case_images: PMC3357023_01
case_images: PMC3357023_02
case_images: Right profile view
case_images: JISP-16-129-g001.jpg
case_images: PMC3357023_02_JISP-16-129-g001.jpg
case_images: F1
case_images: When the patient was examined extra-orally, there was asymmetry in the facial appearance [Figures 1-3].
case_images: Left profile view
case_images: JISP-16-129-g002.jpg
case_images: PMC3357023_02_JISP-16-129-g002.jpg
case_images: F2
case_images: When the patient was examined extra-orally, there was asymmetry in the facial appearance [Figures 1-3].
case_images: Enlargement of the nasal process of maxilla
case_images: JISP-16-129-g003.jpg
case_images: PMC3357023_02_JISP-16-129-g003.jpg
case_images: F3
case_images: When the patient was examined extra-orally, there was asymmetry in the facial appearance [Figures 1-3].
case_images: Bony enlargement of the palate
case_images: JISP-16-129-g004.jpg
case_images: PMC3357023_02_JISP-16-129-g004.jpg
case_images: F4
case_images: When intra-oral examination was done, there was spacing present between the teeth and there was bony prominence on the right side of the palate till the mid palatine region [Figure 4].
case_images: Spacing between the teeth in the 1st and 4th quadarant
case_images: JISP-16-129-g005.jpg
case_images: PMC3357023_02_JISP-16-129-g005.jpg
case_images: F5
case_images: While recording the history, the patient mentioned that the circumference of the head gradually increased for the past 10 years; there was also gradual increase in spacing between the teeth [Figures 5 and 6] since her paget's disease was diagnosed, which could be due to the increase in the size of the jaws.
case_images: Spacing between the teeth in the 3rdquadarant
case_images: JISP-16-129-g006.jpg
case_images: PMC3357023_02_JISP-16-129-g006.jpg
case_images: F6
case_images: While recording the history, the patient mentioned that the circumference of the head gradually increased for the past 10 years; there was also gradual increase in spacing between the teeth [Figures 5 and 6] since her paget's disease was diagnosed, which could be due to the increase in the size of the jaws.
case_images: Preoperative pocket measurements in 16 and 17 regions
case_images: JISP-16-129-g007.jpg
case_images: PMC3357023_02_JISP-16-129-g007.jpg
case_images: F7
case_images: Seven millimeter pocket was observed locally, in the regions 16 and 17 [Figure 7].
case_images: OPG showing hypercementosis in 14 and 15 regions
case_images: JISP-16-129-g008.jpg
case_images: PMC3357023_02_JISP-16-129-g008.jpg
case_images: F8
case_images: OPG revealed hypercementosis in the teeth 14 and 15 [Figure 8].
case_images: Saggital section of CT scan showing growth in the intercorticol spaces of saggital and occipital bones
case_images: JISP-16-129-g009.jpg
case_images: PMC3357023_02_JISP-16-129-g009.jpg
case_images: F9
case_images: CT scan revealed the presence of woven bone or immature bone by observing the radio density in the occipital region, palate, and mandible that correlated the clinical findings [Figures 9-11].
case_images: Cross sectional view of CT scan showing growth in the intercorticol spaces of maxilla and occipital bones
case_images: JISP-16-129-g010.jpg
case_images: PMC3357023_02_JISP-16-129-g010.jpg
case_images: F10
case_images: CT scan revealed the presence of woven bone or immature bone by observing the radio density in the occipital region, palate, and mandible that correlated the clinical findings [Figures 9-11].
case_images: Saggital section of CT scan showing pockets being measured using software
case_images: JISP-16-129-g011.jpg
case_images: PMC3357023_02_JISP-16-129-g011.jpg
case_images: F11
case_images: CT scan revealed the presence of woven bone or immature bone by observing the radio density in the occipital region, palate, and mandible that correlated the clinical findings [Figures 9-11].
case_images: PMC3357023_03
case_images: Horizontal bone loss in 16 and 17 regions
case_images: JISP-16-129-g012.jpg
case_images: PMC3357023_03_JISP-16-129-g012.jpg
case_images: F12
case_images: So phase II or surgical phase therapy was carried out for the patient, which consisted of flap surgery in the areas 16 and 17 [Figures 12 and 13].
case_images: Flap closure with black silk
case_images: JISP-16-129-g013.jpg
case_images: PMC3357023_03_JISP-16-129-g013.jpg
case_images: F13
case_images: So phase II or surgical phase therapy was carried out for the patient, which consisted of flap surgery in the areas 16 and 17 [Figures 12 and 13].
case_images: Postoperative view of 16 and 17 regions
case_images: JISP-16-129-g014.jpg
case_images: PMC3357023_03_JISP-16-129-g014.jpg
case_images: F14
case_images: The treatment was uneventful with healing without complications, and after one week, the sutures were removed [Figure 14].
case_images: PMC3357023_04