Dentaltown September 2019 - 75
Question
One
Here's an image of the left buccal mucosa. A 65-year-old
patient who presented to the dental clinic for a hygiene
visit states he has a "sore" in his mouth that has been there
for a month. He also broke a tooth around the same time.
The lesion has not changed in size over the past month and
causes a mild level of pain.
Answer: Traumatic ulceration.
Question
Traumatic ulcerations will show an area of erythema
surrounding a yellow fibrinopurulent membrane. Sometimes
there can be a rolled white border of hyperkeratosis adjacent
to the ulcerated area. Notice the proximity of the ulceration to
tooth #18, which is fractured. The clinical appearance of this lesion points to a clear traumatic etiology.
While these lesions generally heal in two weeks, they will not heal appropriately if the source of trauma is
not removed. In this patient's case, he needed to have #18 treated for the site to heal.
Two
A healthy 22-year-old patient presents with a
growth on her lip. She reports a history of biting on it,
which causes pain. Clinical exam shows a soft, ulcerated, well-defined growth on the lower left labial side
of the lip. When the patient closes, the lesion approximates the occlusal line.
Answer: Traumatic fibroma.
A fibroma is a reactive hyperplasia of fibrous connective tissue. This occurs because of a local
irritant or trauma. They are commonly located on mucosa that approximates the occlusal line
(such as the buccal mucosa, lower lip) but can occur anywhere in the mouth. Clinically, the lesion
usually appears as a sessile nodule with a smooth, pink surface. The overlying mucosa is typically
similar to the surrounding mucosa, but sometimes can appear pigmented, keratotic or ulcerated. It
is generally soft-feeling on palpation. Conservative surgical excision is treatment of modality for a
symptomatic lesion.
dentaltown.com \\ SEPTEMBER 2019
75
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Dentaltown September 2019
Table of Contents for the Digital Edition of Dentaltown September 2019
Dentaltown September 2019 - Intro
Dentaltown September 2019 - Cover1
Dentaltown September 2019 - Cover2
Dentaltown September 2019 - 1
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Dentaltown September 2019 - Cover3
Dentaltown September 2019 - Cover4
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