Case Reports in Dentistry http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. A Rare Interstitial Duplication of 8q22.1–8q24.3 Associated with Syndromic Bilateral Cleft Lip/Palate Tue, 25 Nov 2014 00:00:00 +0000 http://www.hindawi.com/journals/crid/2014/730375/ We present a rare case of 8q interstitial duplication derived from maternal balanced translocations in a patient with bilateral cleft lip and palate in syndromic form associated with other congenital malformations. G-banding cytogenetic analysis revealed a chromosomal abnormality in the form of the karyotype 46,XX der(22)t(8;22)(q22.1;p11.1)mat. Chromosome microarray analysis evidenced a 49 Mb duplicated segment of chromosome 8q with no pathogenic imbalances on chromosome 22. Two siblings also carry the balanced translocation. We have compared this case with other “pure” trisomies of 8q patients reported in the literature and with genome wide association studies recently published. This work highlights the involvement of chromosome 8q in orofacial clefts. Regina Ferreira Rezek, Ana Angélica Rodrigues Abbas, Juliana Forte Mazzeu, Siliana Maria Duarte Miranda, and Cibele Velloso-Rodrigues Copyright © 2014 Regina Ferreira Rezek et al. All rights reserved. Diagnosis and Treatment of Pseudo-Class III Malocclusion Mon, 24 Nov 2014 08:43:49 +0000 http://www.hindawi.com/journals/crid/2014/652936/ Pseudo-Class III malocclusion is characterized by the presence of an anterior crossbite due to a forward functional displacement of the mandible; in most cases, the maxillary incisors present some degree of retroclination, and the mandibular incisors are proclined. Various types of appliances have been described in the literature for the early treatment of pseudo-Class III malocclusion. The objectives of this paper are to demonstrate the importance of making the differential diagnosis between a skeletal and a pseudo-Class III malocclusion and to describe the correction of an anterior crossbite. The association of maxillary expansion and a 2 × 4 appliance can successfully be used to correct anterior crossbites. Ariel Reyes, Luis Serret, Marcos Peguero, and Orlando Tanaka Copyright © 2014 Ariel Reyes et al. All rights reserved. Interdisciplinary Management of an Isolated Intrabony Defect Sun, 23 Nov 2014 12:00:02 +0000 http://www.hindawi.com/journals/crid/2014/672152/ The treatment of intrabony defects is a real challenge in molar teeth as it is chronic, slowly progressing disease which needs timely intervention. Periodontal inflammation associated with intrabony defect is not a separate entity as it secondarily affects the pulp causing retrograde pulpitis. However, treatment of these lesions will be complicated due to extensive bone loss. The tooth was endodontically treated followed by periodontal surgery to eliminate the deep periodontal pocket and promote bone fill in osseous defect. PepGen P-15 composited with platelet rich plasma was utilized for enhancing bone formation. The combination of these graft materials provides synergistic effect on bone regeneration. Sheetal Ghivari, Anand C. Patil, Shavina Patil, Sunita Shivanand, and Anukriti Tyagi Copyright © 2014 Sheetal Ghivari et al. All rights reserved. Central Odontogenic Fibroma of Simple Type Sun, 23 Nov 2014 09:20:46 +0000 http://www.hindawi.com/journals/crid/2014/642905/ Central odontogenic fibroma (COF) is an extremely rare benign tumor that accounts for 0.1% of all odontogenic tumors. It is a lesion associated with the crown of an unerupted tooth resembling dentigerous cyst. In this report, a 10-year-old male patient is presented, who was diagnosed with central odontogenic fibroma of simple type from clinical, radiological, and histopathological findings. Prasanth Thankappan, Naga Sirisha V. Chundru, Rajesh Amudala, Prashanthi Yanadi, S. A. K. Uroof Rahamthullah, and Meeramma Botu Copyright © 2014 Prasanth Thankappan et al. All rights reserved. Extensive Presentation of Central Ossifying Fibroma Treated with Conservative Surgical Excision Sun, 23 Nov 2014 08:05:51 +0000 http://www.hindawi.com/journals/crid/2014/204258/ Central ossifying fibroma is a benign slow-growing tumor of mesenchymal origin and it tends to occur in the second and third decades of life, with predilection for women and for the mandibular premolar and molar areas. Clinically, it is a large asymptomatic tumor of aggressive appearance, with possible tooth displacement. Occasionally treated by curettage enucleation, this conservative surgical excision is showing a recurrence rate extremely low. The objective of this study was to report a case of a 44-year-old woman, presenting a very large ossifying fibroma in the mandible, which was successfully treated with curettage, and to conduct a brief literature review of this lesion, focusing on the histology, clinical behavior, and management of these uncommon lesions. Matheus Henrique Lopes Dominguete, Alexandre Augusto Sarto Dominguette, Bruno Henrique Matos, Paulo Roberto Dominguete, Jorge Esquiche León, and Lucinei Roberto Oliveira Copyright © 2014 Matheus Henrique Lopes Dominguete et al. All rights reserved. A Case of Odontogenic Infection by Streptococcus constellatus Leading to Systemic Infection in a Cogan’s Syndrome Patient Thu, 20 Nov 2014 00:00:00 +0000 http://www.hindawi.com/journals/crid/2014/793174/ Odontogenic infection in immunocompromised patients tends to extend systemically beyond the oral cavity. Our case report presents a patient with sepsis due to a Streptococcus constellatus (S. constellatus) odontogenic infection in a 64-year-old-immunocompromised woman with Cogan’s syndrome. She had been suffering from chronic mandibular osteomyelitis which was thought to have been caused by dental caries and/or chronic periodontitis with furcation involvement of the left mandibular first molar. We suspect that the acute symptoms of the chronic osteomyelitis due to S. constellatus led to the systemic infection. This infection could be accelerated by the use of a corticosteroid and an alendronate. This is the first report which represents the potential association between odontogenic infection and Cogan’s syndrome. Masanobu Abe, Yoshiyuki Mori, Ryoko Inaki, Yae Ohata, Takahiro Abe, Hideto Saijo, Kazumi Ohkubo, Kazuto Hoshi, and Tsuyoshi Takato Copyright © 2014 Masanobu Abe et al. All rights reserved. Endodontic Management of a Maxillary Molar with Three Mesiobuccal Canals Wed, 19 Nov 2014 06:44:42 +0000 http://www.hindawi.com/journals/crid/2014/320196/ It is imperative that the clinician should have comprehensive knowledge about the normal anatomy and its variations of the teeth as the deviations from the usual are very common. An increased awareness of unusual anatomy and a better understanding of the root canal system guide the clinician in accurate diagnosis and treatment of such variations in order to achieve a successful endodontic outcome. The maxillary first molar has been shown to have a wide variation in respect to the number of canals specifically noted in the mesiobuccal root. The current case report shows the successful management of a maxillary molar in which the mesiobuccal root had three canals. Sirisha Gundam, Radhika Maddu, and Sindhura Reddy Gurram Copyright © 2014 Sirisha Gundam et al. All rights reserved. Multidisciplinary Approach for the Treatment of Horizontal Root-Fractured Maxillary Anterior Teeth Mon, 17 Nov 2014 07:02:11 +0000 http://www.hindawi.com/journals/crid/2014/472759/ Dental trauma can lead to a wide range of injuries of which crown and root fractures are examples. Crown-root fractures often need complex treatment planning. This case report describes the use of MTA in the multidisciplinary management of a patient with a horizontally fractured central incisor and luxation in a different central incisor. A 42-year-old female patient presented within 1 h of receiving direct trauma to her maxillary area. Clinical examination revealed that the right and left maxillary central incisors presented mobility and sensitivity to percussion and palpation but no sensitivity to thermal stimulations. Occlusal displacement with extrusion in the left maxillary central incisor and luxation in the right maxillary central incisor was observed. Radiographic examination revealed horizontal root fracture at the apical third of the left maxillary central incisor. Root fracture in the right maxillary incisor was not observed. Endodontic and aesthetic restorative treatments were completed. MTA showed a good long-term outcome when used in root-fractured and luxated teeth. In addition, composite resin restoration provided satisfactory aesthetic results even after 15 months. Berkan Celikten, Ceren Feriha Uzuntas, Reza Safaralizadeh, Gulbike Demirel, and Semra Sevimay Copyright © 2014 Berkan Celikten et al. All rights reserved. Primary Malignant Melanoma of Maxilla: Report of a Case with Discussion Mon, 17 Nov 2014 00:00:00 +0000 http://www.hindawi.com/journals/crid/2014/624306/ Primary oral malignant melanoma, very rare neoplasm of melanocytic origin, usually presents as a bluish black to tan-brown colored lesion Which is accounting for 0.2 to 8% of all melanomas, 1.6% of all head and neck malignancies, and 0.5% of all oral neoplasia. In general, the prognosis of oral melanoma is poor and worse than that of cutaneous melanoma. Here a case of oral malignant melanoma is presented, which was undetected during the first visit to a dental clinic. When a simple oral surgical treatment was carried out in that region, it resulted in the appearance of a massive pigmented lesion which was histopathologically diagnosed as malignant melanoma. This paper is presented to reemphasize the fact that any pigmented lesion in the oral cavity should be viewed with suspicion and proper investigation (biopsy) should be carried out to rule out any untoward experiences later. G. Shirisha Rani, T. Vinay Kumar, Balaram Kolasani, Md Rezwana Begum, and Anu Priya Srinivasan Copyright © 2014 G. Shirisha Rani et al. All rights reserved. Treatment of Two Canals in All Mandibular Incisor Teeth in the Same Patient Sun, 16 Nov 2014 07:03:11 +0000 http://www.hindawi.com/journals/crid/2014/893980/ The main reason for unfavourable outcome in endodontic treatment of mandibular incisor is the inability to detect the presence of second canal. Pain even after extirpation of complete pulp tissue from root canal of vital teeth is the main indication of hidden canals. The present case report is also on pain because of another neglected canal in all mandibular incisors in the same patient. Vandana B. Kokane, Swapnil N. Patil, Mohit K. Gunwal, Rajesh Kubde, and Swaraj Atre Copyright © 2014 Vandana B. Kokane et al. All rights reserved. Management of Sjogren’s Syndrome Patient: A Case Report of Prosthetic Rehabilitation with 6-Year Follow-Up Thu, 13 Nov 2014 00:00:00 +0000 http://www.hindawi.com/journals/crid/2014/761251/ Completely and partially edentulous patients with Sjogren’s syndrome (SS) experience severe hyposalivation, xerostomia, and considerable difficulty in using tissue-supported prosthesis. This clinical paper describes the management, treatment, and 6-year follow-up of a patient diagnosed with SS type II, who uses corticosteroids and antihyperglycemic drugs. The patient received restorative, periodontal, and surgical treatments followed by implant-supported fixed prosthesis. Radiographic evaluation and probing depth showed gingival health and no bone loss after 6 years. Treatment with implant-retained dental prosthesis greatly increased comfort and function, offering an alternative to patients with SS. Marcos de Mendonça Invernici, Amanda Finger Stadler, Gastão Vale Nicolau, Maria Ângela Naval Machado, Antônio Adilson Soares de Lima, and Marilia Compagnoni Martins Copyright © 2014 Marcos de Mendonça Invernici et al. All rights reserved. Iatrogenic Displacement of a Foreign Body into the Periapical Tissues Tue, 11 Nov 2014 11:53:59 +0000 http://www.hindawi.com/journals/crid/2014/698538/ The presence of a foreign body in the periapical tissues can cause endodontic failure by triggering an inflammatory response and a subsequent foreign body reaction. This inflammatory response, which can occur to varying degrees, appears radiographically as a radiolucency that can remain asymptomatic for many years. A foreign object can reach the apical region by accident or iatrogenic procedures during dental procedures. The aim of the present case report is to describe the endodontic surgical treatment of an iatrogenic displacement of a foreign body (a metal fragment) into the periapical tissues and to describe its clinical and radiographic follow-up over a period of 52 months. Hugo Plascencia, Alvaro Cruz, Rodrigo Solís, Mariana Díaz, and Josué Vázquez Copyright © 2014 Hugo Plascencia et al. All rights reserved. Impact of Orthodontic Decompensation on Bone Insertion Mon, 10 Nov 2014 11:18:04 +0000 http://www.hindawi.com/journals/crid/2014/341752/ There has always been concern in determining the relationship between orthodontic tooth movement and the consequent biological costs to the periodontium and tooth root. The possibility of evaluating the tooth and bone morphology by CBCT allows more accurate analysis of qualitative and quantitative aspects of these processes. This paper presents a case report of a 20-year-old male patient with Class III malocclusion and hyperdivergent facial pattern, who was surgically treated. A significant amount of labial movement of mandibular incisors was performed during orthodontic treatment before surgery. CBCT was used for evaluation of buccal and lingual bone plates before and after tooth decompensation. The changes in the bone insertion level of maxillary and mandibular incisors in the present case encourage a reflection on the treatment protocol in individuals with dentoskeletal discrepancies. Fabio Pinto Guedes, Leopoldino Capelozza Filho, Daniela Gamba Garib, Hugo Nary Filho, Evandro José Borgo, and Mauricio de Almeida Cardoso Copyright © 2014 Fabio Pinto Guedes et al. All rights reserved. Paradigm Shift in the Management of the Atrophic Posterior Maxilla Mon, 10 Nov 2014 00:00:00 +0000 http://www.hindawi.com/journals/crid/2014/486949/ When the posterior maxilla is atrophic, the reference standard of care would be to perform sinus augmentation with an autologous bone graft through the lateral approach and delayed implant placement. However, placement of short implants with the osteotome sinus floor elevation technique and without graft can be proposed for an efficient treatment of clinical cases with a maxillary residual bone height of 4 to 8 mm. The use of grafting material is recommended only when the residual bone height is ≤4 mm. Indications of the lateral sinus floor elevation are limited to cases with a residual bone height ≤ 2 mm and fused corticals, uncompleted healing of the edentulous site, and absence of flat cortical bone crest or when the patient wishes to wear a removable prosthesis during the healing period. The presented case report illustrates osteotome sinus floor elevation with and without grafting and simultaneous implant placement in extreme conditions: atrophic maxilla, short implant placement, reduced healing time, and single crown rehabilitation. After 6 years, all placed implants were functional with an endosinus bone gain. Rabah Nedir, Nathalie Nurdin, Paul Khoury, Marc El Hage, Semaan Abi Najm, and Mark Bischof Copyright © 2014 Rabah Nedir et al. All rights reserved. Class III Malocclusion Surgical-Orthodontic Treatment Thu, 06 Nov 2014 07:26:32 +0000 http://www.hindawi.com/journals/crid/2014/868390/ The aim of the present case report is to describe the orthodontic-surgical treatment of a 17-year-and-9-month-old female patient with a Class III malocclusion, poor facial esthetics, and mandibular and chin protrusion. She had significant anteroposterior and transverse discrepancies, a concave profile, and strained lip closure. Intraorally, she had a negative overjet of 5 mm and an overbite of 5 mm. The treatment objectives were to correct the malocclusion, and facial esthetic and also return the correct function. The surgical procedures included a Le Fort I osteotomy for expansion, advancement, impaction, and rotation of the maxilla to correct the occlusal plane inclination. There was 2 mm of impaction of the anterior portion of the maxilla and 5 mm of extrusion in the posterior region. A bilateral sagittal split osteotomy was performed in order to allow counterclockwise rotation of the mandible and anterior projection of the chin, accompanying the maxillary occlusal plane. Rigid internal fixation was used without any intermaxillary fixation. It was concluded that these procedures were very effective in producing a pleasing facial esthetic result, showing stability 7 years posttreatment. Bruna Alves Furquim, Karina Maria Salvatore de Freitas, Guilherme Janson, Luis Fernando Simoneti, Marcos Roberto de Freitas, and Daniel Salvatore de Freitas Copyright © 2014 Bruna Alves Furquim et al. All rights reserved. Endodontic Treatment of a Mandibular Second Premolar with Three Roots and Three Canals Wed, 05 Nov 2014 11:53:54 +0000 http://www.hindawi.com/journals/crid/2014/973410/ Complex root canal system with atypical variations is a common finding among mandibular premolars. Endodontic treatment in these teeth may not be successful due to the failure to recognise and treat multiple canals. This paper presents endodontic treatment of a mandibular second premolar with three roots and three canals. Bonny Paul and Kavita Dube Copyright © 2014 Bonny Paul and Kavita Dube. All rights reserved. Er:YAG Laser Dental Treatment of Patients Affected by Epidermolysis Bullosa Wed, 05 Nov 2014 09:14:27 +0000 http://www.hindawi.com/journals/crid/2014/421783/ Aim. The purpose of this study was to evaluate the efficacy of Er:YAG laser used for treating hard dental tissue in patients with epidermolysis bullosa (EB). Methods. We report two cases of EB in which an Er:YAG laser was used for conservative treatments. In the first case, the Er:YAG laser (2,940 μm, 265 mJ, 25 Hz) was used to treat caries on a deciduous maxillary canine in an 8-year-old male patient affected by dystrophic EB. In the second case, we treated a 26-year-old female patient, affected by junctional EB, with generalized enamel hypoplasia, and an Er:YAG laser (2,940 μm, 265 mJ, 25 Hz) was used to remove the damaged enamel on maxillary incisors. Results. The use of the Er:YAG laser, with the appropriate energy, was effective in the selective removal of carious tissue and enamel hypoplasia. During dental treatment with the Er:YAG laser, patients required only a few interruptions due to the absence of pain, vibration, and noise. Conclusions. Laser treatment of hard dental tissues is a valuable choice for patients affected by EB since it is less invasive compared to conventional treatment, resulting in improved patient compliance. Angela Galeotti, Vincenzo D’Antò, Tina Gentile, Alexandros Galanakis, Simona Giancristoforo, Roberto Uomo, and Umberto Romeo Copyright © 2014 Angela Galeotti et al. All rights reserved. Single-Tooth Morse Taper Connection Implant Placed in Grafted Site of the Anterior Maxilla: Clinical and Radiographic Evaluation Wed, 05 Nov 2014 08:11:49 +0000 http://www.hindawi.com/journals/crid/2014/183872/ The aim of this study was to achieve aesthetically pleasing soft tissue contours in a severely compromised tooth in the anterior region of the maxilla. For a right-maxillary central incisor with localized advanced chronic periodontitis a tooth extraction followed by reconstructive procedures and delayed implant placement was proposed and accepted by the patient. Guided bone regeneration (GBR) technique was employed, with a biphasic calcium-phosphate (BCP) block graft placed in the extraction socket in conjunction with granules of the same material and a resorbable barrier membrane. After 6 months of healing, an implant was installed. The acrylic provisional restoration remained in situ for 3 months and then was substituted with the definitive crown. This ridge reconstruction technique enabled preserving both hard and soft tissues and counteracting vertical and horizontal bone resorption after tooth extraction and allowed for an ideal three-dimensional implant placement. Localized severe alveolar bone resorption of the anterior maxilla associated with chronic periodontal disease can be successfully treated by means of ridge reconstruction with GBR and delayed implant insertion; the placement of an early-loaded, Morse taper connection implant in the grafted site was effective to create an excellent clinical aesthetic result and to maintain it along time. Francesco Guido Mangano, Piero Zecca, Fabrizia Luongo, Giovanna Iezzi, and Carlo Mangano Copyright © 2014 Francesco Guido Mangano et al. All rights reserved. Management of a Large Internal Resorption Lesion with Metal Reinforced Glass Ionomer Cement Tue, 04 Nov 2014 09:56:56 +0000 http://www.hindawi.com/journals/crid/2014/205028/ Mineral trioxide aggregate is the mainstay of treatment of large internal resorption defects. But its cost may be a deterrent to its use in some patients. The present case report describes the successful endodontic management of an extensive internal resorptive lesion in a mandibular molar with metal reinforced glass ionomer cement. Gurdeep Singh Gill, Atool Chandra Bhuyan, Suraj Arora, Kunal Sethi, Rajwinder Kaur, and Tarun Kalra Copyright © 2014 Gurdeep Singh Gill et al. All rights reserved. Tufted Angioma in Children: Report of Two Cases and a Review of the Literature Tue, 04 Nov 2014 09:18:27 +0000 http://www.hindawi.com/journals/crid/2014/942489/ Tufted angioma (TA) is a benign vascular tumor with endothelial origin. It is extremely rare in oral mucosa; only seven cases have been reported in the literature so far. Here, we describe two cases of tufted angioma observed in children and we also present a review of the literature about this pathology, concerning the differential diagnosis and management of this lesion in children. Alessandra Dutra da Silva, Grasieli de Oliveira Ramos, Rita Fabiane Teixeira Gomes, Marco Antônio Trevizani Martins, Marcelo Lazzaron Lamers, Manoel Santa’Ana Filho, Pantelis Varvaki Rados, Laura de Campos Hildebrand, and Fernanda Visioli Copyright © 2014 Alessandra Dutra da Silva et al. All rights reserved. Reattachment of Fractured Tooth Fragment with Fiber Post: A Case Series with 1-Year Followup Mon, 03 Nov 2014 17:18:08 +0000 http://www.hindawi.com/journals/crid/2014/376267/ Coronal fractures of the anterior teeth are common sequelae of dental trauma. In case of complex fractures, where the fractured segment is available and there is close approximation of the segment to the remaining tooth, root canal treatment followed by reattachment of the fractured segment with fiber post reinforcement is a feasible option. The procedure is simple and economic and needs less chair-side time as compared to many conventional methods. In addition, the procedure provides good and long-lasting esthetics, because the original morphology, color, and surface texture are maintained. This paper reports three cases of complex coronal tooth fracture successfully managed using tooth fragment reattachment. C. M. Sapna, R. Priya, N. B. Sreedevi, Rakesh R. Rajan, and Renjith Kumar Copyright © 2014 C. M. Sapna et al. All rights reserved. Regenerative Endodontic Treatment of an Infected Immature Dens Invaginatus with the Aid of Cone-Beam Computed Tomography Thu, 30 Oct 2014 09:20:22 +0000 http://www.hindawi.com/journals/crid/2014/403045/ Dens invaginatus is a developmental anomaly that results in an enamel-lined cavity intruding into the crown or root before the mineralization phase. This report presents regenerative endodontic treatment of a necrotic immature tooth with Oehler’s type III dens invaginatus of a nine-year-old female patient. A diagnosis of dens invaginatus (Oehler’s type III) and a large periapical lesion was established with the aid of cone-beam computed tomography (CBCT). In the presented case contrary to the classic revascularization protocol, mechanical instrumentation was performed which apparently did not interfere with the regeneration process. After mechanical instrumentation of the invaginated canal by manual K-files, the invaginated canal space was disinfected by triple antibiotic paste followed by blood clot induction from the periapical tissues and the placement of mineral trioxide aggregate. At one-year follow-up, the tooth remained clinically asymptomatic. Radiographic examination revealed complete healing of the periapical lesion. At the 20-month follow-up, the radiographic examination also showed that the open apex was closed and the walls of the root canal were thickened. Işıl Kaya-Büyükbayram, Şerife Özalp, Emre Aytugar, and Seda Aydemir Copyright © 2014 Işıl Kaya-Büyükbayram et al. All rights reserved. Wharton’s Duct Sialolith of Unusual Size: A Case Report with a Review of the Literature Mon, 27 Oct 2014 08:54:02 +0000 http://www.hindawi.com/journals/crid/2014/373245/ There is an increased incidence of submandibular gland duct developing sialoliths. Among them the sialoliths attaining a size of more than 1.5 cms are rare. Here we present a case with an abnormally sized sialolith in Wharton’s duct and a review of the literature about the abnormally sized sialoliths and various anatomical and physiological considerations of the duct which contribute to the higher incidence of sialolith in the duct. Nithin Mathew Cherian, Sankar Vinod Vichattu, Ninan Thomas, and Aabu Varghese Copyright © 2014 Nithin Mathew Cherian et al. All rights reserved. Retracted: Primary Small Cell Undifferentiated (Neuroendocrine) Carcinoma of the Maxillary Sinus Tue, 21 Oct 2014 08:59:22 +0000 http://www.hindawi.com/journals/crid/2014/609802/ Case Reports in Dentistry Copyright © 2014 Case Reports in Dentistry. All rights reserved. Multiple Marginal Tissue Recession Treated with a Simplified Lateral Sliding Flap Technique Tue, 21 Oct 2014 00:00:00 +0000 http://www.hindawi.com/journals/crid/2014/432960/ Marginal tissue recession is a common esthetic problem that is usually accompanied by dentin sensitivity, and patients frequently report a fear of dental loss. Lateral sliding flaps have been used for localized recession, but they are rarely used for multiple recessions. The aim of this paper was to report a case of coverage of multiple marginal tissue recessions by means of a lateral sliding flap associated with a connective tissue graft. This was a modification of Nelson’s technique, which was originally described as the combination of the double papilla technique, lateral sliding flap, and connective tissue graft. In the present case, double papilla was not performed, rendering the maneuver less complicated. After surgery on teeth #23 to #25, total root coverage, decreased dentin sensitivity, and increased keratinized tissue band and gingival thickness were achieved. In the present case, modified Nelson technique proved to be a more simple procedure for the treatment of multiple recessions in one session, resulting in adequate healing, predictable root coverage, and, more importantly, esthetic and functional success. Fernando Salimon Ribeiro, Juliana Aparecida Najarro Dearo de Morais-Camillo, José Marcos Alves Fernandes, Juliana Rico Pires, Elizangela Partata Zuza, and Ana Emília Farias Pontes Copyright © 2014 Fernando Salimon Ribeiro et al. All rights reserved. Boon of MTA Apexification in Young Permanent Posterior Teeth Mon, 20 Oct 2014 00:00:00 +0000 http://www.hindawi.com/journals/crid/2014/673127/ Single visit apexification using mineral trioxide aggregate (MTA) is a new boon in effective management of nonvital tooth with an open apex which has steadily gained popularity with clinicians; also it shortens the treatment period and improves patient compliance. Importance of this approach lies in expedient cleaning and shaping of the root canal system, followed by its apical seal with MTA. There are several case reports available describing the use of MTA as an apexification agent in incisors and premolar, but presented cases are the unique case reports demonstrating successful apexification procedure using MTA in young permanent mandibular molars. After eight-month follow-up, teeth were without any abnormal clinical symptoms; rather there were radiographic resolution of the periapical lesion and induction of root end closure with new hard tissue formation over MTA. Vinod Kumar, Mohammed Zameer, Vijaya Prasad, and T. Mahantesh Copyright © 2014 Vinod Kumar et al. All rights reserved. High-Wattage Pulsed Irradiation of Linearly Polarized Near-Infrared Light to Stellate Ganglion Area for Burning Mouth Syndrome Sun, 19 Oct 2014 00:00:00 +0000 http://www.hindawi.com/journals/crid/2014/171657/ The purpose of this study was to apply high-wattage pulsed irradiation of linearly polarized near-infrared light to the stellate ganglion area for burning mouth syndrome (BMS) and to assess the efficacy of the stellate ganglion area irradiation (SGR) on BMS using differential time-/frequency-domain parameters (D parameters). Three patients with BMS received high-wattage pulsed SGR; the response to SGR was evaluated by visual analogue scale (VAS) representing the intensity of glossalgia and D parameters used in heart rate variability analysis. High-wattage pulsed SGR significantly decreased the mean value of VAS in all cases without any adverse event such as thermal injury. D parameters mostly correlated with clinical condition of BMS. High-wattage pulsed SGR was safe and effective for the treatment of BMS; D parameters are useful for assessing efficacy of SGR on BMS. Yukihiro Momota, Koichi Kani, Hideyuki Takano, Fumihiro Matsumoto, Keiko Aota, Daisuke Takegawa, Tomoko Yamanoi, Chika Kondo, Shigemasa Tomioka, and Masayuki Azuma Copyright © 2014 Yukihiro Momota et al. All rights reserved. Extraction of Maxillary Central Incisors: An Orthodontic-Restorative Treatment Thu, 16 Oct 2014 00:00:00 +0000 http://www.hindawi.com/journals/crid/2014/268590/ Malformed central incisors with poor prognosis could be candidates for extraction especially in crowded dental arches. This case report refers to a 12-year-old boy who suffered from malformed upper central incisors associated with severe attrition. Upper lateral incisors were positioned palatally and canines were rotated and positioned in the high buccal area. The patient had class II malocclusion and space deficiency in both dental arches. Due to incisal wear and malformed short maxillary central incisors and the need for root canal therapy with a major crown build-up, these teeth were extracted. The maxillary lateral incisors were substituted. Thus the maxillary canines were substituted for lateral incisors and the first premolars were substituted for canines. In the lower dental arch the first bicuspids were extracted. Composite resin build-up was performed on the maxillary lateral incisors and canines. This allowed for the crowding and the malocclusion to be corrected. Subsequent gingivectomy improved the patient's gingival margins and smile esthetics one month after orthodontic therapy. Zohreh Hedayati, Maryam Zare, and Fateme Bahramnia Copyright © 2014 Zohreh Hedayati et al. All rights reserved. Severe Periodontal Disease Associated with Long-Term Treatment with Intravenous Immunoglobulin Wed, 15 Oct 2014 06:30:25 +0000 http://www.hindawi.com/journals/crid/2014/860804/ Intravenous immunoglobulin (IVIG) is used in the treatment of neuropathy. This case report presents, for the first time, a patient with severe periodontal destruction after chronic therapy with IVIG. The patient reported having extracted his maxillary anterior teeth himself due to high mobility. Clinical examination and radiographic images show a generalized and severe periodontitis. No significant alterations in genetic or microbiological features were observed. The present case suggests that periodontal disease aggravation could be considered a new adverse effect of IVIG therapy. Postulated mechanisms are immune complexes formation, complement activation, and a direct effect in osteoclasts. In conclusion, it is important that patients that will receive IVIG treatment underwent dental evaluation. Jôice Dias Corrêa, Amanda Leal Rocha, Lidiane Cristina Machado Costa, Denise Travassos, Wagner Henriques Castro, Gustavo Pompermaier Garlet, Rodrigo Santiago Gomez, Antônio Lúcio Teixeira, and Tarcília Aparecida Silva Copyright © 2014 Jôice Dias Corrêa et al. All rights reserved. Modified Anchor Shaped Post Core Design for Primary Anterior Teeth Tue, 14 Oct 2014 13:40:44 +0000 http://www.hindawi.com/journals/crid/2014/306910/ Restoring severely damaged primary anterior teeth is challenging to pedodontist. Many materials are tried as a post core but each one of them has its own drawbacks. This a case report describing a technique to restore severely damaged primary anterior teeth with a modified anchor shaped post. This technique is not only simple and inexpensive but also produces better retention. R. Rajesh, Kusai Baroudi, K. Bala Kasi Reddy, B. H. Praveen, V. Sumanth Kumar, and S. Amit Copyright © 2014 R. Rajesh et al. All rights reserved.