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Case presentations A computerized education programme. Some benign and malignant lesions in dentistry by
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He first noticed this swelling about six months before the CT investigation we saw in the foregoing image. At that point of time, the following panoramic image was taken.
Immediately before the CT-investigation that we saw in the first picture, the following radiographs were also exposed
Click on the most probable differential diagnosis of this lesion according to your opinion
No, this answer is not the most probable. A cyst or a benign tumor has usually not a worm eaten or dissolved border like this lesion has. Go back and try once more!
Yes, congratulations...your answer is correct (and it was a difficult one)! The final PAD diff. diagnosis was a fibrosarcoma
No your answer is wrong. A fibro-osseous lesion usually fades more imperceptibly into normal bone tissue
Which one, of the characteristics downunder is also most correct for a malign tumor?
Yes, quite correct. Now, please proceed with the next slide and patient
No, a slow developing lesion is usually benign. You should have chosen the other alternative. Proceed to the next patient or return to check up the right alternative
The following patient is a middleaged woman, hale and hearty, but with some problem from her right maxillae as well. She pays a visit to her dentist, who finds a fistula in regio 13/14 and he also takes the following radiograph
A CT-investigation is also performed in this patient and downunder is one of the slices from the maxillae, apical of the toothroots.
The following view is disclosed during the following operation, when a flap is opened up
Which one of the following diagnosis do you propose as the most probable (the correct answer will usually -well almost always-be given after the PAD examination)
No, an ameloblastoma has usually not a well demarcated border, as this lesion seems to have. And ameloblastoma is seldom seen in the frontal maxillary region.
No, a lateral periodontal cyst seems not so probable, they are usually smaller and situated near the cortical marginal bone
No, a dentigerous or follicular cyst forms around the crown of an unerupted tooth
Yes, this must be the most probable diagnosis and it was PAD confirmed for this patient
The young lady in this radiograph is only about eleven to twelwe years and has a large swelling in her right ramus area. She has not directly any symptoms, except this swelling. There are no signs of sickness or growth disturbances in her history
As can be seen, the swelling is remarkable, it is surprising that the patient not has came to her dentist earlier
A CT-investigation is also performed, some of the slices are seen downunder
In order to establish the most probable differential diagnosis a MRI investigation is finally performed. Here is some of the frontal views
Now, nominate your proposal to the most probable diagnosis
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Yes, congratulations your answer now is the most probable according to the radiological appearance and the patient´s age and history. Procced until next case, please!
This is an elderly lady with a partial denture in the lower jaw. The patient first visited her dentist two weeks ago, due to problem from this denture, regio 34…36. Her dentist then adjusted the denture since it seemed to be overextended.
Today you can still view the sore in the same place, and we have now no natural explanation for it. In an intraoral radiograph the area looks like this
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