Case #2


	Upon taking a medical history, you find that Mrs. Evans is 37-years-old and has mild hypertension for which she takes propranolol 40mg BID. She has taken this medication for 2 years and takes no other medications other than ibuprofen as needed for her dental pain. Mrs. Evans’ surgical history includes a tubal ligation 5 years ago and a tonsillectomy and adenoidectomy as a child. She had no complications with these procedures. She has a 25-pack-year smoking history, although she hasn’t smoked for 3 years. Her medical history is otherwise unremarkable.


	Upon initial examination, Mrs. Evans’ blood pressure is 136/84. Her vital signs are stable and she is afebrile. Extraorally, her physical findings are unremarkable.



		*Upon retraction of her left upper lip, a fluctuant swelling is clearly identified in the buccal vestibule at the premolar region.*


	There is a porcelain-fused-to-metal bridge spanning from maxillary left canine to the left second premolar. Percussion of these teeth is not painful and probing depths are all less than 4mm. To examine all local structures, an occlusal radiograph is made.


	After considering the following questions, continue to the next page.


	*What is the differential diagnosis for Mrs. Evans’ lesion?* *How would you proceed to treat this lesion?* *What would you tell Mrs. Evans?*


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