroma or peripheral odontogenic fibroma.
This case report describes a rare case of synovial chondromatosis in the temporomandibular joint of a 36-year-old male patient who presented with a history of difficulty opening his mouth and pain in the left temporomandibular joint region. Imaging and histopathological examination confirmed the diagnosis of synovial chondromatosis. The lesion was surgically excised and the patient's symptoms were relieved post-operatively. Synovial chondromatosis is a benign tumor-like disorder involving the formation of loose cartilaginous nodules in the synovial membrane of joints.
This document discusses TMJ ankylosis, including classifications, causes, diagnosis, and surgical treatment. It begins by classifying TMJ disorders into organic, non-organic functional, and non-organic with secondary organic changes. Ankylosis is discussed as an organic articular disturbance that can be fibrous, bony, unilateral, or bilateral. Common causes are trauma, infection, and inflammation. Diagnosis involves limited or no mouth opening and radiographic findings. Surgical treatment aims to create a gap, improve function and nutrition, and sometimes uses costochondral grafts or temporalis fascia. The Popowich modification of preauricular surgical approach is described as advantageous for reducing facial nerve injury and improving visibility
A 17-year-old male presented with difficulty opening his mouth for 4 days following a road traffic accident. Clinical examination and X-rays revealed a left condylar fracture with medial displacement. The patient underwent open reduction and internal fixation surgery to repair the fractured condylar segment and meniscus using a pre-auricular incision. Post-operative recovery was uneventful, with normal facial nerve function and occlusion restored.
A 45-year-old female presented with a painful swelling in her upper left jaw. Imaging and biopsy revealed an odontogenic fibromyxoma, a rare benign tumor. The tumor was surgically excised via partial maxillectomy. Histopathological examination of the specimen confirmed the diagnosis. At follow-ups 6 months post-operation, the patient was comfortable without signs of recurrence. Odontogenic fibromyxomas are rare benign tumors of ectomesenchymal origin that commonly occur in the mandible of females in their 20s-30s. Wide local excision is the standard treatment, with recurrence rates around 25% requiring close monitoring.
Chemical facial peels are a cosmetic treatment that removes the top layers of damaged skin to reveal smoother, younger-looking skin underneath. There are different types of peels that vary in strength from superficial peels using alpha hydroxy acids to deep peels using phenol. A chemical peel can improve the appearance of acne scarring, sun damage, age spots and fine lines. The treatment involves applying chemicals to the skin that cause it to peel and shed over the course of a week. Possible side effects include temporary redness, swelling or discoloration but risks like scarring and infection must also be considered.
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Our backs are like superheroes, holding us up and helping us move around. But sometimes, even superheroes can get hurt. That’s where slip discs come in.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
3. 45 yr old female with painful swelling in the upper
left back teeth region since 4 months.
Dull aching pain radiating occasionally to ear on
same side.
3
CHIEF COMPLAINT
4. PAST DENTAL HISTORY
Removal of upper left back tooth and a small portion
of the swelling was surgically removed and sent for lab
examination in a local dental hospital about 4
months back . The reports of which were not available
with patient.
4
5. EXTRAORAL FINDINGS
Solitary, diffuse and firm swelling on left side of the face
Approx 40x40 mm causing mild facial asymmetry.
A-P extending from tragus to the ala of the nose
S-I extending from lower eye lid till the zygomatic buttress
No signs of any inflammation or sinus opening.
5
7. INTRA ORAL FINDINGS
3×2 cm diffuse swelling from 25-28 .
Oval and covered with diffuse erythematous areas of mucosa.
Obliteration of the buccal sulcus.
The palatal aspect, was unremarkable.
Teeth #27 and #28 were clinically missing.
Lymph nodes : palpable
Mouth opening : 28mm and restricted movements.
7
10. • PROVISIONAL DIAGNOSIS :
Fibro osseous lesion of the jaw
• DIFFERENTIAL DIAGNOSIS:
Central giant cell tumour
Central hemangioma
Odontogenic keratocyst
Maxillary sinus tumor
10
11. HISTO PATHOLOGY
• Incisional biopsy was performed showed loosely arranged
stellate, spindle-shaped and round cells in an abundant
loose myxoid stroma with collagen fibres and islands of
odontogenic epithelium
11
odontogenic
FIBROMYXOMA
13. TREATMENT PLAN
• Partial maxillectomy under general anaesthesia was
planned.
• Preoperative impressions and study casts were
made.
• Obturator was made with short labial bow and
Adams clasp on 16 and 26.
13
14. INTRA OP
• Excision of the lesion along with partial maxillectomy was
performed through intra oral approach under general
anaesthesia.
• Buccal fat pad was mobilized for closure and soframycin
ribbon gauze was placed through nasal antrostomy for next
two days.
14
15. SPECIMEN
• Complete excision of the lesion was done and sent for histo
pathological examination.
• Obturator was placed next day after surgery to prevent
hematoma formation.Postoperative hospital stay was
uneventful except an episode of vomiting after 8hrs of
surgery. 15
16. POST OP
At follow up of 1week, 1month and 2months & 6 months patient was
comfortable without any complaints follow up OPG and PNS view was
unremarkable.
16
19. DISCUSSION
• Fibromyxoma is a benign tumour of ectomesenchymal
origin with or without odontogenic epithelium
• The term “Myxoma” -Virchow in 1863
• “Fibromyxoma” - Dietrich et al
• In 1947, Thoma and Goldman first described myxomas
of the jaws.
19
20. James DR,Lucas VS: maxillary myxoma in a child of 11 months age- a case report-
J.cranio max facial surgery,15:42 -44,1987
• Slow growing expansile and locally destructive.
• Solitary growths.
• Occur in soft and bony tissues.
• Subclassified into osteogenic and odontogenic entities .
• Heart, skin, and subcutaneous tissue and centrally in the
bone.
• 1% to 3% of all cysts and tumors of the jaws .
20
21. *Abiose BO,ajagbe HA,thomas O: fibromyxoma of jawbones-a study of ten cases. Br j oral
maxillofac surgery, 25:415-421,1987
*Adamo AK,Locricchio RC, Freedman P: Myxoma of mandible treated by peripheral ostectomy
and immediate reconstruction- Report of a case, J oral surg, 38:530-533,1980
• Mandible > maxilla*
• Displacement of dentition*
• 2nd and 3rd decades of life.
• Females > Males.
• Children < 12 years- rare
21
INCIDENCE
22. ETIOLOGY
• Odontogenic ectomesenchymal origin.
(Goldblatt LI Ultrastructural study of an odontogenic oral surg
oral med oral pathol 1976 Aug;42(2):206-20.)
• Odontogenic fibroma that has undergone myxomatous
changes
(Willis RA: Pathology of tumors. St Louis, MO, Mosby,1948, pp
642-655)
• From remnants of embryonic mesenchyme
(Ewing J: Neoplastic disease: A treatise on tumors, (ed4).
Philadelphia, PA, Saunders, 1940, pp 182-189
22
23. • True mesenchymal neoplasm
(Ghosh BC, Huvos AG, Gerold FP, et al: Myxoma of the jaw bones.
Cancer 31:237-240, 1973)
• Infectious origin
(Glazunov MF, Puchkov JG: Human muscular myxoma and
intracellnlar inclusions. Vopr Onkol 6:11- 27, 1960)
• Antecedent trauma is also considered as an inciting event
(Whitman RA, Stewart S, Stoopack JG, et al: Myxoma of the
mandible: Report of a case. J Oral Surg 28:63-70, 1971)
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24. CLINICAL PRESENTATION
• Main sign -swelling of the affected region
• With pain occurring less frequently mostly in cases of
soft tissue myxomas.
• Paresthesia, hyperesthesia, anesthesia- very rare
24
25. • More aggressive in maxilla than in mandible
( Reichart PA, Philipsen HP. Odontogenic tumors and allied
lesions. London: Quintessence Publishing Co Ltd; 2004)
• Exophthalmus &obliteration of nasolabial fold
(Sasidhar Singaraju, Sangeetha P Wanjari, Rajkumar N Parwani.
Odontogenic myxoma of the maxilla: A report of a rare case
and review of the literature. January-June 2010, 14(1):19-23
• Tooth displacement and cortical bone expansion
25
26. Radiographic features
Unilocular radiolucency: common in anterior region
Multilocular radiolucency: posterior region
Gracile septae may be found giving rise to tennis rachet /
honey combed/ soap bubble appearance
Diffuse calcifications
(Chuchurru JA, Luberti R, Cornicelli JC, Dominguez FV. Myxoma
of the mandible with unusual radiographic appearance. J
Oral Maxillofac Surg 1985;43:987-90)
26
27. • Tooth displacement is common
• Root resorption is rare
• Scalloping of tumor between roots
(Farman AG, Nortje CJ, Grotepass FW, Farman FJ, Van Zyl JA.
Myxofibroma of the jaws. Br J Oral Surg 1977;15:3-18.)
27
28. Differential diagnosis
• When unilocular and without septae : peri apical cyst,
traumatic bone cyst
• When multilocular: Ameloblastoma ,, central hemangioma,
central giant cell granuloma and odontogenic keratocyst
and certain non-neoplastic lesions (fibrous dysplasia)
Peltola, B Magnusson, RP Happonen and H Borrman,
Odontogenic myxoma—a radiographic study of 21 tumours,
Br J Oral Maxillofac Surg 32 (1994), pp. 298–302
28
29. Dezoti MSG et al: Odontogenic myxoma -a case report and clinico radiographic study of
seven tumuors. J.contemp dent prac 7,107,2006
• Small tumours- Curettage followed by cauterization.
• Larger tumours - Extensive resection.
• Recurrence rates as high as 10 %to 33% and average 25%
have been reported.*
• Prognosis of fibromyxoma (jaw) > fibromyxoma (long
bones)
29
MANAGEMENT
31. • Abiose et al. reported that fibromyxomas constituted
3.73% of all benign and malignant oral tumors and 20%
of tumors of dental origin second in incidence to
ameloblastoma.
• However, James etal. reported the case of a maxillary
myxoma in a child of 11 months.
REVIEW OF LITERATURE
31
32. • Keszler et al. (10) found that myxoma in childhood
represented 12.5% of the 80 cases of this tumor and stated
that fibromyxoma must be taken into account in the
differential diagnosis of intraosseous radiolucencies in
young patients.
• In their review of fibromyxomas, Farman et al. stated that
three mandibular cases were found for every two maxillary
cases and that fibromyxomas were more common in the
premolar and molar regions.
REVIEW OF LITERATURE
32
33. REVIEW OF LITERATURE
• Wide resection with preservation of vital structures and
simultaneous autogenous bone graft reconstruction.
Chen CT, Chen YR, Lai JP, Tung TC. Maxillary myxoma treated
with wide resection and immediate reconstruction: a case
report. Ann Plast Surg. 1997; 39(1): 87-93
• More aggressive surgical treatment should be reserved for
lesions for which there is a strong suspicion of malignant
transformation.
Frezzini C, Maglione M, Rizzardi C, Melato M. Odontogenic
myxoma recurring after 11 years: case report and
observations on this unusual neoplasm. Minnerva Stomatol.
2003; 52(5): 247-51.
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34. REVIEW OF LITERATURE
• A very rare malignant form of the lesion showing marked
cellularity and cellular atypism has been designated as
MYXOSARCOMAS
Lamberg MA, Calonius BP, Makinen JE, Paavolainen MP,
Syrjanen KJ. A case of malignant myxoma (myxosarcoma) of
the maxilla. Scand J Dent Res 1984; 92: 352-57.
• Cytogenetic analysis of malignant myxosarcoma has
revealed an unexpectedly aberrant hypertetraploid
chromosome complement that was considered as
incompatible with the usual karyotypic patterns of benign
tumours.
Pahl S, Henn W, Binger T, Stein U, Remberger K. Malignant
odontogenic myxoma of the maxilla: case with cytogenetic
34
35. TAKE HOME MESSAGE
• Benign tumour of ectomesenchymal origin with
or without odontogenic epithelium
• 1% to 3% of all cysts and tumors of the jaws .
• Mandible
• 2nd and 3rd decades of life.
• Females
• Small tumours- Curettage followed by
cauterization.
• Larger tumours - Extensive resection.
• Recurrence rates as high as 25% have been
reported.
• Prognosis of fibromyxoma (jaw) > fibromyxoma
(long bones)
• Malignant transformation of fibromyxoma
35