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 reviews giant cell lesions of bones and jaws. It discusses controversies around classifying giant cell tumors versus granulomas. While Jaffe separated them in 1953 based on differences in presentation, others argue they are one entity. For long bones, giant cell tumors usually occur in adults and can be aggressive, while central jaw lesions typically occur in younger patients and respond well to curettage. Peripheral jaw lesions are reactive and associated with local irritation. Treatment involves surgical excision or resection depending on size and location of the lesion.
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 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.
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.
The document discusses various topics related to oral pathology including fractures of the jaw, traumatic bone cysts, focal osteoporotic bone marrow defects, surgical ciliated cysts of the maxilla, and the effects of orthodontic tooth movement. It provides details on the causes, clinical features, radiographic features, histologic features, and treatment for each topic.
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.
Giant cell tumor is a benign bone tumor composed of mononuclear cells and multinucleated giant cells. It typically occurs in long bones of young and middle-aged adults. Symptoms include pain and swelling. Treatment involves curettage of the tumor along with adjuvants like phenol or bone cement to reduce the risk of recurrence. For large tumors or those in critical locations, alternatives like denosumab or bisphosphonates can be considered to stabilize the disease.
Osteosarcoma is the most common type of primary bone cancer that typically affects the long bones of children and young adults. It originates in the bone and spreads aggressively. Symptoms can include pain, swelling, and limited movement near the affected bone. Diagnosis involves physical exams, x-rays showing bone destruction and tumor formation, and biopsies. Treatment consists of several months of chemotherapy before surgery to remove the tumor and surrounding tissue, followed by additional chemotherapy or radiation, with 5-year survival rates of 60-80% when treated.
This document reviews giant cell lesions of bones and jaws. It discusses controversies around classifying giant cell tumors versus granulomas. While Jaffe separated them in 1953 based on differences in presentation, others argue they are one entity. For long bones, giant cell tumors usually occur in adults and can be aggressive, while central jaw lesions typically occur in younger patients and respond well to curettage. Peripheral jaw lesions are reactive and associated with local irritation. Treatment involves surgical excision or resection depending on size and location of the lesion.
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 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.
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.
The document discusses various topics related to oral pathology including fractures of the jaw, traumatic bone cysts, focal osteoporotic bone marrow defects, surgical ciliated cysts of the maxilla, and the effects of orthodontic tooth movement. It provides details on the causes, clinical features, radiographic features, histologic features, and treatment for each topic.
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.
Giant cell tumor is a benign bone tumor composed of mononuclear cells and multinucleated giant cells. It typically occurs in long bones of young and middle-aged adults. Symptoms include pain and swelling. Treatment involves curettage of the tumor along with adjuvants like phenol or bone cement to reduce the risk of recurrence. For large tumors or those in critical locations, alternatives like denosumab or bisphosphonates can be considered to stabilize the disease.
Osteosarcoma is the most common type of primary bone cancer that typically affects the long bones of children and young adults. It originates in the bone and spreads aggressively. Symptoms can include pain, swelling, and limited movement near the affected bone. Diagnosis involves physical exams, x-rays showing bone destruction and tumor formation, and biopsies. Treatment consists of several months of chemotherapy before surgery to remove the tumor and surrounding tissue, followed by additional chemotherapy or radiation, with 5-year survival rates of 60-80% when treated.
Gaint cell lesions of bone/oral surgery courses by indian dental academyIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
This document provides information on examining radiographic films and interpreting x-rays. It discusses mounting films properly and viewing them as if inside the patient's mouth. When interpreting films, the dentist should do so systematically while considering the patient's age, history and clinical exam findings. Key areas to examine on x-rays include the teeth, bone, sinuses and joints. Terms used in radiographic diagnosis are also defined.
1) The document outlines a systematic process for interpreting radiographic images, beginning with localizing and describing the abnormality. Key steps include assessing the periphery, shape, internal structure, and effects on surrounding tissues.
2) Important characteristics to note include well-defined versus ill-defined borders, size, location in the jaw, and whether the abnormality is single or multifocal.
3) The final step is to formulate an interpretation by determining if the structure is normal or abnormal, and if abnormal, categorizing it as developmental, acquired, cyst, benign tumor, etc. Further imaging or biopsy may be needed.
This study examines the surgical management of ameloblastoma in 15 Taiwanese children between 1991-2004. The average patient age was 13.7 years. Most lesions were located in the mandible. Treatment methods included enucleation with peripheral ostectomy, decompression before enucleation, and segmental resection with bone grafting. The unicystic type lesions did not recur, while 3 of the multicystic cases recurred. Complications included numbness and facial deformity. The study concludes conservative surgery can achieve good results for ameloblastoma in children, and secondary surgery is effective for recurrence. Careful long-term follow-up is important.
Fibro osseous lesions are intraosseous lesions characterized by replacement of normal bone by collagenous tissue containing varying amounts of mineralized substances. They are classified into developmental, reactive/reparative, neoplastic, endocrinal/metabolic, and idiopathic lesions. Common examples include solitary bone cysts, central giant cell granulomas, ossifying fibromas, and fibrous dysplasia. These lesions are typically benign and often asymptomatic, with imaging and histopathological examination required for diagnosis and guidance of treatment.
This document provides information on various benign bone tumors and non-neoplastic bone lesions. It discusses the classification, presentation, diagnostic evaluation and treatment of conditions such as nonossifying fibroma, fibrous dysplasia, osteofibrous dysplasia, lipoma, hemangioma, Paget's disease, and bone infarcts. For many of these asymptomatic lesions, treatment is not required. Symptomatic lesions may be treated with splinting, curettage, bone grafting or internal fixation depending on the severity and location. Recurrence rates after treatment vary between conditions.
This document defines and classifies odontogenic cysts, which are epithelium-lined sacs that arise from odontogenic epithelium. It discusses the most common types, including periapical (radicular) cysts, dentigerous cysts, odontogenic keratocysts, glandular odontogenic cysts, and calcifying odontogenic cysts. For each cyst type, it describes characteristics such as prevalence, location, radiographic appearance, histopathology, treatment involving enucleation or marsupialization, and prognosis. It also discusses the basal cell nevus syndrome that can be associated with odontogenic keratocysts.
A rare case of patellar osteoblastoma with anteriorrohit raj
This case report describes a rare case of osteoblastoma in the patella of a 21-year-old male who presented with 6 months of anterior knee pain. Imaging showed a well-defined lytic lesion in the patella. The patient underwent curettage of the lesion and bone grafting. Histopathological examination confirmed the diagnosis of osteoblastoma. At follow-up the patient's symptoms had resolved and the bone graft had consolidated properly with no recurrence of the tumor. Osteoblastoma is a rare benign bone tumor that can present as knee pain. Though rare, it should be considered in the differential diagnosis of patellar lesions.
This document discusses orthognathic surgery and facial asymmetry. It begins with an overview of craniofacial growth and diagnosis/treatment planning for orthognathic surgery cases. It then describes various orthognathic surgeries for the mandible and maxilla, including BSSO, VSSO, genioplasty, and Le Fort I osteotomy. The document concludes with a discussion of facial asymmetry causes like hemifacial microsomia and treatment options that may involve orthognathic surgery, distraction osteogenesis, or condylectomy.
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.
Clinical and radiologic behaviour of ameloblastoma in 4 casesQuách Bảo Toàn
This document describes 4 cases of ameloblastoma, a benign odontogenic tumor that commonly occurs in the mandible. Radiographs and CT scans showed expansile lesions in the mandible in all 4 cases. The lesions ranged in size and involved different areas of the mandible. Two cases showed impacted teeth and root resorption. The tumors were treated with conservative surgery including enucleation and bone curettage. Follow up is important to monitor for recurrence of this locally aggressive tumor.
Presentation on bone tumors for undergraduate 2nd year MBBS medical students. The information for this presentation has been taken from texbook of Robbins & Cotran Pathologic Basis of Disease 8th ed.
The document discusses several rare bone tumors including:
- Synovial chondromatosis, which involves cartilaginous metaplasia within joints that can lead to loose bodies. Symptoms vary depending on location and stages of the disease. Treatment includes surgery.
- Desmoid tumors (fibromatosis), which are locally aggressive proliferative lesions of connective tissue that infiltrate muscle but do not metastasize. Surgery is the main treatment.
- Hemangiomas, which are benign tumors of blood vessels that can be painful and recur without complete removal. Location and invasiveness vary.
- Osteoid osteoma, a benign bone tumor most common in young males. Presentation includes pain
This document provides an overview of common benign bone lesions. It begins with an introduction to bone tumors and their classification as benign or malignant. Several common benign bone tumors are then described in detail, including their clinical features, radiological appearance, diagnosis, treatment, and prognosis. Examples discussed include osteoid osteoma, osteoblastoma, bone islands, chondromas, osteochondromas, chondromyxoid fibroma, chondroblastoma, non-ossifying fibroma, fibrous dysplasia, unicameral bone cyst, aneurysmal bone cyst, and hemangioma. For each lesion, the key presenting symptoms, diagnostic imaging findings, treatment approaches such as surgery or observation, and recurrence risks
Odontogenic tumors iv /orthodontic courses by Indian dental academy Indian dental academy
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.for more details please visit
www.indiandentalacademy.com
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.
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.
- 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.
Implant Dentistry: Basics to Advance provides an overview of implant dentistry from history to advanced concepts. Key points covered include:
- A brief history of dental implants from early bamboo pegs in ancient China to Branemark's pioneering work with osseointegration in the 1950s.
- Definitions of implants, abutments, components and their various designs.
- Bone biology concepts including cells, composition, modeling/remodeling and osseointegration.
- Differences between implants and natural teeth and factors for patient selection, indications, contraindications and diagnosis.
- Principles of implant planning including anatomic considerations, available bone, vertical/
This document outlines ophthalmic conditions and provides triage guidelines for determining the urgency of each case. Conditions are categorized as red (emergency), amber (urgent), or green (routine). Red cases include penetrating eye injuries, endophthalmitis, and sudden vision loss and require same-day assessment. Amber cases include flashes/floaters and diabetic retinopathy and should be seen within 72 hours. Green cases such as conjunctivitis can be managed by GPs or optometrists on a non-urgent basis. Specific conditions like corneal abrasions, foreign bodies, and vitreous detachments are also discussed. The future of ophthalmic care is predicted to involve increased demand, improved triage systems,
Gaint cell lesions of bone/oral surgery courses by indian dental academyIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
This document provides information on examining radiographic films and interpreting x-rays. It discusses mounting films properly and viewing them as if inside the patient's mouth. When interpreting films, the dentist should do so systematically while considering the patient's age, history and clinical exam findings. Key areas to examine on x-rays include the teeth, bone, sinuses and joints. Terms used in radiographic diagnosis are also defined.
1) The document outlines a systematic process for interpreting radiographic images, beginning with localizing and describing the abnormality. Key steps include assessing the periphery, shape, internal structure, and effects on surrounding tissues.
2) Important characteristics to note include well-defined versus ill-defined borders, size, location in the jaw, and whether the abnormality is single or multifocal.
3) The final step is to formulate an interpretation by determining if the structure is normal or abnormal, and if abnormal, categorizing it as developmental, acquired, cyst, benign tumor, etc. Further imaging or biopsy may be needed.
This study examines the surgical management of ameloblastoma in 15 Taiwanese children between 1991-2004. The average patient age was 13.7 years. Most lesions were located in the mandible. Treatment methods included enucleation with peripheral ostectomy, decompression before enucleation, and segmental resection with bone grafting. The unicystic type lesions did not recur, while 3 of the multicystic cases recurred. Complications included numbness and facial deformity. The study concludes conservative surgery can achieve good results for ameloblastoma in children, and secondary surgery is effective for recurrence. Careful long-term follow-up is important.
Fibro osseous lesions are intraosseous lesions characterized by replacement of normal bone by collagenous tissue containing varying amounts of mineralized substances. They are classified into developmental, reactive/reparative, neoplastic, endocrinal/metabolic, and idiopathic lesions. Common examples include solitary bone cysts, central giant cell granulomas, ossifying fibromas, and fibrous dysplasia. These lesions are typically benign and often asymptomatic, with imaging and histopathological examination required for diagnosis and guidance of treatment.
This document provides information on various benign bone tumors and non-neoplastic bone lesions. It discusses the classification, presentation, diagnostic evaluation and treatment of conditions such as nonossifying fibroma, fibrous dysplasia, osteofibrous dysplasia, lipoma, hemangioma, Paget's disease, and bone infarcts. For many of these asymptomatic lesions, treatment is not required. Symptomatic lesions may be treated with splinting, curettage, bone grafting or internal fixation depending on the severity and location. Recurrence rates after treatment vary between conditions.
This document defines and classifies odontogenic cysts, which are epithelium-lined sacs that arise from odontogenic epithelium. It discusses the most common types, including periapical (radicular) cysts, dentigerous cysts, odontogenic keratocysts, glandular odontogenic cysts, and calcifying odontogenic cysts. For each cyst type, it describes characteristics such as prevalence, location, radiographic appearance, histopathology, treatment involving enucleation or marsupialization, and prognosis. It also discusses the basal cell nevus syndrome that can be associated with odontogenic keratocysts.
A rare case of patellar osteoblastoma with anteriorrohit raj
This case report describes a rare case of osteoblastoma in the patella of a 21-year-old male who presented with 6 months of anterior knee pain. Imaging showed a well-defined lytic lesion in the patella. The patient underwent curettage of the lesion and bone grafting. Histopathological examination confirmed the diagnosis of osteoblastoma. At follow-up the patient's symptoms had resolved and the bone graft had consolidated properly with no recurrence of the tumor. Osteoblastoma is a rare benign bone tumor that can present as knee pain. Though rare, it should be considered in the differential diagnosis of patellar lesions.
This document discusses orthognathic surgery and facial asymmetry. It begins with an overview of craniofacial growth and diagnosis/treatment planning for orthognathic surgery cases. It then describes various orthognathic surgeries for the mandible and maxilla, including BSSO, VSSO, genioplasty, and Le Fort I osteotomy. The document concludes with a discussion of facial asymmetry causes like hemifacial microsomia and treatment options that may involve orthognathic surgery, distraction osteogenesis, or condylectomy.
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.
Clinical and radiologic behaviour of ameloblastoma in 4 casesQuách Bảo Toàn
This document describes 4 cases of ameloblastoma, a benign odontogenic tumor that commonly occurs in the mandible. Radiographs and CT scans showed expansile lesions in the mandible in all 4 cases. The lesions ranged in size and involved different areas of the mandible. Two cases showed impacted teeth and root resorption. The tumors were treated with conservative surgery including enucleation and bone curettage. Follow up is important to monitor for recurrence of this locally aggressive tumor.
Presentation on bone tumors for undergraduate 2nd year MBBS medical students. The information for this presentation has been taken from texbook of Robbins & Cotran Pathologic Basis of Disease 8th ed.
The document discusses several rare bone tumors including:
- Synovial chondromatosis, which involves cartilaginous metaplasia within joints that can lead to loose bodies. Symptoms vary depending on location and stages of the disease. Treatment includes surgery.
- Desmoid tumors (fibromatosis), which are locally aggressive proliferative lesions of connective tissue that infiltrate muscle but do not metastasize. Surgery is the main treatment.
- Hemangiomas, which are benign tumors of blood vessels that can be painful and recur without complete removal. Location and invasiveness vary.
- Osteoid osteoma, a benign bone tumor most common in young males. Presentation includes pain
This document provides an overview of common benign bone lesions. It begins with an introduction to bone tumors and their classification as benign or malignant. Several common benign bone tumors are then described in detail, including their clinical features, radiological appearance, diagnosis, treatment, and prognosis. Examples discussed include osteoid osteoma, osteoblastoma, bone islands, chondromas, osteochondromas, chondromyxoid fibroma, chondroblastoma, non-ossifying fibroma, fibrous dysplasia, unicameral bone cyst, aneurysmal bone cyst, and hemangioma. For each lesion, the key presenting symptoms, diagnostic imaging findings, treatment approaches such as surgery or observation, and recurrence risks
Odontogenic tumors iv /orthodontic courses by Indian dental academy Indian dental academy
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.for more details please visit
www.indiandentalacademy.com
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.
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.
- 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.
Implant Dentistry: Basics to Advance provides an overview of implant dentistry from history to advanced concepts. Key points covered include:
- A brief history of dental implants from early bamboo pegs in ancient China to Branemark's pioneering work with osseointegration in the 1950s.
- Definitions of implants, abutments, components and their various designs.
- Bone biology concepts including cells, composition, modeling/remodeling and osseointegration.
- Differences between implants and natural teeth and factors for patient selection, indications, contraindications and diagnosis.
- Principles of implant planning including anatomic considerations, available bone, vertical/
This document outlines ophthalmic conditions and provides triage guidelines for determining the urgency of each case. Conditions are categorized as red (emergency), amber (urgent), or green (routine). Red cases include penetrating eye injuries, endophthalmitis, and sudden vision loss and require same-day assessment. Amber cases include flashes/floaters and diabetic retinopathy and should be seen within 72 hours. Green cases such as conjunctivitis can be managed by GPs or optometrists on a non-urgent basis. Specific conditions like corneal abrasions, foreign bodies, and vitreous detachments are also discussed. The future of ophthalmic care is predicted to involve increased demand, improved triage systems,
The skull bone consists of 28 total bones, divided into 14 calvarium bones that form the brain box and 14 facial bones. The calvarium bones include the parietal, occipital, temporal, frontal, sphenoid, and ethmoid bones. The 14 facial bones include the zygomatic, maxilla, mandible, lacrimal, nasal, palatine, and inferior nasal conchae bones. Fractures in different areas of the skull can lead to bleeding, cerebrospinal fluid leakage, and damage to cranial nerves. Premature closure of skull sutures is known as craniosynostosis and can cause skull deformities.
The document contains the ward duty roster for doctors in Group B for the month of January 2019. It lists which doctors are assigned to morning, evening, and night shifts each day of the week. Dr. Uroosa, Dr. Nasir, Dr. Ameer Gul, Dr. Meena, Dr. Maria, Dr. Tarique, Dr. Hamayon, Dr. Komal, and others are assigned to different shifts throughout the month.
This document lists the bones found in the human calvarium and facial regions. It notes that the calvarium contains 8 bones: the sphenoid, parietal (2), occipital, temporal (2), ethmoid, and frontal. It also lists that there are 14 facial bones, including the maxilla, vomer, lacrimal, mandible, zygomatic, palatine, inferior concha, and nasal bones.
1) Pain is an unpleasant sensory and emotional experience caused by actual or potential tissue damage. It is the fifth vital sign due to its clinical significance.
2) Pain can be classified based on duration, location, intensity, and etiology. The general pain pathway involves nociceptors, spinal cord transmission to the brain, and response.
3) The spinothalamic tract involves first, second, and third order neurons transmitting nociceptive signals from receptors to the thalamus and cortex. The spino-reticular tract is also involved in emotional and behavioral responses to pain.
- Salivary gland neoplasms make up 1.2% of all neoplasms and can be either benign or malignant. The parotid gland is the most common site.
- Pleomorphic adenoma is the most common benign tumor, while mucoepidermoid carcinoma is the most frequent malignant salivary gland tumor.
- Diagnostic tools include FNAC, CT, MRI, and biopsy. Treatment depends on whether the tumor is benign or malignant and may involve surgery or radiation therapy.
The submandibular gland is one of the major salivary glands located bilaterally in the face within the submandibular triangle. It produces a mixture of mucus and serous salivary secretions that are released through Wharton's duct into the oral cavity floor. The parotid gland is the largest major salivary gland located superficial to the ear and deep to the ramus of the mandible, releasing secretions through Stensen's duct by the maxillary molars. Salivary glands contain secretory units called acini that produce serous or mucous secretions which drain into striated ducts and are modified by reabsorption and ion transport before exiting through
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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3. Introduction
♦ Giant cell lesions of bones represent a broad
category of entities.
♦ These include, giant cell lesions of the bones,
central and peripheral giant cell granulomas,
aneurysmal bone cysts, brown tumors of
hyperparathyroidism and cherubism.
4. Introduction
♦ There is a longstanding controversy regarding the
relationship between giant cell tumors of the axial
skeleton and giant cell granulomas of the jaws.
5. Controversies : Giant Cell Lesions
♦ Until the mid 1950’s giant cell tumors of
the extragnathic skeleton were considered
closely related to giant cell lesions which
occurred in the jaws.
6. Controversies : Jaffe’s recommendations
♦ In 1953, Jaffe separated the giant cell
lesions occurring in the jaws from the giant
cell tumors of the long bones, based on the
differences in the clinical presentation,
histopathology, radiography and treatment
response between these two lesions.
7. Controversies : Jaffe’s recommendations
♦ Jaffe called these giant cell lesions of the jaws as
“giant cell reparative granulomas”.
♦ He indicated that the jaw lesions tend to occur in
younger patients (10 to 25), where as giant cell
tumors of the axial skeleton usually appeared after
the age of 20.
8. Controversies : Jaffe’s recommendations
♦ He suggested that giant cell tumors of long bones
were far more aggressive, with higher rates of
recurrence with potential to undergo malignant
transformation.
9. Controversies : Giant Cell Lesions
♦ In 1966, Waldron and Shafer argued that the
“giant cell tumors” of the long bones and “giant
cell reparative granulomas” of the jaws are one
and the same entity but may differ in presentation
and histology.
10. Controversies : Giant Cell Lesions
♦ Currently there are two schools of thought
regarding the existence of giant cell tumors in the
facial skeleton.
11. Controversies : Giant Cell Lesions
♦ Some like Jaffe, firmly believe that true giant cell
tumors either do not exist or occur very rarely in
the maxillofacial region.
♦ However other pathologists and clinicians remain
convinced that giant cell tumors do occur within
the jaws.
12. Controversies : Giant Cell Lesions
♦ Abrams and shear in 1974, consolidated these two
positions, and suggested that certain jaw lesions
may be true giant cell tumors and certain giant cell
lesions outside the jaws maybe giant cell
granulomas.
14. Giant cell lesions of the long bones: Clinical
features
♦ The females have a slight predilection.
♦ The peak incidence is in the third decade with the
tumor occurring in over 80% of cases after the age
of 20.
15. Giant cell lesions of the long bones: Clinical
features
♦ Most long bone lesions are located at the
epiphyseal region of the bone.
♦ Most of these lesions appear as a solitary lesion,
and multifocal disease is very rare.
♦ Patients present with pain, localized swelling and
tenderness at the site of the affected bone.
16. Giant cell lesions of the long bones: Clinical
features
♦ These lesions present with a wide range of
aggressiveness, ranging from the more
conventional giant cell tumor to true malignancies
with a high potential for recurrence and
metastasis.
♦ Incidence of truly malignant giant lesion ranges
from 3% to 30%.(Franklin et al).
18. Giant cell lesions of the long bones:
Histopathology
♦ There are large number of multinucleated giant
cells of varying density separated by stromal cells.
♦ This type of histologic pattern is similar in many
other bone lesions like (browns tumor, non
ossifying fibroma, Aneurysmal bone cyst, e.t.c.,)
19. Giant cell lesions of the long bones
Therefore, the clinician must also correlate the
histological findings with the clinical and
radiographic presentation to make the correct
diagnosis.
20. Giant cell lesions of the long bones: Treatment
♦ The surgical treatment is either curettage or
resection and is performed based on the type and
extension of the tumor which affects the bone.
22. Central Giant cell lesions of the Jaws
♦ The literature regarding giant cell lesions of the
jaw is confusing because some authors have
included both central and peripheral lesions in
their series.
23. Central Giant cell lesions of the Jaws
♦ It is now well recognized that the peripheral giant
cell lesion differs in clinical presentation and
behavior from the central lesion.
24. Central Giant cell lesions of the Jaws: Clinical
features
♦ These lesions occurs between the age of 2 to 81
years, but the average age is within the second
decade of life.
♦ Sex: 2:1 female predilection.
♦ The mandible is clearly the preferred site.
25. Central Giant cell lesions of the Jaws: Clinical
features
♦ These lesions mainly occur in the anterior portion
of the maxilla and mandible.
♦ Posterior maxilla or mandible is rarely involved.
26. Central Giant cell lesions of the Jaws: Clinical
features
♦ Multiple central giant cell lesions in a single
patient are exceedingly rare.
♦ A painless local swelling is the most commonest
presenting symptom although some patients may
have pain or anesthesia.
27. Central Giant cell lesions of the Jaws:
Radiographic features
♦ The most characteristic X-ray feature is a radiolucency
within bone and can either have an multilocular or
unilocular configuration.
28. ♦ Thin, wispy septa.
♦ Resorption of teeth very common.
♦ “Salt & Pepper “ calcification can be seen.
Central Giant cell lesions of the Jaws: Radiographic
features
29. ♦ V-shaped bony ridges separating the locules.
Central Giant cell lesions of the Jaws: Radiographic
features
30. Central Giant cell lesions of the Jaws:
Histopathology
♦ Histologically a central giant cell lesion is
characterized by numerous multinucleated giant
cells within a loose fibrous connective tissue
Stroma.
31. Central Giant cell lesions of the Jaws: Clinical
behaviour
♦ Small, slow growing, asymptomatic mass
responds well to curettage.
♦ However, the large and aggressive mass produces
pain and recurs frequently, especially in younger
patients.
♦ True malignant giant cell tumors of the jaw may
produce distant and local metastases.
32. Central Giant cell lesions of the Jaws: Clinical
behaviour
♦ There are no definitive histological parameter to
predict the clinical behavior.
♦ Therefore, the clinician must use his judgment,
appropriate treatment strategies and long-term
follow-up in order to properly manage these
lesions.
33. Central Giant cell lesions of the Jaws:
Treatment
Surgical curettage is the most commonest
procedure.
♦ Large aggressive lesions of the maxilla and
mandible may require an en-bloc resection.
34. Central Giant cell lesions of the Jaws:
Treatment
♦ In some lesions both the overlying mucosa and
periosteum must be removed.
♦ Non surgical modalities of treatment include
systemic calcitionin administration, anti-
angiogenic therapy with interferon, and intra-
lesional corticosteroids.
35. Central Giant cell lesions of the Jaws:
Treatment
♦ Harris (1992) reported regression of these masses
with systemic calcitonin therapy. Two of the four
patients in his study exhibited complete
regression, while the other required additional
surgery to eradicate the lesion.
36. Central Giant cell lesions of the Jaws:
Treatment
♦ Lange et. al. (1999) had obtained significant
regression of the lesions(central giant cell
granuloma) in all his four patients following
cacitonin treatment.
♦ The efficacy of intra-lesional steroids use in the
treatment of giant cell lesions remains to be
proven.
38. Peripheral Giant cell lesions of the Jaws
♦ In the past these lesions were referred to as “giant
cell epulis”.
39. Peripheral Giant cell lesions of the Jaws :
Etiology
♦ The exact etiology for these lesions is not known.
♦ However, it is believed that these lesions are
reactive in nature and develop as a result of
localized trauma or irritation ( e.g., tooth extraction,
calculus deposits, ill fitting dentures and poor
restorations).
40. Peripheral Giant cell lesions of the Jaws:
Clinical features
Although the peripheral giant cell lesion occurs at
a much higher frequency than the central type, it
remains relatively uncommon (accounting for only
0.3% to 0.5% of all oral biopsies).
♦ They are usually seen in patient’s between the
third and fifth decades of life.
41. Peripheral Giant cell lesions of the Jaws:
Clinical features
♦ There is a significant female predilection, suggesting the
role of hormone levels in the development of these lesions.
♦ Most lesions occur on the gingiva or the edentulous
alveolar ridge in either a posterior or anterior portion on
the jaw.
♦ The mandible is affected slightly more than the maxilla .
42. Peripheral Giant cell lesions of the Jaws:
Clinical features
The lesions can be either pedunculated or sessile.
♦ They rarely exceed 2 cm in size and typically
present with a bluish – purple color.
43. Peripheral Giant cell lesions of the Jaws:
Radiographic features
♦ As most of these lesions are usually manifestations within
the gingiva, no radiological finding is reported other than
an occasional ovoid surface erosion of the underlying
bone.
44. Peripheral Giant cell lesions of the Jaws:
Histopathology
♦ The histological features demonstrate the characteristic
giant cells in a fibrous connective tissue stroma which is
covered by a surface epithelium.
45. Peripheral Giant cell lesions of the Jaws:
Treatment
♦ The treatment of choice is a surgical excision.
♦ In lesions involving the gingival mucosa around
the teeth, care must be taken to debride the
surrounding teeth and surgical site, so as to
remove all sources of possible irritation.
Extraction is no longer recommended.
46. Peripheral Giant cell lesions of the Jaws:
Recurrence
♦ Recurrence rate ranges between 5% and 10%.
♦ These recurrences are most often due to failure in
removing the entire lesion or the source of any
local irritation.
48. Hyperparathyroidism (Brown’s tumor)
♦ Brown’s tumor of hyperparathyroidism is
clinically, histologically and radiographically
indistinguishable from other types of giant cell
lesions.
49. Hyperparathyroidism: Types
♦ Primary hyperparathyroidism is caused by an
overproduction of parathormone by the
parathyroid gland affected by adenoma or
hyperplasia.
♦ Secondary hyperparathyroidism also results in
increased production of parathormone and is
found to occur in various disease states where
there is resistance to the metabolic actions of the
parathormone.
50. Hyperparathyroidism: Clinical features
♦ The typical hyperparathyroidism patient presents
without any significant symptoms.
♦ Some patients present with renal calculi or some
skeletal manifestations.
♦ The disease is easily diagnosed by measuring the
patient’s serum calcium and parathormone levels.
52. Hyperparathyroidism: Treatment
♦ Treatment is directed towards normalizing
calcium/phosphate/parathyroid homeostasis.
♦ If a parathyroid adenoma is the cause of elevated
hormone level, surgical excision of this tumor
produces a complete recovery.
♦ In secondary hyperparathyroidism, the treatment
efforts is on correcting the underlying metabolic
disturbance.
54. Aneurysmal bone cyst
♦ In 1942, Jaffe and Lichenstein, introduced the
term aneurysmal bone cyst.
♦ Other names for this lesion include, aneurysmal
giant cell tumor, subperiosteal giant cell tumor
e.t.c.
55. Aneurysmal bone cyst : Etiology
♦ There is controversy regarding the etiology of this lesion.
♦ For the moment there are no strong evidences to prove
that these lesions develop primarily, or to say that they
develop secondarily due to another underlying disease
process.
56. Aneurysmal bone cyst: Etiology
♦ Lichenstein indicates that this lesion results from a
locallised vascular disturbance such as a venous
thrombosis or arteriovenous malformation.
57. Aneurysmal bone cyst: Etiology
♦ Others believe that this lesion can either be a separate
reactive process, arising from another primary bone lesion
such as fibrous dyplasia, central giant cell granuloma, or
pagets disease.
58. Aneurysmal bone cyst : Clinical features
♦ This lesion occurs in younger patients usually
below 20 years of age.
♦ The mandible appears to be more commonly
affected than the maxilla.
59. Aneurysmal bone cyst: Clinical features
♦ The posterior molar-bearing segments of the maxilla and
mandible seem to be more commonly affected region.
♦ Clinically these lesions are characterized by a non-pulsatile
swelling of variable duration.
60. Aneurysmal bone cyst: Clinical features
♦ 50% of patients present with pain in the affected region.
♦ Tooth displacement and external root resorption may also
be seen.
♦ There is a slight female predilection in both the long bones
and jaw lesions.
61. Aneurysmal bone cyst: Radiographic features
♦ This lesion is classically described as an expanded,
cystically transformed, eccentric ballooning of the bone.
♦ Fine bony trabeculations in the lesion give a “soap bubble
appearance”.
62. Aneurysmal bone cyst: Histopathology
♦ Microscopically this lesion is not a true cyst, as it does not
have a epithelial lining, and is characterized by large,
blood filled cavities contained within a thin, bony
framework.
♦ The histologic pattern of the stroma between the sinusoids
is very similar to that of other giant cell lesions.
63. Aneurysmal bone cyst: Recurrence
♦ The recurrence rate of these lesions in th long
bones is about 21% to 40%, and in the jaws is
about 19%.
64. Aneurysmal bone cyst: Treatment
♦ Despite the recurrence rates, a thorough curettage
is the most commonest treatment modality for this
lesion.
65. Aneurysmal bone cyst: Treatment
♦ In some lesions with associated vascular
malformations, preoperative super-selective
embolization of the feeding vessels to the lesion is
mandatory before surgery.
♦ Following embolization either curettage or en-bloc
resection can be performed.
67. Cherubism
♦ Jones reported on the clinical entity known as Cherubism
in the year 1933.
♦ He coined the term cherubism due to these patients
resemblance to the cherubs portrayed in renaissance art.
68. Cherubism: Clinical features
♦ Classic cherubic appearance is due to a characteristic
bilateral enlargement of the maxillae, causing retraction of
the lower eyelids and exposure of the sclera, giving an
“eyes raised to heaven” appearance.
69. Cherubism: Clinical features
♦ In contrast to other giant cell lesions, cherubism has a
hereditary predilection which helps to differentiate it from
other similar entities.
70. Cherubism: Clinical features
♦ Cherubism is an autosomal dominant disorder with
variable expressivity.
♦ Cherubism may also result from a spontaneous mutation
with no apparent familial involvement.
♦ The disease occurs with a 2 : 1 male preponderance.
71. Cherubism: Clinical features
♦ Cherubism is not found to occur very commonly.
♦ Typically, it appears in young children before the age of
five, most commonly prior to the second birthday.
72. Cherubism: Clinical features
♦ The lesion occurs almost exclusively in the mandible and
maxilla, but in some cases have occurred in extragnathic
sites.
♦ They are most often seen in the mandible, with the
ascending rami and the retromolar area being most
commonly affected.
73. Cherubism: Clinical features
♦ In rare cases the mandibular condyles can also be
involved.
♦ The lesions are classically bilateral, although
unilateral involvement has been reported.
74. Cherubism: Clinical features
♦ Maxilla involvement is less frequent.
However,when it occurs it involves the maxillary
tuberosity region.
♦ These lesions may also involve the orbital floor
and anterior maxilla.
75. Cherubism: Grading
♦ The diverse clinical presentation has prompted
some clinicians to adopt a grading system which
categorizes these lesions according to extent of
involvement.
76. Cherubism: Grading
♦ Grade 1 : Involvement of both mandibular ascending rami.
♦ Grade 2 : Involvement of both rami and both maxillary
tuberosities.
♦ Grade 3 : Diffuse bilateral involvement of the entire
maxilla and mandible with sparing of the condyle.
♦ Grade 4 : Lesions with the features of grade 3 but with
orbital floor involvement.
77. Cherubism: Clinical behavior
♦ These lesions present as a progressively enlarging, painless
swelling with marked bony expansion.
♦ The dentition in the affected region is often displaced.
78. Cherubism: Clinical behavior
♦ The deciduous teeth are usually exfoliated by the age of
three and the permanent tooth follicles are displaced,
resulting in delayed eruption, multiple impacted teeth or
both.
79. Cherubism: Clinical behavior
♦ Uniform, bilateral mandibular involvement can
commonly result in gross malocclusion in addition
to facial disfigurement.
♦ In the most severe cases, speech, swallowing, and
respiration can be affected.
80. Cherubism: Radiographic features
♦ The typical radiographic presentation is a diffuse osteolytic
radiolucent process with diffuse cortical expansion and
thinning of the involved bone.
♦ In the tooth-bearing segments of the mandible, the teeth
are described as “floating in cyst-like spaces”.
81. Cherubism: Histopathology
♦ The histologic profile of cherubism is similar to
other giant cell lesions and shows numerous
multinucleated giant cells are contained within
highly vascular fibrous stroma.
82. Cherubism: Treatment
♦ The prognosis for cherubism remains good, given
the fact that these lesions usually are self-limiting
and tend to regress with time.
♦ The lesions become static as a patient approaches
puberty and thereafter begins to slowly regress.
83. Cherubism: Treatment
♦ Most cases undergo a surgical procedure for
cosmetic or functional needs.
♦ Curettage and re-contouring is advocated by some
to arrest the disease process and stimulate bone
deposition.
♦ Few others recommend no treatment other than
following the patient.
84. Giant Cell Lesions: Discussion
Miles et al (1991) provided the following comments
regarding their understanding of giant cell lesions:
♦ A central giant cell lesion may consists of several related
reactive lesions which result from trauma or vascular insult
which produces intramedullary bleeding.
85. ♦ If the blood supply is cut off completely, no giant cell
reaction occurs and the traumatic bone cyst occurs.
♦ Conversely, if the blood supply is maintained fully, an A-V
malformation develops.
♦ However, if the blood supply is maintained only partially,
then an aneurysmal bone cyst or central giant cell lesion
could result.
Giant Cell Lesions: Discussion - Miles et al (1991)