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Medicine case present
Transcript of Medicine case present
Lives in ElA'mreya
Telephone number 01097157402 Annoying mass with pain
and bleeding upon eating
or any irritation. EXTRAORAL The lesion Differential diagnosis Investigations needed Final diagnosis The patient suffering no systemic diseases, having no medication and not pregnant. None
Lethal X-ray machine at dentists: Health experts race to track down killer scanners No para functional habits and non smoker.
Brushes once daily. Description Surgical excision Follow up Treatment Plan INTRAORAL PALATE LABIAL
MUCOSA TONGUE FLOOR OF MOUTH Excisional biobsy Case Presentation Oral Medicine, Periodontology and Radiology Dept. TEETH History of chief complain A small lingual mass discovered a month ago approximately with history of pain and bleeding on irritation. Extraction of badly decayed lower left first molar on March 17th this year and had an OPG done on the same day. Examination Lips, skin, eye, nose and TMJ were all examined and found to be normal Lymph nodes were normal Vital signs were taken and all noted within the normal values Decay related to 47, 48, 37
and 38 Extracted 36 1-Pyogenic Granuloma.
2-Peripheral Giant Cell Granuloma.
4-Peripheral Ossifying Fibroma. Radiographs
Biobsy (Excisional) Pyogenic Granuloma Non specific conditioned gingival enlargement.
Most site is Gingiva, appearing according to it's stage.
Smooth, lobulated or ulcerated if traumatized.
Mainly pedunculated with High rate of recurrence.
Histologically represented by newly formed blood essels, newly formed fibroblasts and acute/chronic inflammatory cells. Phase I theraby Before After 1 2 3 4 5 The patient was given Catafast 50 mg granules for oral solution to use only if needed when pain is untolerated.
Also she was given Augmentin 625 mg as an antibiotic.
Multivitamins and iron supplements were prescribed. One Week One Month pyogenic
HISTORY GINGIVA Normal Normal BUCCAL
MUCOSA Labial gingiva
Normal Lingual gingiva Labial gingiva Palatal gingiva An exophytic mass
at lower right premolar
STUDIES Long-pulse 1,064-nm Nd:YAG laser
Effective, low-risk, minimally invasive method of treating PyG.
Therapeutic option that achieves good cosmetic results. When used with the right strategy Pyogenic granuloma, an impaired wound healing process, linked to vascular growth driven by FLT4 and the nitric oxide pathway Normal Normal Normal Normal A Single Exophytic Pedunculated mass about 3 cm length, 5 mm width and 3 mm height related to lower right premolar lingual area.
Red color, Smooth surface with some ulcerations and Soft in consistncy.
Painful and Bleeds upon eating.
Appeared nearly a month ago with no prior history. Genome-wide transcriptional profiling of laser-captured vessels from pyogenic granuloma was performed, the study identified a gene signature specific to pyogenic granuloma, it was cross linked in serial analysis of gene expression (SAGE) database to :
1)white blood cells monocytes’.
2) high enrichment for gene ontology terms corresponding to ‘vasculature development’ and ‘regulation of blood pressure’.
3)genes of the nitric oxide pathway , genes related to hypoxia-induced angiogenesis and vascular injury.
4)FLT4, a tyrosine-kinase receptor related to pathological angiogenesis.
These data advocate for pyogenic granuloma to be a reactive lesion resulting from tissue injury, followed by an impaired wound healing response, during which vascular growth is driven by FLT4 and the nitric oxide pathway. Etiopathogenesis of PyGr Done by Heba Nabil
Mohamed Mostafa Elkenany
Hesham Mohamed Amir
Hesham Mosa'd A'bdou Hams Hamed Seroor
Wessam Mohamed Amin
Yehia Ahmed Salah