Tuesday, April 27, 2010

4 Mandibular Anomalies

Indeed I see more different things in a month in Africa than perhaps a career as a GD back home. Take a look.

First Patient) 5 years previous 9 YOBM was in RTA. Experienced broken mandible at angle (L side) and was treated with ORIF. Never returned year later to have ORIF removed. Came to our clinic today (at age 14) complaining of... and with visible localized swelling in parasymphaseal (L side). Palpation is firm, no pain. Closer look on x-ray shows tooth # 20 failed to erupt caught at inferior border of mandible superimposed by ORIF.

Second Patient) 70 YOF. No Pain. Edentulous. Motor Vehicle accident 1 month previous.

The fracture (L side) is one month old. Malunion has occurred. No mobility of the mandibular fragments, swelling, or puss. Patient has surprisingly normal ROM.

Fracture and badly displaced segments. Patient declines surgery and wants new denture fabricated.

Third Patient) 63 YOBF 1 year after full mouth edentulation. Chronic intraoral draining fistula and necrotic mandible exposed on R side. All indications point to osteomyelitis of the mandible.

Fourth Patient) Determining if patient can touch his shoulders together (He can not). No sign of Bifid ribs or Basal Cell Nevus Syndrome. Notice very little extra-oral swelling.

Two years previous 17 and 32 were extracted and biopsy was taken. The biopsy was positive for Odontogenic Keratocyst (OKC). You can see how this cyst has extended from body of mandible up into ramus and well within coronoid and condyle. Little if any intra-oral swelling is seen.

1 comment:

Anonymous said...

I am sorry ptn number 1 was not originally treated with a few weeks of intradental wires. It would have worked. Dad