Ameloblastoma: an aggressive lesion of the mandible.

Ameloblastoma is a benign locally invasive epithelial odontogenic tumour comprising 1% of all tumours and cysts arising in the jaws. It is commonly found in the third and fourth decade in the molar ramus region of the mandible. Among all types of ameloblastoma, multicystic ameloblastoma is believed to be locally aggressive lesion that has the tendency for recurrence. In this report we present a large multicystic ameloblastoma in the left body-ramus region of the mandible in a 55-year-old woman. This large lesion was diagnosed with the help of CT and was successfully managed by hemimandibulectomy with simultaneous reconstruction using iliac crest bone.

Aesthetic finger prosthesis with silicone biomaterial.

The fabrication of finger prosthesis is as much an art as it is science. The ideally constructed prosthesis must duplicate the missing structures so precisely that patients can appear in public without fear of attracting unwanted attraction. A 65-years-old patient reported with loss of his right index finger up to the second phalanx and wanted to get it replaced. An impression of the amputated finger and donor were made. A wax pattern of the prosthesis was fabricated using the donor impression; a trial was performed and flasked. Medical grade silicone was intrinsically stained to match the skin tone, following which it was packed, processed and finished. This clinical report describes a method of attaining retention by selective scoring of the master cast of partially amputated finger to enhance the vacuum effect at par with the proportional distribution of the positive forces on the tissues exerted by the prosthesis.

Diagnosis demystified: CT as diagnostic tool in endodontics.

Diagnosis in endodontics is usually based on clinical and radiographical presentations, which are only empirical methods. The role of healing profession is to apply knowledge and skills towards maintaining and restoring the patient's health. Recent advances in imaging technologies have added to correct interpretation and diagnosis. CT is proving to be an effective tool in solving endodontic mysteries through its three-dimensional visualisation. CT imaging offers many diagnostic advantages to produce reconstructed images in selected projection and low-contrast resolution far superior to that of all other X-ray imaging modalities. This case report is an endeavour towards effective treatment planning of cases with root fracture, root resorption using spiral CT as an adjuvant diagnostic tool.

Atypical histiocytic granuloma of tongue.

A 40-year-old male patient presented with a 3-week history of a painless ulcer on the dorsum of the tongue. He was a chronic smoker since the age of 15 years. The ulcer was well-defined, non-tender and indurated. An incisional biopsy was performed and the diagnosis of atypical histiocytic granuloma was made after histopathological examination. The lesion resolved spontaneously after the incisional biopsy and the patient was on follow-up for 6 months and no recurrences were observed. Here we report a rare case of atypical histiocytic granuloma. Hence, it must be borne in mind in the differential diagnosis of ulcers on the tongue.

Desmoplastic ameloblastoma: a rare odontogenic neoplasm with unusual radiographic and histomorphological presentation.

Desmoplastic ameloblastoma (DA) is a newly recognised, rare odontogenic neoplasm that is a histological variant of ameloblastoma. In this type, the islands of ameloblastoma are surrounded and often compressed by a dense and sometimes hyalinised fibrous connective tissue. Although ameloblastomas are usually located in the mandible, this variant often occurs in the anterior maxilla. In view of the paucity of DA case series and only limited understanding of its biological behaviour and prognosis, proper treatment strategies for DA are not entirely defined so far. The purpose of this paper was to review the literature and to demonstrate a rare case for an improved understanding of the behaviour and prognosis of DA.

Aberration in the palatal root of the maxillary first molar.

Thorough knowledge of root canal morphology is essential for the endodontic therapy. Variations in the root and root canal morphology, especially in multirooted teeth, are a constant challenge for diagnosis and management. The dentist needs to be familiar with the various root canal configurations and their variations for successful endodontic therapy. There are rare variations in canal number and configuration in maxillary molars, which could affect treatment outcome. Two lingual root structures are occasionally found on human permanent maxillary molars. One of these is the normal lingual root, which is always present, the other is a supernumerary structure which can be located either mesiolingually (radix mesiolingualis) or distolingually (radix distolingualis). The purpose of this paper is to review the literature and to demonstrate a case report which describes the successful non-surgical endodontic management of an unusual maxillary first molar with four separate roots and four canals.

Reactive dentures: a novel approach to decrease residual ridge resorption.

The need for reduction of traumatic forces transmitted through the prosthesis has long been recognised and studies have shown that either a soft acrylic resin/silicone rubber can serve as a stress distributor and absorb some of the forces applied to the teeth. These dentures permit reaction to impacting forces which allows independent movement of one or more teeth in function unlike the conventional dentures. A completely edentulous patient with adequate inter-ridge distance was selected for the case, the dentures with soft liner placed between the patient's teeth and denture base were fabricated. This report presents a completely new technique to reduce the ridge resorption and facilitate patient comfort.

Lobulated capillary haemangioma: a common lesion in an uncommon site.

Pyogenic granuloma (PG) is a well-known localised granulation tissue overgrowth. It remains an aetiopathological enigma, with trauma, inflammatory and infectious agents being the suspected causative factors. It is a relatively common benign mucocutaneous lesion occurring intraorally or extraorally and is more common in women in the second decade of their lives than in men. Although it is a common lesion it may present with varying clinical features that sometimes may mimic more serious lesions such as malignancies. The clinical diagnosis of such lesion can be quite challenging. This case report drives attention towards the uncommon location of PG of lobular capillary haemangioma type occurring on anterior palate. Surgical excision of the lesion was planned because of the discomfort attributed to large size of the lesion and hindrance in mastication.

Endodontic management of middle mesial canal of the mandibular molar.

Thorough knowledge of root canal morphology and unusual anatomy of the tooth is critical for successful endodontic treatment. Although the most common configuration is two roots and three root canals, mandibular molars might have many different combinations. In the literature, it is less described about three mesial canals and two distal canals in mandibular second molars, indicating a rare anatomical configuration. A case of unusual root canal morphology is presented to demonstrate anatomical variations in mandibular molars. Endodontic therapy was performed in a mandibular second molar with five separate canals, three mesial and two distal. This report points out the importance of looking for additional canals and unusual canal morphology, because knowledge of their existence might occasionally enable clinicians to treat a case successfully that otherwise might have ended in failure. In conclusion, every attempt should be made to find and treat all root canals of a tooth.