Dentaltown April 2013 - (Page 26)

oral pathology message board “Funny Feeling” on Lower Right Jaw » Dentaltown Message Boards > Oral Pathology, Pharmacology, and Cariology > Oral Pathology > “Funny Feeling” on Lower Right Jaw JustBe Member Since: 10/06/06 Post: 1 of 40 t Visit other message boards to keep tabs on the panograph debate. Panographs… Search: Panographs Anybody Ever Stop Using and Get Rid of Their Panographs? Search: Stop Panographs t A Townie discovers a suspicious radiolucency and sparks a debate: Are panographs necessary for all patients? I thought I’d share this case. I had an emergency patient in her 50s presented to the office in November of 2006 for a broken tooth #30. We took a PA of the tooth. Patient described a “funny feeling on the lower right jaw,” radiating along the lower right mandible to the lip area, and it seemed to have come from the #31 area, where a tooth had been extracted a few months prior. She described the present feeling as “not a toothache” kind of pain. #30 had a large broken amalgam, percussion was sensitive, but nowhere was it close to the pulp. When I reviewed the PA of #30 carefully, I noticed a suspicious-looking radiolucency beyond the apices. According to the patient, #31 was extracted because she was told it wasn’t restorable at that time. I decided to take the panograph. To my surprise, I found that lesion. To address the patient’s chief complaint, I decided to do the large composite buildup and evaluated for the need for RCT. At the same time, I immediately sent the patient to an oral surgeon for consultation/biopsy. The lesion was removed and biopsied in late November. After the surgery, she didn’t have any sensation in the right area for about six months. The diagnosis from the pathologist: chronically inflamed dentigerous cyst associated with impacted #32. (The differential was OKC.) As of 8/11/07, all her symptoms have disappeared and #30 has been crowned. Had I not taken the panograph or elicited better responses from the patient with further questions (besides an obvious broken tooth), I would have missed this lesion. I haven’t found too many true oral pathologies, so this was a wake up call. n Phil AUG 12 2007 Bradi Member Since: 06/10/07 Post: 2 of 40 Well done, Phil! I can see where without the panograph a PA might have made it look like the tooth had a radiolucency, and with the tenderness to percussion, might have been pointing in the direction of an RCT – very nice save. By the way, is the tooth still vital? (Just asking because I do not remember how these lesions affect the teeth they surround). n AUG 12 2007 mamedboza Member Since: 03/16/03   Post: 3 of 40   Well done! I take a panograph on every single patient that comes in. During my GPR (general practice residency), I saw plenty of patients who could have been spared losing their continued on page 28 26 APRIL 2013 »

Table of Contents for the Digital Edition of Dentaltown April 2013 Highlights
Howard Speaks: What Winners Do and Losers Don’t
Professional Courtesy: Three Cheers for IT
Continuing Education Update
Dentaltown Research: Lasers
“Funny Feeling” on Lower Right Jaw
Missing Laterals, Bonded Maryland Bridges, Ribbond or Something Else?
Corporate Profile: Henry Schein
New Products
Office Visit: A Giant in Dentistry
Do-it-Yourself Finance, Part V: Insurance
Two Techniques to Make a Bite Record for a Full-arch Case
Team Strength: What Drives Your Team to Do More?
Living by the Golden Dozen
Diagnosing Aesthetic Disharmonies
Cosmetic Case Presentation
Using Tetric EvoCeram Bulk Fill to Easily and Predictably Place Direct Posterior Restorations
Continuing Education: Utilizing Laser Procedures for Restorative Access
Product Profile: Imaging Sciences International’s i-CAT FLX
In This Issue: Preparing for the Future
Perio Reports
Ad Index
Profile in Oral Health: The RDH’s Approach to Periodontal Therapy: Past, Present and Future
Perio Maintenance
Dentally Incorrect
Dentaltown Special Supplement
Product Profile: Zimmer Dental
Full Lower – Converted to Immediate Load
Immediate Placement #19 and 20 with BSB
American Academy of Implant Dentistry 62nd Annual Meeting Preview
Raising Your Denture Patient to a Higher Standard
Back to the Future – Extractions and Small Diameter Implants for Overdentures
Continuing Education: Top Implantology Breakthroughs for the GP: Part 2

Dentaltown April 2013