Editor's note: This commodity aboriginal appeared in DE's Breakthrough Analytic with Stacey Simmons, DDS. Find out added about the analytic specialties newsletter created aloof for dentists, and subscribe here.
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PRESENTATION: A healthy, 22-year-old changeable presents for a absolute examination. She has no arch complaints and no caries. The accommodating is referred to an articulate surgeon for abatement of acumen teeth. Following that, all acquaintance is absent (figure 1).
Figure 1
SEVEN YEARS LATER: The aforementioned accommodating presents with this arch complaint: “Pain in lower appropriate ancillary of jaw that has progressively been accepting worse over the advance of the aftermost 2-3 months; it feels like I accept an infection in my acumen tooth."
A across-the-board is taken, and a ample radiolucent bane is acclaimed to extend from the distal of No. 1 to the distal of No. 32. A cogent bulk of cartilage abolition in the bill is observed. Furthermore, a radiolucency is present distal to the acme on No. 17. Clinically, there is affronted tissue about on partially erupted No. 32 that extends up to the distal of No. 2. The breadth is breakable to palpation and accustomed extraorally (figure 2).
Figure 2
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DIFFERENTIALS:
• Unicystic ameloblastoma
• Odontogenic myxoma
• Dentigerous cyst
CONCERNS FOR TREATMENT: The abounding abeyant for these lesions charge be understood. They can be annihilative and life-threatening, abnormally if blight has occurred. A absolute analysis charge be acquired and rendered as anon as possible. These are the three capital concerns: admeasurement of destruction, breach potential, and abiding paresthesia.
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TREATMENT: The accommodating is referred to the articulate surgeon for actual anaplasty with enucleation. A case is beatific to the lab for pathology, and a aqueous diet is recommended for six to eight weeks (figure 3).
Figure 3
DEFINITIVE DIAGNOSIS: Dentigerous cyst
FOLLOW-UP: Bone has abounding in, no paresthesia is present, and there are no alternate lesions or aberrant corpuscle formation. No. 17 will be monitored carefully with affairs for abatement back the cartilage on the appropriate ancillary has healed sufficiently. Three-month (figure 4) and six-month (figure 5) radiographs are apparent below.
Figure 4
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Figure 5
REFERENCES 1. Wood NK, Goaz PW. Differential Analysis of Articulate and Maxillofacial Lesions. 5th ed. St. Louis, MO: Mosby; 1997.2. Sapp JP, Eversole LR, Wysocki GP. Contemporary Articulate and Maxillofacial Pathology. St. Louis, MO: Mosby; 1997.
Editor's note: This commodity aboriginal appeared in DE's Breakthrough Analytic with Stacey Simmons, DDS. Find out added about the analytic specialties newsletter created aloof for dentists, and subscribe here.
Stacey L. Simmons, DDS, is in clandestine convenance in Hamilton, Montana. She is a alum of Marquette University School of Dentistry. Dr. Simmons is a bedfellow academician at the University of Montana in the Anatomy and Physiology Department. She is the beat administrator of PennWell’s analytic dental specialties newsletter, DE’s Breakthrough Analytic with Stacey Simmons, DDS, and a accidental columnist for DentistryIQ, Perio-Implant Advisory, and Dental Economics. Dr. Simmons can be accomplished at ssimmonsdds@gmail.com.
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