Brown's tumor

A patient 22 year old reported to have a painless swelling associated with lower right canine . The same swelling came by simple blow of head of teenage boy . The swelling is increasing in size very fast in a small amount of time .
Other complaint , patient is having that all his teeth are mobile . So we examined his oral cavity and we noticed that all his upper anteriors are grade 1 mobile . He has grade 2 mobility with lower left second molar involving first molar & third molar region . The third molar in the same area is extracted six months ago without any investigations. So  clinically seen , lesion seems to be neoplastic .

Now we decided to go for full mouth CBCT & whole blood investigation.

Whole blood investigation shows anemia & raised alkaline phosphatse level , showing osteoclastic activity with hypercalcemia (raised blood calcium level ).

For the same case, we took opinion of endocrinologist so that we decide the managment for oral lesions.

In CBCT , We found surprisingly aggressive lesions in the maxilla as well as in the mandible.

Maxillary lesion is widely spread, crossing midline , involving entire premaxilla , invading both the maxillary sinuses , showing resorption of roots of all anterior teeth giving floating teeth appearance, is seen in CBCT.

Mandibular lesions is two in number. One lesion is around the lower right canine region showing non neoplastic lesion on CBCT. Second lesion is involving lower left second molar.

Angioedema

Please go through clinical picture & biopsy report .....

A CBCT of Le fort 1 fracture

A CBCT of patient met with a road traffic accident showing bilateral le fort 1 fracture & orbital fractures.

A case of angioedema (suspected)

This case pics clinically shows angioedema.
Patient is on antihistamines & steroid .
Lip biopsy is taken for further investigations.

Re treatment of lower right second molar

Re treatment of lower right second molar

Preoperative RVG of lower right second molar

In this RVG of lower second molar , we can easily visualize post obturation restoration is fractured. Lateral condensation in the distal canal is very poor . In mesial lingual and buccal canal , we can hardly notice any gutta percha point inside it.In the middle third of the mesial root , file is fractured . So we decided to go for re rootcanal treatment with the same tooth.

Postoperative RVG of lower right second molar

In this above RVG , we can eaisly make out the fractured part of file is bypassed and successful obturation is done with the distal as well as mesial canals followed by temproray restoration with ZOE cement.