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.
Odontogenic keratocyst (OKC) is the cyst arising from the cell rests of dental lamina. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. Radiographically, most OKCs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst.
Odontogenic keratocyst (OKC) is the cyst arising from the cell rests of dental lamina. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. Radiographically, most OKCs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst.
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
Fibro-osseous lesions of the jaws
Fibrous dysplasia
Cemento-osseous dysplasia
Focal cemento-osseous dysplasia
Periapical cemento-osseous dysplasia
Florid cemento-osseous dysplasia
Ossifying fibroma
Juvenile aggressive ossifying fibroma
Cherubism
Fibro-osseous lesions (FOL) are characterized by replacement of normal bone architecture by collagen fibers and fibroblasts containing calcified tissue.
They include a wide variety of lesions of developmental, dysplastic and neoplastic origins with clinical and radiographic presentation and behavior.
Because of the histological similarities between diverse diseases, proper diagnosis requires correlation of history, clinical and radiographic findings.Fibrous Dysplasia
2. Reactive (dysplastic lesions arising in the tooth-bearing area (presumably of periodontal origin).
a. Periapical cemento-osseous dysplasia
b. Focal cemento-osseous dysplasia
c. Florid cemento-osseous dysplasia
3. Fibro-osseous neoplasms (widely designated as cementifying fibroma, ossifying fibroma or cemento-ossifying fibroma.Bone dysplasias
a. Fibrous dyspla i. Monostoticii. Polyostotic
iii. Polyostotic with endocrinopathy (McCune-Albright)
iv Osteofibrous dysplasia
b. Osteitis deformansc. Pagetoid heritable bone dysplasias of childhood
d. Segmental odontomaxillary dysplasia
2. Cemento-osseous dysplasias
a. Focal cemento-osseous dysplasia b. Florid cemento-osseous dysplasia
3.Inflammatory/reactive processes
a. Focal sclerosing osteomyelitisb. Diffuse sclerosing osteomyelitis
c. Proliferative periostitis
4. Metabolic Disease: hyperparathyroidism
5. Neoplastic lesions (Ossifying fibromas)
a. Ossifying fibromab. Hyperparathyroidism jaw lesion syndrome
c. Juvenile ossifying fibroma i. Trabecular typeii. Psammomatoid type
d. Gigantiform cementomas
A cyst is an epithelium-lined sac containing fluid or semisolid material. In the formation of a cyst, the epithelial cells first proliferate and later undergo degeneration and liquefaction. The liquefied material exerts equal pressure on the walls of the cyst from within. Cysts grow by expansion and thus displace the adjacent teeth by pressure. May can produce expansion of the cortical bone. On a radiograph, the radiolucency of a cyst is usually bordered by a radiopaque periphery of dense sclerotic bone. The radiolucency may be unilocular or multilocular. Odontogenic cysts are those which arise from the epithelium associated with the development of teeth. The source of epithelium is from the enamel organ, the reduced enamel epithelium, the cell rests of Malassez or the remnants of the dental lamina.
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
Fibro-osseous lesions of the jaws
Fibrous dysplasia
Cemento-osseous dysplasia
Focal cemento-osseous dysplasia
Periapical cemento-osseous dysplasia
Florid cemento-osseous dysplasia
Ossifying fibroma
Juvenile aggressive ossifying fibroma
Cherubism
Fibro-osseous lesions (FOL) are characterized by replacement of normal bone architecture by collagen fibers and fibroblasts containing calcified tissue.
They include a wide variety of lesions of developmental, dysplastic and neoplastic origins with clinical and radiographic presentation and behavior.
Because of the histological similarities between diverse diseases, proper diagnosis requires correlation of history, clinical and radiographic findings.Fibrous Dysplasia
2. Reactive (dysplastic lesions arising in the tooth-bearing area (presumably of periodontal origin).
a. Periapical cemento-osseous dysplasia
b. Focal cemento-osseous dysplasia
c. Florid cemento-osseous dysplasia
3. Fibro-osseous neoplasms (widely designated as cementifying fibroma, ossifying fibroma or cemento-ossifying fibroma.Bone dysplasias
a. Fibrous dyspla i. Monostoticii. Polyostotic
iii. Polyostotic with endocrinopathy (McCune-Albright)
iv Osteofibrous dysplasia
b. Osteitis deformansc. Pagetoid heritable bone dysplasias of childhood
d. Segmental odontomaxillary dysplasia
2. Cemento-osseous dysplasias
a. Focal cemento-osseous dysplasia b. Florid cemento-osseous dysplasia
3.Inflammatory/reactive processes
a. Focal sclerosing osteomyelitisb. Diffuse sclerosing osteomyelitis
c. Proliferative periostitis
4. Metabolic Disease: hyperparathyroidism
5. Neoplastic lesions (Ossifying fibromas)
a. Ossifying fibromab. Hyperparathyroidism jaw lesion syndrome
c. Juvenile ossifying fibroma i. Trabecular typeii. Psammomatoid type
d. Gigantiform cementomas
A cyst is an epithelium-lined sac containing fluid or semisolid material. In the formation of a cyst, the epithelial cells first proliferate and later undergo degeneration and liquefaction. The liquefied material exerts equal pressure on the walls of the cyst from within. Cysts grow by expansion and thus displace the adjacent teeth by pressure. May can produce expansion of the cortical bone. On a radiograph, the radiolucency of a cyst is usually bordered by a radiopaque periphery of dense sclerotic bone. The radiolucency may be unilocular or multilocular. Odontogenic cysts are those which arise from the epithelium associated with the development of teeth. The source of epithelium is from the enamel organ, the reduced enamel epithelium, the cell rests of Malassez or the remnants of the dental lamina.
A brief introduction to the IBD and its classification. Mainly dealing here with the Imaging techniques used in the diagnosis of the IBD.
Inflammatory bowel disease (IBD) is an idiopathic disease caused by a dysregulated immune response to host intestinal microflora. The two major types of inflammatory bowel disease are ulcerative colitis (UC), which is limited to the colon, and Crohn disease (CD), which can affect any segment of the gastrointestinal tract from the mouth to the anus, involves "skip lesions," and is transmural. There is a genetic predisposition for IBD, and patients with this condition are more prone to the development of malignancy.
inflammatory bowel disease is a diagnosis of exclusion and it has two form known as crohn's disease which can affect all GI tract from ''gum to bum'' with skip lesion and the formation of cobblestones. ulcerative colitis affect only the colon and also causes proctitis and toxic megacolon. both of the disease has extraGI symptoms like sclerosing cholangitis, uveitis, ankylosing spondylitis,conjunctivitis, liver cirrhosis, pyoderma gangrenosum, arthropathy and althralgia, etc .
Temporomandibular joint /certified fixed orthodontic courses by Indian denta...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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Dept of Oral Medicine & Radiology
Ameloblastoma A case report
Dhananjay Singh
CHIEF COMPLAINT
HISTORY OF PRESENT ILLNESS
dental history
medical history
diagnosis
investigation
final diagnosis
treatment
clinical features
oral medicine
radiology
xray
oral diagnosis
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.
A case report on mesenchymal chondrosarcoma / dental implant coursesIndian 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.
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.
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.
I report a case of rare type of anal cancer in a relatively young individual. A 35-year-old male presented to the OPD Clinic from Nigeria with pain in anal region. Patient was referred for CT scan which showed anal mass. Biopsy showed highly aggressive adenocarcinoma with no metastasis. Patient was started on radiation therapy and multi-drug regimen chemotherapy. After receiving 2 appointments of radiation therapy, patient contracted community acquired pneumonia. Patient’s condition deteriorated and was admitted to ICU for 15 days aggressively treated with antibiotics. Patient was scheduled to undergo abdominoperineal resection. Financially drained and post- surgery complications, patient decided on not receiving any further treatment and returning back home.
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.
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
CARCINOMA OF THE ORAL CAVITY. Diagnosis and management.tDr. RIFFAT KHATTAK
The Oral Cavity, with it's seven subsites,is a host of multiple epithelial, mesenchymal & glandular structures. Thus, if exposed to multiple risk factors, either in isolation or in combination, could undergo drastic histological changes leading to malgnancies. A thorough clinical examination, diagnosis and timely intervention followed by rehabilitation of the patient, via a multi disciplinary approach is the mainstay of treatment.
Opportunity for Dentists (BDS/MDS )to relocate to United kingdom -Register as a DENTAL HYGIENIST/ DENTAL THERAPIST without Board exams and after approval you can register in GDC as a DH/DT and start working as a DH/DT Immediately and get paid.
You can complete the whole process in 3-4 months.Salary range for DH/DT is around 2500-3500 Pounds per month.
Eligibility / requirements-
1. An International English Language Testing System (IELTS) certificate
at the appropriate level.(Within 2 yrs of application date )
2: A recent primary dental qualification that has been taught and examined in English..(Within 2 yrs of application date )
3: A recent pass in a language test for registration with a regulatory authority in a country where the first language is English.
If you are interested Please contact us for more details.
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...Indian 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.
I –Aligners are made with FDA approved transparent thermoplastic materials using 3D scanning, 3D Printing and finally Trays with Pressure vacuum formers.
Dear Doctor,
Indian Dental Academy Now offers comprehensive online Orthodontics course.
Course includes:
1.whiteboard lecture presentations
2.Case Discussions
3.with hundreds of pictures.
4.Demo on Models
5.Demo on Patients
6. subtitles in your own language
12 months unlimited access and support @350 USD only.
For Demo please visit :www.idalectures.com/preview/
For more details visit: www.idalectures.com
Please contact us for any clarifications:
idalectures@gmail.com
indiandentalacademy@gmail.com
Thanks & Regards
Indian Dental Academy
--
Indian Dental Academy
Leader in continuing dental education
www.indiandentalacademy.com
skype:indiandentalacademy
+919248678078
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
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
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...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
Diagnosis and treatment planning in completely endntulous arches/dental coursesIndian 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
Properties of Denture base materials /rotary endodontic coursesIndian 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
Use of modified tooth forms in complete denture occlusion / dental implant...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
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
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
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
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
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
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
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
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
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
2. Primary intraosseous carcinoma is a very rare but well
recognized entity.
First described by Loos in 1913 and named as intra- alveolar
epidermoid carcinoma by Wills in 1948.
Term primary intraosseous carcinoma (PIOC) was suggested
by Pindborg et al in 1972.
The term primary intraosseous odontogenic carcinoma
(PIOC) has been primarily used to describe a squamous cell
carcinoma within the jaws as de novo.
www.indiandentalacademy.com
3. According to WHO classification, PIOC is an odontogenic
carcinoma defined as “ a squamous cell carcinoma arising
within the jaw, having no initial connection with the oral
mucosa, and presumably developing from residues of the
odontogenic epithelium.”
www.indiandentalacademy.com
4. Waldron & Mustoe (1989), classification of odontogenic
carcinomas -
Type 1. Arising ex odontogenic cyst
Type 2. Arising ex ameloblastoma
A. well differentiated (malignant ameloblastoma)
B. poorly differeentiated (ameloblastic carcinoma)
Type 3. Primary Intraosseous carcinoma arising de nova (PIOC)
A. non-keratinizing
B. Keratinizing
Type 4. Intraosseous mucoepidermoid carcinoma
www.indiandentalacademy.com
5. CLINICAL FEATURES –
Occurs in adult patients in sixth to seventh decade of life.
Occurs only in the jaw bones & predominantly in the
posterior mandible.
Up to 2/3rd
of odontogenic carcinoma arise due to its
malignant transformation within Odontogenic cyst or
tumour while PIOC arising de novo is relatively rare.
Affects men more than women with ratio about 2.2 : 1
www.indiandentalacademy.com
6. The most common symptoms is pain and swelling.
Facial asymmetry.
Overlying mucosa or skin intact.
Sensory disturbance like paresthesia and numbness.
Cotical plate expansion.
Regional lymphadenopathy.
www.indiandentalacademy.com
9. 60 yr. old female visited the department of Oral Medicine &
Radiology, Guru Nanak Dev Dental College and
Research Institute, Sunam with the chief complaint of
pain & swelling over the right side of face since 8-9
months.
www.indiandentalacademy.com
10. History of presenting illness revealed that there was small swelling
over the right side of face 8-9 months back which gradually
increased in size from last 1 month to attain the present size.
H/o pain in the same region since 1 month which was dull, aching,
continuous and non- radiating in nature. Aggravated while
chewing and opening the mouth and relieved temporarily by
taking medication.
Difficulty in eating food.
Paresthesia of lower lip since 3-4 months.
www.indiandentalacademy.com
11. Excessive salivation
No history of trauma, sinus formation or pus discharge.
Patient denied the history of any recent development of
ulcer or other soft tissue lesion in the oral cavity.
No history of fever or decrease in weight in recent past
www.indiandentalacademy.com
12. Medical history revealed that -
Patient is known hypertensive since 10 years and not taking
medications regularly.
Never hospitalized in the past.
Not allergy to any drug was reported.
www.indiandentalacademy.com
13. Patient underwent extraction of 47 from local dentist 1 month back
because of mobility of tooth . After that pain and progressive
swelling of the extraction wound persisted.
www.indiandentalacademy.com
14. Family history was not contributary
Personal history –
Married
Vegetarian diet
No history of tobacco or betal nut chewing .
Oral hygiene bad , brushes once in 15 – 20 days.
Mild to moderate bleeding from gums .
www.indiandentalacademy.com
15. General examination –
Gait – no abnormality detected
Height – 5’3’’
Weight – 64 kg
Average built and moderately nourished.
Mild pallor, no cyanosis and clubbing of fingers
Except blood pressure (146/ 90mm of Hg) all vitals signs were in
normal limits.
www.indiandentalacademy.com
16. Extra oral examination revealed a single
oval swelling over the right, lower 1/3rd
of face leading to gross facial
asymmetry.
.ANT – POT. EXTENSION – starts
from angle of mouth and goes upto
posterior border of ramus of mandible.
SUPERIO- INFERIOR EXTENSION
– 1.5cm below the ala-tragus line and
inferiorly it goes beyond the lower
border of the mandible.
Skin over the swelling was stretched with
no change of color. www.indiandentalacademy.com
17. On palpation , swelling was tender , hard in consistency
without localized increased in temperature
Step deformity was appreciated on the right lower border
of body of mandible.
Two right submandibular lymph nodes both measuring not
more than 1.5 cms in size, hard in consistency, tender on
palpation, one lymph node was fixed to underlying tissues
and other was freely mobile in all directions.
www.indiandentalacademy.com
18. Intraoral examination –
Single oval swelling present over the
right alveolar ridge in the region of
45 46 47
Examination revealed an intact
Overlying normal -appearing mucosa
except for 47 region were
Extraction socket was present.
Medially swelling starts from floor of
mouth, Laterally it obliterates the
right vestibule w.r.t 45 46 47.
On palpation swelling was tender ,
hard in consistency with expansion
of buccal & lingual cortical plates.www.indiandentalacademy.com
19. Teeth missing – 17 24 32 41 42 43 44 45
46 47 48
Dental caries – 18 (tender on percussion) 26 36
Mobile – grade I (16 23 26 )
Grade II ( 37)
Generalized attrition of all the teeth.
Severe gingival recession.
Bleeding on probing present
Both hard and soft deposits present.
Vestibule obliterated w.r.t 46 47.www.indiandentalacademy.com
20. Based on history and clinical examination provisional diagnosis of
tumour of mandible was made and differential diagnosis of-
Residual cyst
Ameloblastoma
Osteosarcoma
Metastatic carcinoma
Chronic osteomylitis
Primary Intra-osseous carcinoma
Carcinoma arising in odontogenic cyst were considered.www.indiandentalacademy.com
25. Right lateral oblique view of mandible showing large ill-defined radiolucency
with infiltrative borders involving body of mandible.
Discontinue inferior cortex of body of mandible suggestive of pathological
fracture.
www.indiandentalacademy.com
26. Large non- homogenous radiolucency involving the right side of body of
mandible and ascending ramus with specks of radio-opacities.
Ill defined margins with infiltrative borders.
Discontinuity of inferior cortical margin of right side of jaw at angle region
suggestive of pathological fracture. Erosion of cortical margins of dental canal.
Generalized horizontal bone loss.
www.indiandentalacademy.com
29. Incisional biopsy of the lesion was performed and the
specimen was send for histopathology examination.
www.indiandentalacademy.com
30. The histopathological report of multiple grayish white soft tissue
mass was suggestive of WELL DIFFERENTIATED –
SQUAMOUS CELL CARCINOMA
Eosinophilic cytoplasm
Keratin pearls
N/C increased
www.indiandentalacademy.com
32. As confirmed of malignancy, patient was referred to oral and
Maxillofacial Surgery department for further management.
Commando surgery was performed with right side functional neck
dissection and hemimandibulectomy. The resected specimen was
send for histopathological examination
www.indiandentalacademy.com
33. Intact mucosa lining
Foreign body giant
cellsKeratin pearls
H/P report was suggestive of Well- differentiated Primary
intra-osseous carcinoma of mandible.
www.indiandentalacademy.com
34. Based upon the history, clinical features,
radiographic features and histopathological examination final
diagnosis of Well -differentiated keratinizing Primary
Intra-osseous carcinoma (de nova) of mandible was made.
www.indiandentalacademy.com
36. Till now 97 case of Primary intra osseous carcinoma (de nova) have
been reported.
Tumour is believed to arise from Odontogenic epithelial cell rests.
(Lucas et al )
The common factor may be reactive inflammatory stimulus with or
without a predisposing genetic cofactor, inducing neoplastic formation.
The clinical features were non specific while pain (54.8%) and
sometimes sensory disturbances (16.1%) presented in most of cases.
Diagnosis of PIOC is difficult, partly the initial symptoms are often
thought to be of dental origin. (Mc Gowan RH 1980).
www.indiandentalacademy.com
37. Radiographically there is great variation in the appearance of
borders ranging from well defined smoothly contoured to ill-
defined infiltrative that makes them indistinguishable from other
benign or malignant tumours. (Nolan R 1976)
Kaffe et al have proposed that an important feature of PIOC is
the presence of indistinct margins without sclerotic outline.
PIOC type 3 shows equal tendency toward keratinizing and non-
keratinizing types .
Prognosis of PIOC is quite poor, and emphasis should be given to
early diagnosis so that suitable treatment can be given at the
earliest opportunity. (2-year survival rate in 40% patients)
(To E H W et al 1991)
www.indiandentalacademy.com
38. CONCLUSION
Diagnosing this very rare and well recognized entity is
challenging task for oral physician because of its close
resemblance to many other benign & malignant lesions both
clinically and radiographically.
Proper diagnosis at an early stage is important for better
prognosis.
www.indiandentalacademy.com