dental biopsy

[kesmin]

Hi, just after a bit of advice re recovery time,
i noticed a boney lump over my upper canine about 12 weeks ago, went to dentist who took x-rays and referred me to max fax, this lump is completley painless.
consultant wasnt sure what it was, no history of trauma, no infection basically good teeth, there is also a 'cystic' looking area on x-ray between my inscisor and canine, any way he wants to remove part of the boney lump to see what that tells them rather than just wade in, as a nurse i do understand the caution even if the thought of going through my mouth being poked about with twice ( dental phobia!) is a little frustrating.
so next monday i will be having this intial bit done, i have asked my boss for the following day off as my job involves much talking and i would rather not ring in sick at short notice.
today i have covered said shift but the nurse doing it told me her daughter had had something similar where they shaved bone off and she was off work for a week due to swelling and not being able to talk and i'm wondering how likely i'll need more time off than i think!
many thanks.

[Bryanna]

Hi kesmin,

FYI... the canine and the incisor are the same tooth just different names. With regard to the "radiographic" cystic area between two teeth.... are either of those teeth root canaled or heavily restored with large fillings or crowns? Are they sure it's a cyst and not a radiopaque image of a bony growth which has grown on the buccal (the cheek side) above the tooth? Sometimes these growths can be seen on xrays.

Most people have a boney lump or bony ridge above their upper canine teeth. Which is normal. Some people have what is called Buccal Exostosis or Tori. This is a normal (benign) bony proturberance that can appear in various areas of the mouth. Sometimes it is located on the buccal side (the cheek side) along the alveolar ridge. Usually above the canines and premolars. They can be in one area or numerous areas. It can be on one side of the mouth or both sides of the mouth.

Here is a picture of buccal exostosis. This person has many along the alveolar ridge.
http://www.maxillofacialcenter.com/B...exostosis.html

You can google buccal exostosis pictures for more views of these.

The oral surgeon should be familiar with this type of growths as they are very common. Is there some reason why there would be some pathology associated with this lump.... infection, trauma,.... has the lump appeared suddenly and/or is it growing?

I have many dental patients who have no idea they have these bony growths until I point them out!! Once recognize, they can't help but notice them!

Hope this information helps... hope the bump is nothing

Bryanna

Originally Posted by kesmin

Hi, just after a bit of advice re recovery time,
i noticed a boney lump over my upper canine about 12 weeks ago, went to dentist who took x-rays and referred me to max fax, this lump is completley painless.
consultant wasnt sure what it was, no history of trauma, no infection basically good teeth, there is also a 'cystic' looking area on x-ray between my inscisor and canine, any way he wants to remove part of the boney lump to see what that tells them rather than just wade in, as a nurse i do understand the caution even if the thought of going through my mouth being poked about with twice ( dental phobia!) is a little frustrating.
so next monday i will be having this intial bit done, i have asked my boss for the following day off as my job involves much talking and i would rather not ring in sick at short notice.
today i have covered said shift but the nurse doing it told me her daughter had had something similar where they shaved bone off and she was off work for a week due to swelling and not being able to talk and i'm wondering how likely i'll need more time off than i think!
many thanks.

[kesmin]

Hi, thank you for your response.
I had realised after my post I had the tooth names wrong, too used to the UK numbering system! the radiotranslucent area is between my right upper 2 And 3.
the lump did come up suddenly and was initially very ' sharp' it continues to grow but more as though the surrounding area is catching up with the point and smoothing out, it's half a pea size.
initially I felt that it was nothing but sensibly got it checked, when the dentist didn't know what it was I just thought, with no disrespect, that she was young and when I saw someone who had been in practice longer they would know.
having done much reading my money is on OKC, fast growing and the most common location in the maxilla.
I had looked at tori Etc but not that.
No root canal, cap crown or even a filling in that area, two small fillings is all I have, one upper left 7 And lower right 5, always had really good teeth, none impacted. the max fax guy did initially think infection or trauma but after much looking and imaging this has been excluded at this time, his words were ' there is something going on with your jaw I' m just not sure what' and ' we are still gathering info' hence the shaving for histology.
I' m not concerned as the odds are so long for malignancy that it's not worth going there! more concerned that this procedure will keep me off work for more than 24 hours due to the talking,( and frightening my patients looking like I've had a punch in the mouth!)
many thanks,
Mel

[mrsD]

You might want to get some blood work done.

Elevated alkaline phosphatase may be present and hint at
a systemic condition called Paget's disease. Often this is silent (in early cases)
except for the deposition of calcium in places around the body along any bone surface.

[kesmin]

Originally Posted by mrsD

You might want to get some blood work done.

Elevated alkaline phosphatase may be present and hint at
a systemic condition called Paget's disease. Often this is silent (in early cases)
except for the deposition of calcium in places around the body along any bone surface.

many thanks mrsD, I have had bloods done and all was normal on that front, I'm sure it's nothing to worry about probably just a cyst with a slightly strange presentation, it,s just the inconvenience, rubbish patient me!

[Bryanna]

Hi Mel,

An Odontogenic Keratocyst is very possible. They are found in the mandible more so than the maxilla, but I've seen them in both areas in various sizes.

There are actually several different types of bony cysts that take on a similar appearance. Usually an MRI can help differentiate between the types. Did your oral surgeon do an MRI?

Bryanna

Originally Posted by kesmin

Hi, thank you for your response.
I had realised after my post I had the tooth names wrong, too used to the UK numbering system! the radiotranslucent area is between my right upper 2 And 3.
the lump did come up suddenly and was initially very ' sharp' it continues to grow but more as though the surrounding area is catching up with the point and smoothing out, it's half a pea size.
initially I felt that it was nothing but sensibly got it checked, when the dentist didn't know what it was I just thought, with no disrespect, that she was young and when I saw someone who had been in practice longer they would know.
having done much reading my money is on OKC, fast growing and the most common location in the maxilla.
I had looked at tori Etc but not that.
No root canal, cap crown or even a filling in that area, two small fillings is all I have, one upper left 7 And lower right 5, always had really good teeth, none impacted. the max fax guy did initially think infection or trauma but after much looking and imaging this has been excluded at this time, his words were ' there is something going on with your jaw I' m just not sure what' and ' we are still gathering info' hence the shaving for histology.
I' m not concerned as the odds are so long for malignancy that it's not worth going there! more concerned that this procedure will keep me off work for more than 24 hours due to the talking,( and frightening my patients looking like I've had a punch in the mouth!)
many thanks,
Mel