Name : 謝XX
Sex : 男
Age : 20 y/o
Native : 鳳山市
Marital status : 未婚
Occupation : 學生
Attending V.S. : 王文岑醫師,陳俊明醫師
First visit : 96.11.22
An exophytic mass over left upper
posterior area for 3~4 months.
This 20 y/o male found an exophytic
mass over tooth 26 area 3~4 months ago and he didn’t care about that.
Recently the lesion was found by a
doctor during 學校體檢 (屏東麟洛鄉) and
he is refered to our OPD with a 篩檢單 for
a mass over L’t upper molar region.
Exophytic mass over tooth 26 area
Fixed, Size: 2.5x2 cm
Dome- shaped
Smooth surface
Firm
Normal mucosa color
Tenderness: (-)
Pain: (-)
Induration: (-)
26 embedded, 27
displaced buccally by the mass, 28 partial
eruption
NP
There is a well-defined round-shaped soft tissue radiodensity image with residual root 26
embedded, extending from distal aspect of 25 to mesial aspect of 27, measuring approximately
1.7x1.7 cm in diameter. No obvious bony
destruction or bony border can be found.
Dental findings：
tooth abnormality: 28 partial eruption
caries: 11.12.14.15.21.22.23.31.32.33.34.38.41.42.43.44.45.47
missing tooth: 18.36
endodontic condition: Endo treated 11.12.14.15.21.22.37, Incomplete endo 46,
PAP 23.26.44.45.46
restoration (e.g. C & B): Bridge 12~22,
filling (e.g. amalgam): 16.25.34.44.45.47
residual root: 14.15.26.27.37.46
others: idiopathic osteosclerosis near 43.44 apex
Periapical film shows a well-defined
round-shaped
radiolucency around the apex of palatal root of tooth 26,
measuring
approximately
0.5x0.5 cm in
diameter.
Past medical history
- mitral valve prolapse
- Denied any drug or food allergy
Past dental history - endo and OD
- prosthesis fabrication
Current medicine: yes
Risk factors related to malignancy
› Alcohol：(-)
› Betel quid ：(-)
› Cigarette ：(+),三年多
No evident correlation to this disease.
X-ray finding:
- soft tissue radiodensity
-no bony destruction or border
Clinical finding:
- a exophytic firm mass over embedded 26 mucosa area.
- no fever, no spontaneous pain , no tenderness
- no redness
- no lymphadenopathy
N e o p l a s m
X-ray finding:
- no bony destruction
Clinical finding:
- mucosa intact, no induration - painless and no tenderness - slow-growing
B e n i g n
X-ray finding: no bony destruction
P e r i p h e r a l
1. Peripheral odontogenic fibroma 2. Peripheral ameloblastoma
3. Peripheral ossifying fibroma 4. Fibromatosis, peripheral
5. Fibroma
Peripheral Odontogenic fibroma
Our case Peripheral Odontogenic fibroma
Gender Male Not mentioned
Age 20 20~70
Site Tooth 26 area Facial gingiva of mandible
Size 2.5x2 cm 0.5~1.5 cm
Duration 3~4 month Not mentioned Risk factor
Alcohol smoking betel nut
- + -
Not mentioned
Our case Peripheral Odontogenic fibroma Color Normal mucosa Normal-appearing mucosa
Shape Dome Dome
Surface Smooth Smooth
Consistency Firm firm
Pain - -
Tenderness - Not mentioned
Mobility Fixed -
Induration - -
Ulcer - -
X-ray finding Our case Peripheral Odontogenic Fibroma
Radiodensity Soft tissue radiodensity Soft tissue radiodensity Border No obvious bony border
Shape Round
Effect on surrounding
structure
27 R.R displacement No bony expansion No bony destruction
Peripheral ameloblastoma
Our case Peripheral ameloblastoma
Gender Male Not mentioned
Age 20 Middle age, average 52
Site Tooth 26 area Posterior gingiva and alveolar mucosa
Size 2.5x2 cm <1.5 cm, larger also reported Duration 3~4 month Not mentioned
Risk factor Alcohol smoking betel nut
- + -
Not mentioned
Our case Peripheral ameloblastoma Color Normal mucosa Normal-appearing mucosa Shape Dome Sessile or pedunculated
Surface Smooth Smooth
Consistency Firm Not mentioned
Pain - -
Tenderness - Not mentioned
Mobility Fixed Fixed
Induration - -
Ulcer - -
X-ray finding Our case Peripheral ameloblastoma
Radiodensity Soft tissue radiodensity Soft tissue radiodensity
Border No obvious bony border No significant bony involvement
Shape Round
Effect on surrounding
structure
27 R.R displacement No bony expansion No bony destruction
Superficial bone slightly eroded in some cases
Peripheral Ossifying Fibroma
Our case Peripheral Ossifying Fibroma
Gender Male Female
Age 20 10-20
Site Tooth 26 area Maxillary incisor-cuspid region
Size 2.5x2 cm < 2cm
Duration 3~4 month Many weeks to months Risk factor
Alcohol smoking betel nut
- + -
- - -
Our case Peripheral Ossifying Fibroma Color Normal mucosa Normal mucosa
Shape Dome Dome
Surface Smooth Ulcerative
Consistency Firm Firm
Pain - -/+
Tenderness - -
Mobility Fixed Fixed
Induration - -
Ulcer - -
X-ray finding Our case Peripheral Ossifying Fibroma
Radiodensity Soft tissue radiodensity Radiolucent with varying radiopacity Border No obvious bony border Some sclerotic border
Shape Round Nodular
Effect on surrounding
structure
27 R.R displacement No bony expansion No bony destruction
Migration or loosening of adjacent teeth
Fibromatosis
Our case Fibromatosis Gender Male
Age 20 1~20(mean:14)
Site Tooth 26 area Paramadibular soft tissue region Size 2.5x2 cm Can grow to considerable size Duration 3~4 month
Risk factor Alcohol smoking betel nut
- + -
Our case Fibromatosis Color Normal mucosa Normal mucosa
Shape Dome Dome
Surface Smooth Smooth
Consistency Firm Firm
Pain - -
Tenderness -
Mobility Fixed
Induration -
Ulcer -
X-ray finding Our case Fibromatosis Radiodensity Soft tissue radiodensity Radiolucency
Border No obvious bony border Ill-defined
Shape Round Irregular shape
Effect on surrounding
structure
27 R.R displacement No bony expansion No bony destruction
Bony expansion Often break through
outer cortex (central type)
Fibroma
Our case Fibroma
Gender Male Female
Age 20 Fourth to sixth decades
Site Tooth 26 area Most often in the buccal mucosa along the bite line
Size 2.5x2 cm Varying from tiny lesions (mm) to large mass (cm) ; but most often
less 1.5 cm Duration 3~4 month
Risk factor Alcohol smoking betel nut
- + -
Seems to be no relative
Our case Fibroma
Color Normal mucosa Similar to the surronding mucosa
Shape Dome Nodule
Surface Smooth Smooth
Consistency Firm Firm
Pain - -
Tenderness - -
Mobility Fixed Fixed
Induration - -
Ulcer - If secondary trauma happen
X-ray finding Our case Fibroma
Radiodensity Soft tissue radiodensity Border No obvious bony border
Shape Round
Effect on surrounding
structure
27 R.R displacement No bony expansion No bony destruction
