JournalTOCs

Case Reports in Dentistry
Journal Prestige (SJR): 0.229

Number of Followers: 6

This is an Open Access Journal

Open Access journal
ISSN (Print) 2090-6447 - ISSN (Online) 2090-6455
Published by Hindawi

[339 journals]

Hemodialysis-Related Amyloidosis in the Tongue
- Abstract: Dialysis-related amyloidosis (DRA) represents a group of relatively rare disorders characterized by the systemic extracellular deposition of insoluble fibrils of amyloid protein in long-term dialysis patients. We describe herein a case of relatively early DRA on the tongue of a long-term dialysis patient. A 67-year-old man with a 39-year history of dialysis was referred for diagnosis of a tongue mass. On examination, a collection of whitish-yellow papules was identified on the ventral surface of the tongue tip. The pathological diagnosis was DRA. Clinicians should be aware that long-term dialysis can cause oral amyloidosis of the tongue.
  PubDate: Wed, 18 May 2022 12:20:01 +000
A Novel Nontraumatic Gingival Retraction Method for a Single-Unit Crown
Impression
- Abstract: Until now, there have been three traditional options for gingival retraction procedures, mechanical, chemicomechanical, and surgical methods, which have a degree of trauma that varies according to the clinical experience. The gingival tissue may be very delicate and susceptible to recession if too much trauma was applied. This article describes a novel nontraumatic gingival retraction method, without cords, chemicals, surgery, or any special equipment.
  PubDate: Wed, 18 May 2022 12:20:01 +000
A Case Report of Dental Implants and Site Augmentation in a Patient with
Erosive Lichen Planus
- Abstract: Lichen planus (LP) is an autoimmune inflammatory disease that affects oral mucosal tissue, leading to complications in patients treated with dental implant therapy. This case report discusses the clinical management of a patient diagnosed with an erosive type of LP. After disease management, the patient was treated with dental implants in the upper and lower jaws with augmentation procedures around the implants. All implants were loaded after a three-month period of healing. Slight bone loss was observed in the upper premolar area following an exaggerated soft tissue response to the augmentation procedure. Within one year of implant placement, no additional complications were encountered.
  PubDate: Mon, 16 May 2022 14:50:01 +000
Orthodontic Management of Skeletal Class II Malocclusion with the
Invisalign Mandibular Advancement Feature Appliance: A Case Report and
Review of the Literature
- Abstract: The treatment of Class II malocclusion due to mandibular retrognathia is one of the most common challenges met in orthodontic practice. When it comes to a growing patient, functional appliances are the optimal way to achieve growth modification by enhancing mandibular growth. Clear aligners have been part of the orthodontic treatment for several decades but until recently they were only used to correct mild malocclusions. In 2017, Align Technology introduced the Invisalign with Mandibular Advancement Feature (IMAF) which replicates the action of functional appliances. As this device is new to clinical practice, there is limited literature on its clinical efficiency. This case report describes the orthodontic management of a 12-year-old male patient having skeletal Class II malocclusion due to mandibular retrognathia. As the patient was experiencing active growth, the IMAF appliance was chosen for his treatment. The IMAF appliance appears to be successful in the treatment of Class II malocclusion with mandibular retrognathism in a growing patient. As with all functional appliances, the correction of the malocclusion is a result of both skeletal and dental effects and the IMAF presents the advantage of producing less proclination of the lower incisors compared to other functional appliances.
  PubDate: Fri, 13 May 2022 11:20:00 +000
Symptomatic Apical Periodontitis of the Mandibular First Molar with the
Accessory Canal in the Furcation Area Mimicking Furcation Perforation
- Abstract: Apical periodontitis frequently presents as a chronic disease. To arrive at a true diagnosis, in addition to the clinical examination, it is mandatory to undertake radiographic examinations and evaluate the clinical presentation. Knowledge of the root canal morphology is a prerequisite for effective nonsurgical endodontic treatment. The internal morphological features of the pulp chamber are variable and complex. This case report describes the treatment and outcome of symptomatic apical periodontitis of a mandibular first molar with the accessory (chamber) canal. The applied treatment fully contributed to the periapical lesion regression as shown in the four-year recall periapical radiography.
  PubDate: Thu, 12 May 2022 11:35:01 +000
Root Membrane Replantation as an Alternative Technique for the Socket
Preservation
- Abstract: Background and Overview. Socket shield is a technique that allows the maintenance of tissue volumes. In the reported clinical case, the replantation of the buccal root fragment mistakenly extracted during a socket shield surgery is performed. We present a follow-up to 5 years with an unexpected healing.Case Description. An 88-year-old patient underwent an immediate loading implant placement associated with the replantation of the mistakenly extracted root fragment. The shaping of the fragment was performed extraorally, and the replantation was done so that the fragment protruded above the crest margin.Conclusions and Practical Implications. The 5-year follow-up shows an uneventful healing of the implant. At 48 months, postoperative CBCT exam reports images compatible with the regeneration of the bone over the portion of root that protruded over the margin. The outcome suggests clinical implications, as the opportunity to easily shape the fragment extraorally and replant sound portion of the root (not necessary the buccal) in buccal socket with bone defect.
  PubDate: Mon, 02 May 2022 04:35:00 +000
Compound Odontoma Associated with Dentigerous Cyst Incidentally Detected
in an Adult Patient: Tomography and Histological Features
- Abstract: Odontoma is the most common benign odontogenic tumor of epithelial and mesenchymal origin. The standard treatment involves a conservative approach. While this procedure is generally well accepted and tolerated, some difficulties may arise in case of odontomas associated with cystic lesions. In general, the expansive nature of cystic lesions requires their surgical excision, different from isolated nonsymptomatic odontomas that can be monitored radiographically. However, to the best of our knowledge, there is scarce evidence currently available reporting on the presence of odontoma-associated cystic lesions in the oral cavity. Therefore, the present case report is aimed at describing the diagnostic clinical, radiological, and histological features together with the surgical management of a dentigerous cyst associated with a compound odontoma. Following surgical removal of the lesion, no recurrence was observed after 12 months of follow-up.
  PubDate: Mon, 02 May 2022 04:35:00 +000
Orthodontic Management of a Rare Incidence Bilateral Maxillary
Canine-First Premolar Transposition Using Fixed Appliance
- Abstract: Objective. A change in the location of two permanent teeth within the same quadrant of the dental arch is known as tooth transposition. This article illustrates the nonextraction treatment of a bilaterally complete transposition between maxillary canines and first premolars, using fixed mechanics. Material and Method. Upper and lower preadjusted, edgewise, fixed appliances with MBT prescription ( slot size brackets) were used for the treatment. After providing room for the canine teeth, the piggyback technique was used to bring the right canine to the arch in the position of the first premolar. In the final phase of treatment, both the upper and lower arches had stainless steel wire with Class II elastic 4 oz on the right and left sides. Result. It showed that the maxillary first premolars and canines were favorably aligned into transposed position. The upper right and left premolars occluded with the lower canines in Class I relationship and good intercuspation as well as skeletal and molar Class I relationships were maintained with a pleasant facial profile. Conclusion. The early diagnosis plays a significant role as much as considering esthetics and function factors in deciding which treatment strategy should be followed. The key to a successful and stable result is substantial treatment planning and careful orthodontic management.
  PubDate: Fri, 29 Apr 2022 13:05:00 +000
The Alteration of Brain Function by the Improvement of Periodontal Tissues
and Occlusal State
- Abstract: Objective. In this study, we have introduced a case in which the effective blood oxygenation level-dependent signal on functional magnetic resonance imaging (fMRI) was altered by the improvement of periodontal tissue and occlusal function in a patient with periodontitis Stage II Grade B. Material and Methods. A 61-year-old female patient requiring periodontal treatment was diagnosed as having periodontitis Stage II Grade B via clinical and radiographic examinations. Her past medical history included type 2 diabetes, hypertension, and hyperlipidemia. Following the patient’s informed written consent, the periodontal initial treatment provided to the patient included tooth brushing instruction and scaling and root planing; however, occlusal adjustment was not performed at this stage. Occlusal force and fMRI results were also evaluated at the initial and reevaluation examinations. Results. After the periodontal initial treatment had been performed, it was noted that the patient’s periodontal tissue and occlusal force had improved. It was also evident from fMRI that cerebral blood flow had been activated in the insula, primary motor cortex, and premotor cortex. Conclusion. This result suggested that the periodontal ligament had recovered and the periodontal ligament neuron had been further subjected to clenching in the insula so that the muscle spindle sensation impacted the motor cortex.
  PubDate: Wed, 27 Apr 2022 10:05:00 +000
A Successful Esthetic Approach of Gingival Depigmentation Using
Microneedling Technique and Ascorbic Acid (Vitamin C)
- Abstract: A gingival depigmentation is a periodontal plastic procedure that is performed in order to remove melanocytic pigmentation. A variety of different modalities have been proposed for removing hyperpigmentation involving surgical scraping, gingival autograft, cryotherapy, electrosurgery, and lasers. However, the microneedling technique is a nonsurgical procedure that creates microholes to facilitate the penetration of topical medications across the connective tissues. Case Description. A healthy female patient aged 25 years with a pigmented gingiva seeking gingival depigmentation. On examination, a dark brown ribbon of hyperpigmentation was observed within the mandibular attached gingiva. The case was diagnosed as physiological moderate gingival pigmentation (). The patient was interested in achieving aesthetic results with minimally invasive, nonexpensive procedures. Based on the patient’s concerns, the microneedling technique using vitamin C was suggested and consented. We used a dermapen device to microneedle the gingiva until bleeding pinpoints were observed; then, topical ascorbic acid was applied. After 3 days, our outcomes revealed an excellent aesthetic pink gingival appearance. Conclusions and Practical Implications. Compared to other minimally invasive techniques, our technique is less expensive and more risk-free. Our novel technique of using dermapen and topical ascorbic acid has shown promising results to our case which gives new perspectives for its application in gingival depigmentation.
  PubDate: Mon, 25 Apr 2022 09:05:00 +000
Dental Management of a Tunisian Child with Sanjad-Sakati Syndrome
- Abstract: Sanjad-Sakati syndrome (SSS) is a rare autosomal recessive congenital disorder. The present case report is aimed at describing the orofacial manifestations and dental management of a 4-year seven-month-old, Tunisian boy with SSS. The patient has typical dysmorphic facial features and growth retardation. Intraoral examination revealed micrognathic mandible and maxilla, an arched palate, and small dental arches with an open bite. All the maxillary and mandibular teeth were decayed due to the poor oral hygiene, plaque accumulation, and enamel hypoplasia. Oral rehabilitation involved pulpotomies and root canal therapies on decayed teeth. Resin composite restorations were performed on maxillary and mandibular incisors, and stainless-steel crowns were placed on maxillary and mandibular first and second primary molars. Dental treatment of children with SSS should improve their quality of life and their general health. Undeveloped dental arches associated with dental anomalies as well as learning deficit make very difficult of the oral rehabilitation of such patients.
  PubDate: Fri, 22 Apr 2022 12:20:00 +000
Primary Extra Nodal Diffuse Large B-Cell Lymphoma of the Maxillary Sinus
with Symptoms of Acute Pulpitis
- Abstract: Diffuse large B-cell lymphoma not otherwise specified (DLBCL-NOS) is a subtype of large B-cell non-Hodgkin lymphoma with various clinical and pathological manifestations. DLBCL-NOS which primarily arises from maxillary sinus is rare and hard to diagnose due to unique anatomy. Here, we present a case of DLBCL-NOS that developed in the left maxillary sinus of a 72-year-old male, who presented with severe toothache that resembled acute pulpitis. The lesion was diagnosed and treated based on radiographs, histological, immunohistological examinations, and PET-CT analysis. Despite its rare incidence, DLBCL-NOS should still be included in differential diagnoses to rule out malignancy in cases of endodontic disease.
  PubDate: Thu, 07 Apr 2022 08:20:00 +000
Angiofibroma of the Mandible: Report of a Rare Case
- Abstract: Angiofibroma is an uncommon, highly vascular benign lesion that occurs in the head and neck region, typically arising in the nasopharyngeal area, potentially with a locally aggressive course. Angiofibroma with a primary intraoral presentation is extremely rare; few case reports have been published in the literature, with only three cases of angiofibroma in the mandible published to date. In this case, a 37-year-old man presented with swelling at the right mandible and underwent enucleation of the lesion under general anesthesia. After 1-year follow-up, there were no signs of recurrence.
  PubDate: Tue, 05 Apr 2022 04:35:01 +000
Digital Workflow for Immediate Implant Placement and Chairside
Provisionalization in the Esthetic Zone
- Abstract: Introduction. Immediate implant placement and immediate chairside provisionalization in the esthetic zone require meticulous treatment planning. A digital workflow that combines intraoral scans and a cone beam computed tomography scan can be used to visualize the surgical and restorative aspects of the treatment and to plan a prosthetically driven implant position. A digital workflow in implant dentistry enables the prefabrication of an individualized CAD/CAM temporary restoration, based on the planned implant position. This could be a predictable method to deliver a screw-retained temporary restoration, directly after static computer-assisted immediate implant surgery. Interventions. Three patients with a failing tooth in the maxillary esthetic zone were treated with immediate implant placement and chairside provisionalization using this digital workflow. After 3 months, a final restoration was placed. Clinical, radiographic, and patient-reported outcome measures were collected prior to implant treatment, 6 weeks after placing the temporary restoration and then 1 month and 1 year after placing the final restoration. Outcomes. At the 1-year follow-up, healthy soft tissues were observed, and peri-implant bone levels were stable. Patient satisfaction after the treatment was high. Conclusion. The three reported cases demonstrate the potential for predictable immediate implant placement and chairside provisionalization using a digital workflow.
  PubDate: Fri, 01 Apr 2022 09:35:00 +000
Endodontic Management of Mandibular Second Premolar with Vertucci Root
Canal Configuration Type V
- Abstract: The diversity of root canal anatomy in permanent dentition is quite common. Understanding the basic anatomy of the root canal morphology and its variations is particularly important for successful root canal treatment. Mandibular second premolar usually consists of a single root with a single root canal. The presence of split roots in the apical third of the root with two separate root canals is quite rare. The major cause of endodontic failure in missed canals is that it harbors bacteria and other microorganisms. Careful radiographic interpretation and clinical examination of the pulp chamber will be helpful in locating canal orifices. The mandibular premolars with Vertucci type V canal configuration pose a challenge in clinical management. Identifying them early is important to aid appropriate modification in treatment protocol. In this case report, important modifications of clinical steps and application of magnification for successful management with access chamber modification are explained.
  PubDate: Fri, 01 Apr 2022 07:35:00 +000
MAML2-Rearranged Mucoepidermoid Carcinoma of the Parotid Gland: A Report
in a 20-Month-Old Toddler
- Abstract: Malignancies of salivary gland origin are rare in children. Mucoepidermoid carcinoma (MEC) is the most common histologic type of salivary gland neoplasm in pediatrics. We report a rare case of parotid MEC in a 20-month-old female patient. The tumor was composed of nests of epidermoid cells with nuclei appearing vesicular, pleomorphic, and hyperchromatic with an admixture of mucous cells and cystic spaces within a prominent connective tissue stroma. Immunohistochemically, the epidermoid cells showed cytokeratin 7 and P63 positivity, and mucous cells were positive for mucicarmine. Molecularly, this case was positive for MAML2 rearrangement by FISH. To our knowledge, this is one of the youngest cases of MEC of the parotid gland reported in the English literature.
  PubDate: Tue, 29 Mar 2022 11:05:02 +000
Rosuvastatin-Induced Oral Ulcer: A Case Report and Review of Literature
- Abstract: Background. The benefits of prescribing statins are well published in the treatment of hypercholesterolemia. With such widespread usage of statins, physicians may be ignoring or misdiagnosing the association of oral side effects with these medications. Case Summary. A 54-year-old man presented with a painful ulceration on the dorsum of his tongue that had been recurring for 10 months. Originally, he experienced a burning sensation on his tongue, and as the lesion advanced, the pain became more intense specially when consuming spicy or acidic foods. He is on rosuvastatin for the treatment of hypercholesterolemia for over five years. Several months prior to the lesion forming, his physician increased his daily dosage of rosuvastatin from 10 mg to 20 mg. Four weeks later at a follow-up appointment, all workup did not show any significant findings, the examination revealed a new ulcer on the dorsum of the tongue, and he reported no improvement after antifungal lozenges, nor when administered a short one-week treatment with oral steroids. After eight weeks of statin discontinued, the patient showed improvement with no episodes of ulceration. Conclusion. Physicians do note that statins affect multiple immunological pathways, which could explain some adverse cutaneous reactions. More research is needed in discovering the link of statins and oral disorders.
  PubDate: Tue, 29 Mar 2022 11:05:02 +000
Multiple Nonsyndromic Unerupted Supernumerary Teeth: A Report of a Rare
Case
- Abstract: Introduction. The prevalence of nonsyndromic multiple supernumerary teeth is less than 1% of all hyperdontia cases which themselves have a rather small prevalence. Cases with 10 impacted nonsyndromic supernumerary teeth are extremely rare. This report presents such a case of nonsyndromic multiple impacted supernumerary teeth. Case. A 17-year-old boy with a completely orthodontic chief complaint attended our center. He had no systemic complaints and no signs or symptoms. Oral examination showed no abnormalities. On routine pretreatment panoramic radiography, numerous impacted supernumerary teeth appeared. A CBCT showed 10 impacted vertically aligned supplementary supernumerary teeth with incomplete roots: In the maxilla, the bilateral canine-premolar areas were involved, each having 2 supernumerary teeth palatal to the permanent teeth. In the mandible, the right premolar area included 2 supernumerary teeth. The left premolar-molar area contained 3 supernumerary teeth lingual to the permanent teeth. And in the right mandibular molar area, there was a distomolar tooth distal to the third molar. No bony ankyloses, root resorptions, or fusions were observed. The surrounding bone had become thinner and the mandibular alveolar canal was involved. Interventions. All supernumerary teeth except a mandibular distomolar were extracted carefully before beginning the orthodontic treatment. No complications were seen after the extraction, after orthodontic treatment, and 2 years after treatment. Conclusions. The possibility of completely hidden unerupted supernumerary teeth without any signs and symptoms might highlight the value of some radiographic screenings.
  PubDate: Tue, 29 Mar 2022 11:05:02 +000
Nonsyndromic Generalized Radiculomegaly of Permanent Dentition: A Rare
Case Report
- Abstract: Introduction. Radiculomegaly (marked elongation of dental roots) is a distinct dental abnormality with a major clinical significance that is closely related to oculofaciocardiodental syndrome (OFCD). Since OFCD syndrome was first identified in 1996, only a few cases of nonsyndromic/nonfamilial radiculomegaly have been reported. We report a new nonsyndromic/nonfamilial radiculomegaly case and the association of OFCD syndrome with the dental challenges. Case Presentation. 18-year-old medically free male presented to the screening dental clinics complaining of teeth malposition. Panoramic radiograph incidentally revealed extremely long and wide roots of almost all dentition. Apical radiographs and cone-beam computed tomography (CBCT) were taken to confirm this anomaly and to rule out any artifact. The images confirmed the excessive length of the roots. A cephalometric X-ray was performed on the patient to rule out any dentofacial deformity. History and physical examinations were negative for ocular or cardiac anomalies. Due to lack of evidence of physical signs and symptoms consistent with OFCD syndrome, genetic testing was not performed. Conclusion. Dentists need to be informed of the clinical and radiographic features of different dental anomalies, especially radiculomegaly, as it is considered one of the significant features of OFCD syndrome. Challenges related to radiculomegaly face dentists while the current literature has not yet provided a solid baseline for managing such patients. The challenges include repairing the root canals, extracting and/or moving the teeth orthodontically. Early diagnosis of the syndrome is crucial to prevent dental challenges and provide the best dental care services.
  PubDate: Tue, 29 Mar 2022 10:50:01 +000
A Case of Drastic Reduction of Membranous Substances in the Pharynx by
Interprofessional Cooperative Oral Care
- Abstract: Membranous substances in the pharynx are occasionally observed in tube feeding patients during the fiberoptic endoscopic evaluation of swallowing. Although the mechanism of the formation of these deposits sometimes causes problems, such as dysphagia, asphyxia, or aspiration pneumonia, a 91-year-old male complained about difficulty of swallowing. He had a history of cerebral infarction and aspiration pneumonitis. There was a large amount of oral desquamated epithelium, dental plaque, and calculus in his mouth. Nurses and care workers administered oral care such as rubbing the tongue and buccal mucosa daily. Dentists and oral hygienists visited and provided special oral care three times per week. At least for 77 days, the patient had no recurrence of pneumonitis. The oral desquamated epithelium and membranous substances in the pharynx decreased drastically. 2 months after the first examination, the patient was able to start rehabilitation with food. Some studies have indicated that pharyngeal deposits are derived from the oral mucosa, and through our case, we realized the importance of daily oral care by interprofessional work to reduce membranous substances in the pharynx.
  PubDate: Sun, 27 Mar 2022 12:05:00 +000
Anatomical Variant of Spinal Accessory Nerve Passing through Fenestrated
Internal Jugular Vein
- Abstract: Neck dissection (ND) is a major surgery for head and neck cancer. Currently, some or all of the spinal accessory nerve (SAN), sternocleidomastoid muscle, and internal jugular vein (IJV) are aggressively preserved during ND to reduce postoperative complications. Since the anatomical relationship between the SAN and IJV has several variations, knowledge of these variations is necessary to avoid iatrogenic damage. In the present case, the SAN was observed to pass through the fenestrated IJV at the level of the posterior belly of the digastric muscle during ND in a patient with squamous cell carcinoma of the mandible. Although the anatomical structure of the SAN and IJV is rare, surgeons must be aware of this anatomical variation.
  PubDate: Sat, 26 Mar 2022 07:50:00 +000
Multilayer Super-Translucent Zirconia for Chairside Fabrication of a
Monolithic Posterior Crown
- Abstract: This case report describes the chairside fabrication of a monolithic posterior crown using a multilayer super-translucent zirconia material. According to the manufacturer’s information, the newly introduced multilayer zirconia (4-YTZP) offers a unique combination of fracture strength (>850 MPa with speed-sintering) and improved optical properties, thus allowing a reduced minimum material thickness and optional temporary luting. By using up-to-date components of the CEREC system, including superfast dry-milling and a speed-sintering process, the fabrication of a monolithic zirconia crown is possible within an acceptable timeframe for the chairside workflow (60-75 min). The usage of a multilayer super-translucent material allows for the individualization of the restoration, typically in a single combined stain and glaze firing. However, it should be noted that clinical data for this type of restoration are still sparse. Therefore, manufacturer recommendations regarding indication, preparation, and cementation must be followed very strictly.
  PubDate: Wed, 23 Mar 2022 07:50:00 +000
Rehabilitation Considerations for Very Young Children with Severe
Oligodontia due to Ectodermal Dysplasia: Report of Three Clinical Cases
with a 2-Year Follow-Up
- Abstract: Introduction. Management of oligodontia can be complicated and requires multidiscipline care, involving a wide spectrum of interventions. The aim of this report is to describe the challenges of oral rehabilitation of three very young children with oligodontia. Report. Three preschool aged Caucasian males, diagnosed with ectodermal dysplasia, were treated with interim removable dentures in order to replace missing teeth, reclaim vertical dimension, and improve function and aesthetics. The main challenges faced were patient cooperation, dental and skeletal characteristics, and parental expectations. Two years post-treatment, both patients and parents reported excellent adaptation to prosthesis and satisfaction with aesthetics. Conclusion. Rehabilitation of oligodontia may be challenging due to accompanying oral findings, dentofacial growth considerations, and behavioral issues. Establishment of good rapport between patients, parents, and clinician is the key for the success of the treatment even with the use of nonpharmacological behavioral management techniques.
  PubDate: Tue, 22 Mar 2022 08:35:00 +000
Active Peripheral Osteoma in the Mandibular Notch: A Longitudinal Clinical
Report
- Abstract: Osteomas are benign osteogenic tumors composed of mature compact or cancellous bone and are characterized by slow, painless growth. A peripheral osteoma located in the mandibular notch is extremely rare. Here, we describe the case of a 38-year-old woman with an active peripheral osteoma in the mandibular notch for long-term follow up. Surgical resection of the lesion was performed, which resulted in the improvement of the mandibular function and temporomandibular dysfunction. This is the first report of resection surgery after confirming the activity of peripheral osteoma by bone scintigraphy. Creating a three-dimensional model of the mandible promises an accurate surgical plan.
  PubDate: Tue, 22 Mar 2022 08:05:01 +000
Customized Allogeneic Bone Augmentation Improves Esthetic Outcome in
Anteromaxillary Dental Implantation
- Abstract: Purpose. In cases of severe atrophic maxilla or maxillary involution, augmentation is necessary for implant-supported prosthetics. Using bone grafts is a standard procedure, and using customized allogeneic bone blocks may be a predictable alternative before dental implantation. Clinical Findings. This case study shows the digital workflow, including a preimplantological augmentation by a customized allogeneic block, followed by soft tissue optimization and template-based dental implantation, after six months of healing. It is part of a three-year follow-up study on the resorption rate of allogeneic bone blocks. Outcomes. Allogeneic bone augmentation is an alternative treatment option to autologous bone grafts. It allows predictable advanced backward planning (ABP) even in the maxillary esthetic zone. Diameter-reduced implants show long-term stability of a minimum of three years after loading and excellent results of prosthetic fixtures. Conclusion. Prefabricated customized allogeneic blocks for augmentation may increase the fitting accuracy of the graft, decrease morbidity, and reduce the operation time in esthetic maxillary rehabilitation.
  PubDate: Tue, 22 Mar 2022 04:35:00 +000
Osteosarcoma of the Mandible in an Elderly Patient
- Abstract: Osteosarcoma is a malignant tumor in which the cancerous cells produce an osteoid matrix or mineralized bone. Jaw bones are affected in 6% of all osteosarcomas and are the fourth most common site of origin. Surgical treatment of osteosarcoma in elderly patients is rarely reported. Here, we report successful treatment of osteosarcoma arising in the mandible of a 90-year-old man. The patient was referred to our institution for diagnosis and treatment of an oral lesion. Intraoral examination revealed that a hard mass measuring was located on the floor of the oral cavity, attached to the bone, and its growth displaced the tongue posteriorly. Therefore, he experienced difficulty in speech and swallowing. Biopsy of the mandibular mass was suspicious for chondrosarcoma. Preoperative examination did not detect critical risks for general anesthesia or surgery. Based on a clinical diagnosis of a malignant bone tumor of the mandible, segmental mandibular resection with reconstruction using a titanium plate was performed. Surgical site infection occurred on postoperative day 12, which was resolved by drainage, local irrigation, and administration of antibiotics. There was no delirium or cardiovascular or pulmonary complications. Surgery resolved the patient’s difficulties in speech and swallowing. There was no evidence of tumor recurrence or metastasis 4 years after surgery. This case showed that it was not necessary to exclude surgical treatment merely because the patient was 90 years old. Indications for surgery should be determined individually to improve the patient’s quality of life.
  PubDate: Thu, 17 Mar 2022 07:35:00 +000
Management of 3 Avulsed Permanent Teeth: Case Report of a 3-Year Follow-up
- Abstract: Dental avulsion is one of the most serious dental injuries. When the tooth is knocked out, the blood supply to the pulp is interrupted and the periodontal ligament cells are exposed to injuries caused by the external environment. In recent years, research findings have shown the possibility of complete healing under favorable conditions: replanting the tooth according to the criteria required by the guideline such as the extra oral time which should be very short, the time of pulp removal after replantation, and the appropriate storage medium. This set of criteria may lead to a slower progression of the phenomenon of resorption with a better prognosis over time; however, there is a high risk of complications such as external root resorption which lies in late replantation. The research results of many research-groups around the world have given us a better understanding of healing and complications. Nowadays, even teeth that are replanted after a delay can be saved. The dentist remains the key person in the case of dental trauma, namely, dental avulsion as his role is the management of the emergency situations. The objective of this case study is to present a successful management of 3 avulsed permanent incisors, replanted and remained with no complications for over a period of 3 years.
  PubDate: Wed, 16 Mar 2022 11:20:00 +000
Osteoblastoma and Osteoid Osteoma of the Mandible: Review of the
Literature and Report of Two Cases
- Abstract: Osteoblastoma and osteoid osteoma are rare benign neoplasms of the jaws. We reviewed current literature surrounding the ongoing debate over similarities and differences of osteoblastoma and osteoid osteoma and present two cases. Both cases are well-demarcated mixed radiodensity mandibular lesions with histological features of osteoblastoma. They exhibit, however, distinctly unique and contrasting clinical and imaging characteristics suggesting that the first case is osteoblastoma and the second is osteoid osteoma. The first case of a 37-year-old male presents with a large, expansile lesion at posterior mandible, surrounded by a thick sclerotic band. Unusual features include significant buccal/lingual expansion, extensive new bone apposition, and soft tissue edema in the masseter muscle. This is in contrast to the second case of a much smaller lesion in a 17-year-old male with history of recent third molar extraction in the left posterior mandible. In this case, CT imaging revealed a circular, nonexpansile lesion with a sclerotic border surrounded by a radiolucent rim. Both patients underwent surgical excision of the lesion with extraction of the adjacent tooth. We discuss herein the distinct clinical and imaging features.
  PubDate: Tue, 08 Mar 2022 08:50:02 +000
A Multidisciplinary Approach to Malocclusion Caused by Facial Multiple
Fracture
- Abstract: In the case of multiple facial fractures, a simple open reduction occasionally causes various disorders during healing process after the surgery. Moreover, esthetic disturbance of a facial deformity might be induced. Therefore, the acquisition of facial symmetry and the recovery of occlusal and masticatory functions become increasingly important. This case report presents a successful treatment of facial multiple fracture induced by a car accident. A 20-year-old male was diagnosed with suffered multiple midface and mandibular fractures induced by a car accident. Midface fractures included the LeFort I and II type fractures, as well as sagittal fracture at midline and fractures from right maxillary sinus anterior wall to orbital wall. In the mandible, midline and left body fractures were detected. The patient underwent open reduction and rigid fixation of the fractured left zygoma, comminuted LeFort I and II fractures, and midline and left body of the mandible with intermaxillary fixation by multibracket appliance; maxillary osteotomy with iliac bone grafting; orthognathic two-jaw surgery with coronoid process grafts onto the depressed zygoma; and onlay graft of hydroxyapatite block on mandible. As the result, the multidisciplinary treatments successfully recover functions and esthetics to the satisfactory level of the patient with multiple facial fractures. As treatments for multiple facial fractures are required complexity due to the extent of trauma, multidisciplinary approach under the close cooperation between hospital departments is thought to be important.
  PubDate: Thu, 03 Mar 2022 11:35:00 +000
Canine Rise Method: A Conservative Approach for Worn Teeth Rehabilitation
with Different Adhesive Restorative Materials
- Abstract: Background. In this article, two cases with generalized dental wear and four cases with localized dental wear are reported. In some of the cases, the worn teeth were restored with direct composite techniques with no mock-up and articulator mounting according to the canine rise method. This method is used without any change in the intercuspation of posterior teeth without a muscle relaxation appliance. It introduces a stable occlusal condition that can alter neuromuscular reflex activity, leading to improvements in certain muscle pain disorders. It is also used to protect the teeth and supporting structures from abnormal forces that might create a further breakdown and/or tooth wear. Methods. The first step of treatment in all the cases was a composite build-up for maxillary and mandibular canines to restrict and guide the horizontal and vertical jaw movements and create adequate space for restorations. The second step was the placement of direct or indirect restorations on upper and lower anterior teeth efficiently and accurately. Results. This method enhanced the esthetic outcomes in a conservative approach with no reduction in tooth material or time-consuming treatments. Conclusions. This technique can be suggested for the treatment of worn teeth in patients with Angle’s Cl I and Cl II classifications of malocclusion based on the follow-up results. It is not applicable for the treatment of worn teeth in patients with Angle’s class III because occlusion is reversed, and canine teeth do not have guidance role. Practical Implications. This method significantly reduces the overall treatment time, and additional steps are required to restore the worn-out teeth and/or occlusion using the canine rise method.
  PubDate: Sun, 27 Feb 2022 12:35:01 +000