Oral and Maxillofacial Surgery

Case of the Month


September 1997

Subjective:

The patient was referred to our practice by his family physician with a chief complaint of drainage in his mouth and facial swelling for three weeks. Antibiotics had improved the patients condition. In addition, paresthesia of the mental nerve distribution was reported on questioning.

Objective:

The patient is a 68 y.o. white male allergic to Reglan. Medications Procardia and Zestortic for hypertension. Prior operations included an inguinal hernia repair, lumbar disectomy, and excision of a small squamous cell carcinoma from the patient's back.

Laboratory data was within normal limits.
Oral examination revealed gingival erythema and gingival edema. A draining fistula was noted in the left mandibular retomolar area, that could be probed to a depth of 15 mm. There was no bruitt or thrill. The maxilla was edentulous. The patient had a complete maxillary denture. Dental calculus was present on the lingual surfaces of the mandibular incisors. Teeth #'s 21 and 28 were carious. Class III mobility was present for teeth # 21, 24, and 25.

Radiographic examination revealed mandibular horizontal alveolar bone loss and dental calculus. Teeth #'s 21 and 28 were carious. Tooth 17 was impacted with a distoangular inclination. A large radiolucent lesion was associated with the crown of # 17. The radiolucent lesion encroached upon the inferior alveolar nerovascular bundle.

Assessment:

  1. Dentigerous Cyst of Left Mandibular Vertical Ramus
  2. Impacted Tooth # 17
  3. Dental Caries
  4. Periodontitis
  5. Hypertension

Plan:

  1. Admission to OMHS Out-Patient Surgery Dept.
  2. Enucleation of Mandibular Cyst Under General Anesthesia
  3. Full Mouth Extraction with Alveoloplasties

Results:

Intraoperative digital photograph of mandibular ramus osseous defect following enucleation of dentigerous cyst.
Digital photograph of tooth # 17 and mandibular dentigerous cyst following enucleation.
Digital photomicrograph of histopathologic slide. Cystic lumen, epithelial lining, and connective tissue are noted.
Patient treated by:
  • Dr. Steven R. Tucker Oral and Maxillofacial Surgery 


 Steven R. Tucker DMD, PSC
 Oral and Maxillofacial Surgery
 909 Scherm Road
 Owensboro, KY 42301
 phone: 1-502-926-4107
 fax: 1-502-926-4166
 url: http://www.srt-psc.com

steven@occ-uky.campus.mci.net

Last Modified: August 31, 1997

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