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Case Study

Case Study
Case#158Case#159
Case#158
A 15-year-old male was referred to an oral surgery clinic for the diagnosis and treatment of a radiopaque lesion of left mandible. The lesion was asymptomatic and was closely associated with a retained primary molar and developing permanent bicuspid.(as shown in figure)
Final Diagnosis: Compound Odontoma
Odontomas are hamartomatous lesions, not true neoplasms. They are often found in children and young adults and usually discovered when a tooth fails to erupt or in a routine radiographic evaluation.

Odontomas are the most common odontogenic tumors and are composed of enamel, dentin, pulp and cementum. Some of them are composed of small malformed tooth-like structures and called compound odontoma. They are usually found in anterior parts of the jaws and are either over the crowns of unerupted teeth or between the roots of erupted ones.

Radiographically, the compound odontomas are presented as a unilocular radiolucency containing several small radiopaque structures resembling teeth. Some odontomas do not have any recognizable tooth shape structure and are called complex odontomas. They are mostly found in posterior regions of the jaws. Complex odontomas appear as a solid amorphous radiopaque mass surrounded by a thin radiolucent zone. Both forms of odontomas are encapsulated and have a limited growth potential. They should be enucleated and recurrence is not usually a problem. However, complex odontomas are occasionally associated with another odontogenic tumor called ameloblastic fibroma. This combined lesion has potential for local destruction.

Case#159
A 68-year-old female was referred to an oral surgery clinic for the diagnosis and treatment of a slightly raised and erythro-leukoplakic lesion of right posterior buccal mucosa (as shown in figure). The lesion was asymptomatic and its duration was not known.
Final Diagnosis: Invasive squamous cell carcinoma
Squamous-cell carcinoma is the most common, primary malignancies of the mouth (90 percent of all oral cancers). Tobacco habits and drinking alcoholic beverages are implicated as the main causative factors in development of the oral squamous cell carcinoma.

Actinic radiation, immunosuppression and chronic irritation may also contribute in formation of this type of cancer in the oral cavity. Lower-lip and lateral-tongue and floor of the mouth are the most common locations for the development of oral squamous cell carcinoma.

Clinically, the lesions may be presented as a leukoplakic, erythroplakic, ulcerated and fungating and expanding lesions. Any mucosal lesion in the mouth that does not disappear after initial treatment must be biopsied in order to rule out malignancy. Treatment of the oral squamous cell carcinoma may include surgery, radiation therapy and chemotherapy, depends on the size, location and the stage of the tumor.