Root Displacement Research Articles

Trigeminal Neuralgia in the Presence of a Vascular Loop and Response to Medical Management: Experience From Saudi Arabia.

Trigeminal neuralgia (TN) is a neurovascular disorder characterized by severe, episodic facial pain, often attributed to vascular compression of the trigeminal nerve. The commonly reported artery responsible for compression is the superior cerebellar artery. Additionally, the anterior inferior cerebellar artery is also noted as a potential contributor to vascular loop compression. These vascular structures can lead to nerve root atrophy or displacement, which is significant in the pathophysiology of TN. While extensively studied globally, the specific characteristics of TN in the Saudi Arabian population remain underexplored. The primary objective of this study is to evaluate the response to medical management in patients with TN and vascular loop compression. The study was conducted at King Fahad Specialist Hospital in Dammam, Saudi Arabia, from April to August 2023, and utilized a retrospective case series design to review medical reports of 13 patients diagnosed with TN and vascular loop compression. The primary objective was to evaluate the response to medical management in this specific patient population. In this study, we included 13 patients with TN, providing a comprehensive snapshot of the patient population under study, encompassing demographic characteristics, clinical presentations, treatment responses, and other relevant variables. The mean age of the patients in the study is 48.23 years, with a standard deviation of 11.7, and a range from 30 to 71 years. The main findings of this study underscore the positive response to medical management in patients with TN and vascular loop compression. All patients in the study responded positively to the treatment, indicating a favorable overall response rate. The time to respond varied, with the majority responding within three months (46.16%), followed by those responding within 12 months (38.46%). This study highlights the potential efficacy of non-surgical approaches in managing the debilitating facial pain associated with TN. The positive outcomes observed in response to medical management emphasize the need for further exploration and validation of non-surgical approaches in the context of TN with vascular loop compression. This finding contributes to the global understanding of TN and offers promise for improving patient quality of life in Saudi Arabia.

Reconstruction of Pathology Induced Anterior Maxillary Defect: A Case Report

A cyst is defined as a pathologic cavity lined by epithelium. Nasopalatine duct cysts (NPDC) are of non-odontogenic origin arising from epithelial remnants from two embryonic nasopalatine ducts. These cysts may form anywhere along the ducts’ course, which runs from posterior palatal midline to the soft tissue palatine papilla also known as the incisive papilla. NPDC often develop between the 4th and 5th decades of life with men being affected more than women (2:1 ratio). They are typically asymptomatic but present with palatal swelling in the anterior maxillary region. Larger cysts may create a labial expansion in addition to a midpalate expansion which is usually compressible due to resorption of bone beneath the mucosa. Radiography often shows a well demarcated round or pear-shaped radiolucency superimposed on the incisive canal, tooth displacement or divergence of roots may be observed. This pathology is usually greater than 6mm in size which differentiates it from the incisive canal. Differential diagnoses often include a periapical granuloma or radicular cyst from nonvital central incisors, however a palatal radiolucency and expansion represents a NPDC until proven otherwise. Typical treatment includes enucleation and curettage with low recurrence rates.

Stress Analysis of Periodontal Tissue in en Masse Retraction With Integration of Maxillary Anterior Teeth: A Three-Dimensional Finite Element Method Study.

To simulate the en masse traction technique with the integration (EMTI) of six maxillary anterior teeth using a finite element model (FEM) and explore various protocols for maxillary protrusion. The study aimed to investigate root displacement and stress distribution in the periodontal ligament (PDL) by varying the retraction position and direction of EMTI applied to the maxillary anterior teeth. No actual participants were involved. The FEM model included six teeth (central and lateral incisors and canines) with a PDL thickness of 0.3 mm. The model encompassing the alveolar bone (ALB) and EMTI had 180,528 elements and 47,836 nodes. The EMTI integrated six anterior teeth via a 0.9-mm-diameter stainless steel lingual wire, equipped with three moment arms extending toward the root apex: one midline (central arm) and two distal to the canines (lateral arms). The position and direction of the traction force applied to the three moment arms of the EMTI were varied to assess crown and apex displacement, as well as PDL stress. Lingual tipping was consistent across all protocols, emphasizing controlled incisor tipping. The application of horizontal traction at 10 mm and traction at 7 mm from the central and lateral arms of the EMTI, respectively, demonstrated the most uniform stress distribution across the PDL of all six anterior teeth. The FEM analysis results suggest that the new EMTI method, which retracts the maxillary anterior teeth as a unit, is effective for tooth movement and PDL stress distribution. The EMTI technique, with its specific traction protocols and emphasis on controlled tipping, appears to be a promising approach for addressing maxillary protrusions.

Arc root dynamics in the context of lightning strikes to aircraft

During lightning strikes to aircraft, there is a displacement of the impacted area on the aircraft’s surface and the dynamic of the arc root is a key to understanding and predicting the damage produced on the aircraft skin. This work aims at studying experimentally this dynamic with a new method of producing sweeping arcs based on a stationary arc and an electromagnetic launcher propelling aeronautical test samples. The experiments are also achieved with a wind tunnel that blows the arc on the test sample for comparison. After a description of the previous experiments of arc root displacement and a distinction between the cathodic and anodic emission processes, this paper characterizes the arc root physical properties with direct visualization through high-speed cameras and electric measurements for different initial conditions. The results are separated by the arc root polarity and discussed to give an insight into the influence of the experimental conditions on the interaction between the electric arc root and the test sample during swept-stroke. It is shown that for a cathodic arc root, the nature of the displacement—continuous or jumping—highly depends on the current level and the speed of the relative motion between the electric arc and the test sample. For an anodic arc roots, the variations of these parameters provoke jumping modes of displacement with different characteristics.

Raman developmental markers in root cell walls are associated with lodging tendency in tef

Main conclusionUsing Raman micro-spectroscopy on tef roots, we could monitor cell wall maturation in lines with varied genetic lodging tendency. We describe the developing cell wall composition in root endodermis and cylinder tissue.Tef [Eragrostis tef (Zucc.) Trotter] is an important staple crop in Ethiopia and Eritrea, producing gluten-free and protein-rich grains. However, this crop is not adapted to modern farming practices due to high lodging susceptibility, which prevents the application of mechanical harvest. Lodging describes the displacement of roots (root lodging) or fracture of culms (stem lodging), forcing plants to bend or fall from their vertical position, causing significant yield losses. In this study, we aimed to understand the microstructural properties of crown roots, underlining tef tolerance/susceptibility to lodging. We analyzed plants at 5 and 10 weeks after emergence and compared trellised to lodged plants. Root cross sections from different tef genotypes were characterized by scanning electron microscopy, micro-computed tomography, and Raman micro-spectroscopy. Lodging susceptible genotypes exhibited early tissue maturation, including developed aerenchyma, intensive lignification, and lignin with high levels of crosslinks. A comparison between trellised and lodged plants suggested that lodging itself does not affect the histology of root tissue. Furthermore, cell wall composition along plant maturation was typical to each of the tested genotypes independently of trellising. Our results suggest that it is possible to select lines that exhibit slow maturation of crown roots. Such lines are predicted to show reduction in lodging and facilitate mechanical harvest.

Four-dimensional analysis of aortic root motion in normal population using retrospective multiphase computed tomography.

Aortic root motion is suspected to contribute to proximal aortic dissection. While motion of the aorta in four dimensions can be traced with real-time imaging, displacement and rotation in quantitative terms remain unknown. The hypothesis was to show feasibility of quantification of three-dimensional aortic root motion from dynamic CT imaging. Dynamic CT images of 40 patients for coronary assessment were acquired using a dynamic protocol. Scans were ECG-triggered and segmented in 10 time-stepped phases (0-90%) per cardiac cycle. With identification of the sinotubular junction (STJ), a patient-specific co-ordinate system was created with the z-axis (out-of-plane) parallel to longitudinal direction. The left and right coronary ostia were traced at each time-step to quantify downward motion in reference to the STJ plane, motion within the STJ plane (in-plane), and the degree of rotation. Enrolled individuals had an age of 65 ± 12, and 14 were male (35%). The out-of-plane motion was recorded with the largest displacement of 10.26 ± 2.20 and 8.67 ± 1.69 mm referenced by left and right coronary ostia, respectively. The mean downward movement of aortic root was 9.13 ± 1.86 mm. The largest in-plane motion was recorded at 9.17 ± 2.33 mm and 6.51 ± 1.75 mm referenced by left and right coronary ostia, respectively. The largest STJ in-plane motion was 7.37 ± 1.96 mm, and rotation of the aortic root was 11.8 ± 4.60°. In vivo spatial and temporal displacement of the aortic root can be identified and quantified from multiphase ECG-gated contrast-enhanced CT images. Knowledge of normal 4D motion of the aortic root may help understand its biomechanical impact in patients with aortopathy and pre- and post-surgical or transcatheter aortic valve replacement.

Reliability and validity of Oswestry Disability Index among patients undergoing lumbar spinal surgery

BackgroundThe objective of this study was to explore the internal consistency and factor structure of the Oswestry Disability Index among patients undergoing spinal surgery. The sample consisted of 1,515 patients who underwent lumbar spinal surgery at a university hospital between 2018 and 2021.MethodsThe patients responded to the Oswestry Disability Index within 2 months before surgery. Cronbach’s alpha was used to assess the internal consistency. The factor structure was evaluated using exploratory and confirmatory factor analyses.ResultsThe average age of 1,515 patients was 58.5 (SD 15.8) years and 53% were women. The mean ODI score was 43.4% (SD 17.4%). Of the patients, 68% underwent microsurgical excision of the lumbar intervertebral disc displacement or decompression of the lumbar nerve roots. The internal consistency of the Oswestry Disability Index was found to be good, with an alpha of 0.87 (95% CL 0.86 to 0.88). Exploratory factor analysis resulted in unidimensional structure. Item loadings on this retained factor were moderate to substantial for all 10 items. One-factor confirmatory factor analysis model demonstrated an acceptable fit. The correlations between the main factor “disability” and the individual items varied from moderate (0.44) to substantial (0.76). The highest correlations were observed for items “traveling”, “personal care”, and “social life”. The lowest correlations were observed for the item “standing”.ConclusionsThe Oswestry Disability Index is a unidimensional and internally consistent scale that can be used to assess the severity of disability in patients undergoing lumbar spinal surgery. In the studied population, “traveling,” “social life,” “sex life” and “personal care” were the most important items to define the severity of disability, while “walking” and “standing” were the least important items. The generalizability of the results might be affected by the heterogeneity and modest size of the studied cohort.Trial registrationNot applicable.

Image Diagnosis of Trigeminal Neuralgia

Classic trigeminal neuralgia is mainly caused by arterial compression; most cases involve the superior cerebellar artery, followed by the anterior cerebellar, basilar, and vertebral arteries. The detection of neurovascular conflicts in trigeminal neuralgia requires special magnetic resonance imaging(MRI)modalities, including high-resolution three-dimensional(3D)-T2 sequence, 3D-time of flight angiography, 3D-T1 sequencing with gadolinium injection, and merged images of these sequences. The conflicting sites are not necessarily restricted to the root entry zone of the trigeminal nerve root and can be located more distally, proximal to the Meckel's cavum. Arterial compression and its severity, including displacement, angulation, distortion, and atrophy of the trigeminal root, are good predictors of the long-term efficacy of decompression surgery. Veins, primarily the transverse pontine vein, comprise 10%-20% of all causative vessels in trigeminal neuralgia. Gadolinium-enhanced 3D-T1 MRI and high-resolution 3D-T2 MRI merged with computed tomographic angiography are useful for detecting venous compression.

Effects of antagonistic muscle actuation on the bilaminar structure of ray-finned fish in propulsion

In this study, the effects of antagonistic muscle actuation on the propulsion of a bilaminar-structure fish fin ray were investigated using a two-dimensional computational flow–structure interaction (FSI) model. The structure and material properties of the model were based on the realistic biological data of the sunfish fin. The effect of muscle actuation was modelled using root displacement offset between the two hemitrichs. Parametric FSI simulations were conducted by assuming a sinusoidal function of the offset over a cycle and varying the amplitude and phase difference between the actuations and pitching/plunging motions. The results show that the phase of muscle actuation is a critical factor affecting its effects. Three performance regions can be identified with different phase ranges, including a thrust-favour region, an efficiency-favour region and a thrust-efficiency-unfavour region. In each region, the relationships among the root actuations, fin-ray kinematics, vortex dynamics and resulting performance are studied and discussed. Furthermore, a strong positive correlation between the trailing–leading amplitude ratio and thrust coefficient as well as a negative relationship between the efficiency and angle of attack at the centre of mass of the fin ray are observed.

504 A Curious Case of a Slow-Growing Intra-Oral Swelling in a Paediatric Patient

Abstract Background A 15-year-old male attended the paediatric dental department as an urgent self-referral. Clinical examination revealed a large, firm lesion in the right maxilla which had been slowly increasing in size for the past year. No altered sensation and facial numbness was detected. The upper right central incisor (UR1) was missing however, a primary central incisor was extracted at the dentist three months prior. Investigations An orthopantomogram (OPG) at initial presentation illustrated a well-defined radiolucency extending from the upper right first molar (UR6) to the upper left central incisor (UL1) with root displacement of adjacent teeth. A subsequent cone beam computed tomography (CBCT) scan identified a well-defined corticated radiolucency with an area of radioopacity of mixed density in the posterior-medial aspect. Buccal expansion and root displacement in the premolar segment were noted. The unerupted UR1 was extremely displaced, lying horizontal and just inferior to the nasal cavity. Diagnosis/Management Differential diagnoses for the anterior right maxilla radiolucency included calcifying epithelial odontogenic tumour, adenomatoid odontogenic tumour and an odontome. The histopathology of the cystic lining taken under general anaesthetic during enucleation and curettage revealed the diagnosis of a calcifying odontogenic cyst. Discussion Calcifying odontogenic cysts are very rare developmental lesions occuring due to proliferation of odontogenic epitheluim and scattered nest cells. As in this case, these cysts are usually associated with unerupted/impacted teeth. Awareness of dental eruption timelines is essential in identifying impacted teeth and associated pathology. Slow growing lesions in the maxilla should be identified early and investigated within multidisciplinary teams.

Central odontogenic fibroma: A case report

The central odontogenic fibroma (COF) is a rare benign odontogenic mesenchymal tumour of jaw bone derived from the odontogenic ectomesenchyme. It is characterized by a fibrous mature stroma with variable number of strands or islands of inactive-looking odontogenic epithelium. The presented case is a 46 years old male complaining of asymptomatic mandibular bony swelling. Radiographically, the lesion is unilocular radiolucent, with root resorption and displacement of teeth. Histopathology showed dense fibrous connective tissue stroma, loosely arranged with spindle and stellate-shaped mesenchymal cells, inactive odontogenic epithelium island and osteoid tissue. In this case report, we also discuss about the types, pathogenesis, and recent concepts regarding COF.

Is 1:1000 adrenaline as a topical haemostat an effective alternative to control bleeding in dentistry and oral surgery?

Minor oral surgery can give rise to bleeding intra- and post-operatively. This can be minimal in most patients; however, it can be more problematic in patients with impaired clotting disorders, liver disease, or taking any form of anticoagulation therapy. Haemostatic agents are available to overcome such bleeding risks. The topical application of 1:1000 adrenaline used in medicine can be considered for use in dentistry. Adrenaline is widely used within medicine, surgery and dentistry. Examples include its use in local anaesthetic agents, in the management of anaphylaxis and as part of the cardiopulmonary resuscitation algorithm. 1:1000 adrenaline used topically for ear, nose and throat surgeries has shown improved visual fields during surgery with better surgical outcomes. It is relatively safe, but in patients with cardiovascular comorbidities, it should be practised with caution. This has precipitated the idea for its use within oral surgical procedures, including canine exposures, third molar surgery, root displacement into the antrum and periapical surgery. The haemostatic effect of 1:1000 adrenaline as an alternative should be considered in operative dentistry and oral surgery to aid in haemostasis and improve intra-operative visualisation, reducing the risk of iatrogenic damage and bleeding, thereby improving treatment outcomes.

Three-Dimensional Characterization of Aortic Root Motion by Vascular Deformation Mapping

The aorta is in constant motion due to the combination of cyclic loading and unloading with its mechanical coupling to the contractile left ventricle (LV) myocardium. This aortic root motion has been proposed as a marker for aortic disease progression. Aortic root motion extraction techniques have been mostly based on 2D image analysis and have thus lacked a rigorous description of the different components of aortic root motion (e.g., axial versus in-plane). In this study, we utilized a novel technique termed vascular deformation mapping (VDM(D)) to extract 3D aortic root motion from dynamic computed tomography angiography images. Aortic root displacement (axial and in-plane), area ratio and distensibility, axial tilt, aortic rotation, and LV/Ao angles were extracted and compared for four different subject groups: non-aneurysmal, TAA, Marfan, and repair. The repair group showed smaller aortic root displacement, aortic rotation, and distensibility than the other groups. The repair group was also the only group that showed a larger relative in-plane displacement than relative axial displacement. The Marfan group showed the largest heterogeneity in aortic root displacement, distensibility, and age. The non-aneurysmal group showed a negative correlation between age and distensibility, consistent with previous studies. Our results revealed a strong positive correlation between LV/Ao angle and relative axial displacement and a strong negative correlation between LV/Ao angle and relative in-plane displacement. VDM(D)-derived 3D aortic root motion can be used in future studies to define improved boundary conditions for aortic wall stress analysis.

Quantification of swallowing movements by ultrasound imaging in normal and disordered subjects

Ultrasound imaging may be useful for tracking oral-pharyngeal structures of the vocal tract critical for effective swallowing, but use of this technology has been hampered by a lack of validation against standard clinical measures derived from x-ray video fluoroscopy (Modified Barium Swallow Studies or MBSS). Here, we compare quantitative tracking of hyoid bone and tongue motion from ultrasound imaging and simultaneously measured MBSS from a range of participants with disordered and healthy swallowing behavior. The proximal edge of the hyoid bone in MBSS and ultrasound recordings is tracked using CASM (Computational Analysis of Swallowing Mechanics) software, while tongue motion is tracked using TonguePART software, originally developed for analysis of speech. Hyoid trajectories and velocities measured from synchronized ultrasound and MBSS recordings are compared and standard deviations of differences between the two measurements are evaluated. Tongue motion during swallowing is characterized by analysis of root, dorsum, and blade displacement, velocity, and timingas well as tongue base retraction in the pharynx. Preliminary findings show quantitatively similar patterns in ultrasound and MBSS, suggesting that ultrasound has potential utility as an accessible tool for bedside diagnosis and biofeedback. Characteristic patterns separating normal from healthy swallowing, as well as potential therapeutic targets for biofeedback treatment of dysphagia, will be discussed.

RETRIEVAL OF DISPLACED ROOT FRAGMENT ASSOCIATED WITH FUNGAL BALL IN THE MAXILLARY SINUS USING FUNCTIONAL ENDOSCOPIC SINUS SURGERY- A CASE REPORT

Introduction: Fungal ball is a non-invasive sinus disease and the incidence of this disease has increased in recent years and also several case reports and case series have suggested a relationship with the accidental displacement of root into maxillary sinus. We report a case where fungal ball was removed along with the dental root fragment which was accidentally displaced into the maxillary sinus following traumatic dental extraction. A 32-years-o Case Report: ld female patient presented to Maxillofacial Surgery Department with complaint of pain in the left orofacial region for one month. The patient had a history of traumatic extraction of posterior maxillary teeth 4 years back. On examination, no dental cause of pain was detected. On further evaluation, a foreign body within the left maxillary sinus was seen in the panoramic radiograph. Computed tomography images revealed displaced root in the left maxillary sinus with surrounding heterogenous soft tissue opacity. Following the detection of foreign body, patient underwent Functional Endoscopic Sinus Surgery (FESS) and the root was retrieved and the adjacent soft tissue specimen was sent for histopathological examination. The presence of fungus consistent with the Aspergillus species was confirmed. Conclusion: This article emphasizes the importance of atraumatic dental extraction, the association of fungal ball with displaced root and the utility of FESS in clearing the same.

Surgical Approach to Odontogenic Maxillary Sinusitis Caused by Tooth Root Displacement into the Maxillary Sinus: A Case Report

Paranasal sinuses affected by foreign bodies are uncommon clinical situations. Foreign body displacement into facial sinuses is a potential iatrogenic complication, that may cause an oroantral fistula, sinusitis, cellulitis, and subdural emphysema. The maxillary sinus is usually the most affected by tooth displacements, due to its proximity. A dental fragment in the maxillary sinus may cause Odontogenic Maxillary Sinusitis (OMS). The present case report presents a case from the diagnosis to treatment of OMS originated by a fragment of tooth root displacement into the sinus during a previous dental extraction. A female patient, 13-yearold, had characteristic signs of sinusitis, reporting rhinorrhoea, headache, eye pain, and pain on the left side of the face. The clinical examination showed pain on palpation in the buccal region of the upper left first molar, which was absent. The Cone Beam Computed Tomography (CBCT) showed a foreign body inside the maxillary sinus, complete opacification, and bone defect on the sinus floor. Given the final diagnosis of OMS, the treatment selected was the combination of antibiotic therapy and fragment removal from the sinus. The diagnosis, planning, and correct use of surgical techniques described in the literature are essential for preventing iatrogenesis and actively ensuring patient health. In this sense, patients need to be informed about any complication, which should be written in the medical records along with resolution measures.

Finite element analysis of complete structure of tower cranes

In order to ensure the safety and stability of the tower crane in operation, the static and dynamic characteristics of the QTZ100 tower crane in typical working conditions are analyzed by the finite element method, so as to verify the safety of its use and put forward targeted suggestions for the optimization of cranes. The results show that the equivalent stress is less than the ultimate design stress of the tower crane, and there is stress concentration in the plate connected between the upper turntable and the lifting arm. The frequency of the fully loaded motor is far from the normal operating frequency of the tower. The horizontal root displacement of the lifting arm corresponding to the peak displacement response is relatively large. The buckling factor of the tower crane is higher than the empirical value. Therefore, to meet the strength and stability requirements of the tower crane, the connection between the upper turntable and the lifting arm should be strengthened. The motor will not resonate with the tower crane when it is fully loaded, and the dynamic rigidity is poor when it works at the frequency corresponding to the peak value. The buckling factor is higher, so the stability is better.

Assessing The Proximity of the Roots of Maxillary Molars and Premolars to the Maxillary Sinus in UAE Residents

Background: The proximity of the roots of the maxillary posterior teeth (MPT) to the maxillary sinus (MS) may result in an increased risk of the development of MS pathology. Moreover, surgical procedures for the MPT, which are close to the MS can result in several complications like oroantral communication and displacement of roots into the MS. Objective: This cross-sectional study evaluated the MPT's proximity to the MS using digital panoramic radiography in a sample of individuals living in the United Arab Emirates (UAE). Methods: A total of 141 panoramic radiographs showing the presence of all MPT were retrieved from the Oral Radiology Department of Ajman University, Fujairah Campus. Thus, the proximity of 1410 MPT to the MS was evaluated on a scale of zero to three. Results: The roots of the first and the second molars are the closest to the MS (χ2 = 374.612; p 0.000). The distance between the roots of MPT and MS did not differ statistically between males and females (χ2 = 2.44, p= .124), nor between the right and left sides (χ2 = 0.46, p= .872). However, there was a highly significant negative correlation between the root-sinus proximity and age. (rho= -.201, p < .001). Conclusion: In UAE residents, the roots of the first and second molars are closer to the MS than other MPT. Therefore, more precautions should be taken when doing a surgical procedure in this region.

Position-based dynamics simulator of vessel deformations for path planning in robotic endovascular catheterization.

A major challenge during autonomous navigation in endovascular interventions is the complexity of operating in a deformable but constrained workspace with an instrument. Simulation of deformations for it can provide a cost-effective training platform for path planning. Aim of this study is to develop a realistic, auto-adaptive, and visually plausible simulator to predict vessels' global deformation induced by the robotic catheter's contact and cyclic heartbeat motion. Based on a Position-based Dynamics (PBD) approach for vessel modeling, Particle Swarm Optimization (PSO) algorithm is employed for an auto-adaptive calibration of PBD deformation parameters and of the vessels movement due to a heartbeat. In-vitro experiments were conducted and compared with in-silico results. The end-user evaluation results were reported through quantitative performance metrics and a 5-Point Likert Scale questionnaire. Compared with literature, this simulator has an error of 0.23±0.13% for deformation and 0.30±0.85mm for the aortic root displacement. In-vitro experiments show an error of 1.35±1.38mm for deformation prediction. The end-user evaluation results show that novices are more accustomed to using joystick controllers, and cardiologists are more satisfied with the visual authenticity. The real-time and accurate performance of the simulator make this framework suitable for creating a dynamic environment for autonomous navigation of robotic catheters.

Surgical management of gigantiform osteoma of angle causing facial deformity

Osteoma is a rare, benign lesion wherein deposition of newly formed bone results in a tumor mass. Variants of osteomas can develop either as a peripheral mass arising from the periosteum or a central mass arising from the endosteum. Peripheral ones are usually asymptomatic and larger lesions primarily cause facial asymmetry. Central osteoma, in most cases results in cortical expansion and root displacement in some. Central osteomas pose a diagnostic dilemma and need to be discriminated from other similar lesions such as condensing osteitis, odontoma, ossifying fibroma, osteoblastoma. Isolated single osteomas are usually non-syndromic whereas, multiple osteomas are hallmark features of Gardner syndrome. Craniofacial bones such as paranasal sinuses and jawbones are frequently affected, although rare cases in other bones and soft tissues have been reported. This is a presentation of osteoma in the rare angle of mandible region in a young patient which was managed by intraoral approach.