Breakthrough Clinical oral pathology case: No. 31

Dr. Stacey Simmons describes the oral pathology case of a 60-year-old patient who presents for a limited exam. Chief complaint: She noticed some white tissue under her lower implant prosthesis. The patient is concerned because a similar type of lesion was removed and diagnosed as precancerous five years ago when her implants were placed.

Content Dam Diq Online Articles 2017 10 17oct5bcpathcase31 Thumbnail

Dr. Stacey Simmons describes the oral pathology case of a 60-year-old patient who presents for a limited exam. Chief complaint: She noticed some white tissue under her lower implant prosthesis. The patient is concerned because a similar lesion was removed and diagnosed as precancerous five years ago when her implants were placed.


Editor's note: This article first appeared in DE's Breakthrough Clinical with Stacey Simmons, DDS. Find out more about the clinical specialties newsletter created just for dentists, and subscribe here.


17oct5bcpathcase31 P01
Figure 1


PRESENTATION:
A 60-year-old female with a noncontributory health history presents for a limited exam.

CHIEF COMPLAINT: The patient noticed some white tissue under her lower implant prosthesis (figure 1). The patient reported no pain in the area but was concerned about the white tissue being something pathological. Apparently, when she had her implants placed five years prior, a lesion of similar nature was removed and diagnosed as precancerous.

THREE MONTHS EARLIER: The patient had been seen three months earlier for a recall exam and lower prosthesis removal and cleaning. Findings at the soft-tissue exam were within normal limits.

CLINICAL EXAM: Clinical assessment reveals a white, corrugated lesion lingual to the acrylic of the fixed hybrid prosthesis (figure 2). The lesion measures 5x24 mm and is not able to be scraped off or removed. It is not painful or symptomatic, and there are no swellings noted in the sublingual or submandibular lymph node areas (figures 3 and 4).

17oct5bcpathcase31 P02
Figure 2

17oct5bcpathcase31 P03
Figure 3

17oct5bcpathcase31 P04
Figure 4


What are your differentials and recommended course of treatment modalities?

Send your answers to DEbreakthrough@pennwell.com or join our Facebook group to discuss this oral pathology case and more. Next month, we will discuss the final diagnosis and recommended treatment for this case.

Do you have an interesting oral pathology case you would like to share with Breakthrough’s readers? If so, submit a clinical radiograph or high-resolution photograph, a patient history, diagnosis, and treatment rendered to: DEbreakthrough@pennwell.com. We will let you know if we select your case.


For more oral pathology articles, click here.


Editor's note: This article first appeared inDE's Breakthrough Clinical with Stacey Simmons, DDS. Find out more about the clinical specialties newsletter created just for dentists, andsubscribe here.



Staceylsimmonsdds 124x124Stacey L. Simmons, DDS, is in private practice in Hamilton, Montana. She is a graduate of Marquette University School of Dentistry. Dr. Simmons is a guest lecturer at the University of Montana in the Anatomy and Physiology Department. She is the editorial director of PennWell’s clinical dental specialties newsletter, DE’s Breakthrough Clinical with Stacey Simmons, DDS, and a contributing author for DentistryIQ, Perio-Implant Advisory, and Dental Economics. Dr. Simmons can be reached at ssimmonsdds@gmail.com.


For the most current dental headlines, click here.


More in Clinical