oprm-web-case-op-st-29

Oral Pathology: Soft Tissue Case #29

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Patient: Adult, either sex.

Chief Complaint:
The patient reports swelling of three days duration. The swelling is persistent, painful, and is larger now than when first noted. Brushing the teeth in the area of the lesion exacerbates the pain. Aspirin relieves the pain only slightly. The patient reports a similar problem with a maxillary tooth in the past.

Medical History:
No abnormalities are identified.

Dental History:
The patient has a history of dental problems resulting in tooth extractions.

Clinical Findings:
The lesion is a 5 x 7 mm soft tissue enlargement of the buccal gingiva between teeth #29 and #30. The lesion is fluctuant and painful to palpation. It is fixed to the surface mucosa and the underlying structures. It has a smooth erythematous surface which does not blanch upon pressure. Periodontal probing reveals a 7 mm pocket. A periapical radiograph reveals 5 mm of horizontal alveolar bone loss. The teeth in the area are vital. Probing of the area causes bleeding and the release of a purulent exudate. Right submandibular lymph nodes are tender, compressible, and not fixed to surrounding structures.