Chondroma : This neoplasm may develop at any age and shows no apparent gender predilection. The chondroma usually arises as a painless, slowly progressive swelling of the jaw which, like many other neoplasms, may cause loosening of the teeth. The overlying mucosa is seldom ulcerated. The anterior portion of the maxilla is the most frequent site of involvement by this tumor because it is here that vestigial cartilage rests are found, particularly in the midline lingual to or between the central incisors. In the mandible the most common site of occurrence is posterior to the cuspid tooth, involving the body of the mandible, or the coronoid or condylar processes
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The most common site of occurrence of Benign osteoblastoma (Giant osteoid osteoma) is the vertebral column. Other frequently affected sites include the sacrum, long tubular bones and calvarium.
Nodular fasciitis : A benign and probably reactive fibroblastic growth extending as a solitary nodule from the superficial fascia into the subcutaneous fat, or less frequently, into the subjacent muscle. Confusion with a sarcoma is possible because of its cellularity, its mitotic activity, its richly mucoid stroma, and its rapid growth. Other fibroblastic proliferations, such as proliferative myositis, are probably akin to this lesion. Nodular fasciitis is most common in the upper extremity, the trunk and the neck region of young adults.
Aggressive fibromatosis : A nonmetastasizing tumor like fibroblastic growth of unknown pathogenesis involving voluntary muscle as well as aponeurotic and fascial structures. Histologically, it is indistinguishable from an abdominal fibromatosis. The lesion has a strong tendency to local recurrence and aggressive, infiltrating growth. It is most common in the shoulder girdle, the thigh, and the buttock of young adults
Fibrous histiocytoma : A benign, unencapsulated and often richly vascular growth made up of histiocytes and collagen-producing fibroblast-like cells, which are arranged in a whorled or cartwheel pattern. Frequently, the growth contains lipid-carrying macrophages. It may occur anywhere but is most common in the dermis
Surgical excision is the treatment of choice for heterotopic oral gastrointestinal cyst, although this lesion cannot be diagnosed clinically and is seldom suspected.
Nasopharyngeal carcinoma is difficult to treat surgically because of the early metastasis to regional lymph nodes. The tumor is resistant to chemotherapy, and radiotherapy is the treatment of choice. However, because the tumor usually presents late, the prognosis is poor with a five-year survival rate of 20%. It may be possible to prevent the development of NPC with the use of an EBV vaccine at an early age
Conservative excision is the treatment of choice for granular cell tumor. Recurrence is seen in fewer than 7% of cases thus treated, even if granular cells extend beyond the surgical margins of the biopsy sample. A few reported metastasizing granular cell tumors have appeared to be histologically benign, and for this reason, tumors that recur, grow rapidly or reach a size greater than 5 cm should be viewed with grave suspicion
Radical surgery is the treatment of choice for leiomyosarcoma, with adjunctive chemotherapy or radiotherapy used occasionally. The prognosis is poor, with numerous recurrences and distant metastases. Overall five-year survival is approximately 35–50%
The treatment of choice for Melanotic Neuroectodermal Tumor of Infancy (MNTI) is surgical excision, and it is usually curative. This treatment can usually be accomplished with a partial maxillectomy. Many clinicians advocate a 5 mm margin of healthy tissue to be included with the surgical specimen. Local recurrence has been documented in 10–60% of patients. Overall, the average recurrence rate is 15–20%. Approximately 1% of tumors are malignant, with only rare tumors producing metastases
The treatment of choice for oncocytoma is surgical excision, and the tumor does not tend to recur. Malignant transformation is uncommon, but malignant oncocytoma is now a well-established entity
Conservative excision seems to be the treatment of choice in canalicular adenoma
Tularemia responds well to antibiotic therapy. Streptomycin is the drug of choice. This disease also responds to adequate doses of gentamicin and tetracycline.
Incision and drainage, accompanied by massive antibiotic therapy, have proven moderately successful in treating the disease. Tetracycline alone or in combination with chloramphenicol were considered to be drugs of choice in Melioidosis
Penicillin is the drug of choice in congenital syphillis. Erythromycin or tetracycline is used if the patient is allergic to penicillin. Surgical correction of the facial defects gives good esthetic results.
Herpes zoster virus infection is a recurrent viral infection seen in HIV-infected patients and presents a clinical course, which is more severe in morbidity than that encountered in immunocompetent patients. In AIDS patients herpes zoster begins as a unilateral cluster of vesicles and ulcers in a classical dermatome distribution but subsequently extends beyond the dermatomal boundary and heals by scarring. Oral acyclovir is the drug of choice in the treatment of herpes zoster
Surgical removal of the growths is recommended as treatment of choice in Rhinosporidiosis
Zinc Oxide and Eugenol : It is used routinely as a temporary filling material or root canal sealer. Eugenol of this cement fixes cells, depresses the cell respiration, and reduces the neural transmission in vitro. There is almost universal agreement that zinc oxide and eugenol is the least injurious of all filling materials to the dental pulp. Not only is there no irritation produced by this substance, but actually it exerts a palliative and sedative effect on the mildly damaged pulp, since it inhibits synthesis of prostaglandins and leukotrienes. It seems to be such a bland substance that it may lack even the necessary irritating properties requisite to the stimulation of secondary dentin formation. In view of these findings, zinc oxide and eugenol is the material of choice for use over injured pulps or as a base in deep cavity preparations.
The site, direction, and size of the crack or fracture dictates the choice of the treatment in cracked tooth syndrome. It ranges from stabilization with a stainless steel band or crown to endodontic treatment and restoration. If untreated, CTS can lead to severe pain, possible pulpal necrosis and periapical abscess. Unfortunately, management of CTS is not always successful. In some cases, such as in vertical root fractures (split root) in single rooted teeth, the only treatment option is tooth extraction
Counselling and psychotherapy are the treatment of choice in lip biting and cheek biting. However an acrylic shield will help to prevent the access of the teeth to lips and cheeks
Sodium hypochlorite (NaOCl) is commonly used as root canal irrigant. Due to its efficacy against pathogenic organisms and pulp digestion it is considered to be the medicament of choice. It is found to be sporicidal and virucidal and shows far greater tissue dissolving effects on necrotic than on vital tissues as well as the organic components of the smear layer.
Needle biopsy has little value in the diagnosis of oral lesions. The scalpel is the instrument of choice, since it cleanly removes the tissue and does not dehydrate it as cautery or the high-frequency cutting knife may. This latter instrument is of great value, however, in dealing with vascular lesions, where it controls bleeding at the biopsy site
In all cases of rickets, the study of choice is radiography of the wrists, knees, ankles, and long bones. No pathognomonic sign on X-ray distinguishes hypophosphatemic rickets from other variants of rickets.
For septic arthritis, treatment of choice is antibiotics and arthrocentesis under low pressure. If treatment is instituted in the acute phase, the sequelae will be less deforming or disabling than if the disease has been allowed to enter a chronic phase. After infection subsides, physiotherapy may help in improving mobility of the joint
Surgery is the treatment of choice in Synovial Chondromatosis (loose joint bodies). Arthroscopy and open surgery are used to remove the loose joint bodies and resection of the diseased synovial tissues. After surgical removal, recurrence is low
Radiographic findings in TMJ correlate to the etiology of TMD; in cases of rheumatoid arthritis and seronegative spondyloarthropathies, conventional radiographs show erosions, osteophytes, subchondral bony sclerosis, and condylar-glenoid fossa remodeling. A variety of new imaging techniques are being used and perfected to study TMJ. CT scan can explore both bony structures and muscular soft tissues. It is relatively less expensive and can be done with contrasting material injected into the joint cavity. MRI, though costly, should be used as the study of choice if an articular or meniscal pathology is suspected and an endoscopic or surgical procedure is contemplated in a case of traumatic TMD
The prognosis in Hand-Schüller-Christian disease is good. Approximately half of the patients undergo spontaneous remission over a period of years. The treatment of choice is curettage or excision of lesions. Inaccessible lesions may be irradiated. Some patients benefit from chemotherapeutic drugs, including prednisone, vinblastine, and cyclophosphamide. One of the most significant factors influencing the morbidity and mortality of the disease is the extent of the disease at the time of initial diagnosis and number of organ systems involved.
Dental hard tissues gain importance in identification based on the condition of the human remains. Teeth are one of the strongest structures in the body, and are usually resistant to postmortem decomposition. Moreover, most materials used by the dentist for restoring and replacing teeth are also resistant to postmortem changes. Therefore, the use of dental evidence is the method of choice in establishing identity of badly burned, traumatized, decomposed, and skeletonized remains
Impression of the human bite area may be made when tooth indentations exist. The material of choice is Vinyl Polysiloxane. The impression material may be reinforced with dental stone, autopolymerizing acrylic or impression compound to prevent dimensional change. It is to be noted that if the bite mark is on an area accessible to the victim’s own dentition, impressions of the victim’s teeth should be made to rule out self-inflicted bites