Today was the day for my appointment with the oral surgeon, and we’re finally getting some answers, if not some relief. Initially they did a panoramic x-ray, but that didn’t show much of anything, so Dr. Miller ordered a 3D CT image. After having a look at that and a peek inside my mouth, he told us that what I had was likely a brown tumor;
The brown tumor is a bone lesion that arises in settings of excess osteoclast activity, such as hyperparathyroidism. It is not a true neoplasm, as the term “tumor” suggests; however, it may mimic a true neoplasm.
Pathology
Brown tumours consist of fibrous tissue, woven bone and supporting vasculature, but no matrix. The osteoclasts consume the trabecular bone that osteoblasts lay down and this front of reparative bone deposition followed by additional resorption can expand beyond the usual shape of the bone, involving the periosteum thus causing bone pain. The characteristic brown coloration results from hemosiderin deposition into the osteolytic cysts. Hemosiderin deposition is not a distinctive feature of brown tumors; it may also be seen giant cell tumors of the bone.
Well, the pathology sure seems to fit my situation; the front of reparative bone deposition has been expanding the bone around those teeth enough to shove the teeth around to where they should not be, and making life miserable for me. The doc is reasonably sure that’s the deal, but only a biopsy will tell for sure, and that’s scheduled for next Monday. And the great part of the biopsy is that they’ll remove the tumor/lesion/whatever it is, but I’ll probably lose a couple of teeth in the process. Great. And I don’t even get to keep them, which is really too bad because I’ll probably need to get dental implants later on, and it would just make so much sense to use them for the implants… The assistant told me they are considered a biohazard, so they go to the incinerator. Too bad.
When the tumor is removed, there will likely be a sizable gap left behind; a variety of materials will be used to fill it in, and with time the other teeth ought to migrate back to their original positions. Eating will be easier, but not back to normal because of the missing teeth; later, after things heal up, and I can afford it, the option of implant-supported crowns is there. And I’ll look a bit trailer-park-ish with the missing teeth, but the fact that it’s most likely non-cancerous is enough to make me very, very thankful. I can live with trailer-park-ish; radiation & chemo therapy… I’ll pass, thanks.
Now I just need to figure out how to make it through the next few days and nights; eating will still be a challenge, but oatmeal and other soft foods aren’t all bad. The surest path to a good night’s sleep that I’ve found is two Vicoden, two ibuprofen, and my SleepRight Dental Guard. My mouth still hurts like crazy when I wake up, but things look so much better after a good restful night. Knowing that it’s not cancer, and knowing there is light at the end of the tunnel is huge. After last Thursday I was praying & hoping for the best, but bracing for the worst. I know God is good — all the time — and he will see me through whatever comes, but I still worried about my ability to cope. This won’t be an easy path, but I have some hope.
