The presentation explain white lesions in oral cavity and the classification the demonstrate the etiology, histopathology, diagnosis and treatment for each one.
The presentation explain white lesions in oral cavity and the classification the demonstrate the etiology, histopathology, diagnosis and treatment for each one.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
1. Presented By:
Dr. Bhavik Miyani
Guided By:
Dr Anil Managutti
Dr Shailesh Menat
Dr Rushit Patel
Dr Nirav Patel
Case of Radicular Cyst
Department of OMFS, NPDCH, SPU, Visnagar.
3. CASE REPORT
NAME :- Nehal ben Patel
AGE/SEX :- 33 Years/ Female
OCCUPATION :- Teacher
ADDRESS :- Unjha
OPD NO. :- 24234-H
4. CHIEF COMPLAINT
• Patient complaint of non healing ulcer irt with lower
chin region since 8 years and pain since 1 month.
5. HISTORY OF PRESENT ILLNESS
Patient was relatively asymptomatic before 8 years.
Then she developed one boil on lower anterior region of chin. she noticed pus
like white thick purulent material discharging from ulcer.
After two month she visited to Dermatologist at private clinic at Visnagar where
they diagnosed with mole and given laser therapy.
Then boil is healed completely.
Then after 8 month recurrence of boil at same site occurs.
Then she referred to surgeon where they advised surgical removal of lesion and
she underwent excision of lesion under local anesthesia.
6. HISTORY OF PRESENT ILLNESS
After this lesion is subsided till 8 months.
Then she developed pain irt with same region which mild,
continues and dull aching type with no associated symptoms and
then she came to the department of OMFS, NPDCH with above
mentioned complain.
H/O- Trauma at the age of 15 years in mandibular teeth region.
No H/O- Fever, malaise or loss of appetite.
7. PAST MEDICAL HISTORY :-
- No H/O previous hospitalization
- No H/O any systemic diseases like Hypertension,
Diabetes Mellitus, Hepatitis
PAST DENTAL HISTORY :-
- No relevant past dental history
DRUG HISTORY :-
- No relevant drug allergy
FAMILY HISTORY :-
- No relevant family history
8. PERSONAL HISTORY :-
- Habits :-No any harmful habit.
- Diet :- Vegetarian
- Marital status :- Married
- Brushing :- Once a day with toothbrush
9. • Conscious
• Cooperative
• Well Oriented to time, place and person
• Built :-Well built
• Nourishment :- Well nourished
• Gait :- Normal
Vital signs :-
Temperature: Afebrile
Blood pressure: 134/86 mmHg
Pulse rate: 78beats/min
Respiratory rate: 16 cycles/min
GENERAL EXAMINATION
10. • Face :- No gross facial asymmetry.
• Skin and soft tissue :- NAD.
• Lips :- Competent.
• Jaw movement :- No jaw deviation while opening or closing jaw.
• TMJ :- NAD.
• Mouth opening :- 38 mm.
1. EXTRA- ORAL EXAMINATION
11. Swelling Examination
• Inspection:
• A solitary, well defined, round shaped measuring around 1*1 cm in
size swelling present over mandibular chin region having fistula.
• Palpation:
• All the inspector findings are confirmed by palpation. Swelling was
non tender, soft, overlying temperature normal.
21. CT-NECK
OPG is showing fracture line starting from crest
of alveolar ridge between 33 and 34 tooth and passing
inferior and backward direction involving inferior border
of mandible suggestive of Parasymphysis fracture. There
is also presence of fracture line passing from
48 inferior and backward direction involving basal bone
suggestive of simple fracture.
27. Radicular cysts are the most common inflammatory cysts arising from the epithelial residues
in the periodontal ligament as a result of periapical periodontitis following necrosis of the
pulp, remains asymptomatic and left unnoticed until detected during routine periapical
radiography.
These cysts comprise about 52% to 68% of all the cysts affecting the human jaw. Their
incidence is highest in third and fourth decade of life with male predominance. Anatomically
the periapical cysts occur in all tooth-bearing sites of the jaw but are more frequent in the
maxillary than the mandibular region.
INTRODUCTION
DISCUSSION
28. Caries is the most frequent aetiological factor of radicular cyst. They also result
from the traumatic injuries.
These cysts are slow growing and asymptomatic unless secondarily infected.
Extraction or endodontic treatment of the affected tooth is required when clinical
and radiographic characteristics indicate a periapical inflammatory lesion.
The normal treatments for radicular cysts include total enucleation in the case of
small lesions, marsupialisation for decompression of larger cysts, or a
combination of the two techniques. Inflammatory cysts do not recur after
adequate treatment.
29. o Components of a cyst: Lumen (cavity), Epithelial lining, Wall
30.
31. Also known as Periapical cyst, Apical periodontal cyst, Root end cyst
or Dental cyst.
A cyst that most likely results when rests of epithelial cells (Malassez) in the
periodontal ligament are stimulated to proliferate and undergo cystic
degeneration by inflammatory products from a non-vital tooth.
Most common odontogenic cystic lesion of inflammatory origin.
Radicular cysts are found at root apices of involved teeth. These cysts
may persists even after extraction of offending tooth, such cysts are called
Residual Cysts.
RADICULAR CYST
32. 1) Periapical Cyst (70%): These are the
radicular cysts which are present at root
apex.
2) Lateral Radicular Cyst (20%): These
are the radicular cysts which are present at
the opening of lateral accessory root canals
of offending tooth.
3) Residual Cyst: These are the radicular
cysts which remains even after extraction
of offending tooth.
33. Most common location: (maxilla 3x more affected)
o Maxillary anterior region
o Maxillary posterior region
o Mandibular posterior region
o Mandibular anterior region
34. • Usually asymptomatic
• Slowly progressing
• If infection enters, the swelling becomes
painful and rapidly expands
• Initially swelling is round and hard
• Later part of the wall is resorbed leaving a soft
fluctuant swelling, bluish in color, beneath the
mucous membrane
• When bone has been reduced to egg shell
thickness a crackling sensation (crepitant) may
be felt on pressure.
CLINICAL FEATURES
37. o Cyst fluid (watery & opalescent) but sometimes viscid and yellowish.
o Sometimes shimmers with cholesterol crystals (typically rectangular
shaped cholesterol crystals with a notched corner is characteristic).
o Cholesterol crystals are not specific to radicular cysts.
o Protein content of fluid – seen as amorphous eosinophilic material often
containing broken-down leucocytes and and cells distended with fat
globules.
HISTOPATHOLOGY
Lumen
38. o Non-keratinized stratified squamous epithelium.
o Lacks a well-defined basal cell layer.
o Thick, irregular, hyperplasti or net like forming
rings & arcades.
o Hyaline bodies (Rushton bodies) may be found
o Mucous cells – as a result of metaplasia.
Epithelial lining
39. • Hyaline bodies (Rushton bodies): characterized
by a hairpin or a slightly-curved shaped,
concentric lamination and occasional basophilic
mineralization.
o Are within the epithelium lining
o Origin believed to be previous haemorrhage
o Are of no clinical significance
• Russel bodies: refractile and spherical
intracellular bodies representing Gamma
Globulin.
40. • Round/ovoid radiolucency with an opaque border.
• Apex of the tooth is within the radiolucency.
• Adjacent teeth and structures are displaced.
• Infected cyst:
o Poorly demarcated borders.
o Background structures become invisible and the defect appears as tunneling.
o PDL space around the involved tooth becomes widened.
RADIOGRAPHIC SIGNS
41.
42. Treatment of a tooth with radicular cyst may include:
o Tooth extraction.
o Endodontic therapy- if the involved non vital tooth is to be retained.
o Enucleation- all the cyst tissue will be available for histological examination; have minimal
aftercare. Potentially problematic as this may deprive adjacent teeth of their blood supply
and render them non vital.
o Marsupialization- partial removal; indicated in large cysts that involves apices of adjacent
teeth; requires considerable aftercare and good patient cooperation.
• Disadvantage: not all cyst lining is available to histologic examination which may lead to misdiagnosis
MANAGEMENT
43. Patient Radicular Cyst Dentigerous Cyst Ameloblastoma
Location: left body of
the mandible
Non-vital tooth (apex or
lateral part of the tooth).
Crown of an unerupted
tooth (third molars and
maxillary canines).
Mandible and maxillary
area
Radiologic features:
unilocular radiolucency
Unilocular radiolucency at
the apical portion of a
non-vital tooth.
Unilocular radiolucency,
which is associated with
an unerupted tooth.
Radiolucent, unilocular
lesions, with well-
demarcated, corticated
borders;
larger lesions : “soap
bubble” or honeycomb
Microscopic features Luminal lining:
nonkeratinized
stratified squamous
epithelium.
Odontogenic rests are
rarely seen in the cyst
wall.
Cholesterol slits, foreign
body giant cells, and
hemosiderin deposits are
common findings.
Luminal lining:
nonkeratinized
stratified squamous
epithelium.
Odontogenic rests are
scattered within the
connective tissue.
Cholesterol slits and
their associated
multinucleated giant
cells may be present.
Columnar basilar cells,
palisading of basilar
cells, polarization of
basilar layer nuclei away
from the basement
membrane,
hyperchromatism of
basal cell nuclei in the
epithelial lining, and
subnuclear vacuolization
of the cytoplasm of the
basal cells.
44. • The radicular cyst is usually symptomless and detected incidentally on plain OPG
while investigating for other diseases.
• However, as some of them grow, they can cause mobility and displacement of teeth
and once infected, lead to pain and swelling, after which the patient usually
becomes aware of the problem.
• The swelling is slowly enlarging and initially bony hard to palpate which later
becomes rubbery and fluctuant.
• The treatment of choice is dependent on the size and localization of the lesion, the
bone integrity of the cystic wall and its proximity to vital structures.
CONCLUSION
45. • Several treatment options are available for a radicular cyst such as surgical
endodontic treatment, extraction of the offending tooth, enucleation with
primary closure, and marsupialization followed by enucleation.
• In this case, surgical enucleation was preferred and was performed
uneventfully.
• To conclude, a radicular cyst is a common condition found in the oral cavity.
However, it usually goes unnoticed and rarely exceeds the palpable
dimension.
46. 1. Cawson’s Essentials of Oral Pathology & Oral Medicine- 7th edition.
2. Oral and Maxillofacial Medicine (Crispian Scully CBE).
3. Shafer’s Contemporary Oral and Maxillofacial Pathology.
4. Lucas’s pathology of tumors of the oral tissues- 5th edition.
REFERENCES