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Clinical Case - #548-8-44

Clinical Case - #548-8-44. Justin Orr. Patient Medical History. 71 yo African American male; large in stature Pacemaker inserted three years ago due to heart flutter Appendectomy two years prior High blood pressure Type II Diabetes. Medications.

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Clinical Case - #548-8-44

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  1. Clinical Case - #548-8-44 Justin Orr

  2. Patient Medical History • 71 yo African American male; large in stature • Pacemaker inserted three years ago due to heart flutter • Appendectomy two years prior • High blood pressure • Type II Diabetes

  3. Medications • Allopurinol – 300 mg/day – used to treat kidney stones and high uric acid • Amiodarone Hydrochloride – 200mg/day - Management of life-threatening recurrent ventricular fibrillation • Amlodipine and Benazepril– 10mg/day – Hypertension • Aspirin – 325 mg/day • Benicar – 40mg/day – Hypertension • Carvedilol – 2.5mg BID - Mild-to-severe heart failure of ischemic or cardiomyopathic origin; management of hypertension • Doxazosin – 4mg/day – hypertension and urinary outflow obstruction • Furosemide – 40mg/day - Management of edema associated with heart failure and hepatic or renal disease • KlorCon M20 – 20mg/day – Treatment/prevention of hypokalemia • Lisinopril– 20mg/day – hypertension • MetoprololTartate injection – 100mg - Treatment of angina pectoris, hypertension, or hemodynamically-stable acute myocardial infarction • NovoLog – 100units/ml – Treatment of diabetes mellitus • Novolin N – 10 units/12 hours – Diabetes • Simvastatin – 20mg/day – Cholesterol control • Vitamin D3

  4. Lesion Description The lesion was a large, unilocular radiolucency in the posterior mandible associated with an unerupted 3rd molar Patient was unaware of the lesion and could feel no pressure or swelling (amazingly)

  5. Patient Dialogue • Have you been aware of any swelling or discomfort in your lower right jaw? • Do you know when you last had a panogram survery? Did a previous dentist ever notice any lesion in the area?

  6. Diagnosis • Differential: • Dentigerous Cyst • Ameloblastoma • OdontogenicKeratocyst • Provisional Diagnosis • Dentigerous Cyst • Due to the location of the lesion and its association with an unerupted tooth, it is most likely that this is a follicular dentigerous cyst. Excision of the cyst and tooth is necessary. And OKC can often mimic a dentigerous cyst, but has a greater tendency to recur after removal.

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