Hi Everyone,
Thank you for taking the time to read and answer my question(s). All relevant pictures and xrays are below:
In December 2017, my dentist noticed an oral lesion. Since then I have been to over 4 dental specialists in New York City but each doctor has told me that it is unlike anything they have seen before. To give you some background. I got my cleaning done in June 2017 and filling up of two cavities in July 2017. I again visited dentist for 6 monthly scaling in Dec 2017 which is when this spot was first seen by her. This spot is coincidentally in the same region as the tooth which were filled. For filling, an anesthetic injection was given on the buccal side. The composition of the anesthetic is 4% Septocaine 1:100K epinephrine, and the composition of the filling material is a universal resin composite.
Endodontist Report (January 2018).
Evaluation of the upper left quadrant. We found no significant findings pulpally. The upper left posterior teeth all tested normal to cold, percussion, and palpation. There is a small rectangular red patch on the palatal gingiva in the apical area of 14-15. We advised the patient to see an oral pathologist to evaluate it, since it is unlikely to be due to endodontic origin.
Oral Pathologist Report (February 2018):
Consultation regarding a lesion on her left posterior hard palate. According to the patient, the lesion was discovered 12/22/17 during a routine dental appointment. Patient reports that the lesion is in the same region that she had resin composite dental fillings placed in July. Patient consulted with an endodontist who found the teeth are vital and no endodontic issues were found. Patient stated that she checks the lesion regularly since it was discovered and she does not believe that the lesion has changed in size. The lesion is asymptomatic. Patient has not applied any medications to the lesion but has been salt water rinses regularly. A review of Patient’s past medical history is non-contributory. My clinical examination revealed an approximately 1cm erythematous patch with a faint brown periphery located on the posterior left hard palate in the region of teeth #14/15. The overlying mucosa appeared intact and the lesion blanched with the application of pressure. The remainder of her oral soft tissues were unremarkable. Based on the clinical presentation the lesion appears benign and I favor a vascular origin although the exact diagnosis and etiology is unclear. For that reason I recommend an incisional biopsy.
So my questions are:
1) Do you know what this may be?
2) Are there any alternatives to the incisional biopsy?
3) What precautions do I need to take for an incisional biopsy?
4) How long does it take to get the results for an incisional biopsy?
Thank you for taking the time to read and answer my question(s). All relevant pictures and xrays are below:
In December 2017, my dentist noticed an oral lesion. Since then I have been to over 4 dental specialists in New York City but each doctor has told me that it is unlike anything they have seen before. To give you some background. I got my cleaning done in June 2017 and filling up of two cavities in July 2017. I again visited dentist for 6 monthly scaling in Dec 2017 which is when this spot was first seen by her. This spot is coincidentally in the same region as the tooth which were filled. For filling, an anesthetic injection was given on the buccal side. The composition of the anesthetic is 4% Septocaine 1:100K epinephrine, and the composition of the filling material is a universal resin composite.
Endodontist Report (January 2018).
Evaluation of the upper left quadrant. We found no significant findings pulpally. The upper left posterior teeth all tested normal to cold, percussion, and palpation. There is a small rectangular red patch on the palatal gingiva in the apical area of 14-15. We advised the patient to see an oral pathologist to evaluate it, since it is unlikely to be due to endodontic origin.
Oral Pathologist Report (February 2018):
Consultation regarding a lesion on her left posterior hard palate. According to the patient, the lesion was discovered 12/22/17 during a routine dental appointment. Patient reports that the lesion is in the same region that she had resin composite dental fillings placed in July. Patient consulted with an endodontist who found the teeth are vital and no endodontic issues were found. Patient stated that she checks the lesion regularly since it was discovered and she does not believe that the lesion has changed in size. The lesion is asymptomatic. Patient has not applied any medications to the lesion but has been salt water rinses regularly. A review of Patient’s past medical history is non-contributory. My clinical examination revealed an approximately 1cm erythematous patch with a faint brown periphery located on the posterior left hard palate in the region of teeth #14/15. The overlying mucosa appeared intact and the lesion blanched with the application of pressure. The remainder of her oral soft tissues were unremarkable. Based on the clinical presentation the lesion appears benign and I favor a vascular origin although the exact diagnosis and etiology is unclear. For that reason I recommend an incisional biopsy.
So my questions are:
1) Do you know what this may be?
2) Are there any alternatives to the incisional biopsy?
3) What precautions do I need to take for an incisional biopsy?
4) How long does it take to get the results for an incisional biopsy?
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