This document provides information about case histories in dentistry. It defines a case history as a planned conversation between patient and doctor to determine the nature of the patient's illness or mental state. The summary includes details about the contents, purpose, and components of a thorough case history, which establishes the patient's medical history, dental history, and other relevant details to allow for an accurate diagnosis and safe treatment plan. Physical examinations and potential investigations are also discussed.
This document provides an overview of surgical approaches to the temporomandibular joint (TMJ). It discusses several extraoral and intraoral approaches, including the preauricular, endaural, postauricular, coronal, retromandibular, and intraoral vestibular approaches. For each approach, it highlights considerations for exposure and visibility of the joint, avoidance of neurovascular structures, and postoperative aesthetics. Complications are also briefly mentioned. Detailed anatomical descriptions and illustrations are provided to demonstrate the surgical planning and exposure for different approaches.
The document discusses cysts of the jaws, including their classification and pathogenesis. It focuses on odontogenic cysts and developmental cysts. Specifically, it describes a dentigerous cyst as an odontogenic cyst that surrounds the crown of an impacted tooth, caused by fluid accumulation between the reduced enamel epithelium and enamel surface, resulting in a cyst enclosing the tooth crown. Dentigerous cysts usually involve permanent teeth, often third molars or cuspids. They present as well-defined radiolucencies associated with unerupted teeth on imaging.
This document discusses cysts of the oral and maxillofacial region. It defines true cysts as pathological cavities lined by epithelium and containing fluid, and pseudo cysts as cavities not lined by epithelium that may contain fluid. Cysts are classified based on their origin (odontogenic vs non-odontogenic) and location. Diagnosis involves history, clinical examination, radiographic evaluation and sometimes aspiration biopsy or surgical biopsy. Treatment options include enucleation, marsupialization, or a combination depending on the cyst size and location.
The document discusses various tumors of the jaw bones, including benign and malignant tumors. It provides classifications for odontogenic tumors, which originate from tooth-forming tissues, and non-odontogenic tumors. Specific benign jaw tumors mentioned include ameloblastoma, calcifying epithelial odontogenic tumor (CEOT), adenomatoid odontogenic tumor (AOT), odontoma, and cementoblastoma. Ameloblastoma is described as a locally invasive benign epithelial odontogenic neoplasm with a strong tendency to recur. Surgical treatment options aim to completely remove the tumor while preserving normal tissue.
Central Giant Cell Granuloma :
WHO has defined it as an intraosseous lesion consisting of cellular and fibrous tissue that contains multiple foci of hemorrhage, aggregation of multinucleated giant cells and occasionally trabaculae of woven bone
Etiology JAFFE (1953): considered this lesion to be a local reparative reaction of bone, possibly to intramedullary hemorrhage or trauma, hence the term reparative giant cell granuloma was accepted.
Charles A Waldron & W G Shafer (1966) suggested trauma be an important etiological factor in the initiation of the CGCG of the jaws
Thoma K H (1986) suggested that the lesion may be due to capillary injury caused by defective wall due to some type of trauma
J V Soames and J C Southam (1997) suggested that it could be a reaction to some form of hemodynamic disturbance in bone marrow, perhaps associated with trauma and hemorrhage REGEZI AND SCIUBBA(1999) :
Suggested that
Response to previous traumatic or inflammatory episodes.
This lesion is charecterised by proliferation of fibroblasts and multinucleated giant cells, in a densely packed stromaThe CGCG is a benign process that occurs almost exclusively within the jaw bones
CLINICAL PRESENTATION
Found predominantly in children and young adult
It has a female predilection (2:1)
Most commonly affected site is the anterior portion of the jaws, with an increased frequency of occurrence in the mandible
Majority of the CGCG of jaws are painless, expansion of bone is detected on routine examination
Few cases may be associated with pain, paresthesia or perforation of a cortical bone plate, occasionally resulting in the ulceration of the mucosal surface by the underlying lesion
Radiographic featuresCentral giant cell lesions present as radiolucent defects. Which may be unilocular or multilocular.
The defect is usually well delineated
The lesion may vary from a 5×5mm incidental radiographic findings to a destructive lesion greater than 10cm in size.
radiographic findings
A small unilocular lesion may be confused with periapical granuloma or cysts.
multilocular giant cell lesions cannot be radiographically distinguished from ameloblastomas or other multilocular lesions. Based on clinical and radiological features CGCG may be divided into two categories
- Non-aggressive lesion
- Aggressive lesion
The non aggressive lesion makes up most cases and exhibit few or no symptoms, they demonstrate slow growth and do not show cortical perforation or root resorption of teeth involved in the lesion. The aggressive lesions are characterized by pain, rapid growth, cortical perforation and root resorption and show marked tendency to recur when compared with non aggressive typeSoft spongy, brownish to reddish friable tissue of various size.
A specimen is usually coated with fresh or coagulated blood. Giant cell lesions of the jaws show a variety of features. Common to all is the presence of few to many multinucleated
This document discusses odontomas, which are benign odontogenic tumors composed of dental tissue like enamel, dentin, and pulp. There are two main types: compound odontomas, which appear like small tooth structures, and complex odontomas, which have a disorganized appearance. Odontomas are usually asymptomatic and discovered incidentally on x-rays during dental exams. On x-rays, they appear as radiopaque masses surrounded by a radiolucent rim. Treatment involves simple surgical removal, with an excellent prognosis and no recurrence.
This document provides information about case histories in dentistry. It defines a case history as a planned conversation between patient and doctor to determine the nature of the patient's illness or mental state. The summary includes details about the contents, purpose, and components of a thorough case history, which establishes the patient's medical history, dental history, and other relevant details to allow for an accurate diagnosis and safe treatment plan. Physical examinations and potential investigations are also discussed.
This document provides an overview of surgical approaches to the temporomandibular joint (TMJ). It discusses several extraoral and intraoral approaches, including the preauricular, endaural, postauricular, coronal, retromandibular, and intraoral vestibular approaches. For each approach, it highlights considerations for exposure and visibility of the joint, avoidance of neurovascular structures, and postoperative aesthetics. Complications are also briefly mentioned. Detailed anatomical descriptions and illustrations are provided to demonstrate the surgical planning and exposure for different approaches.
The document discusses cysts of the jaws, including their classification and pathogenesis. It focuses on odontogenic cysts and developmental cysts. Specifically, it describes a dentigerous cyst as an odontogenic cyst that surrounds the crown of an impacted tooth, caused by fluid accumulation between the reduced enamel epithelium and enamel surface, resulting in a cyst enclosing the tooth crown. Dentigerous cysts usually involve permanent teeth, often third molars or cuspids. They present as well-defined radiolucencies associated with unerupted teeth on imaging.
This document discusses cysts of the oral and maxillofacial region. It defines true cysts as pathological cavities lined by epithelium and containing fluid, and pseudo cysts as cavities not lined by epithelium that may contain fluid. Cysts are classified based on their origin (odontogenic vs non-odontogenic) and location. Diagnosis involves history, clinical examination, radiographic evaluation and sometimes aspiration biopsy or surgical biopsy. Treatment options include enucleation, marsupialization, or a combination depending on the cyst size and location.
The document discusses various tumors of the jaw bones, including benign and malignant tumors. It provides classifications for odontogenic tumors, which originate from tooth-forming tissues, and non-odontogenic tumors. Specific benign jaw tumors mentioned include ameloblastoma, calcifying epithelial odontogenic tumor (CEOT), adenomatoid odontogenic tumor (AOT), odontoma, and cementoblastoma. Ameloblastoma is described as a locally invasive benign epithelial odontogenic neoplasm with a strong tendency to recur. Surgical treatment options aim to completely remove the tumor while preserving normal tissue.
Central Giant Cell Granuloma :
WHO has defined it as an intraosseous lesion consisting of cellular and fibrous tissue that contains multiple foci of hemorrhage, aggregation of multinucleated giant cells and occasionally trabaculae of woven bone
Etiology JAFFE (1953): considered this lesion to be a local reparative reaction of bone, possibly to intramedullary hemorrhage or trauma, hence the term reparative giant cell granuloma was accepted.
Charles A Waldron & W G Shafer (1966) suggested trauma be an important etiological factor in the initiation of the CGCG of the jaws
Thoma K H (1986) suggested that the lesion may be due to capillary injury caused by defective wall due to some type of trauma
J V Soames and J C Southam (1997) suggested that it could be a reaction to some form of hemodynamic disturbance in bone marrow, perhaps associated with trauma and hemorrhage REGEZI AND SCIUBBA(1999) :
Suggested that
Response to previous traumatic or inflammatory episodes.
This lesion is charecterised by proliferation of fibroblasts and multinucleated giant cells, in a densely packed stromaThe CGCG is a benign process that occurs almost exclusively within the jaw bones
CLINICAL PRESENTATION
Found predominantly in children and young adult
It has a female predilection (2:1)
Most commonly affected site is the anterior portion of the jaws, with an increased frequency of occurrence in the mandible
Majority of the CGCG of jaws are painless, expansion of bone is detected on routine examination
Few cases may be associated with pain, paresthesia or perforation of a cortical bone plate, occasionally resulting in the ulceration of the mucosal surface by the underlying lesion
Radiographic featuresCentral giant cell lesions present as radiolucent defects. Which may be unilocular or multilocular.
The defect is usually well delineated
The lesion may vary from a 5×5mm incidental radiographic findings to a destructive lesion greater than 10cm in size.
radiographic findings
A small unilocular lesion may be confused with periapical granuloma or cysts.
multilocular giant cell lesions cannot be radiographically distinguished from ameloblastomas or other multilocular lesions. Based on clinical and radiological features CGCG may be divided into two categories
- Non-aggressive lesion
- Aggressive lesion
The non aggressive lesion makes up most cases and exhibit few or no symptoms, they demonstrate slow growth and do not show cortical perforation or root resorption of teeth involved in the lesion. The aggressive lesions are characterized by pain, rapid growth, cortical perforation and root resorption and show marked tendency to recur when compared with non aggressive typeSoft spongy, brownish to reddish friable tissue of various size.
A specimen is usually coated with fresh or coagulated blood. Giant cell lesions of the jaws show a variety of features. Common to all is the presence of few to many multinucleated
This document discusses odontomas, which are benign odontogenic tumors composed of dental tissue like enamel, dentin, and pulp. There are two main types: compound odontomas, which appear like small tooth structures, and complex odontomas, which have a disorganized appearance. Odontomas are usually asymptomatic and discovered incidentally on x-rays during dental exams. On x-rays, they appear as radiopaque masses surrounded by a radiolucent rim. Treatment involves simple surgical removal, with an excellent prognosis and no recurrence.
This document discusses condylar fractures of the mandible. It begins by providing background on condylar fracture development, anatomy, surgical anatomy, blood supply, nerve supply and muscle attachments. It then covers the etiology, associated injuries, mechanisms of injury and various classification systems for condylar fractures. The document outlines the diagnosis process including history, clinical examination and radiographic imaging. It concludes by discussing treatment approaches, focusing on the aims of surgery and indications for conservative versus surgical management.
This document provides information on bilateral sagittal split osteotomy (BSSO), a common surgical procedure for the mandible. Some key points:
- BSSO involves making sagittal cuts along the ramus and body of the mandible to allow advancement or setback of the mandible. It was first described in the 1950s and has undergone several modifications.
- Indications for BSSO include mandibular deficiencies, prognathism, asymmetries, open bites, and cross bites. Contraindications include decreased posterior body height and ramus hypoplasia.
- The surgical procedure involves incisions, osteotomy cuts, splitting the segments, mobilization, positioning, and
This document discusses impacted teeth, specifically focusing on impacted third molars. It begins with definitions of impacted teeth and provides the etymology and theories of tooth impaction. Local and systemic causes of impaction are described. Surgical anatomy of impacted third molars is reviewed, along with classifications of impacted mandibular third molars. Indications and contraindications for removal are outlined. Complications are briefly mentioned. The document is intended as a reference for oral and maxillofacial surgeons regarding the management of impacted third molars.
Differential diagnosis and management of radiolucent lesionsAamirr Xeb
This document discusses the differential diagnosis and management of radiolucent lesions. It begins by listing various potential diagnoses for periapical and pericoronal radiolucencies. It then discusses giant cell lesions, fibro-osseous lesions, and odontogenic tumors. The management section describes the therapeutic goals of surgical procedures and details various surgical techniques used to treat oral lesions, including enucleation, marsupialization, enucleation with curettage, and resection. It provides indications, advantages, and disadvantages of each technique.
This document discusses fractures of the mandibular condyle. It begins with an introduction and overview of the surgical anatomy and classification of condylar fractures. It then covers the etiology, diagnosis, and management of these fractures. Key points include that condylar fractures account for 20-30% of mandibular fractures. Diagnosis involves clinical examination, radiological imaging like CT scans, and the fractures can be classified in various ways. Management involves either conservative treatment with immobilization or functional exercises, or surgical treatment depending on the type and severity of the fracture. The document provides details on techniques, indications, and advantages/disadvantages of different treatment approaches.
This document discusses odontogenic tumors, specifically ameloblastoma. It provides details on the classification, clinical features, histologic features, treatment and prognosis of ameloblastoma. Key points include:
- Ameloblastoma is the most common odontogenic tumor and occurs most often in the mandible. It is typically benign but locally invasive.
- Radiographically, it appears as a well-circumscribed radiolucent lesion that can be unilocular or multilocular.
- Treatment options range from curettage to marginal resection, with the goal of obtaining clear margins of at least 1cm. Wide excision is necessary in the maxilla due to risk of local invasion.
The document discusses the classification of odontogenic cysts. It describes several classification systems proposed over time, including Robinson's classification from 1945, Thoma-Robinson-Bernier classification from 1960, Pindborg and Kramer's classification from 1971, and the WHO classification from 1971 and its update in 1992. The WHO classifications categorize cysts as developmental or inflammatory, and further divide developmental cysts into odontogenic and non-odontogenic types. Shafer's classification also categorizes cysts based on etiology as developmental or inflammatory, and further divides them based on the tissue of origin.
Odontogenic keratocyst- A case presentationBinaya Subedi
This case presentation describes a 74-year-old female patient with a swelling in the lower front region of her jaw. Radiographs and biopsy revealed an odontogenic keratocyst. Odontogenic keratocysts are developmental cysts that arise from cell rests of the dental lamina and have a high recurrence rate due to their thin lining. Treatment options considered for this patient's odontogenic keratocyst include curettage with or without peripheral osteotomy or segmental resection of the mandible.
This document outlines orthognathic surgery procedures. It discusses diagnosis and planning, including indications, contraindications, and special considerations. Presurgical orthodontics including decompensation and arch coordination are described. Surgical techniques for the maxilla include LeFort I, II, III osteotomies and segmental procedures. For the mandible, procedures include sagittal split and vertical subsigmoid osteotomies. Splint fabrication and post-surgical care are also covered.
This document provides an overview of Lefort I osteotomy, including:
- A brief history describing the development of maxillary osteotomy techniques.
- Anatomical considerations and the biologic basis for maxillary osteotomies, which have shown adequate blood supply can be maintained.
- Indications for Lefort I osteotomy include altering vertical dimension, anteroposterior movements, and surgical expansion of the maxilla.
- Types of Lefort I osteotomies are described, including classic, quadrangular, and segmental variations. Postoperative management and potential complications are also outlined.
The document discusses temporomandibular joint ankylosis, including its causes, clinical features, diagnosis using radiographs, and various treatment methods. Key points include: TMJ ankylosis is the fusion of the mandibular condyle with the glenoid fossa, immobilizing the mandible. Common causes are trauma, infection, and inflammation. Treatment involves surgical resection of the ankylotic mass with coronoidectomy and interpositional arthroplasty using grafts to prevent re-ankylosis, followed by aggressive physiotherapy. Complications can include recurrence if physiotherapy is not continued long-term.
This document describes surgical techniques for treating TMJ ankylosis in children, including:
1. Excising the ankylotic mass through a preauricular incision and reconstructing the ramus condyle unit with either a costochondral graft or distraction osteogenesis.
2. Lining the glenoid fossa with a vascularized temporalis fascia flap to prevent reankylosis.
3. An intensive post-operative physical therapy regimen to regain jaw mobility.
An overview of various pathological processes affecting the Jaw Bones- Maxilla and Mandible including odontogenic cysts and tumours including their radiological findings!
This document discusses the surgical management of odontogenic cysts. It describes different flap techniques used such as trapezoidal, triangular, envelope, and semilunar flaps. It also discusses the surgical procedures for enucleation and marsupialization of cysts. Enucleation involves complete removal of the cyst sac while marsupialization creates a window to drain the cyst contents and suture the cyst wall to heal. The steps for each procedure are outlined including reflection of flaps, removal of bone, draining of cyst, and suturing.
This document discusses various non-odontogenic tumors classified according to their origin. It covers giant cell lesions including central giant cell granuloma and brown tumor of hyperparathyroidism. Vascular lesions such as hemangiomas, vascular malformations, and neurogenic tumors including neurofibromas are also discussed. For each type of lesion, the document provides information on classification, clinical features, radiographic findings, diagnosis, and treatment options.
Indian Dental Academy is a leader in continuing dental education, providing both online and offline courses. The document discusses ameloblastoma, a type of odontogenic tumor. It defines ameloblastoma, provides its history and classifications including clinical, radiological, and histopathological. Treatment options discussed include medical therapy, radiotherapy, and various surgical treatments such as enucleation, marsupialization, and curettage. Radiographs, biopsy, CT, and MRI are investigated for ameloblastoma.
The document discusses the history, anatomy, classification, examination, diagnosis, and treatment of mandibular fractures. It traces the history from descriptions in ancient texts to modern techniques. The mandible has a unique anatomy as a bent bone that provides both compression and tension zones. Fractures are classified in various ways including by location, number of fragments, involvement of surrounding tissues, and relation to occlusion. Clinical examination involves inspection, palpation, and neurological and range of motion tests while radiographs help confirm and characterize fractures.
This case report describes a 4-year-old girl presenting with swelling of the cheeks and upward gaze of the eyes. Radiographs showed multilocular radiolucencies in the jaws characteristic of cherubism. Cherubism is a benign fibro-osseous condition caused by mutations in the SH3BP2 gene. It typically presents in early childhood with bilateral symmetric swelling of the jaws. The lesions have a soap bubble appearance on radiographs and usually regress after puberty without treatment. A definitive diagnosis of cherubism was made based on the clinical and radiographic findings.
Management of Thallasemia Patient of Dental SurgerySyed Muhammad Ali
1) Dr Syed Muhammad Ali is an oral surgery resident under the supervision of Prof Dr Syed Mahmood Haider at Karachi Medical and Dental College in Pakistan.
2) The document discusses thalassemia, including that it is a common autosomal recessive blood disease characterized by reduced hemoglobin. It also discusses the different types of thalassemia (alpha and beta) and their characteristics.
3) Management strategies before and after diagnosis are mentioned, including population screening, genetic counseling, and prenatal diagnosis to control the disease, as well as treatments like blood transfusions, bone marrow transplants, and genetic engineering.
This document provides an overview of aneurysmal bone cyst (ABC). It begins by defining ABC as a true neoplasm characterized by thin-walled blood-filled cystic cavities that can be induced by trauma or tumor. It accounts for 1-2% of primary bone lesions and typically affects children and adolescents. Clinically, patients present with pain or a palpable lump. Radiologically, ABC appears as an eccentric lytic lesion with septal ossification. Treatment involves surgical curettage with bone grafting or radiotherapy, with the prognosis being possible spontaneous regression but not typical natural history. Differential diagnoses include other fluid-fluid bone lesions.
This document discusses giant cell lesions of the jaws. It begins by defining giant cells and describing their origin from monocytes and macrophages. Giant cell lesions are then classified as inflammatory/reactive, metabolic, or neoplastic. Central giant cell granuloma, aneurysmal bone cyst, and traumatic bone cyst are discussed as examples of inflammatory/reactive lesions. Cherubism and brown tumor of hyperparathyroidism represent metabolic giant cell lesions. Osteoblastoma is provided as an example of a neoplastic giant cell lesion. Clinical, radiographic, histologic, and treatment details are outlined for many of the conditions.
This document discusses condylar fractures of the mandible. It begins by providing background on condylar fracture development, anatomy, surgical anatomy, blood supply, nerve supply and muscle attachments. It then covers the etiology, associated injuries, mechanisms of injury and various classification systems for condylar fractures. The document outlines the diagnosis process including history, clinical examination and radiographic imaging. It concludes by discussing treatment approaches, focusing on the aims of surgery and indications for conservative versus surgical management.
This document provides information on bilateral sagittal split osteotomy (BSSO), a common surgical procedure for the mandible. Some key points:
- BSSO involves making sagittal cuts along the ramus and body of the mandible to allow advancement or setback of the mandible. It was first described in the 1950s and has undergone several modifications.
- Indications for BSSO include mandibular deficiencies, prognathism, asymmetries, open bites, and cross bites. Contraindications include decreased posterior body height and ramus hypoplasia.
- The surgical procedure involves incisions, osteotomy cuts, splitting the segments, mobilization, positioning, and
This document discusses impacted teeth, specifically focusing on impacted third molars. It begins with definitions of impacted teeth and provides the etymology and theories of tooth impaction. Local and systemic causes of impaction are described. Surgical anatomy of impacted third molars is reviewed, along with classifications of impacted mandibular third molars. Indications and contraindications for removal are outlined. Complications are briefly mentioned. The document is intended as a reference for oral and maxillofacial surgeons regarding the management of impacted third molars.
Differential diagnosis and management of radiolucent lesionsAamirr Xeb
This document discusses the differential diagnosis and management of radiolucent lesions. It begins by listing various potential diagnoses for periapical and pericoronal radiolucencies. It then discusses giant cell lesions, fibro-osseous lesions, and odontogenic tumors. The management section describes the therapeutic goals of surgical procedures and details various surgical techniques used to treat oral lesions, including enucleation, marsupialization, enucleation with curettage, and resection. It provides indications, advantages, and disadvantages of each technique.
This document discusses fractures of the mandibular condyle. It begins with an introduction and overview of the surgical anatomy and classification of condylar fractures. It then covers the etiology, diagnosis, and management of these fractures. Key points include that condylar fractures account for 20-30% of mandibular fractures. Diagnosis involves clinical examination, radiological imaging like CT scans, and the fractures can be classified in various ways. Management involves either conservative treatment with immobilization or functional exercises, or surgical treatment depending on the type and severity of the fracture. The document provides details on techniques, indications, and advantages/disadvantages of different treatment approaches.
This document discusses odontogenic tumors, specifically ameloblastoma. It provides details on the classification, clinical features, histologic features, treatment and prognosis of ameloblastoma. Key points include:
- Ameloblastoma is the most common odontogenic tumor and occurs most often in the mandible. It is typically benign but locally invasive.
- Radiographically, it appears as a well-circumscribed radiolucent lesion that can be unilocular or multilocular.
- Treatment options range from curettage to marginal resection, with the goal of obtaining clear margins of at least 1cm. Wide excision is necessary in the maxilla due to risk of local invasion.
The document discusses the classification of odontogenic cysts. It describes several classification systems proposed over time, including Robinson's classification from 1945, Thoma-Robinson-Bernier classification from 1960, Pindborg and Kramer's classification from 1971, and the WHO classification from 1971 and its update in 1992. The WHO classifications categorize cysts as developmental or inflammatory, and further divide developmental cysts into odontogenic and non-odontogenic types. Shafer's classification also categorizes cysts based on etiology as developmental or inflammatory, and further divides them based on the tissue of origin.
Odontogenic keratocyst- A case presentationBinaya Subedi
This case presentation describes a 74-year-old female patient with a swelling in the lower front region of her jaw. Radiographs and biopsy revealed an odontogenic keratocyst. Odontogenic keratocysts are developmental cysts that arise from cell rests of the dental lamina and have a high recurrence rate due to their thin lining. Treatment options considered for this patient's odontogenic keratocyst include curettage with or without peripheral osteotomy or segmental resection of the mandible.
This document outlines orthognathic surgery procedures. It discusses diagnosis and planning, including indications, contraindications, and special considerations. Presurgical orthodontics including decompensation and arch coordination are described. Surgical techniques for the maxilla include LeFort I, II, III osteotomies and segmental procedures. For the mandible, procedures include sagittal split and vertical subsigmoid osteotomies. Splint fabrication and post-surgical care are also covered.
This document provides an overview of Lefort I osteotomy, including:
- A brief history describing the development of maxillary osteotomy techniques.
- Anatomical considerations and the biologic basis for maxillary osteotomies, which have shown adequate blood supply can be maintained.
- Indications for Lefort I osteotomy include altering vertical dimension, anteroposterior movements, and surgical expansion of the maxilla.
- Types of Lefort I osteotomies are described, including classic, quadrangular, and segmental variations. Postoperative management and potential complications are also outlined.
The document discusses temporomandibular joint ankylosis, including its causes, clinical features, diagnosis using radiographs, and various treatment methods. Key points include: TMJ ankylosis is the fusion of the mandibular condyle with the glenoid fossa, immobilizing the mandible. Common causes are trauma, infection, and inflammation. Treatment involves surgical resection of the ankylotic mass with coronoidectomy and interpositional arthroplasty using grafts to prevent re-ankylosis, followed by aggressive physiotherapy. Complications can include recurrence if physiotherapy is not continued long-term.
This document describes surgical techniques for treating TMJ ankylosis in children, including:
1. Excising the ankylotic mass through a preauricular incision and reconstructing the ramus condyle unit with either a costochondral graft or distraction osteogenesis.
2. Lining the glenoid fossa with a vascularized temporalis fascia flap to prevent reankylosis.
3. An intensive post-operative physical therapy regimen to regain jaw mobility.
An overview of various pathological processes affecting the Jaw Bones- Maxilla and Mandible including odontogenic cysts and tumours including their radiological findings!
This document discusses the surgical management of odontogenic cysts. It describes different flap techniques used such as trapezoidal, triangular, envelope, and semilunar flaps. It also discusses the surgical procedures for enucleation and marsupialization of cysts. Enucleation involves complete removal of the cyst sac while marsupialization creates a window to drain the cyst contents and suture the cyst wall to heal. The steps for each procedure are outlined including reflection of flaps, removal of bone, draining of cyst, and suturing.
This document discusses various non-odontogenic tumors classified according to their origin. It covers giant cell lesions including central giant cell granuloma and brown tumor of hyperparathyroidism. Vascular lesions such as hemangiomas, vascular malformations, and neurogenic tumors including neurofibromas are also discussed. For each type of lesion, the document provides information on classification, clinical features, radiographic findings, diagnosis, and treatment options.
Indian Dental Academy is a leader in continuing dental education, providing both online and offline courses. The document discusses ameloblastoma, a type of odontogenic tumor. It defines ameloblastoma, provides its history and classifications including clinical, radiological, and histopathological. Treatment options discussed include medical therapy, radiotherapy, and various surgical treatments such as enucleation, marsupialization, and curettage. Radiographs, biopsy, CT, and MRI are investigated for ameloblastoma.
The document discusses the history, anatomy, classification, examination, diagnosis, and treatment of mandibular fractures. It traces the history from descriptions in ancient texts to modern techniques. The mandible has a unique anatomy as a bent bone that provides both compression and tension zones. Fractures are classified in various ways including by location, number of fragments, involvement of surrounding tissues, and relation to occlusion. Clinical examination involves inspection, palpation, and neurological and range of motion tests while radiographs help confirm and characterize fractures.
This case report describes a 4-year-old girl presenting with swelling of the cheeks and upward gaze of the eyes. Radiographs showed multilocular radiolucencies in the jaws characteristic of cherubism. Cherubism is a benign fibro-osseous condition caused by mutations in the SH3BP2 gene. It typically presents in early childhood with bilateral symmetric swelling of the jaws. The lesions have a soap bubble appearance on radiographs and usually regress after puberty without treatment. A definitive diagnosis of cherubism was made based on the clinical and radiographic findings.
Management of Thallasemia Patient of Dental SurgerySyed Muhammad Ali
1) Dr Syed Muhammad Ali is an oral surgery resident under the supervision of Prof Dr Syed Mahmood Haider at Karachi Medical and Dental College in Pakistan.
2) The document discusses thalassemia, including that it is a common autosomal recessive blood disease characterized by reduced hemoglobin. It also discusses the different types of thalassemia (alpha and beta) and their characteristics.
3) Management strategies before and after diagnosis are mentioned, including population screening, genetic counseling, and prenatal diagnosis to control the disease, as well as treatments like blood transfusions, bone marrow transplants, and genetic engineering.
This document provides an overview of aneurysmal bone cyst (ABC). It begins by defining ABC as a true neoplasm characterized by thin-walled blood-filled cystic cavities that can be induced by trauma or tumor. It accounts for 1-2% of primary bone lesions and typically affects children and adolescents. Clinically, patients present with pain or a palpable lump. Radiologically, ABC appears as an eccentric lytic lesion with septal ossification. Treatment involves surgical curettage with bone grafting or radiotherapy, with the prognosis being possible spontaneous regression but not typical natural history. Differential diagnoses include other fluid-fluid bone lesions.
This document discusses giant cell lesions of the jaws. It begins by defining giant cells and describing their origin from monocytes and macrophages. Giant cell lesions are then classified as inflammatory/reactive, metabolic, or neoplastic. Central giant cell granuloma, aneurysmal bone cyst, and traumatic bone cyst are discussed as examples of inflammatory/reactive lesions. Cherubism and brown tumor of hyperparathyroidism represent metabolic giant cell lesions. Osteoblastoma is provided as an example of a neoplastic giant cell lesion. Clinical, radiographic, histologic, and treatment details are outlined for many of the conditions.
A 37-year-old female patient presented with a swelling in her lower left jaw that had been growing over the past 2 years. On examination, a hard, non-tender swelling was found distal to tooth 37, causing expansion of the lingual cortical plate. Radiographs showed a multilocular radiolucency extending from the ramus to the angle of the mandible. The provisional diagnosis was ameloblastoma. Ameloblastomas are benign odontogenic tumors that commonly present as slow-growing swellings in the posterior mandible. They appear radiographically as multilocular radiolucencies with characteristic septations. The treatment is surgical resection.
This document reviews various giant cell lesions including giant cell tumors of long bones, central and peripheral giant cell lesions of the jaws, brown tumors of hyperparathyroidism, aneurysmal bone cysts, and cherubism. It discusses the controversies around classifying these lesions and compares their clinical features, histopathology, radiographic appearance, treatment, and prognosis. In particular, it notes differences in presentation between central and peripheral giant cell lesions of the jaws.
This document summarizes an orthopedic case presentation. It describes a 53-year-old female patient who presented with a 1.5x1 cm swelling on her right ring finger that was painful. Examination and imaging found a lesion. Differential diagnoses included ganglion cyst, giant cell tumor of tendon sheath, and others. Biopsy revealed chondromyxoid fibroma. The patient underwent excision and curettage. Histopathology confirmed chondromyxoid fibroma.
1. A 45-year-old female presented with pain and swelling in the right side of the upper jaw and bad breath. Examination found diffuse swelling in the right maxillary region with exposed and inflamed bone.
2. Imaging showed radiolucent and radiopaque areas in the maxilla. Bone scan found increased activity in the maxilla and mandible.
3. Histopathology showed increased bone formation lines, large osteoclasts, and blood vessels. Paget's disease was diagnosed based on these findings.
This document discusses various fibro-osseous lesions that can affect the head and neck region. It begins by classifying these lesions based on their pathological process as either bone dysplasias, inflammatory/reactive processes, metabolic bone diseases, genetic conditions, or neoplasms. Specific conditions discussed in more detail include fibrous dysplasia, ossifying fibroma, Paget's disease, cemento-osseous dysplasias, and metabolic bone diseases like hyperparathyroidism. For each condition, the document covers epidemiology, clinical presentation, investigations like CT and biopsy, and management approaches including medical, surgical, and conservative options.
- The patient, a 55-year-old male, presented with a painful swelling on the left mandibular area.
- Radiographs revealed an unilocular radiolucency in the area, and the patient underwent surgical enucleation of a radicular cyst.
- Radicular cysts originate from epithelial residues in the periodontal ligament following pulpal necrosis and periapical inflammation. They are usually asymptomatic unless secondarily infected, as seen in this patient.
Radicular cysts are odontogenic cysts that form from cell rests of Malassez in response to inflammation from pulp necrosis. They are commonly found in the maxillary anterior and posterior regions in people aged 20-60 years old. Radicular cysts appear radiolucent on x-rays and are associated with non-vital teeth. Treatment involves root canal therapy or extraction of the offending tooth along with surgical removal of the cyst.
The document describes a case study of a 12-year-old girl diagnosed with juvenile aggressive ossifying fibroma. She presented with a large swelling on the right side of her face that had been growing over the past 3 years. Imaging and biopsy revealed a benign bone tumor composed of proliferating fibroblastic tissue with psammoma-like cementum masses. The tumor involved the right maxillary sinus and other local structures. The patient underwent surgical removal of the tumor. Juvenile aggressive ossifying fibroma is a rare bone lesion that typically occurs in the jaw bones of children and can be difficult to diagnose due to variable presentation.
Dr. Abdelhady provides a lecture on odontogenic tumors. The lecture aims to help students classify and diagnose odontogenic tumors, examine patients presenting with facial swellings, and determine differential diagnoses and management techniques for mandibular and maxillary swellings. Specific odontogenic tumors discussed include cementoblastoma, odontogenic fibroma, central giant cell granuloma, cherubism, fibrous dysplasia, and ossifying fibroma. Radiographic features, histology, treatment options and prognosis are described for each tumor type.
This document provides information about different types of bone tumors. It begins by describing the normal anatomy of bones and then discusses various benign and malignant bone tumors. Some of the tumors covered include osteoma, osteoid osteoma, osteoblastoma, osteosarcoma, chondroma, and chondrosarcoma. For each tumor, the document discusses clinical features, radiographic findings, pathology, histology, treatment and prognosis. It provides classifications of bone tumors and highlights important diagnostic and prognostic factors for osteosarcoma.
This document provides information about different types of bone tumors. It begins by describing the normal anatomy of bones and then discusses various benign and malignant bone tumors. Some of the tumors covered include osteoma, osteoid osteoma, osteoblastoma, osteosarcoma, chondroma, and chondrosarcoma. For each tumor, the document discusses clinical features, radiographic appearance, pathology, histology, treatment and prognosis. It provides classifications of bone tumors and lists some prognostic factors for osteosarcoma.
This document provides information about bone tumors, including benign and malignant types. It discusses the classification and characteristics of common bone tumors such as osteoma, osteoid osteoma, osteoblastoma, and osteosarcoma. For each tumor, the document outlines clinical features, radiographic appearance, pathology, histology, treatment and prognosis. It emphasizes that osteosarcoma is the most common primary malignant bone tumor, occurring most frequently in adolescents and young adults. The etiology may include genetic factors, radiation exposure, and certain pre-existing bone conditions.
A 14-year-old girl presented with pain and swelling in her right leg for 4 months. Imaging showed an expansile lytic lesion in her tibia consistent with an aneurysmal bone cyst. She underwent surgery involving curettage of the lesion and fixation with a fibular bone graft and plate. Histopathology of the removed tissue confirmed the diagnosis of aneurysmal bone cyst. Her post-operative recovery was uneventful and follow-up showed good healing of the bone.
The document discusses various odontogenic cysts and tumors. It provides details on their etiology, clinical presentation, radiographic and microscopic findings, differential diagnosis, and treatment. Some of the cysts and tumors covered include radicular cysts, dentigerous cysts, odontogenic keratocysts, ameloblastoma, calcifying epithelial odontogenic tumor, and odontogenic myxoma. Cysts and tumors are uniquely derived from dental tissues and their diagnosis involves a thorough dental and radiographic examination.
The document discusses various odontogenic cysts and tumors. It provides details on their etiology, clinical presentation, radiographic and microscopic findings, differential diagnosis, and treatment. Some of the cysts and tumors covered include radicular cysts, dentigerous cysts, odontogenic keratocysts, ameloblastomas, calcifying epithelial odontogenic tumors, and odontogenic myxomas. Cysts and tumors are uniquely derived from dental tissues and their diagnosis involves a thorough dental and radiographic examination.
This document discusses periapical cysts and osteomyelitis of the jaws. It describes the etiology and pathogenesis of periapical cysts as developing from pre-existing granulomas due to epithelial proliferation in response to products of inflammation from necrotic pulp tissue. Clinical features include asymptomatic radiolucencies seen on x-rays. Histopathology shows a cyst lined by non-keratinized squamous epithelium. Treatment involves extraction and root canal treatment with curettage. Osteomyelitis can be acute or chronic and results from bacterial infection of the jaw bones. Acute osteomyelitis presents with pain and swelling while chronic osteomyelitis appears as radiolucent lesions on x
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.
Similar to Central Giant Cell granuloma from Diagnosis to Management (20)
Healthy Eating Habits:
Understanding Nutrition Labels: Teaches how to read and interpret food labels, focusing on serving sizes, calorie intake, and nutrients to limit or include.
Tips for Healthy Eating: Offers practical advice such as incorporating a variety of foods, practicing moderation, staying hydrated, and eating mindfully.
Benefits of Regular Exercise:
Physical Benefits: Discusses how exercise aids in weight management, muscle and bone health, cardiovascular health, and flexibility.
Mental Benefits: Explains the psychological advantages, including stress reduction, improved mood, and better sleep.
Tips for Staying Active:
Encourages consistency, variety in exercises, setting realistic goals, and finding enjoyable activities to maintain motivation.
Maintaining a Balanced Lifestyle:
Integrating Nutrition and Exercise: Suggests meal planning and incorporating physical activity into daily routines.
Monitoring Progress: Recommends tracking food intake and exercise, regular health check-ups, and provides tips for achieving balance, such as getting sufficient sleep, managing stress, and staying socially active.
MYASTHENIA GRAVIS POWER POINT PRESENTATIONblessyjannu21
Myasthenia gravis is a neurological disease. It affects the grave muscles in our body. Myasthenia gravis affects how the nerves communicate with the muscles. Drooping eyelids and/or double vision are often the first noticeable sign. It is involving the muscles controlling the eyes movement, facial expression, chewing and swallowing. It also effects the muscles neck and lip movement and respiration.
It is a neuromuscular disease characterized by abnormal weakness of voluntary muscles that improved with rest and the administration of anti-cholinesterase drugs.
The person may find difficult to stand, lift objects and speak or swallow. Medications and surgery can help the patient to relieve the symptoms of this lifelong illness.
2024 HIPAA Compliance Training Guide to the Compliance OfficersConference Panel
Join us for a comprehensive 90-minute lesson designed specifically for Compliance Officers and Practice/Business Managers. This 2024 HIPAA Training session will guide you through the critical steps needed to ensure your practice is fully prepared for upcoming audits. Key updates and significant changes under the Omnibus Rule will be covered, along with the latest applicable updates for 2024.
Key Areas Covered:
Texting and Email Communication: Understand the compliance requirements for electronic communication.
Encryption Standards: Learn what is necessary and what is overhyped.
Medical Messaging and Voice Data: Ensure secure handling of sensitive information.
IT Risk Factors: Identify and mitigate risks related to your IT infrastructure.
Why Attend:
Expert Instructor: Brian Tuttle, with over 20 years in Health IT and Compliance Consulting, brings invaluable experience and knowledge, including insights from over 1000 risk assessments and direct dealings with Office of Civil Rights HIPAA auditors.
Actionable Insights: Receive practical advice on preparing for audits and avoiding common mistakes.
Clarity on Compliance: Clear up misconceptions and understand the reality of HIPAA regulations.
Ensure your compliance strategy is up-to-date and effective. Enroll now and be prepared for the 2024 HIPAA audits.
Enroll Now to secure your spot in this crucial training session and ensure your HIPAA compliance is robust and audit-ready.
https://conferencepanel.com/conference/hipaa-training-for-the-compliance-officer-2024-updates
This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is a summary of Pneumothorax:
Pneumothorax, also known as a collapsed lung, is a condition that occurs when air leaks into the space between the lung and chest wall. This air buildup puts pressure on the lung, preventing it from expanding fully when you breathe. A pneumothorax can cause a complete or partial collapse of the lung.
The best massage spa Ajman is Chandrima Spa Ajman, which was founded in 2023 and is exclusively for men 24 hours a day. As of right now, our parent firm has been providing massage services to over 50,000+ clients in Ajman for the past 10 years. It has about 8+ branches. This demonstrates that Chandrima Spa Ajman is among the most reasonably priced spas in Ajman and the ideal place to unwind and rejuvenate. We provide a wide range of Spa massage treatments, including Indian, Pakistani, Kerala, Malayali, and body-to-body massages. Numerous massage techniques are available, including deep tissue, Swedish, Thai, Russian, and hot stone massages. Our massage therapists produce genuinely unique treatments that generate a revitalized sense of inner serenely by fusing modern techniques, the cleanest natural substances, and traditional holistic therapists.
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
We are one of the top Massage Spa Ajman Our highly skilled, experienced, and certified massage therapists from different corners of the world are committed to serving you with a soothing and relaxing experience. Luxuriate yourself at our spas in Sharjah and Ajman, which are indeed enriched with an ambiance of relaxation and tranquility. We could confidently claim that we are one of the most affordable Spa Ajman and Sharjah as well, where you can book the massage session of your choice for just 99 AED at any time as we are open 24 hours a day, 7 days a week.
Visit : https://massagespaajman.com/
Call : 052 987 1315
Hypertension and it's role of physiotherapy in it.Vishal kr Thakur
This particular slides consist of- what is hypertension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is summary of hypertension -
Hypertension, also known as high blood pressure, is a serious medical condition that occurs when blood pressure in the body's arteries is consistently too high. Blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps it. Hypertension can increase the risk of heart disease, brain disease, kidney disease, and premature death.
Michigan HealthTech Market Map 2024. Includes 7 categories: Policy Makers, Academic Innovation Centers, Digital Health Providers, Healthcare Providers, Payers / Insurance, Device Companies, Life Science Companies, Innovation Accelerators. Developed by the Michigan-Israel Business Accelerator
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...rightmanforbloodline
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...
Central Giant Cell granuloma from Diagnosis to Management
1. Facing the Giant
Central Giant Cell Granuloma
Dr Saikat Saha
MDS (OMFS)
Oral & Maxillofacial Surgeon
Center for Jaw Face Neck Oral Surgery Head and Neck Reconstructive and Onco Surgery
2.
3. “If you do not tame the cub today, be prepared to face the Giant Lion Tomorrow”
4. “If you do not tame the cub today, be prepared to face the Giant Lion Tomorrow”
6. THE CASE
MALE – 32
Swelling on the left side of the lower jaw
since 8 months that gradually grew in size.
The left lip and the chin area subsequently
felt numb. There was no associated pain.
Family History: Not relevant
Past Medical History:
He was treated elsewhere one month back.
7. CLINICAL PRESENTATION
ON EXTRAORAL EXAMINATION:
A Brawny hard swelling of the left body of the
mandible was noted.
The swelling was non-fluctuant.
ON INTRAORAL EXAMINATION:
A Brawny hard swelling was felt over the left
buccal cortical plate with respect to teeth
region #32, #33, #34, #35, #36 and #37.
The left lower buccal vestibule was obliterated.
8.
9. RADIOGRAPHIC INTERPRETATION
Well defined radiolucent osteolytic lesion present at the left body of the mandible
with some fine wispy trabeculae. There are multiple root resorption of the teeth
on the left lower jaw. The lesion appears cystic and expansile with medullary
hollowing out, thinning of the cortical plates and approaching the lower border of
the mandible.
12. CT - FACE & NECK
IMPRESSION
Lobulated , expansile lesion involving the
left half of symphysis menti and body of mandible
with almost deficiency of the wall of the lesion on
left antero-lateral aspect involving the gingivo - buccal sulcus and left mandibular canal.
15. DIFFERENTIAL DIAGNOSIS - Based on Clinical and Radiographic features
AMELOBLASTOMA
BROWN TUMOR OF HYPERPARATHYROIDISM
ANEURYSMAL BONE CYST
TRAUMATIC BONE CYST
CHERUBISM
ODONTOGENIC MYXOMA
16. • It is uncommon in a younger age range, which
is most susceptible to giant cell granuloma.
• Seen in posterior mandible in contrast to giant
cell granuloma which occurs anterior to the
first molar.
• Ameloblastoma demonstrates internal, hard
curved arch like septa whereas giant cell
granuloma has lighter wispy septa.
• Ameloblastoma is usually multiloculated
AMELOBLASTOMA
17. Ameloblastoma is a true neoplasm of enamel organ type.
Unicentric, nonfunctional, intermittent in growth,
It is the second most common odontogenic neoplasm.
Mandible > Maxilla (molar-ramus area region.)
AMELOBLASTOMA
20. Image Courtesy: Journal of Pathology and Translational Medicine
https://www.jpatholtm.org/journal/Figure.php?xn=kjpathol-47-191.xml&id=
Follicular type Plexiform type Acanthomatous type Desmoplastic type
AMELOBLASTOMA
24. AMELOBLASTOMA
Tatapudi R, Samad SA, Reddy RS, Boddu NK. Prevalence of ameloblastoma: A three-year retrospective study . J Indian Acad Oral Med
Radiol [serial online] 2014 [cited 2020 Jul 11];26:145-51. Available from: http://www.jiaomr.in/text.asp?2014/26/2/145/143687
Unicystic type Spider-web type
Soap-bubble type
Honeycomb type
25. BROWN TUMOR OF HYPERPARATHYROIDISM
ECF [Ca 2+]
ECF [Ca 2+] & [Phosphate]
PTH
Vitamin D
26. • Parathyroid hormone (PTH) is released in response to decreased
serum Ca
PTH increase Ca by:
causing an efflux of Ca from the bony skeleton
increased reabsorption by the kidneys.
PTH also leads to increased release of vitamin D from the kidneys,
which in turn causes increased Ca absorption from GIT.
• Conversely, PTH leads to decreased P levels due to increased
excretion by the kidneys.
BROWN TUMOR OF HYPERPARATHYROIDISM
27. • Primary HPT one or more parathyroid glands secrete an
excessive amount of PTH, eg. parathyroid adenoma;
• Secondary HPT increased secretion of PTH is a response
to lowered ionized calcium, typically as a result of renal
disease.
• In Tertiary HPT secretion of PTH occurs as a result of
long-standing chronic renal disease eventually leading to
overactive parathyroid glands that become independent of
the underlying disease.
Hence, tertiary HPT is not corrected when patients receive
a renal transplant that corrects the underlying renal
etiology
BROWN TUMOR OF HYPERPARATHYROIDISM
28. • Uncontrolled HPT BTHPT.
• Presents late in untreated disease
• Extensive bone resorption, which is replaced
by fibrovascular tissue and giant cells with
abundant deposits hemorrhage and
hemosiderin.
BROWN TUMOR OF HYPERPARATHYROIDISM
29. • Histology –
Similar to central reparative giant cell
granulomas. histologically abnormal
calcium homeostasis in HPT.
BROWN TUMOR OF HYPERPARATHYROIDISM
30. Image Courtesy: Shetty, Akshay D., J Namitha and Leena James. “Brown Tumor of Mandible in Association with Primary Hyperparathyroidism: A Case
Report.” Journal of International Oral Health : JIOH 7 (2015): 50 - 52.
31. •
Treatment:
Manage underlying HPT
• Surgical treatment may be required in
[refractory cases] / [symptomatic lesions.]
BROWN TUMOR OF HYPERPARATHYROIDISM
32. • In this current case serum calcium levels were not
elevated. Is it a Brown tumor?
Yes
No
BROWN TUMOR OF HYPERPARATHYROIDISM
33. Calcium is maintained within a fairly narrow range from 8.5 to 10.5 mg/dl (4.3
to 5.3 mEq/L or 2.2 to 2.7 mmol/L).
The Normal Serum calcium levels ?
A) 8.5 to 10.5 mg/dl
B) 4.3 to 5.3 mg/dl
C) 2.2 to 2.7 mg/dl
D) 15 to 20 mg/dl
34. • ABC is a giant cell lesion within a fibroconnective
tissue stroma with blood caverns or sinusoids and no
epithelial lining.
• A reactive lesion of bone rather than a cyst or true
neoplasm,
• it occurs in posterior segment of mandible, posterior
to molar region.
• Aspiration produces blood
ANEURYSMAL BONEC CYST
35. • The radiographic features are not pathognomonic
and are sometimes confusing.
• Can mimic a Neoplasm
• An associated periosteal reaction with reactive new
bone forming a peripheral sclerotic border
(difficult to differentiate from a subperiosteal
hematoma)
ANEURYSMAL BONEC CYST
36. ANEURYSMAL BONEC CYST
Cause : Exaggerated, localized, proliferative response
of vascular tissue in bone.
Diagnosis: Blood aspirate obtained and the
histopathologic findings
37. ANEURYSMAL BONEC CYST
Image Courtesy; Sharma GH, Dabir AV, Das DA, Talreja-Kanchan PP. Bilateral aneurysmal bone cyst of the mandible: A case report. J Indian Acad Oral Med
Radiol [serial online] 2015 [cited 2020 Jul 11];27:479-83. Available from: http://www.jiaomr.in/text.asp?2015/27/3/479/170471
38. TRAUMATIC BONE CYST
•Rare , asymptomatic
• Intraosseous lesion
•Pseudocyst of jaws and long bones .
•It is otherwise regarded as solitary bone cyst, hemorrhagic bone cyst, simple
bone cyst, extravasation cyst or progressive bone cyst.
• Young males in 2nd decade of life.
Long Bones (90-95% in long bones)
Symphysis and body of mandible > (75%) > humerus (65%),> femur (25%)
rare involvement of maxilla and condyle (1%).
•Cortical plate expansion are rarely noticed
39. • No expansion of overlying bone cortex (rare).
• No bodily movement of teeth is present.
• Aspiration is negative mostly or sometimes a
little straw colored liquid.
TRAUMATIC BONE CYST
40. TRAUMATIC BONE CYST
Radiograph features
Well-defined, unilocular radiolucency
+/- sclerotic margins extending between the roots of the tooth
in the affected region, providing a characteristic scalloping
feature.
41. TRAUMATIC BONE CYST
Reference Image: Titsinides S, Kalyvas D. Traumatic bone cyst of the jaw: a case report and review of previous studies. J Dent Health Oral Disord Ther.
2016;5(5):318‒325. DOI: 10.15406/jdhodt.2016.05.00167
42. TRAUMATIC BONE CYST
Reference ImageKarthik KP, Balamurugan R, SahanaPushpa T (2019) Traumatic bone cyst of anterior mandible: A surgical approach. Dent Oral
Maxillofac Res 5: DOI: 10.15761/DOMR.1000306
43. TRAUMATIC BONE CYST
Reference Image: https://www.rdhmag.com/patient-care/radiology/article/16407975/traumatic-bone-cyst
44. Histological findings:
Fibrous connective tissue + chronic inflammatory cell
infiltrate
No epithelial lining.
Treatment:
Surgical excision followed by curettage of cystic cavity.
Surgical exploration bleeding which forms blood clot
within the cavity resolution and regeneration of new bone.
TRAUMATIC BONE CYST
45. 3rd most common odontogenic tumor after ameloblastoma and odontomas.
The tumor is almost always located intraosseously,
Peripheral types have been described.
Odontogenic Myxoma
46. Clinical features
Benign, slow growing but locally aggressive tumor.
2nd to 4th decades.
Common site: Molar and ramus regions of the mandible.
Maxillary lesions also tend to present in the posterior quadrant.
Odontogenic Myxoma
47. Radiographic features
•Well circumscribed / diffuse lesions
•+/- Root displacement / resorption
•
•Missing or impacted tooth is usually a finding.
Odontogenic Myxoma
48. • Small lesions may have a unilocular appearance.
• Most lesions are multilocular radiolucencies with
internal bony septa.
• These septa gives the following radiologic appearances
a) Tennis- racket
b) Honey comb
c) Soap bubble
d) Step Ladder
ODONTOGENIC MYXOMA
Radiographic features
49. Image Reference: Manne, Rakesh Kumar, Venkata suneel Kumar, P. Venkata Sarath, Lavanya Anumula, Sridhar Mundlapudi, and Rambabu Tanikonda.
“Odontogenic Myxoma of the Mandible.” Case Reports in Dentistry. Hindawi, July 9, 2012. https://www.hindawi.com/journals/crid/2012/214704/.
ODONTOGENIC MYXOMA
50. Image Reference : Manne, Rakesh Kumar, Venkata suneel Kumar, P. Venkata Sarath, Lavanya Anumula, Sridhar Mundlapudi, and Rambabu Tanikonda.
“Odontogenic Myxoma of the Mandible.” Case Reports in Dentistry. Hindawi, July 9, 2012. https://www.hindawi.com/journals/crid/2012/214704/.
ODONTOGENIC MYXOMA
51. Image Reference: Wright, John M, and Merva Soluk Tekkesin. “Odontogenic Tumors: Where Are We in 2017 ?” Journal of Istanbul University
Faculty of Dentistry. Istanbul University Faculty of Dentisty, December 2, 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5750825/.
ODONTOGENIC MYXOMA
52. Image Reference: Jawaid, Moazzam, Sunil R. Panat, Ashish Aggarwal, Nitin Upadhayay, Nupur Aggarwal, Astha Durgvanshi and G. N. Sowmya.
“Odontogenic Myxoma of the Mandible : A Rare Case Report.” (2016).
ODONTOGENIC MYXOMA
53. • Histopathology
• Fine delicate stellate, fusiform and round cells in
a bland myxoid stroma
• Appear like ~~ Dental papilla.
• If more collagen
Odontogenic Myxoma
Odontogenic Myxofibroma
54. Treatment and prognosis
•Resection with free margins.
•Small lesions can be treated by conservative surgery.
•Recurrence = 25% (long-term follow-up is required)
Odontogenic Myxoma
55. Odontogenic Myxoma is a _________________ common odontogenic tumor
after ameloblastoma?
A) 2nd Most
B) 3rd Most
C) 4th Most
D) 5th Most
57. Odontogenic Myxoma is a very fast growing tumor?.
1) True
2) False
In Odontogenic Myxoma which radiological appearance is common?.
1) Step Ladder
2) Tennis Racket
3) Honey Comb
58. CHERUBISM
• Inherited
• Characterized by bone degradation and
replacement by fibrous tissue at maxilla and
mandible during childhood.
• This disease tends to show variable degree of
remission or spontaneous involution after puberty;
facial deformity.
59. • It is bilateral in the posterior part of mandible
and there is history of familial involvement.
• It does not cross the midline.
• Frequent in first decade especially in 2-5
years. Females>males, 2:1.
CHERUBISM
60. CHERUBISM
Reference Image : Fernandes Gomes M, Ferraz de Brito Penna Forte L, Hiraoka CM, Augusto Claro F, Costa Armond M. Clinical and surgical
management of an aggressive cherubism treated with autogenous bone graft and calcitonin. ISRN Dentistry. 2011 ;2011:340960. DOI:
10.5402/2011/340960.
61. CHERUBISM
Reference Image : Fernandes Gomes M, Ferraz de Brito Penna Forte L, Hiraoka CM, Augusto Claro F, Costa Armond M. Clinical and surgical
management of an aggressive cherubism treated with autogenous bone graft and calcitonin. ISRN Dentistry. 2011 ;2011:340960. DOI:
10.5402/2011/340960.
62. CHERUBISM
Treatment
• Calcitonin + Autogenous Bone Grafting
Calcitonin inhibits bone resorption Osteoclastic cells
( inhibited)
Osteo-inductive implant material
chemotactic, mitogenic and osteogenic
potential.
Autogenous
bone & marrow grafts
72. Most in children and young adults.
Age= 1st 3 decades
2:1 Female:Male
CGCG = 10% of all the Benign lesions of the jaw
CGCG is less common than the giant cell granulomas of the extremities
73. Mostly confined to the tooth bearing areas of the jaw
Mandible> Maxilla
More common in the anterior mandible,
Often crossing the midline and causing painless swellings
Rarely posterior jaw (ramus and the condyle)
74. Asymptomatic, Painless Expansion
Thinning of the cortical plates with plate perforation
Early Signs = Swelling & Premature deciduous Loose tooth
Jaw/Facial Asymmetry
76. Giant Cells are the most prominent feature
But
The mononuclear spindle cell is the proliferating cell (in cell cycle)
Spindle Cell Originate from the mesenchyme of the marrow.
Expression of the cell cycle protein Ki-67 in CGCGs.
indicated by
79. Radiographic Features
Central giant cell lesions present as radiolucent defects. Which may be
unilocular or multilocolar.
The lesion may vary from a 5×5mm incidental radiographic findings to a
destructive lesion greater than 10cm in size.
The radiographic findings are not specifically diagnostic.
Small unilocular lesion may be confused with periapical granuloma or
cysts.
Multilocular giant cell lesions cannot be radiographically distinguished
from ameloblastomas or other multilocular lesion.
83. Grossing
Brownish to reddish friable tissue of various size.
Specimen is usually coated with fresh or coagulated blood.
84. Central Giant Cell lesions of the jaws are usually treated by curettage
Studies indicate a recurrence rate of about 15-20%.
Long term prognosis is good & no metastasis reported
Surgical resection in more aggressive malignant cases.
Treatment
86. TREATMENT
Surgical Resection of the left partial-mandible
followed by Reconstruction using Rib Graft under
Hypotensive General Anesthesia.
The sample was sent for histopathological
analysis.
107. BROWN TUMOR OF THE MANDIBLE
PEPPER POT APPEARANCE
OF THE SKULL
108. Controversy in the Treatment of
Central Giant Cell Granuloma
Calcitonin
Calcitonin and Interferon ,
Calcitonin/Interferon/Imatinib/Corticosteroids,
Calcitonin/Interferon/Alendronate/Sorafenib
Calcitonin/Interferon/Coritcosteroids in order to correct facial
contours or to remove a remaining lesion after stabilization with
extensive pharmacological treatment.
None of these lesions recurred in the follow-up period
Ref : Schreuder, W. & Berg, Henk & Lange, J.. (2011). Controversy in the Treatment of Central Giant Cell Granuloma: In
Search of Evidence-Based Treatment. Journal of Oral and Maxillofacial Surgery - J ORAL MAXILLOFAC SURG. 69.
10.1016/j.joms.2011.06.231.
Unicystic type, (b) spider-web type (c) Soap-bubble type, and (d) Honeycomb type
The lesion may appear as unilocular, multilocular, soap bubble, honeycomb, or moth-eaten radiolucency causing expansion, destruction of bone, perforation of the cortices, and herniation into the soft tissues, or an associated periosteal reaction with reactive new bone forming a peripheral sclerotic border, which in some cases is difficult to differentiate from a subperiosteal hematoma. The course of the ABC is often confusing, for it may range from a self-limited lesion to an aggressive, rapidly destructive lesion mimicking a malignancy. Pathologic fracture of the jaw has also been reported. ABC has a variable radiological appearance and should be considered in the differential diagnosis of any unilocular or multilocular radiolucent lesion of the jaws as well as any mixed radiolucent-radiopaque lesion.
Monocytes invade areas of damage & inflammation, where they differentiate into macrophages.
When the macrophages fail to deal with particles to be removed they fuse together to form multinucleated giant cells.