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A Case of Swelling: Presented by - Divya Mundada Navodaya Dental College

This patient presented with a 6-month history of a swelling in the upper front tooth region. On examination, a diffuse swelling was found extending from the distal aspect of tooth #11 to the distal aspect of tooth #21, measuring approximately 2x2cm. Radiographs and biopsy revealed the presence of a radicular cyst associated with an impacted supernumerary tooth (mesiodens) between the central incisors. The final diagnosis was a radicular cyst with an impacted mesiodens tooth.

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Mani chandan
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117 views23 pages

A Case of Swelling: Presented by - Divya Mundada Navodaya Dental College

This patient presented with a 6-month history of a swelling in the upper front tooth region. On examination, a diffuse swelling was found extending from the distal aspect of tooth #11 to the distal aspect of tooth #21, measuring approximately 2x2cm. Radiographs and biopsy revealed the presence of a radicular cyst associated with an impacted supernumerary tooth (mesiodens) between the central incisors. The final diagnosis was a radicular cyst with an impacted mesiodens tooth.

Uploaded by

Mani chandan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
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A CASE OF SWELLING

PRESENTED BY -
DIVYA MUNDADA
NAVODAYA DENTAL COLLEGE
Name: Mubena

Age : 35 yrs

Sex: Female

Place : Raichur

C/o – Pt. complains of pain in the upper front


tooth region of the jaw since 6 months
Chief complaint: patient complains of swelling in the upper
front tooth region sine 6 months.

• Patient gives history of minute swelling


started in the upper front tooth region
which was pea nut size which gradually
increased to present size.
History of present • No history of pain or any history blood
illness or pus discharge noted
• Patient gives history of sensitivity to
hot and cold foods
• Patient gives history of pain while taking
hard foods
PAST MEDICAL HISTORY: NRH

PAST DENTAL HISTORY: Patient visited a dentist 3 months


ago where she was given analgesics and antibiotics but there
was no regression in the swelling

HABITS: No deleterious habits patient brushes her teeth


with tooh paste and tooth brush
ON
EXAMINATION
GENERAL PHYSICAL EXAMINATION

 Gait-Normal

 Built-Normal

 Nourishment- Moderate

 Temperature- Afebrile

 Pulse – 72 bpm

 Pallor- Absent

 BP- 120/80 mm Hg.


EXTRAORAL EXAMINATION
EXTRA ORAL EXAMINATION

 No gross facial asymmetry noted


 Slightly raised phitrum area
 No secondary changes noted
 Mouth opening approx 35 mm
 No TMJ abnormality detected
Palpation
Bony hard swelling palpated at the phitrum area on the left side of face
Tenderness on palpation noted on same region
floor of nose had a bony prominence on palpation
INTRA ORAL EXAMINATION

Inspection
• Diffuse swelling extending fro distal aspect of 11 to distal
aspect of 21 measuring approx 2X2cm
• Skin over the mucosa is translucent
• Swelling appears dome shaped
• Vestibular obliteration noted from distal aspect of 11 to distal
aspect of 21
• Bilateral Class 1 molar occlusion noted
PALPATION

 Intra oral swelling is well defined sessile in nature


 Soft inconsistency
 Non fluctuant
 Grade 1 mobility noted irt 11
 Deviation of both the central incisors noted
 Hard tissue prominence felt on palpation of labial vestibule of 11
PROVISIONAL DIAGNOSIS

 Benign odontogenic cyst IRT 11


INVESTIGATIONS

 Blood investigations
 IOPA irt 11 and 21
 OPG
 FNAC
 CT scan
 Pupl vitality test irt 11,12,13,21,22,23
 BIOPSY
INVESTIGATIONS
COMPLETE BLOOD COUNT

• Hb- 12.1 gm%


• WBC count- 6700
cells/cumm
• HBsAg- negative
• Neutrophils- 69%
• HIV- Non-reactive
• Lymphocytes- 26%
• Eosinophils-02%
• Monocytes- 03%
• Basophils- 00%
BIOCHEMISTRY REPORT :

 RBS : 134 mg/dl


 T3 : 1.33 nmol/L
 T4:92.28nmol/L
 TSH : 2.36
PULP VITALITY TEST

 DELAY RESPONSE WITH 23 ,22,21,22


 EARLY RESPONSE IRT 11,13
FINE NEEDLE ASPIRATION CYTOLOGY
Cytology report
 Volume -1.5ml
 Color –green Watery
 Appearance –turbid
 Protein 9.0gm/ml
 Leishmman stained smear –mainly RBC
along with numerous pigment laiden cyst
macrophages with few lymphocytes and
neutrophils
RADIOLOGICAL INVESTIGATIONS
OPG
FINAL DIAGNOSIS

 Radicular cyst with impacted supernumerary tooth (mesiodens)


THANK YOU

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