• Title/Summary/Keyword: Oral diagnosis

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Clival lesion incidentally discovered on cone-beam computed tomography: A case report and review of the literature

  • Jadhav, Aniket B.;Tadinada, Aditya;Rengasamy, Kandasamy;Fellows, Douglas;Lurie, Alan G.
    • Imaging Science in Dentistry
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    • v.44 no.2
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    • pp.165-169
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    • 2014
  • An osteolytic lesion with a small central area of mineralization and sclerotic borders was discovered incidentally in the clivus on the cone-beam computed tomography (CBCT) of a 27-year-old male patient. This benign appearance indicated a primary differential diagnosis of non-aggressive lesions such as fibro-osseous lesions and arrested pneumatization. Further, on magnetic resonance imaging (MRI), the lesion showed a homogenously low T1 signal intensity with mild internal enhancement after post-gadolinium and a heterogeneous T2 signal intensity. These signal characteristics might be attributed to the fibrous tissues, chondroid matrix, calcific material, or cystic component of the lesion; thus, chondroblastoma and chondromyxoid fibroma were added to the differential diagnosis. Although this report was limited by the lack of final diagnosis and the patient lost to follow-up, the incidental skull base finding would be important for interpreting the entire volume of CBCT by a qualified oral and maxillofacial radiologist.

EARLY DIAGNOSIS OF OSTEOMYELITIS OCCURRED IN THE JAWS (악골 골수염의 조기 진단)

  • Choi Eun-Suk;Na Seung-Mog;Lee Un-Gyeong;Koh Kwang-Joon
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.24 no.2
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    • pp.479-487
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    • 1994
  • Early diagnosis and treatment of osteomyelitis provide good prognosis and prevent severe complications. Therefore, it is important to early diagnose and treat before the bony changes are observed in conventional radiograms. Authors experienced three cases of early osteomyelitis, and scintigrams were useful to differentiate them from other diseases. The purpose of this report was to aid in the early diagnosis and treatment of osteomyelitis occurred in the jaws. The characteristic features were as follows: 1. In clinical examination, the patients complained mild pain and localized swelling in the jaws. 2. In radiographic findings, the conventional radiograms showed relatively mild bony changes in the jaws. 3. The more severe periosteal reactions were observed in radiograms in children than in adult patient. 4. It showed marked increased uptake of radioisotopes in all scintigrams. 5. The three phase bone scannings were helpful to differentiate osteomyelitis from soft tissue diseases.

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PRIMARY INTRAOSSEOUS CARCINOMA ON MANDIBLE : A CASE REPORT (하악골에 발생한 원발성 골내암종의 치험례)

  • Kim, Hak-Ryeol;Ryu, Dong-Mok;Oh, Jung-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.3
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    • pp.263-267
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    • 2007
  • Primary intraosseous carcinoma (PIOC) is a rare odontogenic carcinoma defined as a squamous cell carcinoma arising within a jaw having no initial connection with the oral mucosa, and probably developing from residues of the odontogenic epithelium. PIOC appears more common in male than female, especially at posterior portion of the mandible. Radiographic features of PIOC show irregular patterns of bone destruction with ill defined margins. It could be sometimes misdiagnosed as the cyst or benign tumor because it shows well defined margins. If it couldn't be done appropriate treatment initially, PIOC shows extremely aggressive involvement, extensive local destruction and spreads to the overlying soft tissue. Therefore accurate diagnosis in early state is necessary. The diagnosis criteria proposed for PIOC are : (1) absence of ulcer formation, except when caused by other factors, (2) histologic evidence of squamous cell carcinoma without a cystic component or other odontogenic tumor cell, and (3) absence of another primary tumor on chest radiograph obtained at the time of diagnosis and during a follow-up period of more than 6 month(Suei et al., 1994).

Mouth opening limitation caused by coronoid hyperplasia: a report of four cases

  • Kim, Sung-Min;Lee, Jin-Hyeok;Kim, Hak-Jin;Huh, Jong-Ki
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.6
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    • pp.301-307
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    • 2014
  • Coronoid process hyperplasia is a rare condition that causes mouth opening limitation, otherwise known as trismus. The elongated coronoid processes impinge on the medial surfaces of the zygomatic arches when opening the mouth, which limits movement of the mandible and leads to trismus. Patients with trismus due to coronoid process hyperplasia do not have any definite symptoms such as temporomandibular joint pain or sounds upon clinical examination, and no significant abnormal signs are observed on panoramic radiographs or magnetic resonance images of the temporomandibular joint. Thus, the diagnosis of trismus is usually very difficult. However, computed tomography can help with the diagnosis, and the condition can be treated by surgery and postoperative physical therapy. This paper describes four cases of patients who visited our clinic for trismus and were subsequently diagnosed with coronoid process hyperplasia. Three were successfully treated with a coronoidectomy and postoperative physical therapy.

Diagnosis and Treatment of Temporomandibular Disorder in Pregnant Women (임신부에서 측두하악장애의 진단과 치료)

  • Cha, Ji-Hyun;Park, June-Sang;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.25 no.2
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    • pp.241-245
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    • 2000
  • In this case report, I discussed the diagnosis and treatment of two pregnant women with temporomandibular disorders(TMD) who visited the Department of Oral Medicine, PNUH. Also, I reviewed some investigations of diagnosis and treatment of TMD in pregnant women. The obtained results were as follows; 1. No single X-ray diagnostic procedure for TMD results in radiation dose that threatens the well-being of the developing embryo and fetus. 2. Most non-steroidal anti-inflammatory drugs(NSAIDs) have commonly used because these drugs are considered to be nonteratogenic, but these agents are not recommended for routine use after 3rd trimester. 3. Electro-acupuncture stimulation therapy(EAST) is contraindicated for 1st trimester, and ultrasonic deep heat therapy, microwave deep heat therapy, low level laser therapy, myo-monitor are not contraindicated for pregnant women but clinician must consider some risk of adverse fetal effects. 4. The occlusal stabilization splint may be used for pregnant women, if it is fabricated indirectly. 5. Surgical treatment is contraindicated for pregnant women.

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Atypical Trigeminal Neuralgia : Case Report (비정형 삼차신경통의 치험례)

  • Lee, Dong-Sik;Hong, Jung-Pyo
    • Journal of Oral Medicine and Pain
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    • v.25 no.2
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    • pp.229-234
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    • 2000
  • The patient, 62-years-old woman, had a constant dull pain in the right mandible and an intermittent spontaneous burning sensation of the mouth. The pain began 6 months ago. About 5 years ago, a trauma in her right mandible which was so severe that kept her in the hospital for 2 days. This was followed by mouth opening disturbance with pain for about 2 years. However, she did not have a treatment for the temporomandibular disorder symptoms. After then, she experienced the trigeminal neuralgia characterized by an electrical pain which lasted about 30 minutes in her right face and head when touching the skin or hair. After taking a year course treatment of trigeminal neuralgia, the symptom disappeared. The pain was a constant dull pain and a intermittent burning pain which are contradictory. And the pain responded to various modalities such as physical therapy, anti-inflammatory drug, carbamazepine, and amitriptyline, among which carbamazepine was most effective. The diagnosis was clinically made as an atypical trigeminal neuralgia. The term 'atypical' is used when there is something unknown and the problem is not identified. It is thought that an atypical pain may be approached in the perspective of chronic pain, neuropathic pain, and myofascial pain, the mchanisms of which are poorly understood. As the knowledge of pain physiology improves, there needs to be modification and re-evaluation. Pain disorders must be classified on the basis of an understanding of the underlying mechanism and etiology.

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Intraoral HIV-associated Burkitt's lymphoma: a rare case report with special emphasis on differential diagnosis

  • Kamat, Mamata;Datar, Uma;Kanitkar, Sampada;Byakodi, Sanjay
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.4
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    • pp.225-229
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    • 2019
  • Individuals with human immunodeficiency virus (HIV) infection present with unique intraoral manifestations of various neoplasms. Intraoral HIV-associated Burkitt's lymphoma is a rare presentation, especially in patients of Indian origin and may present as an initial sign of HIV. The objective of this paper is to report a rare case of Burkitt's lymphoma in an HIV-positive Indian patient along with a special emphasis on differential diagnosis. A 30-year-old Indian female presented with a solitary, well-defined, exophytic mass extending anteroposteriorly and buccolingually from the 35th to 38th regions with no evidence of intraosseous extension. An incisional biopsy was performed, and histopathology showed sheets of neoplastic lymphoid cells with numerous tingible body macrophages with clear cytoplasm, presenting a starry sky appearance, suggesting a diagnosis of BL. The tumor cells were positive for CD10, CD20, c-myc, and Epstein-Barr virus, with a nearly 100% Ki-67 proliferative index. The patient tested positive for HIV. This report indicates the importance of immunohistochemical analysis to differentiate Burkitt's lymphoma from other similar lesions like diffuse large B-cell lymphoma. Thorough knowledge of the clinical presentation, etiopathogenesis, histopathology, and immunoprofile of intraoral HIV-associated Burkitt's lymphoma is essential among clinicians and pathologists.

CLINICAL STUDY ON SUBMANDIBULAR MASSES (악하부종괴에 대한 임상적 연구)

  • Jang, Hyun-Seok;You, Jun-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.701-705
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    • 1996
  • There are many kind of diagnostic entities in submandibular or neck masses, and we can set up treatment plan and estimate treatment result, prognosis by accurate diagnosis. By reasoning medical and dental history, physical examination, anatomical consideration of masses in submandibular or neck area, location of masses, laboratory and radiographic studies, we can formulate a clinical diagnosis or differential diagnosis. Although a clinical diagnosis might suffice in some instances, a definitive(microscopic) diagnosis is frequently required for proper treatment. In order to get some information about making accurate diagnosis and setting up appropriate treatment plan, we did clinical study and histopathologic classification of 82 patients who visited and were operated for submandibular masses at Department of Oral and Maxillofacial Surgery in Seoul National University Hospital from 1988 to 1992. The result were as follows : 1. Submandibular masses occured most frequently in forties and fifties, and there was no sex predilection. 2. Chief complaints were in order of mass, swelling, pain and consistency were soft mass, mobile hard mass, firm mass, diffuse swelling in descending order. 3. Most frequent pathologic finding was lymphadenitis. 4. Site of submandibular masses were submandible, neck, submental, retromandible in descending order, and there was no predilection between left and right side. 5. Accuracy rate between clinical impression and result was 51.2%.

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