報告日期:97/11/25
指導老師:林立民教授 陳玉昆主任
王文岑主治醫師 陳靜怡住院醫師
報告者:Intern-C組 湯仁牧 李家榮 施賢駿 王天佑
General data
Name : 柯 X X
Sex : 男
Age : 16 y/o
Native : 高雄市
Marital status : 未婚
Attending V.S. : 孫章唐醫師
First visit : 94.07.23
本次報告初診日期 : 97.11.04Chief complaint
A radiolucenct shadow over right lower third molar area areaPresent illness
This 16 y/o male suffered from a mild swelling with tenderness and discharge at tooth 38 areaPast history
Past medical history - Thalassemia
Past dental history - Extraction- Periodontal Tx
Personal habits
Risk factors relate to malignancy - Alcohol (-)- Betel quid (-) - Cigarette (-)
Extra oral examination
Facial asymmetry : unknown
Paresthesia or numbness : unknownOMF examination
Size : 1 X 2 cm
Surface : rough
Base : sessile
Shape : nodule
Consistency : unknown
Color :unknown
Pain : unknown
Tenderness : positive
Induration : unknown
Lymphadenopathy :
Image Finding
Well-defined unilocular, corticated, radiolucent over L’t mandible, extending from 37 distal to middle of
ascending ramus, from 38 edentulous ascending
ramus area down to mandibular canal, approximately
4.0x2.0cm in dimension. Cortical border of mandible is
thinning .
Image Finding
Missing:38 48
Filling:16
Uneruption:18 28Inflammation or Cyst or Neoplasm
•Fever or local heat (+/-)
•Pain (+/-)
•Pus discharge(+)
•Bony expansion(+)
Cyst or Neoplasm
Benign or Malignant
Tenderness (+)
Ulceration (-)
Numbness (-)
Well-defined radiolucency
Slow growing (+)Benign
Peripheral, Intra-bony origin
Induration(-)
Bony destruction (+)
Bony expansion (+)Intra-bony origin
Working Diagnosis
Odontogenic keratocyst
Unicystic amelablastoma
Ameloblastoma with cystic degenerationOdontogenic keratosiscyst
Odontogenic keratocyst This case
Age, sex 10~40 y/o, slight male 16 y/o male X-ray Well-defined mutilocularR-L Well-defined
unilocular R-L Jaw 60~80% in mandible,
uneruptedtooth
Mandible Pain Small: painless
Large: pain
Unknown (may be not)
Growth Slowly growing Slowly growth
Swelling Bony expansion and
thinning of cortical plates
Thinning of cortical plates
Effects on tooth
Less root resorption none
Amelablastoma(Unicystic type)
Amelablastoma This case
Age, sex 23 y/o male 16 y/o male X-ray Well-defined ,
unilocular R-L
Well-defined unilocular R-L
Jaw Molar-ramus area Mandible
Pain Painless, paresthesia of the lip
Unknown (may be not)
Growth Slowly growth Slowly growth
Swelling Bony expansion Thinning of cortical plates
Effects on tooth
Root resorption and tooth displacement
none