PMC4065439_01
(a) Intraoral view revealing silver amalgam-restored 47, (b) Intraoral periapical radiograph of 47 revealing a well-defined radiopacity surrounded by uniform radiolucent halo at the periapex of 47. DVT of 47 region, (c) DVT further characterizing the lesion in three different sections and its relationship with the tooth, (d) Surgically extracted tooth specimen, (e) Postoperative intra-oral radiograph revealing the site of extraction and curettage
JOMFP-18-150a-g001.jpg
PMC4065439_01_JOMFP-18-150a-g001.jpg
F1
On right lower jaw missing 46 and silver amalgam restored 47 was seen [Figure 1a]. Periapically, a small well-defined radiopacity was seen in relation to mesial root that was attached to the apex of the root measuring approximately 1 cm [Figure 1b]. To enhance the view, digital volume tomography (DVT) was taken [Figure 1c]. The specimen was obtained as gritty fragments [Figure 1d inset] and was sent for histopathologic examination. No postoperative complications were seen [Figure 1e] and patient was followed up for a period of 6 months with no signs of recurrence.
(a) Photomicrograph reveals anastomosing curvilinear bony trabeculae in a fibrous connective tissue stroma (H&E stain, x100), (b) Photomicrograph reveals anastomosing curvilinear bony trabeculae (ginger root pattern) with interspersed hemorrhage (arrow) (H&E stain, x40), (c) Photomicrograph depicts irregular thick trabeculae immature bone and irregular basophilic cementum-like structures scattered in a cellular mesenchymal tissue (H&E stain, x100), (d) Photomicrograph represents immature bony trabeculae with osteocytes and osteoblastic rimming (arrows) (H&E stain, x400), (e) Photomicroragph shows the presence of osteoclasts on the edge of bony trabecule within a fibrocellular stroma (arrow) (H&E stain, x400)
JOMFP-18-150a-g002.jpg
PMC4065439_01_JOMFP-18-150a-g002.jpg
F2
The decalcified sections showed anastomosing curvilinear bony trabeculae (ginger root pattern) in a fibrous stroma with basophilic outlines, noted focally [Figure 2a and b]. Areas of hemorrhage were appreciated close to the mineralized masses [Figure 2b]. Section from other fragments revealed cellular mesenchymal tissue composed of spindle-shaped fibroblasts, collagen fibers and several engorged capillaries with mixture of short, irregular and thick trabeculae of immature bone/and irregular basophilic cementum-like masses [Figure 2c]. Irregular thick trabeculae of immature bone with osteocytes and osteoblastic rimming [Figure 2d] and few osteoclasts on the edge of bony trabecule within a homogenous fibro-cellular background [Figure 2e] were also evident.