Peripheral osteoma of the hard palate
Journal name: Journal of Indian Society of Periodontology
Original article title: Peripheral osteoma of the hard palate
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:
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M. L. V. Prabhuji, H. C. Kishore, Gulnar Sethna, Ameya G. Moghe
Journal of Indian Society of Periodontology:
(A bimonthly open-access journal)
Full text available for: Peripheral osteoma of the hard palate
Year: 2012 | Doi: 10.4103/0972-124X.94623
Copyright (license): CC BY-NC-SA
Summary of article contents:
Introduction
Osteomas are benign, slow-growing osteogenic lesions derived from either cancellous or compact bone, often manifesting as sessile tumors composed of dense sclerotic bone. While they typically arise in the maxillofacial region—particularly from the skull and facial bones—they can also appear in other locations. Characteristically asymptomatic in their initial stages, osteomas can lead to disfigurement or functional impairments as they increase in size. The literature categorizes these lesions based on their anatomical location, highlighting variations such as cranial, mandibular, and exophytic osteomas, among others. While the exact etiology remains uncertain, potential factors include developmental, infectious, or traumatic origins.
Histopathological Insights into Osteoma
Histopathological examination plays a critical role in confirming the diagnosis of osteomas. In the reported case of a peripheral osteoma located in the hard palate of a 45-year-old male patient, the histological analysis revealed parakeratinized stratified squamous epithelium with surrounding normal connective tissue and abundant bony trabeculae devoid of osteoblastic rimming. This finding is consistent with the characterization of mature osteomas, also termed "Ivory Osteomas." The presence of delicate inter-trabecular marrow spaces filled with adipose tissue further supported the diagnosis. This case underscores the importance of thorough surgical excision for symptomatic lesions, which, when analyzed histologically, confirmed the benign nature and structural properties of osteomas.
Conclusion
Osteomas represent a unique category of slow-growing benign bony lesions that can pose clinical challenges due to their asymptomatic nature until significant growth occurs. The reported case emphasizes the effectiveness of surgical excision as a definitive treatment for symptomatic osteomas, with a favorable prognosis highlighted by the patient’s lack of recurrence over a year of follow-up. Given their association with Gardner's syndrome, it remains essential for clinicians to consider this connection when formulating treatment plans. Overall, further awareness and understanding of osteomas and their histopathological features are critical for accurate diagnosis and management in dental and medical practices.
FAQ section (important questions/answers):
What is an osteoma and where does it typically occur?
Osteomas are benign, slow-growing osteogenic lesions that usually arise from the maxillofacial bones, especially the skull and facial bones, potentially causing disfigurement or interference with normal function.
What are the symptoms associated with a peripheral osteoma?
Peripheral osteomas are typically asymptomatic until they grow large enough to cause discomfort, disfigurement, or function interference. Patients may experience discomfort or difficulty in mastication when they occur in the jaws.
How are peripheral osteomas diagnosed and treated?
Diagnosis primarily involves clinical examination and histopathological analysis, confirming the lesion. Treatment is generally excision of the bony mass via surgical techniques, offering a low recurrence rate for symptomatic cases.
What are the potential causes for osteoma development?
The exact etiology of osteomas is unknown, but they may arise from developmental factors, infections, trauma, or foreign body reactions, as suggested by some cases.
How can I differentiate an osteoma from other bone lesions?
Osteomas can be difficult to differentiate radiographically from similar lesions. Differential diagnosis may include exostoses, enostosis, fibrous dysplasia, and other ossified lesions, each requiring careful evaluation.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Peripheral osteoma of the hard palate”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Incision:
Incision refers to the surgical cut made in tissues to facilitate access to the underlying area for treatment. In the context of the case, incisions were necessary to remove the osteoma along with any associated periodontal pockets, ensuring proper healing and minimizing trauma to surrounding tissues.
2) Surface:
Surface denotes the outermost layer of a structure. In this case, the osteoma was a peripheral lesion projecting from the cortical surface of the hard palate, highlighting the importance of the surface anatomy in diagnosing and planning surgical intervention for bone lesions in the oral cavity.
3) Male (Mālē):
Male refers to the gender of the patient in the case study. There is a noted higher incidence of osteomas in males, particularly between their second and fourth decades of life. Understanding gender predisposition aids in evaluating risk factors associated with occurrences of benign bony lesions.
4) Krishnadevaraya:
Krishnadevaraya College of Dental Sciences and Hospital is the institution where the patient was treated. This reference signifies the importance of specialized dental centers in providing quality diagnosis and treatment options, contributing significantly to the management of oral pathologies like peripheral osteomas.
5) Disfigurement:
Disfigurement refers to the alteration of one’s physical appearance. In the case of osteomas, their slow growth may lead to disfigurement if left untreated. This possibility emphasizes the need for surgical intervention, especially when lesions interfere with normal functions or aesthetic aspects of the oral cavity.
6) Swelling:
Swelling is indicative of an increase in size or volume of tissue, often resulting from pathological processes such as inflammation or tumor growth. The palatal bony swelling observed in the patient was crucial for diagnosis, showcasing the need to investigate physical changes in the oral cavity.
7) Disease:
Disease refers to a pathological condition that disrupts normal bodily functions. While osteomas are benign, they still represent a disease state when they affect anatomical structures or cause discomfort, necessitating treatment. Understanding disease processes is vital for effective management in clinical settings.
8) Science (Scientific):
Science involves the systematic study of nature and the underlying mechanisms of diseases. The investigation into osteomas falls under medical science, which guides diagnosis and treatment. Advances in scientific research enhance the understanding of such conditions, providing improved patient care and treatment methodologies.
9) Ivory:
Ivory, in this context, describes a type of mature peripheral osteoma characterized by its dense, sclerotic bone similar in appearance to ivory material. This description helps differentiate it from other bone lesions, guiding histopathological classification and influencing treatment approaches for osteogenic lesions.
10) Silk:
Silk refers to the type of sutures used during the surgical procedure. Silk sutures are commonly employed in oral surgeries due to their tensile strength and ease of manipulation. Their use is crucial for ensuring proper closure and healing after excising lesions such as osteomas.
11) Life:
Life encompasses the biological existence and health status of the patient. In the case, life was depicted through the patient's systemic health and functionality impacted by the osteoma. This emphasizes the interconnectedness of oral health with overall quality of life.
12) Sign:
Sign refers to an observable indication of a medical condition. In this case, the clinical signs such as the palatal swelling and periodontal pocket depth guided the diagnosis of a peripheral osteoma. Recognizing these signs is essential for timely and effective intervention.
13) Fish:
Fish pertains to the foreign body (fish bone) lodged in the patient's mouth, which may have contributed to the development of the osteoma. This incident underscores the potential role of trauma or foreign bodies in triggering reactive or proliferative processes in bone tissues.
14) Line:
Line, in this context, relates to the histological aspects seen in osteomas, such as resting lines in the bony trabeculae. These histopathological features are significant for differentiating osteomas from other lesions, contributing to a comprehensive understanding of their morphology and growth patterns.