Case Reports in Dentistry The latest articles from Hindawi Publishing Corporation © 2015 , Hindawi Publishing Corporation . All rights reserved. Atypical Case of Three Dental Implants Displaced into the Maxillary Sinus Thu, 08 Oct 2015 13:27:19 +0000 Oral rehabilitation with dental implants has become a routine treatment in contemporary dentistry. The displacement of dental implants into the sinus membrane, a complication related to the maxillary sinus, is one of the most common accidents reported in the literature. The treatment for this complication is the surgical removal of the implant. A 60-year-old woman with three dental implants displaced into the maxillary sinus (one implant displaced into the left maxillary sinus and two implants displaced into the right maxillary sinus) underwent surgery for removal of the implants. The surgery to remove the implants was performed under local anesthesia through the Caldwell-Luc technique. The patient was subsequently administered antibiotic, anti-inflammatory, and analgesic drugs. The patient returned 7 days after the surgery for suture removal and is being regularly monitored to determine whether future rehabilitation of the edentulous area is necessary. In conclusion, surgical removal of the dental implant displaced into the maxillary sinus is the treatment of choice. This technique is appropriate because it allows the use of local anesthesia and provides direct visualization for the removal of the implants. João Felipe Bonatto Bruniera, Yara Teresinha Corrêa Silva-Sousa, and Paulo Esteves Pinto Faria Copyright © 2015 João Felipe Bonatto Bruniera et al. All rights reserved. Dental Management of a Patient with Nager Acrofacial Dysostosis Wed, 07 Oct 2015 13:17:44 +0000 Nager syndrome is a rare syndrome resulting from developmental abnormalities of the first and second branchial arches. Nager syndrome is rare and mostly sporadic. The main clinical features consist of craniofacial, limb, and musculoskeletal morphogenesis. These findings included malar hypoplasia, maxillomandibular hypoplasia, micrognathia, downslanting palpebral fissures, cleft palate, ear anomalies, hypoplastic thumb, short forearm, proximal radioulnar synostosis, atrial septal defect, lower limb deformities, and flat nasal bridge. The prevalence is unknown; about 100 cases of Nager syndrome have been published up to now. Patients with Nager syndrome are found worldwide among all racial and ethnic groups. Trismus and glossoptosis resulting in oropharyngeal airway narrowing cause life-threatening respiratory distress for patients with Nager syndrome. In this case report, dental rehabilitation of a 10-year-old child with Nager syndrome is presented. R. Bozatlıoğlu and A. P. Münevveroğlu Copyright © 2015 R. Bozatlıoğlu and A. P. Münevveroğlu. All rights reserved. Papillion-Lefèvre Syndrome: Periodontists’ Perspective Wed, 07 Oct 2015 11:08:59 +0000 Papillion-Lefèvre Syndrome is a very rare disorder of autosomal recessive inheritance distinguished by palmar plantar hyperkeratosis and early onset of periodontitis affecting the dentition. Genetic studies have identified a mutation in the major gene locus of chromosome 11q14 with loss of function. Cathepsin C gene is to be responsible for Papillion-Lefèvre Syndrome. The present case report describes a 13-year-old female, who visited the Department of Periodontology with the chief compliant of bleeding gums and loose teeth. She presented with the signs and symptoms of Papillion-Lefèvre Syndrome. The patient had premature shedding of her deciduous dentition. On clinical examination, extraorally, the patient presented with persistent thickening, flaking, and scaling of the skin of palms and soles. Her intraoral examination revealed gingival inflammation, abscess formation, and periodontal pockets. Her intraoral radiographs showed bone loss involving the central incisors and molars. The patient underwent periodontal therapy and is under maintenance. Sunil Kumar Biraggari, K. Krishna Mohana Reddy, J. Sudhakar, Shiva Shankar Bugude, Rajesh Nichenametla, Mazher Ahmed Hakeem, and Swati Reddy Tiyyagura Copyright © 2015 Sunil Kumar Biraggari et al. All rights reserved. Fabrication of Zirconia-Reinforced Lithium Silicate Ceramic Restorations Using a Complete Digital Workflow Mon, 05 Oct 2015 07:54:51 +0000 This case report describes the fabrication of monolithic all-ceramic restorations using zirconia-reinforced lithium silicate (ZLS) ceramics. The use of powder-free intraoral scanner, generative fabrication technology of the working model, and CAD/CAM of the restorations in the dental laboratory allows a completely digitized workflow. The newly introduced ZLS ceramics offer a unique combination of fracture strength (>420 MPa), excellent optical properties, and optimum polishing characteristics, thus making them an interesting material option for monolithic restorations in the digital workflow. Sven Rinke, Matthias Rödiger, Dirk Ziebolz, and Anne-Kathrin Schmidt Copyright © 2015 Sven Rinke et al. All rights reserved. Laser Phototherapy (660 nm) Can Be Beneficial for Reducing Gingival Inflammation in Prosthodontics Wed, 30 Sep 2015 09:40:43 +0000 Among the new technologies developed, low power lasers have enabled new approaches to provide conservative treatment. Low power lasers act at cellular level, resulting in reduced pain, modulating inflammation, and improved tissue healing. Clinical application of the low power laser requires specific knowledge concerning laser interaction with biological tissue so that the correct irradiation protocol can be established. The present case report describes the clinical steps involved in an indirect composite resin restoration performed in a 31-year-old patient, in whom low power laser was used for soft tissue biomodulation. Laser therapy was applied with a semiconductor laser 660 nm, spot size of 0.028 cm2, energy density of 35.7 J/cm2, mean power of 100 mW, and energy per point as 1 J, in contact mode, on a total of 2 points (mesial and distal), totaling 2 J of energy. The therapy with low power laser can contribute positively to the success of an indirect restorative treatment. Sávio José Cardoso Bezerra, Glauco Fioranelli Vieira, Carlos de Paula Eduardo, Patrícia Moreira de Freitas, and Ana Cecilia Corrêa Aranha Copyright © 2015 Sávio José Cardoso Bezerra et al. All rights reserved. Fabrication of Closed Hollow Bulb Obturator Using Thermoplastic Resin Material Sun, 27 Sep 2015 14:12:02 +0000 Purpose. Closed hollow bulb obturators are used for the rehabilitation of postmaxillectomy patients. However, the time consuming process, complexity of fabrication, water leakage, and discoloration are notable disadvantages of this technique. This paper describes a clinical report of fabricating closed hollow bulb obturator using a single flask and one time processing method for an acquired maxillary defect. Hard thermoplastic resin sheet has been used for the fabrication of hollow bulb part of the obturator. Method. After fabrication of master cast conventionally, bulb and lid part of the defect were formed separately and joined by autopolymerizing acrylic resin to form one sized smaller hollow body. During packing procedure, the defect area was loaded with heat polymerizing acrylic resin and then previously fabricated smaller hollow body was adapted over it. The whole area was then loaded with heat cure acrylic. Further processes were carried out conventionally. Conclusion. This technique uses single flask which reduces laboratory time and makes the procedure simple. The thickness of hollow bulb can be controlled and light weight closed hollow bulb prosthesis can be fabricated. It also minimizes the disadvantages of closed hollow bulb obturator such as water leakage, bacterial infection, and discoloration. Bidhan Shrestha, E. Richard Hughes, Raj Kumar Singh, Pramita Suwal, Prakash Kumar Parajuli, Pragya Shrestha, Arati Sharma, and Galav Adhikari Copyright © 2015 Bidhan Shrestha et al. All rights reserved. Congenital Insensitivity to Pain without Anhidrosis: Orodental Problems and Management Sun, 20 Sep 2015 14:04:43 +0000 This paper reports the case of a 4-year-old male patient who was brought by parents requesting for replacement of multiple missing anterior teeth. The patient suffered from congenital insensitivity to pain without anhidrosis and presented with full blown sequelae of the condition in the form of oral self-mutilation leading to loss of teeth, tongue tip amputation, finger tips destruction, and lower limb wound infections. Dental and orthopaedic treatment consists of local management of oral wound and prevention from further oral and finger injuries that takes the form of dental splints and finger sleeve splints, constant feet coverage with shoes, and behavioural medical therapy. The age of the patient and parents’ education present challenges in managing this condition to avoid morbidity and premature mortality. N. Abdullah, Kausar Sadia Fakhruddin, and A. R. Samsudin Copyright © 2015 N. Abdullah et al. All rights reserved. Er:YAG Laser Assisted Treatment of Central Odontogenic Fibroma of the Mandible Sun, 20 Sep 2015 07:39:11 +0000 Central odontogenic fibroma is a very rare benign odontogenic tumour characterized by a fibrous mature stroma with variable strands or islands of inactive-looking odontogenic epithelium. Our aim is to report a case of a central odontogenic fibroma and describe the clinical usefulness of Er:YAG laser for the surgical treatment of this tumour. A 74-year-old woman presented with an expansive lesion located in a mandible with multilocular and mixed radiographic appearance. A conservative excision using Er:YAG laser was performed. Complete removal was obtained. There were no postoperative complications. The histopatologic features were consistent with the diagnosis of central odontogenic fibroma of rich-epithelium type. No recurrence was observed during follow-up. Luis Silva Monteiro, Marco Martins, José Júlio Pacheco, Filomena Salazar, João Magalhães, Paolo Vescovi, and Marco Meleti Copyright © 2015 Luis Silva Monteiro et al. All rights reserved. A Rare Case of Melanosis of the Hard Palate Mucosa in a Patient with Chronic Myeloid Leukemia Tue, 15 Sep 2015 08:19:55 +0000 Imatinib Mesylate, also known as Gleevec or ST1-571, is a tyrosine-kinase inhibitor used as the gold standard medication for the chronic myeloid leukemia (CML); Imatinib has indeed deeply revolutionized the CML therapy allowing most patients to have a good quality of life. Despite its beneficial effects, Imatinib has significant side effects such as mucosal pigmentation. A 72-year-old female having an Imatinib induced mucosal pigmentation is presented: she has been treated with Imatinib since 2003 and only in 2014 discovered, during a routine dental visit, having a pigmented lesion on her hard palate mucosa. Histopathologically, the lesion shows the deposition of fine dark brown spherical bodies within the lamina propria and cloaked in between the collagen fibers. There was no sign of inflammation, hyperplasia, or hemorrhage in the tissue. Umberto Romeo, Gaspare Palaia, Paolo Junior Fantozzi, Gianluca Tenore, and Daniela Bosco Copyright © 2015 Umberto Romeo et al. All rights reserved. Actinomycotic Osteomyelitis of Maxilla Presenting as Oroantral Fistula: A Rare Case Report Tue, 15 Sep 2015 08:19:12 +0000 Actinomycosis is a chronic granulomatous infection caused by Actinomyces species which may involve only soft tissue or bone or the two together. Actinomycotic osteomyelitis of maxilla is relatively rare when compared to mandible. These are normal commensals and become pathogens when they gain entry into tissue layers and bone where they establish and maintain an anaerobic environment with extensive sclerosis and fibrosis. This infection spreads contiguously, frequently ignoring tissue planes and surrounding tissues or organ. The portal of entry may be pulpal, periodontal infection, and so forth which may lead to involvement of adjacent structures as pharynx, larynx, tonsils, and paranasal sinuses and has the propensity to damage extensively. Diagnosis is often delayed and is usually based on histopathology as they are cultured in fewer cases. The chronic clinical course without regional lymphadenopathy may be essential in diagnosis. The management of actinomycotic osteomyelitis is surgical debridement of necrotic tissue combined with antibiotics for 3–6 months. The primary actinomycosis arising within the maxilla with contiguous involvement of paranasal sinus with formation of oroantral fistula is rare. Hence, we present a 50-year-old female patient with chronic sclerosing osteomyelitis of maxilla which presented as oroantral fistula with suppurative and sclerotic features. Ashalata Gannepalli, Bhargavi Krishna Ayinampudi, Pacha Venkat Baghirath, and G. Venkateshwara Reddy Copyright © 2015 Ashalata Gannepalli et al. All rights reserved. Primary Chronic Osteomyelitis of the Jaws in Children: An Update on Pathophysiology, Radiological Findings, Treatment Strategies, and Prospective Analysis of Two Cases Mon, 07 Sep 2015 14:02:36 +0000 Objective. Primary chronic osteomyelitis (PCO) of the jaws in children is associated with pain, trismus, and swelling. In children, temporomandibular joint involvement is rare and few studies have been published due to the relatively low incidence. This paper presents two cases of mandibular PCO in children with the involvement of the collum mandibulae. In addition, a review of the literature regarding demographic data, histological, radiological, and laboratory findings, and treatment strategies of PCO was also performed. Material and Methods. Prospective analyses of two PCO cases. A PubMed search was used and the articles were sorted according to their corresponding key area of focus. Results. Review of the literature revealed twenty-four cases of PCO with two cases of mandibular condyle involvement. The mean age was 18 years; the male to female ratio was 1 : 3. Most of the patients were treated with anti-inflammatory drugs in combination with decortication. Clinical recurrence was seen in 7 cases. Conclusion. A combination of anti-inflammatory drugs and surgical intervention appears to be the first choice of treatment. However, surgical removal of necrotic tissue adjacent to collum mandibulae has its limitations in children. Further investigations are of utmost importance in order to increase our knowledge and understanding of this disease. Caroline Berglund, Karin Ekströmer, and Jahan Abtahi Copyright © 2015 Caroline Berglund et al. All rights reserved. Dental Considerations in Children with Glucose-6-phosphate Dehydrogenase Deficiency (Favism): A Review of the Literature and Case Report Mon, 07 Sep 2015 05:48:47 +0000 Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an uncommon inherited enzyme deficiency characterized by hemolytic anemia, caused by the inability of erythrocytes to detoxify oxidizing agents such as drugs, infectious diseases, or fava bean ingestion. In this later case, the disorder is known as favism. The aim of the present report was to present a review of the literature in this disease, to describe a case report concerning an affected 9-year-old male, and to review the main implications and precautions in pediatric dental management. Daniela Hernández-Pérez, Claudia Butrón-Téllez Girón, Socorro Ruiz-Rodríguez, Arturo Garrocho-Rangel, and Amaury Pozos-Guillén Copyright © 2015 Daniela Hernández-Pérez et al. All rights reserved. Enamel Pearls Implications on Periodontal Disease Sun, 06 Sep 2015 13:36:31 +0000 Dental anatomy is quite complex and diverse factors must be taken into account in its analysis. Teeth with anatomical variations present an increase in the rate of severity periodontal tissue destruction and therefore a higher risk of developing periodontal disease. In this context, this paper reviews the literature regarding enamel pearls and their implications in the development of severe localized periodontal disease as well as in the prognosis of periodontal therapy. Radiographic examination of a patient complaining of pain in the right side of the mandible revealed the presence of a radiopaque structure around the cervical region of lower right first premolar. Periodontal examination revealed extensive bone loss since probing depths ranged from 7.0 mm to 9.0 mm and additionally intense bleeding and suppuration. Surgical exploration detected the presence of an enamel pearl, which was removed. Assessment of the remaining supporting tissues led to the extraction of tooth 44. Local factors such as enamel pearls can lead to inadequate removal of the subgingival biofilm, thus favoring the establishment and progression of periodontal diseases. Elton Gonçalves Zenóbio, Thaís Ribeiral Vieira, Roberta Paula Colen Bustamante, Hayder Egg Gomes, Jamil Awad Shibli, and Rodrigo Villamarin Soares Copyright © 2015 Elton Gonçalves Zenóbio et al. All rights reserved. Interdisciplinary Approach to a Tooth with Open Apex and Persistent Sinus Sun, 06 Sep 2015 12:28:29 +0000 Traumatic injuries in childhood may disrupt root development leading to a tooth with open apex. Apexification procedures in such cases aim at root end closure after reasonable period of time. In some chronic cases, complete healing of the periapical area does not occur resulting in development of a nonhealing sinus. Failure of nonsurgical approach in such cases needs surgical intervention permitting thorough periapical curettage. In the present case, apexification procedure with MTA achieved root end closure but failed to heal the sinus for which surgical treatment was completed with thorough periapical curettage and application of platelet rich fibrin (PRF) and a combination of β-tricalcium phosphate and hydroxyapatite resulted in healing. Anoop N. Das, Krishnamohan Geetha, Ajay Varghese Kurian, Radhakrishnan Nair, and K. Nandakumar Copyright © 2015 Anoop N. Das et al. All rights reserved. Caliber-Persistent Artery Sun, 06 Sep 2015 11:51:48 +0000 Caliber-persistent artery (CPLA) of the lip is a common vascular anomaly in which a main arterial branch extends to the surface of the mucous tissue with no reduction in its diameter. It usually manifests as pulsatile papule, is easily misdiagnosed, and is observed more frequently among older people, suggesting that its development may involve a degenerative process associated with aging; CPLA is also characterized by the loss of tone of the adjacent supporting connective tissue. Although the diagnosis is clinical, high-resolution Doppler ultrasound is a useful noninvasive tool for evaluating the lesion. This report describes the case of a 58-year-old male patient who complained of a lesion of the lower lip with bleeding and recurrent ulceration. The patient was successfully treated in our hospital after a diagnosis of CPLA and is currently undergoing a clinical outpatient follow-up with no complaints. Sabrina Araújo Pinho Costa, Marcelo Martinson Ruiz, Shajadi Pardo Kaba, Giovanna Piacenza Florezi, Celso Augusto Lemos Júnior, and Andréa Lusvarghi Witzel Copyright © 2015 Sabrina Araújo Pinho Costa et al. All rights reserved. Conventional Complete Denture in Patients with Ectodermal Dysplasia Sun, 06 Sep 2015 10:25:32 +0000 Ectodermal dysplasia is described as heritable conditions that involve anomalies of structures derived from the ectoderm, including hypodontia. In the cases of edentulous young patients, who did not finish their craniofacial growth, treatment with conventional complete denture is a suitable alternative. The aim of this study was to report a case of mandibular edentulism treated with conventional complete denture in a thirteen-year-old patient diagnosed with hidrotic ectodermal dysplasia. Typical features, such as frontal bossing, depressed nasal bridge, protuberant lips, scarce hair, and brittle nails, were visualized during the extraoral examination. The intraoral inspection and radiographic analysis revealed oligodontia, dental malformation, and prolonged retention of deciduous teeth at maxilla and total edentulism at mandible. A conventional complete denture was planned and constructed following the same steps of technique as recommended in adults. Although this option is not a definitive treatment, the patient and his parents were satisfied with his improvement in chewing and speech, as well as with the aesthetic benefits. Larissa Soares Reis Vilanova, Alfonso Sánchez-Ayala, Giselle Rodrigues Ribeiro, Camila Heitor Campos, and Arcelino Farias-Neto Copyright © 2015 Larissa Soares Reis Vilanova et al. All rights reserved. Management of a Periodontal Pocket Using a Removable Orthodontic Appliance and Nonsurgical Periodontal Therapy Thu, 03 Sep 2015 16:59:51 +0000 Purpose. As documented in the literature, bony defects can be managed by an orthodontic approach. Methods. This case report describes the treatment of a bony defect caused by orthodontic malposition through phase I periodontal therapy and a simple removable orthodontic appliance used for the first time in a 20-year-old girl. Results. The periodontal pocket was reduced from 8 mm to 3 mm shortly after treatment. Conclusion. This case report concludes that orthodontic therapy can be used successfully in treatment of bony defects caused by mesially tilted molars. Serhat Köseoğlu, Ahmet Fidancıoğlu, Mehmet Sağlam, and Levent Savran Copyright © 2015 Serhat Köseoğlu et al. All rights reserved. Solitary Peripheral Osteoma of the Angle of the Mandible Tue, 01 Sep 2015 13:28:11 +0000 Solitary peripheral osteoma is a benign, slow-growing osteogenic tumor arising from craniofacial bones such as the sinus, temporal, or jaw bones but rarely originating from the mandible. Osteoma consists of compact or cancellous bone that may be of peripheral, central, or extraskeletal type. Peripheral osteoma arises from the periosteum and is commonly a unilateral, pedunculated mushroom-like mass. Solitary peripheral osteomas are characterized by well-defined, rounded, or oval radiopaque mass in the computed tomography. Although multiple osteomas of the jaws are a hallmark of Gardner’s syndrome (familial adenomatous polyposis), nonsyndromic cases are typically solitary. Herein, we report a rare case of solitary peripheral osteoma of the angle of the mandible in a 27-year-old female with clinical, radiologic, and histopathologic findings. Kapil Kshirsagar, Kalyani Bhate, Vivek Pawar, S. N. SanthoshKumar, Supriya Kheur, and Shrikant Dusane Copyright © 2015 Kapil Kshirsagar et al. All rights reserved. Riga-Fede Disease Associated with Natal Teeth: Two Different Approaches in the Same Case Tue, 01 Sep 2015 11:25:22 +0000 Natal teeth are those present in the oral cavity at the child’s birth. These teeth can cause ulcers on the ventral surface of the tongue, lip, and the mother’s breast characterizing the Riga-Fede Disease. The treatment depends on the tooth’s mobility and the risk of aspiration or swallowing; whether it is supernumerary or regular primary teeth; whether it is causing interference in breastfeeding; breast and oral soft tissue injuries; and the general state of child’s health. A 1-month-old female infant was diagnosed with two natal teeth and an ulcerated lesion on the ventral surface of the tongue, leading to the clinical diagnosis of Riga-Fede Disease. The treatment performed consisted of the maintenance of the natal tooth that showed no increased mobility, adding a small increment of glass ionomer cement to its incisal edge, and orientation for hygiene with saline solution. Due to the increased mobility of the other natal tooth, surgical removal was performed. There was regular monitoring of the patient and complete wound healing was observed after 15 days. The proposed treatment was successful and the patient is still in follow-up without recurrence of the lesion after one year. Luiz Evaristo Ricci Volpato, Cintia Aparecida Damo Simões, Flávio Simões, Priscila Alves Nespolo, and Álvaro Henrique Borges Copyright © 2015 Luiz Evaristo Ricci Volpato et al. All rights reserved. Soft Tissue Reconstruction with Free Gingival Graft Technique following Excision of a Fibroma Tue, 18 Aug 2015 10:57:47 +0000 Background. Oral fibromas are benign, asymptomatic, smooth surfaced, firm structured tumoral lesions that originate from gingival connective tissue or periodontal ligament. Histologically, they are nodular masses characterized by a dense connective tissue, surrounded by stratified squamous epithelium. Case Report. This case report includes the clinical, radiographical, and histological findings and periodontal treatment of a 38-year-old female patient having painless swelling on the gingiva. Intraoral examination revealed a fibrotic, sessile, smooth surfaced gingival overgrowth interdentally between the teeth #13 and #14. Radiographical findings were normal. Initial periodontal treatment (IPT) was applied including oral hygiene instructions, scaling, and root planing. Following IPT, the lesion (0.7 × 0.6 × 0.4 cm) was excised and examined histopathologically. Subsequently, flap operation was performed to have an access to alveolar bone. Surgical site was reconstructed with free gingival graft obtained from hard palate. Hematoxylin-eosin stained sections revealed a nodular mass composed by dense collagen fibers in lamina propria covered by a stratified squamous epithelium, which were consistent with fibroma. Gingival healing was uneventful and without any recurrence during the 12-month follow-up. Conclusions. In order to achieve optimal functional and aesthetical outcomes, free gingival graft can be used for the reconstruction of the wound site after the excision of the fibroma. Nurcan Tezci, Suleyman Emre Meseli, Burcu Karaduman, Serap Dogan, and Sabri Hasan Meric Copyright © 2015 Nurcan Tezci et al. All rights reserved. A Rare Case of a Lost Suture Needle during Third Molar Surgery Wed, 12 Aug 2015 08:28:18 +0000 The authors report a case that is started with a simple upper third molar’s surgical extraction and a broken 3.0 suture needle tip incident occurred. Broken fragment’s localization has been detected with 3D cone beam computed tomography (CBCT). Needle tip has been reached with the help of CBCT vision. CBCT’s benefits have been discussed on these types of cases and further migration of the needle tip during surgical procedure is reported. Sertac Aktop, Gokhan Gocmen, M. Elif Özturk, Onur Gonul, and Altan Varol Copyright © 2015 Sertac Aktop et al. All rights reserved. Temporary Mental Nerve Paresthesia Originating from Periapical Infection Thu, 06 Aug 2015 06:28:51 +0000 Many systemic and local factors can cause paresthesia, and it is rarely caused by infections of dental origin. This report presents a case of mental nerve paresthesia caused by endodontic infection of a mandibular left second premolar. Resolution of the paresthesia began two weeks after conventional root canal treatment associated with antibiotic therapy and was completed in eight weeks. One year follow-up radiograph indicated complete healing of the radiolucent periapical lesion. The tooth was asymptomatic and functional. Ozgur Genc Sen and Volkan Kaplan Copyright © 2015 Ozgur Genc Sen and Volkan Kaplan. All rights reserved. When the Midline Diastema Is Not Characteristic of the “Ugly Duckling” Stage Wed, 05 Aug 2015 13:11:43 +0000 This case report presents the interceptive orthodontic treatment of a 9-year, 5-month-old boy with class I malocclusion, a 9.0-mm maxillary midline diastema, and deviation from the midline. The treatment goals were to decrease the magnitude of the diastema and to simulate the characteristics of the “ugly duckling” stage. Braces were placed on the first molars and the maxillary central incisors. The biomechanics of the anchors on the first molars elicited substantial mesial movement of the left central incisor to match the midline. A flat wire segment was bonded onto the palatal surface of the central incisors for retention. Orlando Motohiro Tanaka, Alessandro Yuske Kusano Morino, Oscar Fernando Machuca, and Neblyssa Ágatha Schneider Copyright © 2015 Orlando Motohiro Tanaka et al. All rights reserved. CT Imaging of Craniofacial Fibrous Dysplasia Mon, 03 Aug 2015 11:44:13 +0000 Fibrous dysplasia is a benign fibroosseous bone dysplasia that can involve single (monostotic) or multiple (polyostotic) bones. Monostotic form is more frequent in the jaws. It is termed as craniofacial fibrous dysplasia, when it involves, though rarely, adjacent craniofacial bones. A 16-year-old girl consulted for a painless swelling in the right posterior mandible for two years. Panoramic radiography revealed ground-glass ill-defined lesions in the three different regions of the maxilla and mandible. Axial CT scan (bone window) showed multiple lesions involving skull base and facial bones. Despite lesions in the skull base, the patient had no abnormal neurological findings. The lesion was diagnosed as fibrous dysplasia based on radiological and histopathological examination. In this paper, CT findings and differential diagnosis of CFD are discussed. CT is a useful imaging technique for CFD cases. Zerrin Unal Erzurumlu, Peruze Celenk, Emel Bulut, and Yakup Sancar Barıs Copyright © 2015 Zerrin Unal Erzurumlu et al. All rights reserved. A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries Mon, 03 Aug 2015 07:37:34 +0000 The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a fractured crown. CBCT examination revealed a nondisplaced fracture and an oblique greenstick fracture of the mandibular body and unilateral fracture of the condyle. Closed reduction technique was chosen to manage fractures of the mandible. Favorable healing outcomes on multiple fractures of the mandible throughout the 6-year follow-up period proved the success of the conservative treatment. This case report is important since it presents a variety of pathological sequelae to trauma within one case. Yeliz Guven, Sevgi Zorlu, Abdulkadir Burak Cankaya, Oya Aktoren, and Koray Gencay Copyright © 2015 Yeliz Guven et al. All rights reserved. Canine Gouging: A Taboo Resurfacing in Migrant Urban Population Tue, 21 Jul 2015 07:44:29 +0000 Cosmopolitan cities have become a pool of migrants from different parts of the world, who carry their cultural beliefs and superstitions with them around the globe. Canine gouging is a kind of infant oral mutilation (IOM) which is widely practiced among rural population of Africa where the primary tooth bud of the deciduous canine is enucleated. The belief is that the life threatening illnesses in children like vomiting, diarrhoea, and fevers are caused by worms which infest on tooth buds. This case report is of a 15-year-old Somalian born boy, who presented at the dental institute with intermittent pain in his lower right permanent canine which was associated with a discharging intra oral buccal sinus. The tooth was endodontically treated and then restored with composite. General dental practitioners need to be vigilant when encountered with tooth presenting unusual morphology, unilateral missing tooth, and shift in the midline due to early loss of deciduous/permanent canines. Identification of any such dental mutilation practice will need further counselling of the individual and family members. It is the duty of every dental professional to educate and safeguard the oral and dental health of general public. Anila Virani Noman, Ferranti Wong, and Ravikiran Ramakrishna Pawar Copyright © 2015 Anila Virani Noman et al. All rights reserved. Oral Manifestations of Crohn’s Disease: A Case Report and Review of the Literature Thu, 09 Jul 2015 13:38:37 +0000 Crohn’s disease (CD) is an inflammatory disorder of the gastrointestinal tract that is likely caused by an inappropriate mucosal inflammatory response to intestinal bacteria in a genetically predisposed host. The lesions of CD can involve any region of the GI tract as well as extraintestinal sites such as the skin, joints, and eyes. The most common presenting symptoms are abdominal pain and prolonged diarrhea associated with fevers, fatigue, and malaise. Delayed growth and failure to thrive may also be observed in pediatric patients. Oral manifestations of CD are known as oral CD and may precede GI involvement, thus serving as early markers of this condition. We describe a 6-year-old male who presented with oral lesions as his initial manifestation of disease and review the current literature pertaining to oral CD. Victoria L. Woo Copyright © 2015 Victoria L. Woo. All rights reserved. Gingival Cyst of the Adult as Early Sequela of Connective Tissue Grafting Mon, 06 Jul 2015 10:28:57 +0000 The subepithelial connective tissue graft (SCTG) is a highly predictable procedure with low complication rate. The reported early complications consist of typical postsurgical sequelae, such as pain and swelling. This case report describes the development and management of a gingival cyst following SCTG to obtain root coverage. Three weeks after SCTG procedure, a slightly raised, indurated, ~5 mm diameter asymptomatic lesion was evident. Excisional biopsy was performed and the histopathological evaluation confirmed the gingival cyst diagnosis. At the 1-year follow-up, the site had complete root coverage and normal tissue appearance and the patient remained asymptomatic. Mariana Gil Escalante and Dimitris N. Tatakis Copyright © 2015 Mariana Gil Escalante and Dimitris N. Tatakis. All rights reserved. Full Mouth Reconstruction of a Bruxer with Severely Worn Dentition: A Clinical Report Wed, 01 Jul 2015 12:05:02 +0000 Tooth wear is attributed to several factors many of which often remain unidentified. Management of tooth wear is challenging in preventive and restorative dentistry. Correct assessment of occlusal vertical dimension, interocclusal rest space, and centric relation records are critical for successful treatment. In order to evaluate different treatment modalities and select the treatment of choice some information can be obtained from study casts and diagnostic wax-up. In order to achieve a predictable and desirable result, a systematic approach may be helpful. This paper describes the full mouth rehabilitation of a 36-year-old bruxer with severely worn dentition and other dental problems such as unfavorable restorations. A diagnostic work-up was performed and provisional restorations were made; then, they were clinically evaluated and adjusted based on the criteria dictating esthetics, phonetics, and vertical dimension. After endodontic therapy, clinical crown lengthening was performed. Two short implants were inserted in the posterior mandible. Custom-cast dowel cores and metal-ceramic restorations were fabricated and a full occlusal splint was used to protect the restorations. We ensured stable contacts on all teeth with equal intensity in centric relation and anterior guidance in accord with functional jaw movements. Somayeh Zeighami, Hakimeh Siadat, and Sakineh Nikzad Copyright © 2015 Somayeh Zeighami et al. All rights reserved. Facial Swelling as a Primary Manifestation of Multiple Myeloma Wed, 01 Jul 2015 09:00:53 +0000 Facial swellings are commonly encountered in the dental office, the cause of which could range from a congenital etiology to an acquired one or it may even be a manifestation of an underlying systemic disease. The clinician must have a thorough knowledge of the various clinical and imaging manifestations and the sites of occurrence of the various conditions to arrive at the appropriate diagnosis. Facial swellings can be classified into different groups which include acute swellings with inflammation, nonprogressive swellings, and slowly or rapidly progressive swellings. The various imaging modalities like CT and MRI are useful for assessing the extent of the swelling as well as evaluating the soft tissue and osseous involvement of the swelling. Multiple myeloma represents clonal proliferation of plasma cells and is a condition in which a facial swelling might be present, though not common. This paper reports a case of a patient with a unilateral facial swelling, which on investigation led to a diagnosis of multiple myeloma. Anju E. Thomas, Seema Kurup, Renju Jose, and Cristalle Soman Copyright © 2015 Anju E. Thomas et al. All rights reserved.