CASE REPORT on fiborous dysplasia in maxillary regionpptx

A Case report on Fiborus dysplasia explaining about the clinical and radiological features.
Early evaluation, diagnosis and thorough clinical knowledge helps in better diagnosis of the case which is an important step for proper treatment.
in this case an incisional biopsy was done under LA and was sent for histopathological examination.

1. CASE REPORT FIBROUS DYSPLASIA IN MAXILLARY REGION DR. SHWETA NEHE PGY2 DEPARTMENT OF OMFS

2. PERSONAL HISTORY NAME- Prem Kumar AGE/SEX- 44/male ADDRESS- Ramsal OCCUPATION- Farmer MARITAL STATUS- Married RILIGION- Hindu

3. CHIEF COMPLAINTS Patient complains of pain and swelling in upper right back teeth region of jaw since 1 month.

4. HISTORY OF PRESENT ILLNESS Patient was apparently alright 1 month back when he started experiencing pain in upper right back teeth region. The pain was dull aching in nature, intermittent in duration, relieved after taking medications. For the same reason he visited to a local dentist and was prescribed medications. ( The details of medication are not present with the patient)

5. CONT.. Then the patient started experiencing swelling in the same region after a month. Initially the swelling was a size of an peanut, at present the swelling is of a size of lemon. For the same reason he visited to the dentist and IV antibiotics and analgesics were administered to the patient.

6. No history of trauma to the affected region, trismus, pus drainage, or loosening of the teeth. No history of any dental treatment No relevant medical history. ( No history of diabetes, hypertension, blood dyscarias,etc )

7. FAMILY HISTORY None of the family member suffered from the same illness.

8. PERSONAL HISTORY No deleterious habit present.

9. DRUG HISTORY History of IV antibiotics and analgesics 1 month back.

10. GENERAL PHYSICAL EXAMINATION Patient is consious , co operative and well oriented with time, place and person with vitals within normal physiological units. Moderately built (Mesomorphic) and nourished Pallor – absent Icterus – absent Cyanosis – absent Clubbing - absent

11. Cont …. Edema – absent Lymphadenopathy- non palpable lymph nodes.

12. SYSTEMIC EXAMINATION RS- NAD CVS- NAD P/A- NAD CNS- NO FOCAL NEUROLOGICAL DEFICIT.

13. LOCAL EXAMINATION ( EXTRAORAL) INSPECTION Facial symmetry present. Erythema present on the lateral corner of left eye. No presence of swelling, erythema or edema present. No abnormalities with vision present. Cafe’-au-lait spots were absent.

14. PALPATION Lymph nodes- non palpable and non tender TMJ- Bilateral synchronous movements with no clicking or deviation.

15. INTRAORAL EXAMINATION INSPECTION ( Soft tissue examination) A well defined swelling, present on the posterior surface of the maxillary region starting from 13 tooth region and extending till 18 occupying the maxillary tuberosity anteroposteriorly . Superiorly till the buccal vestibule and inferiorly extending towards the midline of the palate with the presence of dentoalveolar segment in between. Swelling is oval in shape and of size approximately 10cm x 5cm approx buccally and palatally and is divided by teeth in middle.

16. Skin over the swelling is erythematous in colour in the region 16 (localized erythema) with the presence of draining sinus wrt 16 tooth region. Colour of mucosa- pale pink in colour with localized erythema present on the palatal gingiva wrt 16 tooth region. Gingiva- absence of stippling wrt 13 to 18 tooth region Palate- Hard palate- rugae present.

17. Tongue – Pale pink in colour .

18. HARD TISSUE EXAMINATION Teeth present- 18 17 16 15 14 13 12 23 24 25 26 27 28 48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38 Missing teeth- 11 21 22 Dental caries – 18 16 23 46

19. Cont.. Occlusion – Angle’s Class 1. Periodontal status- Poor

20. INTRAORAL EXAMINATION PALPATION All Inspectory findings are confirmed on palpation. Size 12cm x 5cm Swelling is single, bony hard in consistency, non tender, non compressible, fixity to the underlying bony and mucosal tissue. Surrounding temperature not raised. No teeth mobility present.

21. percussion Pain on percussion- negative wrt 16 tooth region.

22. INVESTIGATION CECT MAXILLA- Showed a radiodense mass with ground glass appearance invoving the expansion of the maxillary ridge on right side. OPG INCISIONAL BIOPSY- incisional biopsy was done and was sent for histopathological examination. Reports are awaited. Blood investigations.

23. CECT MAXILLA ( AXIAL VIEW) Radiodense mass with ground glass appearance involving the expansion of the maxillary ridge on right side. OPG

24. INCISIONAL BIOPSY Macroscopically 5 pieces of bony tissues grayish white in colour measuring 3cm x 1cm 2.5cm x 1.5 cm 3cm x 1cm 4cm x 1.5cm 1.5cm x 1 cm

25. FIG- incisional biopsy done under LA.

26. PROVISIONAL DIAGNOSIS FIBOROUS DYSPLASIA OF MAXILLA

27. DIFFERENTIAL DIAGOSIS ODONTOGENIC ABSCESS SALIVARY GLAND TUMOUR CEMENTO OSSIFYING FIBROMA MALIGNANCY OF MAXILLARY SINUS LYMPHOMA