Case Reports in Dentistry The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. Prosthodontic Management of Xerostomic Patient: A Technical Modification Wed, 10 Feb 2016 06:39:07 +0000 Xerostomia is often a contributing factor in both minor and serious health problems. It can affect nutrition and dental as well as psychological health. Common problems faced by such patients are glossitis, mucositis, angular cheilitis, dysgeusia, and difficulty in chewing and swallowing. One of the major problems associated with xerostomic patients is the poor tolerance and retention of removable dental prostheses because of thin dry atrophic mucosa and lack of a saliva film. This paper describes a new technique of incorporating a salivary reservoir in the maxillary complete denture. The salivary reservoir fabricated by this technique provided good lubrication of the oral tissues and was easily cleansed by the wearer and was fabricated from routine denture materials. Haraswarupa Gurkar, Omprakash Yadahally Venkatesh, Jagadeesh Mandya Somashekar, Muthuraj Hariharapura Lakshme Gowda, Madhavi Dwivedi, and Ishani Ningthoujam Copyright © 2016 Haraswarupa Gurkar et al. All rights reserved. A Case of Brain Abscess Caused by Medication-Related Osteonecrosis of the Jaw Tue, 02 Feb 2016 09:38:33 +0000 Reports of brain abscesses caused by medication-related osteonecrosis of the jaw (MRONJ) are very rare. We here present the case of a 76-year-old man with terminal-stage prostatic carcinoma and a brain abscess caused by MRONJ at the maxilla. The patient had been treated with zoledronic acid and denosumab for bone metastasis. For the brain abscess, an antibiotic regimen based on ceftriaxone and metronidazole and a sequestrectomy contributed to a successful outcome. In the case of maxillary MRONJ extending to the maxillary sinus, active resection of the infected bone should be considered to prevent the spread of the infection beyond the maxillary sinus, into the ethmoid sinus, and into the brain. Kenji Yamagata, Hiroki Nagai, Osamu Baba, Fumihiko Uchida, Naomi Kanno, Shogo Hasegawa, Toru Yanagawa, and Hiroki Bukawa Copyright © 2016 Kenji Yamagata et al. All rights reserved. Long-Term Follow-Up of a Revascularized Immature Necrotic Tooth Evaluated by CBCT Mon, 01 Feb 2016 14:33:34 +0000 This case study reports the successful treatment of an immature upper premolar with periapical pathosis and sinus tract using revascularization technique. Clinical and radiographic examination demonstrated the recovery of vitality, continued root development, and periapical healing at the 7-month follow-up. In addition, severe calcification of the canal was noted at the 36-month follow-up. At the 66-month follow-up, cone-beam computed tomography (CBCT) revealed complete periapical healing, apical closure, increase in root length and thickness of dentin, and severe calcification of the root canal. Even though the nature of tissue within the root canal is unknown, revascularization appears to give good clinical and radiographic success. This case report highlights that severe calcification of the canal is one of the long-term outcomes of revascularized root canals. C. M. L. She, G. S. P. Cheung, and C. F. Zhang Copyright © 2016 C. M. L. She et al. All rights reserved. Treatment of Class III with Facemask Therapy Wed, 27 Jan 2016 07:20:21 +0000 Class III malocclusion is one of the most difficult problems to treat in the mixed dentition. It has a multifactorial etiology involving both genetic and environmental causes. The dental and skeletal effects of maxillary protraction with a facemask are well documented in several studies. Although treatment in the late mixed or early permanent dentition can be successful, results are generally better in the deciduous or early mixed dentition. The following case shows early treatment of a young patient with severe sagittal and transverse discrepancy of the maxilla and mandible, using a facemask. Snigdha Pattanaik and Sumita Mishra Copyright © 2016 Snigdha Pattanaik and Sumita Mishra. All rights reserved. Management of Horizontal Root Fracture in the Middle Third via Intraradicular Splinting Using a Fiber Post Sun, 24 Jan 2016 14:17:26 +0000 Radicular fractures in permanent teeth are uncommon injuries and account for only 0.5–7% of dental traumas. These fractures commonly result from a horizontal impact and are transverse to oblique in direction. Their incidence is more in the middle third of the root than at the apical and cervical thirds. This paper describes a case of complicated crown fracture of maxillary incisors along with horizontal root fracture at the middle third of maxillary right central and lateral incisor. The fractured root fragments of the upper right central and lateral incisor were united with the help of a glass fiber post after receiving an endodontic treatment. The other two incisors were treated endodontically followed by post endodontic restorations. Eventually the four incisors were restored with porcelain fused to metal crowns. A one-year follow-up revealed a well stabilized assembly of the root fragments and the post. Ishani Karhade and Meenal N. Gulve Copyright © 2016 Ishani Karhade and Meenal N. Gulve. All rights reserved. Nasolabial Cyst Associated with Odontogenic Infection Sun, 24 Jan 2016 12:33:31 +0000 The nasolabial cyst or Klestadt cyst is a relatively uncommon nonodontogenic cyst that develops in the nasal alar region; it has uncertain pathogenesis. This lesion has slow growth and variable dimensions and is characterized clinically by a floating tumefaction in the nasolabial fold area around the bridge of the nose, causing an elevation of the upper lip and relative facial asymmetry. Diagnosis is primarily made clinically; if necessary, this is complemented by imaging. This paper reports the case of a 39-year-old male patient who complained of pain in the right upper premolar region and poor aesthetics due to a firm tumor in the right wing of the nose. Initially, this was thought to be due to an odontogenic abscess; however, the differential diagnosis was that a nasolabial cyst was communicating with the apex of teeth 14 and 15. Surgical treatment was carried out, followed by histopathological examination and concomitant endodontic treatment of the teeth involved. Eveline Claudia Martini, Fabiana Madalozzo Coppla, Eduardo Bauml Campagnoli, and Marcelo Carlos Bortoluzzi Copyright © 2016 Eveline Claudia Martini et al. All rights reserved. Cone Beam Computed Tomographic Evaluation and Diagnosis of Mandibular First Molar with 6 Canals Thu, 21 Jan 2016 08:55:21 +0000 Root canal treatment of tooth with aberrant root canal morphology is very challenging. So thorough knowledge of both the external and internal anatomy of teeth is an important aspect of root canal treatment. With the advancement in technology it is imperative to use modern diagnostic tools such as magnification devices, CBCT, microscopes, and RVG to confirm the presence of these aberrant configurations. However, in everyday endodontic practice, clinicians have to treat teeth with atypical configurations for root canal treatment to be successful. This case report presents the management of a mandibular first molar with six root canals, four in mesial and two in distal root, and also emphasizes the use and importance of Cone Beam Computed Tomography (CBCT) as a diagnostic tool in endodontics. Shiraz Pasha, Bathula Vimala Chaitanya, and Kusum Valli Somisetty Copyright © 2016 Shiraz Pasha et al. All rights reserved. Breaking the Thumb Sucking Habit: When Compliance Is Essential Wed, 20 Jan 2016 11:10:10 +0000 The anterior open bite (AOB) and posterior cross bite are the most frequent malocclusions associated with prolonged sucking habits. This clinical case illustrates and discusses the use of a Haas-type palatal expander for stopping a thumb sucking habit. The improvement in closing the open bite with discontinuation of the habit was observed. But with the return of the habit and lack of cooperation, the relapse of anterior open bite occurred. Therefore, different approaches are necessary. The need of a multidisciplinary approach, consent, and cooperation are keys to a good prognosis. Orlando Tanaka, Wagner Oliveira, Melissa Galarza, Vanessa Aoki, and Bruno Bertaiolli Copyright © 2016 Orlando Tanaka et al. All rights reserved. Misdiagnosis of Extensive Maxillofacial Infection and Its Relationship with Periodontal Problems and Hyperglycemia Thu, 14 Jan 2016 14:15:45 +0000 Background. Complex dental infections can reach distant areas of the alveolar process, invading the secondary fascial spaces. Objectives. This case report aims to show a misdiagnosis of odontogenic infection and a great need for dentist in the hospital environment. Case Report. A male patient presented facial asymmetry and trismus, while the facial CT examination showed a hyperdense mass involving the left masseteric, pterygomandibular, and superficial temporal regions. The patient was then referred to oral oncology center by emergency physician with cancer suspicion. After 15 days, the patient returned to the same emergency room and was attended by the surgical and maxillofacial trauma team, presenting tachycardia, tachypnea, dysphagia, and trismus. During anamnesis, the patient reported being an uncontrolled diabetic. In intraoral exam, a poor oral condition and generalized periodontitis were observed. Results. Correct diagnosis of odontogenic infection was established and adequately treated. Conclusions. Symptomatology bland may mask the severity of an infection; every increase in volume associated with trismus, poor oral hygiene with or without hyperglycemia should be heavily investigated for the presence of an infectious process. It emphasizes the importance of a dentist working with the physician in emergency room. Cristian Statkievicz, Leonardo P. Faverani, Pedro Henrique Silva Gomes-Ferreira, Gabriel Ramalho-Ferreira, and Idelmo Rangel Garcia-Junior Copyright © 2016 Cristian Statkievicz et al. All rights reserved. Gingival Overgrowth Leading to the Diagnosis of Familial Tuberous Sclerosis Complex Wed, 13 Jan 2016 12:06:16 +0000 Tuberous sclerosis complex (TSC), a neurocutaneous syndrome, is characterized by the development of benign tumours affecting different body systems. We herein present a report of a 40-year-old female patient presenting with dental enamel pits and localized gingival overgrowth that eventually lead to the diagnosis of a case of familial TSC. Diagnosis of familial TSC by comprehensive oral examination and detection of oral manifestations proved to be inevitable as it resulted in institution of appropriate treatment strategies and genetic counselling of the affected family. Parth Purwar, Sagar Sareen, Vaibhav Sheel, Abhishek Gupta, Uzma Ansari, Patel Umeshbhai Becharbhai, Manisha Dixit, Amitesh Bhargava, Rajiv Ratan Singh Yadav, Utkarsh Bansal, and Jaya Dixit Copyright © 2016 Parth Purwar et al. All rights reserved. Direct Midline Diastema Closure with Composite Layering Technique: A One-Year Follow-Up Wed, 06 Jan 2016 11:34:57 +0000 Objective. Maxillary anterior spacing is a common aesthetic complaint of patients. Midline diastema has a multifactorial etiology such as labial frenulum, microdontia, mesiodens, peg-shaped lateral incisors, agenesis, cysts, habits such as finger sucking, tongue thrusting, or lip sucking, dental malformations, genetics, proclinations, dental-skeletal discrepancies, and imperfect coalescence of interdental septum. Appropriate technique and material for effective treatment are based on time, physical, psychological, and economical limitations. Direct composite resins in diastema cases allow dentist and patient complete control of these limitations and formation of natural smile. Clinical Considerations. In this case report a maxillary midline diastema was closed with direct composite resin restorations in one appointment without any preparation. One bottle total etch adhesive was used and translucent/opaque composite resin shades were layered on mesial surfaces of the teeth that were isolated with rubber dam and Teflon bands. Finishing and polishing procedures were achieved by using polishing discs. Patient was informed for recalls for every 6 months. Conclusions. At one-year recall no sensitivities, discolorations, or fractures were detected on teeth and restorations. Direct composite resins seemed to be highly aesthetic and durable restorations that can satisfy patients as under the conditions of case presented. Bora Korkut, Funda Yanikoglu, and Dilek Tagtekin Copyright © 2016 Bora Korkut et al. All rights reserved. A Rare Case of Concomitant Maxilla and Mandible Brown Tumours, Papillary Thyroid Carcinoma, Parathyroid Adenoma, and Osteitis Fibrosa Cystica Sun, 03 Jan 2016 13:24:15 +0000 Objective. The brown tumour of hyperparathyroidism is a result of a metabolic disorder caused by primary hyperparathyroidism. Report. We described a case of a 37-year-old female patient presenting bimaxillary intraoral lesions and swelling in the neck. Incisional biopsy of the oral lesion was performed and histopathological examination revealed a central giant cell lesion composed by intense haemorrhagic exudate, abundant presence of giant cells, and areas with hemosiderin pigment. The patient also presented high levels of serum calcium and parathyroid hormone, hyperfunctioning parathyroid tissue, bilateral parenchymal nephropathy, and densitometry lower than expected, showing an advanced stage of osteitis fibrosa cystica. Synchronous parathyroid adenoma and papillary thyroid carcinoma were confirmed by imaging exams and histopathologically. Conclusion. The composition of all the clinical, pathological, and imaging findings led to the final diagnosis of brown tumour of hyperparathyroidism. The occurrence of parathyroid adenoma, papillary thyroid carcinoma, and brown tumours of hyperparathyroidism in their late stage (osteitis fibrosa cystica) associated with oral brown tumours involving the mandible and maxilla is extremely rare. Thaís Borguezan Nunes, Sheyla Batista Bologna, Andréa Lusvarghi Witzel, Marcello Menta Simonsen Nico, and Silvia Vanessa Lourenço Copyright © 2016 Thaís Borguezan Nunes et al. All rights reserved. Oral Myiasis Affecting Gingiva in a Child Patient: An Uncommon Case Report Sun, 03 Jan 2016 11:10:43 +0000 Certain dipteran flies larvae causing invasion of the tissues and organs of the humans or other vertebrates are called as myiasis, which feed on hosts dead or living tissues. It is well documented in the skin and hot climate regions; underdeveloped countries are affected more commonly. Oral cavity is affected rarely and it can be secondary to serious medical conditions. Poor oral hygiene, alcoholism, senility, or suppurating lesions can be associated with the oral myiasis. Inflammatory and allergic reactions are the commonest clinical manifestations of the disease. In the present case, gingiva of maxillary anterior region was affected by larval infection in a 13-year-old mentally retarded patient. Fareedi Mukram Ali, Kishor Patil, Sanjay Kar, Atulkumar A. Patil, and Shabeer Ahamed Copyright © 2016 Fareedi Mukram Ali et al. All rights reserved. Autoextraction of Permanent Incisors and Self-Inflicted Orodental Trauma in a Severely Burned Child Wed, 30 Dec 2015 13:51:11 +0000 Autoextraction is one type of self-injurious behaviour. In the literature, self-injurious behaviours are observed in syndromes and genetic conditions. However, to the best of our knowledge, SIB and autoextraction in a severely burned patient have not been reported to date. This report describes the self-inflicted trauma and autoextraction in a severely burned child, and the management of the child during and after burn treatment. Sultan Keles, Gülçin Dogusal, and Işıl Sönmez Copyright © 2015 Sultan Keles et al. All rights reserved. Rare Occurrence of Herpes Zoster of Trigeminal Nerve following Extraction of Tooth Sun, 27 Dec 2015 11:05:17 +0000 Herpes Zoster also known as Shingles is an acute viral infection which is an extremely painful and incapacitating ailment. It results from the reactivation of the varicella zoster virus. The triggering factors for the onset of an attack of Herpes Zoster include some form of immunosuppression. The diagnosis of Herpes Zoster can be made on proper medical history and a thorough clinical examination. Here is the report of a male patient affected by Herpes Zoster infection which followed after extraction of a lower first molar. A. Winnifred Christy, T. Jones Raja Deva Thanmbi, J. Leelavathy, and Antoinette Rhema Louis Copyright © 2015 A. Winnifred Christy et al. All rights reserved. Pregnancy Tumor in a 31-Year-Old Female with a Facial Port-Wine Stain Sun, 20 Dec 2015 14:30:01 +0000 Pyogenic granuloma is a type of inflammatory hyperplasia often seen in the oral cavity and occurs in response to stimuli such as local irritants and hormonal factors. Pyogenic granulomas associated with pregnancy are referred to as pregnancy tumors. This report describes the presentation and surgical management of a large pregnancy tumor occurring in a patient with an overlying isolated facial port-wine stain. Andrew Rockafellow, Whitney Florin, Elizabeth Philipone, and David Koslovsky Copyright © 2015 Andrew Rockafellow et al. All rights reserved. Periosteal Pedicle Flap Harvested during Vestibular Extension for Root Coverage Wed, 16 Dec 2015 07:14:50 +0000 Root exposure along with inadequate vestibular depth is a common clinical finding. Treatment option includes many techniques to treat such defects for obtaining predictable root coverage. Normally, the vestibular depth is increased first followed by a second surgery for root coverage. The present case report describes a single-stage technique for vestibular extension and root coverage in a single tooth by using the Periosteal Pedicle Flap (PPF). This technique involves no donor site morbidity and allows for reflection of sufficient amount of periosteal flap tissue with its own blood supply at the surgical site, thus increasing the chances of success of root coverage with simultaneous increase in vestibular depth. Shubham Kumar, Krishna Kumar Gupta, Rahul Agrawal, Pratima Srivastava, and Shalabh Soni Copyright © 2015 Shubham Kumar et al. All rights reserved. Clinical Management of a Peri-Implant Giant Cell Granuloma Mon, 14 Dec 2015 13:52:08 +0000 Purpose. Implant therapy plays an important role in contemporary dentistry with high rates of long-term success. However, in recent years, the incidence of peri-implantitis and implant failures has significantly increased. The peripheral giant cell granuloma (PGCG) rarely occurs in peri-implant tissues and it is clinically comparable to the lesions associated with natural teeth. Therefore, the study of possible diseases associated with dental implants plays an important role in order to be able to diagnose and treat these conditions. Materials and Methods. This report described a 60-year-old Caucasian male who presented a reddish-purple pedunculated mass, of about 2 cm in diameter, associated with a dental implant and the adjacent natural tooth. Results. An excisional biopsy was performed and the dental implant was not removed. Histological examination provided the diagnosis of PGCG. After 19-month follow-up, there were no signs of recurrence of peri-implantitis around the implant. Conclusion. The correct diagnosis and appropriate surgical treatment of peri-implant giant cell granuloma are very important for a proper management of the lesion in order to preserve the implant prosthetic rehabilitation and prevent recurrences. A. Pacifici, D. Carbone, R. Marini, G. L. Sfasciotti, and L. Pacifici Copyright © 2015 A. Pacifici et al. All rights reserved. An Uncommon Case of Solitary Peripheral Osteoma in the Mandible Mon, 14 Dec 2015 06:43:40 +0000 Osteoma is a benign osteogenic lesion which is composed of well differentiated mature compact and/or cancellous bone that proliferates continuously. Its prevalence is 4%. Its pathogenesis is still controversial. Solitary peripheral osteoma of craniofacial region is a rare finding. We report a case of 30-year-old female having solitary peripheral osteoma present on the lingual cortex of the left posterior mandible which was initially asymptomatic but now is causing discomfort while chewing and not associated with Gardner’s syndrome. We also laid emphasis on its clinical, differential diagnosis, radiological, surgical, and histopathological features. The aim of this paper is to present an uncommon case of solitary peripheral osteoma in the mandible along with analysis of literature for peripheral osteomas of jaws and to contribute to the knowledge concerning the pathogenesis, differential diagnosis, and management of these lesions. Rohit Agrawal, Shipra Agrawal, Shitij Bhargava, Mahesh Motlani, and Rahul Agrawal Copyright © 2015 Rohit Agrawal et al. All rights reserved. Amelogenesis Imperfecta: Rehabilitation and Brainstorming on the Treatment Outcome after the First Year Sun, 13 Dec 2015 07:22:59 +0000 Amelogenesis imperfecta (AI) affects enamel on primary and permanent dentition. This hereditary disorder is characterized by loss of enamel, poor esthetics, and hypersensitivity. Functional and cosmetic rehabilitation is challenging with variety of treatment options. This report presents the treatment of an AI patient using conventional fixed dentures and discusses issues related to posttreatment complications and prosthetic treatment outcome after 1 year of follow-up. A 19-year-old male AI patient with impaired self-esteem presented with hypersensitive, discolored, and mutilated teeth. Clinical examination revealed compromised occlusion and anterior open-bite. After hygiene maintenance full-coverage porcelain-fused-to-metal fixed restorations were indicated and applied. At the end of the treatment acceptable functional and esthetic results could be achieved. However, nearly a year after treatment a gingival inflammation in the esthetic zone complicated the outcome. Insufficient oral hygiene was to be blamed. Tooth sensitivity present from early childhood in these patients may prevent oral hygiene from becoming a habit. The relaxation due to relieve of hypersensitivity after treatment makes oral hygiene learning difficult. Continuous oral hygiene maintenance motivation may be crucial for the success of the treatment of AI patients. Treatment of AI patients should be carefully planned and an acceptable risk-benefit balance should be established. Ayça Deniz İzgi, Ediz Kale, and Remzi Niğiz Copyright © 2015 Ayça Deniz İzgi et al. All rights reserved. Essential Palatal Tremor Managed by Cognitive Behavioral Therapy Thu, 10 Dec 2015 09:22:29 +0000 Background. Essential palatal tremor is a disorder of unknown etiology involving involuntary movement of the uvula and soft palate. Treatment attempts including drugs or surgery have been conducted to cease the rhythmical movement. Case Report. A 55-year-old female visited our department complaining of a sudden, noticeable, intermittent, and rhythmical clicking noise in her throat for five years. Oral examination revealed rhythmical contractions of the soft palate with clicking at the frequency of 120 per min. Magnetic resonance imaging (MRI) examination of the brain performed after consulting with the department of neuropathic internal medicine showed no abnormalities. Thus, essential palatal tremor was diagnosed. The symptoms improved with cognitive behavioral therapy without drugs or surgical treatments. The patient is now able to stop the rhythmical movement voluntarily. Discussion. Cognitive behavioral therapy might be suitable as first-line therapy for essential palatal tremor because the therapy is noninvasive. Tomohisa Kitamura, Tsuyoshi Sato, Naoki Hayashi, Yosuke Fukushima, and Tetsuya Yoda Copyright © 2015 Tomohisa Kitamura et al. All rights reserved. Dens Evaginatus: A Problem-Based Approach Tue, 08 Dec 2015 12:26:57 +0000 Dens evaginatus is an uncommon developmental anomaly of human dentition characterized by the presence of tubercle on the occlusal surface of mandibular premolars and lingual surface of anterior teeth. Due to occlusal trauma this tubercle tends to fracture thus exposing the pathway to the pulp chamber of teeth. This case report is about the presentation of dens evaginatus in mandibular premolars bilaterally; among them tooth 44 was associated with chronic apical periodontitis. Fractured tubercle of three premolars was sealed with composite resin. Root canal treatment was performed with tooth 44. Routine endodontic treatment did not result in remission of infection. Therefore, culture and sensitivity tests were performed to identify the cause and modify treatment plan accordingly. Triple antibiotic paste was used as an intracanal medicament to disinfect the root canal that resulted in remission of infection. A. Ayer, M. Vikram, and P. Suwal Copyright © 2015 A. Ayer et al. All rights reserved. Management of an Unusual Maxillary Canine: A Rare Entity Tue, 08 Dec 2015 11:46:36 +0000 Clinicians need to have intimate knowledge and thorough understanding of both pulp chamber and root canal anatomy. They should be aware of possibility of anatomical variations in the root canal system during endodontic treatment. Maxillary canines usually have single root and root canal but rarely may have single root with two root canals. This case describes a lengthier maxillary canine with two root canals. Jaya Nagendra Krishna Muppalla, Krishnamurthy Kavuda, Rajani Punna, and Amulya Vanapatla Copyright © 2015 Jaya Nagendra Krishna Muppalla et al. All rights reserved. Use of a Piezosurgery Technique to Remove a Deeply Impacted Supernumerary Tooth in the Anterior Maxilla Tue, 08 Dec 2015 08:01:23 +0000 Deeply impacted supernumerary teeth in the anterior maxillary cannot be generally removed by the conventional labial or palatal surgical approach because of the risk of damaging the surrounding soft tissues and the possibility of injuring the roots of adjacent permanent teeth. In piezosurgery, bony tissues are selectively cut, thereby avoiding the soft tissue damage caused by rotary cutting instruments. We report the case of a 15-year-old Japanese boy from whom a deeply impacted supernumerary tooth in the anterior maxillary was safely removed through the floor of the nasal cavity. The surgical extraction was performed without damaging the nasal mucosa or adjacent structures such as the roots of the adjacent permanent teeth. Considering that piezosurgery limits the extent of surgical invasion, this technique can be practiced as a minimally invasive and safe surgical procedure for treating suitably selected cases with a deeply impacted supernumerary tooth. Shintaro Sukegawa, Takahiro Kanno, Kiyokazu Kawakami, Akane Shibata, Yuka Takahashi, and Yoshihiko Furuki Copyright © 2015 Shintaro Sukegawa et al. All rights reserved. Biological Restoration of a Fractured Anterior Tooth with the Use of Dentine Pin (Biopins) Tue, 08 Dec 2015 07:42:25 +0000 This case study describes the esthetic and functional reconstruction of a fractured maxillary central incisor. Due to the requirement for additional retention, treatment was performed using the homogenous technique of biological restoration associated with cementation of posts made from human dentin (biopins). This type of treatment is a new alternative to conventional techniques and favors the dental esthetic and function, as well as biocompatibility, and is an inexpensive procedure. Lilian Capanema Nogueira, Karine Taís Aguiar Tavano, Nayara Kelly Lyrio Ferraz, José Cristiano Ramos Glória, and Adriana Maria Botelho Copyright © 2015 Lilian Capanema Nogueira et al. All rights reserved. The Solitary Variant of Mandibular Intraosseous Neurofibroma: Report of a Rare Entity Sun, 06 Dec 2015 14:03:44 +0000 Neurofibroma (NF) is a benign neoplasm derived from peripheral nerve cells. NF may extend either as a solitary lesion or as part of a generalized syndrome of neurofibromatosis. Intraorally, the intraosseous variant of neurofibroma is a very rare tumor. The literature provides only few cases of solitary intraosseous neurofibroma of the mandible. We report a case of 28-year-old female who was diagnosed with a solitary intraosseous neurofibroma involving the lower left quadrant of the mandible. The present case is rare in regard to its dimensions and its location. Pavan Kumar Gujjar, Jayadev M. Hallur, Shruthi T. Patil, Shylaja Mysore Dakshinamurthy, Mayura Chande, Treville Pereira, and Jyoti Zingade Copyright © 2015 Pavan Kumar Gujjar et al. All rights reserved. Split-Framework in Mandibular Implant-Supported Prosthesis Thu, 03 Dec 2015 11:33:32 +0000 During oral rehabilitation of an edentulous patient with an implant-supported prosthesis, mandibular flexure must be considered an important biomechanical factor when planning the metal framework design, especially if implants are installed posterior to the interforaminal region. When an edentulous mandible is restored with a fixed implant-supported prosthesis connected by a fixed full-arch framework, mandibular flexure may cause needless stress in the overall restorative system and lead to screw loosening, poor fit of prosthesis, loss of the posterior implant, and patient’s discomfort due to deformation properties of the mandible during functional movements. The use of a split-framework could decrease the stress with a precise and passive fit on the implants and restore a more natural functional condition of the mandible, helping in the longevity of the prosthesis. Therefore, the present clinical report describes the oral rehabilitation of an edentulous patient by a mandibular fixed implant-supported prosthesis with a split-framework to compensate for mandibular flexure. Clinical Significance. The present clinical report shows that the use of a split-framework reduced the risk of loss of the posterior implants or screws loosening with acceptable patient comfort over the period of a year. The split-framework might have compensated for the mandibular flexure during functional activities. Danny Omar Mendoza Marin, Kássia de Carvalho Dias, André Gustavo Paleari, Ana Carolina Pero, João Neudenir Arioli Filho, and Marco Antonio Compagnoni Copyright © 2015 Danny Omar Mendoza Marin et al. All rights reserved. Giant Cell Fibroma in a Paediatric Patient: A Rare Case Report Thu, 26 Nov 2015 14:03:03 +0000 Giant cell fibroma is a form of fibrous tumour affecting the oral mucosa. Its occurrence is relatively rare in paediatric patients. Clinically it is presented as a painless, sessile, or pedunculated growth which is usually confused with other fibrous lesions like irritation fibromas. Here we are presenting a case where a seven-year-old male patient reported with a painless nodular growth in relation to lingual surface of 41 and 42. Considering the size and location of the lesion, excisional biopsy was performed and sent for histopathological analysis which confirmed the lesion as giant cell fibroma. Veera Kishore Kumar Reddy, Naveen Kumar, Prashant Battepati, Lalitha Samyuktha, and Swapna Priya Nanga Copyright © 2015 Veera Kishore Kumar Reddy et al. All rights reserved. Oral Lesions: The Clue to Diagnosis of Pemphigus Vulgaris Thu, 19 Nov 2015 12:36:34 +0000 Pemphigus is a group of potentially fatal dermatoses with both cutaneous and oral manifestations. Characterized by the appearance of vesicle or bullae, their manifestations in the oral cavity often precede those on the skin by many months or may remain as the only symptoms of the disease. It is therefore important that the oral manifestations of the disease are recognized on time, to make a proper diagnosis and initiate timely treatment. Here we present a case of Pemphigus Vulgaris (PV) that presented with oral lesions at multiple sites including tongue, to highlight the importance of timely recognition of the oral lesions during routine dental practice for the diagnosis and management of this disease. Diana Kuriachan, Rakesh Suresh, Mahija Janardhanan, and Vindhya Savithri Copyright © 2015 Diana Kuriachan et al. All rights reserved. Atypical Trigeminal Neuralgia Secondary to Meningioma Thu, 19 Nov 2015 11:43:10 +0000 Trigeminal neuralgia is a disorder of the fifth cranial nerve that causes episodes of intense, stabbing, electric shock-like pain that lasts from few seconds to few minutes in the areas of the face where the branches of the nerve are distributed. More than one nerve branch can be affected by the disorder. We report an unusual case of trigeminal neuralgia affecting right side of face presenting atypical features of neuralgia and not responding to the usual course of treatment. The magnetic resonance imaging study of brain revealed a large extra-axial mass involving right cerebellopontine angle region causing moderate pressure effect on trigeminal nerve and brain stem. The aim of this case report is to show a tumor of cerebellopontine angle, presenting clinically as atypical trigeminal neuralgia. Premeshwar Niwant, Mukta Motwani, and Sushil Naik Copyright © 2015 Premeshwar Niwant et al. All rights reserved.