Case Reports in Dentistry The latest articles from Hindawi Publishing Corporation © 2015 , Hindawi Publishing Corporation . All rights reserved. Ectopic Compound Odontoma in the Buccal Mucosa: Report of a Rare Case Wed, 25 Feb 2015 13:20:05 +0000 Eruption of tooth into extraosseous locations is an extremely rare condition. We report a case of a six-year-old girl child with tooth-like structure erupting from the right buccal mucosa. Clinical, radiographic, and histopathologic examination suggested the diagnosis of compound odontoma. Very few cases have been reported so far, where tooth has been located completely in the soft tissue and a variety of names have been used for that condition. A brief review of the literature and the ambiguity in naming the situation is discussed. Aparna Venigalla, Leela Krishna Guttikonda, Hasini Nelakurthi, Suresh Babburi, Soujanya Pinisetti, Ajay Banerji Kotti, and Lavanya Kalapala Copyright © 2015 Aparna Venigalla et al. All rights reserved. Severe Impaction of the Primary Mandibular Second Molar Accompanied by Displacement of the Permanent Second Premolar Wed, 25 Feb 2015 11:38:26 +0000 Tooth impaction is defined as any tooth that fails to erupt into a normal functional position and remains unerupted beyond the time at which it should normally erupt. Reports of impaction and eruption failure in primary teeth are relatively rare compared to permanent teeth. We report 2 rare cases where the second premolar was located on the occlusal side of the impacted mandibular second primary molar. In the first case, the succedaneous permanent tooth erupted after extraction of the primary tooth, fenestration, and traction. In the second case, the succedaneous permanent tooth erupted without fenestration or traction. Although the etiology of the tooth displacement was unknown in both cases, inhibition of the eruptive movement of the primary molar may have been associated with displacement of the succedaneous permanent premolar. Junko Matsuyama, Shoko Kinoshita-Kawano, Sachiko Hayashi-Sakai, Tomoe Mitomi, and Tomiko Sano-Asahito Copyright © 2015 Junko Matsuyama et al. All rights reserved. Severe Bradycardia Possibly due to a Local Anesthetic Oral Mucosal Injection during General Anesthesia Wed, 25 Feb 2015 11:38:26 +0000 Local anesthesia may induce systemic complications leading to parasympathetic activity leading to bradycardia and hypotension. We report a case of a 50-year-old man undergoing dental surgery under general anesthesia who experienced severe bradycardia and hypotension after local anesthesia infiltration. Concerns regarding the utilization of a relatively large lumen injection needle for local anesthesia during general anesthesia are discussed. Kenichi Satoh, Ayako Ohashi, Miho Kumagai, Hideki Hoshi, Kousei Otaka, and Shigeharu Joh Copyright © 2015 Kenichi Satoh et al. All rights reserved. Delayed Replantation of Avulsed Teeth: Two Case Reports Wed, 25 Feb 2015 11:36:03 +0000 This case report presents two cases of delayed replantation of avulsed maxillary central incisors after an extended dry extra-alveolar period. Eight-year-old boy and 10-year-old boy presented with avulsed maxillary central incisors due to trauma occurring 27 and 7 hours earlier, respectively. Treatment guidelines for avulsed mature/immature permanent teeth with prolonged extra-oral time were carried out for the teeth and the extra-oral endodontic treatment was completed. After having been repositioned, the teeth were stabilized for 4 weeks and prophylactic antibiotic was prescribed. Clinical and radiographic controls were done after 18 months for Case I and 12 months for Case II. During the follow-up periods the teeth reported in these cases have remained in a stable, functional position but revealed clinical initial replacement resorption and ankylosis. Selcuk Savas, Ebru Kucukyilmaz, Merve Akcay, and Serhat Koseoglu Copyright © 2015 Selcuk Savas et al. All rights reserved. Management of an Intruded Tooth and Adjacent Tooth Showing External Resorption as a Late Complication of Dental Injury: Three-Year Follow-Up Mon, 23 Feb 2015 09:32:24 +0000 Treatment and prognosis of intrusive luxation can vary depending on the age of the patient, type of dentition, stage of root development, and time and severity of the trauma. Some studies have demonstrated that intrusions of up to 3.0 mm have an excellent prognosis, whereas teeth with severe intrusion or teeth that are intruded more than 6.0 mm present an unfavorable prognosis because of the occurrence of inflammatory resorption and pulp necrosis. The aim of this case report is to present an 11-year-old male patient with complete intrusion of the permanent maxillary left lateral incisor, associated with the adjacent central tooth presenting external resorption, treated by immediate surgical repositioning and root canal treatment with a favorable prognosis. After long-term (3-year) clinical and radiographic follow-up, the teeth appeared normal and the patient was pleased with the outcome. Ülkü Şermet Elbay, Mesut Elbay, Emine Kaya, and Alper Sinanoglu Copyright © 2015 Ülkü Şermet Elbay et al. All rights reserved. Unusual Transalveolar and Transmuco-Gingival Root Avulsion of a Fractured Primary Central Incisor: A Case with an 8-Year Follow-Up Sun, 22 Feb 2015 10:00:42 +0000 The purpose of this unique case report is to describe a very unusual dentoalveolar fracture associated with avulsion of the near-complete root. A 3-year-old male patient came for consultation after a dentoalveolar trauma with a “fragment that looks like canine” found in his mouth by his mother. This boy suffered root fracture of the upper primary central right incisor, accompanied by transalveolar and transmuco-gingival avulsion of the tooth root fragment, leaving the crown in its position in the dental arch. Clinical and radiological examinations were performed in order to follow up the case: 15 days, one month, and three months after trauma, the crown had a slight mobility without other clinical or radiological signs. After six months, the upper primary central right incisor’s crown was exfoliated. Open bite due to the persistence of the pacifier habit favored the crown retention in the mouth. This case emphasizes the importance of primary diagnosis and follow-up of trauma cases. To the best of our knowledge, this kind of dental injury has not been previously described in the literature nor in the current Dental Trauma guidelines for the management of traumatic dental injuries in the primary dentition. E. Ferrés-Amat, C. Díaz-Martínez, S. Herrera-Martínez, I. Maura-Solivellas, and E. Ferrés-Padró Copyright © 2015 E. Ferrés-Amat et al. All rights reserved. Sarcomatoid (Spindle Cell) Carcinoma of Tongue: A Report of Two Cases Tue, 17 Feb 2015 11:39:30 +0000 Sarcomatoid Carcinoma (SC) is an unusual and aggressive variant of squamous cell carcinoma, which frequently recurs and metastasizes; for this reason, the right diagnosis is very important. It is considered to be a biphasic tumor made up of cells from squamous and spindle cells carcinoma with a sarcomatous aspect, but of epithelial origin. The diagnosis often represents a clinical-pathological challenge where the study with immunohistochemical technique (IHC) is key to the histopathological diagnosis. The reported cases related to oral mucosa are limited. In this work we present two SC cases where the use of IHC allowed us to achieve a conclusive diagnosis. Montserrat Reyes, Gina Pennacchiotti, Fabio Valdes, Rodrigo Montes, Marcelo Veloso, Maria Angélica Matamala, Luis Zanolli, and Gonzalo Rojas-Alcayaga Copyright © 2015 Montserrat Reyes et al. All rights reserved. A Modified Design for Posterior Inlay-Retained Fixed Dental Prosthesis Mon, 16 Feb 2015 11:59:44 +0000 The aim of this paper is to report a clinical case with bilateral missing mandibular second premolars that were restored by metal-ceramic inlay-retained fixed dental prostheses. The first prosthesis was of a traditional design and the second was of a modified design. The suggested design is created by modifying the retainer wings of the traditional resin-bonded inlay-retained fixed dental prosthesis and covering the wings with composite resin. The modified design is relatively conservative, esthetic and provides an extra element for the retention of posterior metal-ceramic inlay-retained fixed dental prostheses. Abdulaziz Samran, Mohammad Zakaria Nassani, Marwan Aswad, and Amid Abdulkarim Copyright © 2015 Abdulaziz Samran et al. All rights reserved. Clinical Strategies for Complete Denture Rehabilitation in a Patient with Parkinson Disease and Reduced Neuromuscular Control Sun, 08 Feb 2015 08:50:57 +0000 The dentist has a large role in geriatric health care for the ever increasing elder population with associated physical and neurological disorders. The Parkinson disease is progressive neurological disorder with resting tremor, bradykinesia, akinesia, and postural instability. The psychological components of disease include depression, anxiety, and cognitive deficiency. Poor oral hygiene, increased susceptibility for dental caries, and periodontal diseases predispose them to early edentulism. The number of Parkinson affected patients visiting dental clinic seeking complete denture is growing. This case report explains the steps involved in the complete denture rehabilitation of Parkinson patient. The effective prosthesis will help in alleviating functional, aesthetic, and psychological disabilities of the patient. Satheesh B. Haralur Copyright © 2015 Satheesh B. Haralur. All rights reserved. Multiple Congenital Granular Cell Epulis: Case Report and Immunohistochemical Profile with Emphasis on Vascularization Thu, 05 Feb 2015 06:45:59 +0000 Congenital granular cell epulis is a rare benign soft tissue lesion arising from the alveolar ridge in neonates. A rare case of multiple congenital granular cell epulis is reported, alongside a description of its vascular immunohistochemical profile. A female newborn presented with two exophytic pedunculated red nodules located on the alveolar ridge between the future eruption sites of the incisors and canines of the mandible and maxilla. A conservative surgical excision was performed on the second day of life. Histology revealed proliferation of round granular cells containing an abundant eosinophilic cytoplasm with basophilic nuclei, ranging from round to oval in shape. Numerous blood vessels were also seen. Immunohistochemical analysis of the granular cells revealed positivity for CD68, D2-40, Ki67, VEGF, and FGF and negativity for S100, CD34, and CD105. Immunostaining for CD34, CD105, and D2-40 confirmed the presence of a large number of blood and lymphatic vessels. Although rare, an understanding of this lesion is paramount for correct diagnosis and appropriate treatment. In the present report, the immunohistochemical profile confirmed increased vascularization, proving that these lesions are composed of not only new and preexisting blood vessels, but also lymphatic vessels. Patricia Roccon Bianchi, Vera Cavalcanti de Araujo, José Wagner Banterli Ribeiro, Fabricio Passador-Santos, Ney Soares de Araujo, and Andresa Borges Soares Copyright © 2015 Patricia Roccon Bianchi et al. All rights reserved. Natal Teeth: A Case Report and Reappraisal Wed, 04 Feb 2015 09:30:07 +0000 The presence of teeth at birth (natal teeth) or within a month after delivery (neonatal teeth) is a rare condition. Natal and neonatal teeth are conditions of significant importance to pediatric dentists and pediatricians. This report discusses a case in which a five-day-old infant required extraction of a mobile mandibular natal tooth to avoid the risk of aspiration and interference with feeding. Also, a review of the literature was conducted to discuss the etiology, clinical features, complications, and management of natal and neonatal teeth. Ghadah A. Malki, Emad A. Al-Badawi, and Mohammad A. Dahlan Copyright © 2015 Ghadah A. Malki et al. All rights reserved. Dental Extrusion with Orthodontic Miniscrew Anchorage: A Case Report Describing a Modified Method Mon, 02 Feb 2015 14:29:02 +0000 In recent years, the skeletal anchorage through miniscrews has expanded the treatment options in orthodontics (Yamaguchi et al., 2012). We hereby present a modified method for tooth extrusion for cases where crown-lengthening surgery is contraindicated for aesthetic reasons. This modified method uses three orthodontic appliances: a mini-implant, an orthodontic wire, and a bracket. The aim of this case report was to increase the length of the clinical crown of a fractured tooth (tooth 23) by means of an orthodontic extrusion with the modified method of Roth and Diedrich. Ricardo Fidos Horliana, Anna Carolina Ratto Tempestini Horliana, Alexandre do Vale Wuo, Flávio Eduardo Guillin Perez, and Jorge Abrão Copyright © 2015 Ricardo Fidos Horliana et al. All rights reserved. Aesthetic and Functional Rehabilitation of the Primary Dentition Affected by Amelogenesis Imperfecta Mon, 02 Feb 2015 06:35:39 +0000 The objective of this case report was to describe the oral rehabilitation of a five-year-old boy patient diagnosed with amelogenesis imperfecta (AI) in the primary dentition. AI is a group of hereditary disorders that affects the enamel structure. The patient was brought to the dental clinic complaining of tooth hypersensitivity during meals. The medical history and clinical examination were used to arrive at the diagnosis of AI. The treatment was oral rehabilitation of the primary molars with stainless steel crowns and resin-filled celluloid forms. The main objectives of the selected treatment were to enhance the esthetics, restore masticatory function, and eliminate the teeth sensitivity. The child was monitored in the pediatric dentistry clinic at four-month intervals until the mixed dentition stage. Treatment not only restored function and esthetic, but also showed a positive psychological impact and thereby improved perceived quality of life. The preventive, psychological, and curative measures of a young child with AI were successful. This result can encourage the clinicians to seek a cost-effective technique such as stainless steel crowns, and resin-filled celluloid forms to reestablish the oral functions and improve the child’s psychosocial development. Maria Carolina Salomé Marquezin, Bruna Raquel Zancopé, Larissa Ferreira Pacheco, Maria Beatriz Duarte Gavião, and Fernanda Miori Pascon Copyright © 2015 Maria Carolina Salomé Marquezin et al. All rights reserved. Cerebral Abscess Potentially of Odontogenic Origin Sun, 01 Feb 2015 12:53:17 +0000 Odontogenic origins are rarely implicated in the formation of brain abscesses. The relative paucity of this kind of infection and the difficulty in matching the causative microorganisms of a brain abscess to an odontogenic source can explain the late management of patients. We herein describe a case of a 46-year-old man with a cerebellar abscess that was probably due to an odontogenic infection. The diagnosis supported by imaging and microscopic identification, mini craniectomy for abscess drainage followed by eradication of all potential dental infectious foci, and an antibiotic regimen based on cephalosporins, metronidazole, and vancomycine contributed to a successful outcome. Marouene Ben Hadj Hassine, Lamia Oualha, Amine Derbel, and Nabiha Douki Copyright © 2015 Marouene Ben Hadj Hassine et al. All rights reserved. Removal of an Upper Third Molar from the Maxillary Sinus Sun, 01 Feb 2015 09:31:06 +0000 The maxillary sinus or antrum is the largest of the paranasal sinuses. It is located in the maxillary bone and has a proximity to the apexes of upper molars and premolars, which allows it to form a direct link between the sinus and the oral cavity. Dislocation of a foreign body or tooth to the interior of a paranasal sinus is a situation that can occur as a result of car accidents, firearm attacks, or iatrogenic in surgical procedures. Therefore, it is necessary to know how to treat this kind of situation. This study’s objective is to report the case of a 23-year-old female patient, leucoderma, who sought treatment from the Surgical Unit at the Dental Faculty of the Federal University of Sergipe. She had a history of pain and edema in the right side of the genian region and two failed attempts at removing dental unit (DU) 18. The extraoral clinical exam revealed intense edema of the left hemiface with signs of infection, excoriation of the labial commissure, hematoma, a body temperature of 39°C, and a limited ability to open her mouth. The patient was medicated and treated surgically. The tooth was removed from the maxillary sinus with caution, as should have been done initially. Klinger de Souza Amorim, Vanessa Tavares da Silva, Rafael Soares da Cunha, Maria Luisa Silveira Souto, Carla Rocha São Mateus, and Liane Maciel de Almeida Souza Copyright © 2015 Klinger de Souza Amorim et al. All rights reserved. Ameloblastic Fibrodentinoma Presenting as a False Gingival Enlargement in the Maxillary Anterior Region Thu, 29 Jan 2015 11:42:40 +0000 Ameloblastic fibrodentinoma is a rare benign mixed odontogenic neoplasm usually occurring in the first two decades of life. It is more common in males and the most common site of occurrence is in the mandibular premolar molar area. This report presents a case of ameloblastic fibrodentinoma in a 12-year-old boy in the maxillary anterior region, a less common site for the occurrence of ameloblastic fibrodentinoma. A 12-year-old boy presented with a midline diastema in 11 and 21 region and a swelling in the palatal aspect of 11 and 12. Intraoral periapical radiograph showed the presence of rarefaction of bone on the mesial aspect of the cervical and middle third of the root of 11. Excision biopsy was done. The specimen was processed and stained with hematoxylin and eosin. Microscopic examination showed islands, chords and strands of odontogenic epithelium in a primitive ectomesenchyme resembling dental papilla. The odontogenic epithelium exhibited peripheral ameloblast-like and central stellate reticulum-like cells. The presence of dentinoid material was seen adjacent to the odontogenic epithelium in some foci. The lesion was diagnosed as ameloblastic fibrodentinoma. Shiny Joseph, Lakshmi Priya, Dinesh Gopal, Mary Devachen, Ajay Narayan, and Muhammed Afnan Copyright © 2015 Shiny Joseph et al. All rights reserved. Rehabilitation of an Advanced Case of Adenoid Cystic Carcinoma Thu, 29 Jan 2015 10:14:29 +0000 Adenoid cystic carcinoma is a cancer of the salivary gland that primarily affects the parotid, submandibular, and accessory salivary glands. Its growth is slow and it has infiltrative nature. A 46-year-old female patient coming from the rural area presented a lesion on the palate and reported pain in the region for three years. After incisional biopsy, and histopathological diagnosis of adenoid cystic carcinoma of the cribriform type of minor salivary gland, superior hemimaxillectomy and adjuvant treatment with radiotherapy and maxillofacial prosthetic rehabilitation were performed. Luiz Evaristo Ricci Volpato, Lorena Frange Caldas, Paulo Henrique de Souza Castro, Artur Aburad de Carvalhosa, Maria Carmen Palma Faria Volpato, Matheus Coelho Bandéca, and Álvaro Henrique Borges Copyright © 2015 Luiz Evaristo Ricci Volpato et al. All rights reserved. The Importance of the Lifelike Esthetic Appearance of All-Ceramic Restorations on Anterior Teeth Thu, 29 Jan 2015 06:40:05 +0000 The success of rehabilitation will not depend on just clinical procedures. A proper dental technique (ceramist) is required as well as the respect for some biomimetic principles to obtain the desired final result. This study has the purpose of describing a prosthetic rehabilitation with laminate veneers and all-ceramic crowns of a patient unsatisfied with a previous esthetic treatment because of the negligence of some biomimetic principles. A 45-year-old female patient was admitted to the dental clinic complaining about the lifelike appearance of her all-ceramic restorations. Before the fabrication of new restorations, a mock-up was conducted to verify the patient’s satisfaction. A ceramist conducted all the fabrication process so that surface characterizations could be visually verified and the lifelike appearance of natural tooth could be reproduced. After the cementation procedure, the patient reported being satisfied with the lifelike appearance of the new restorations. Based on the clinical findings of the present case report, it can be concluded that the reproduction of the lifelike esthetic appearance of natural teeth and the visualization of the final results before definitive procedures are essential to obtain the clinical success. Daniela Micheline dos Santos, Amália Moreno, Aljomar José Vechiato-Filho, Liliane da Rocha Bonatto, Aldiéris Alves Pesqueira, Murilo César Bento Laurindo Júnior, Rodrigo Antonio de Medeiros, Emily Vivianne Freitas da Silva, and Marcelo Coelho Goiato Copyright © 2015 Daniela Micheline dos Santos et al. All rights reserved. Epidermoid Cyst in the Floor of the Mouth of a 3-Year-Old Wed, 28 Jan 2015 09:44:39 +0000 Epidermoid cysts are a rare entity in the oral cavity and are even less frequent in the floor of the mouth, representing less than 0.01% of all the cases. We present the case of a 3-year-old girl with a growth in the floor of the mouth with 2 months of evolution and without changes since it was discovered by her parents. The lesion was asymptomatic; it did not cause dysphagia, dyspnea, or any other alteration. A CT scan with contrast was done which revealed the location and exact size of the lesion, allowing an intraoral approach for its excision. The histological examination confirmed the clinical speculation of an epidermoid cyst. Rossana Pascual Dabán, Eloy García Díez, Beatriz González Navarro, and José López-López Copyright © 2015 Rossana Pascual Dabán et al. All rights reserved. Untypical Amlodipine-Induced Gingival Hyperplasia Tue, 27 Jan 2015 09:09:50 +0000 Amlodipine is a third generation dihydropyridine calcium channel blocker that is frequently used in therapy of hypertension. Among many side effects, amlodipine has been found associated with gingival overgrowth (GO) which usually occurs within the first three months of starting therapy at a dose of 10 mg/day. However, there are very few reports on amlodipine-induced gingival overgrowth (AIGO) at a lower dose (5 mg/day) and only after short term administration. A 64-year-old male patient with hypertension, who received amlodipine (5 mg/day) for four years, sought medical attention at the Department of Periodontology and Oral Medicine, Institute of Dentistry, Banja Luka, Bosnia and Herzegovina. The patient complained of masticatory problems due to extensive maxillary GO along with pain, bleeding, and foul odor. The clinical and the histological evidences were consistent with AIGO. The first line treatment consisted of the amlodipine substitution (amlodipine was replaced with enalapril, 5 mg/day) and the scaling and root planning/SRP. At one-month follow-up, drug replacement and SRP resulted in some reduction of the inflammation and significant reduction of symptoms. Further, gingivectomy/gingivoplasty helped overcome the effect of these drugs. The possibility of AIGO should be considered for a lower dose, as well as a late presentation. Verica Pavlic, Nina Zubovic, Sanja Ilic, and Tijana Adamovic Copyright © 2015 Verica Pavlic et al. All rights reserved. Bilateral Molariform Mandibular Second Premolars Mon, 19 Jan 2015 06:29:25 +0000 Macrodontia is a rare dental anomaly that refers to teeth that appear larger than normal. Generalised macrodontia can be associated with certain medical conditions and syndromes. This case report presents clinical and radiographic findings of isolated bilateral macrodontia in a 14-year-old child. The patient was referred to the clinic with local crowding of maxillary and mandibular teeth. Radiographic findings revealed the presence of impacted macrodont mandibular second premolar on one side and erupted macrodontic premolar on the other side and their distinct morphological appearance, characterized by large, multitubercular, and molariform crowns and tapering, single roots. Sonu Acharya, Pradip Kumar Mandal, and Chiranjit Ghosh Copyright © 2015 Sonu Acharya et al. All rights reserved. Ectopic Oral Tonsillar Tissue: A Case Series with Bilateral and Solitary Presentations and a Review of the Literature Tue, 13 Jan 2015 10:54:32 +0000 An ectopic tonsil is defined as tonsillar tissue that develops in areas outside of the four major tonsil groups: the palatine, lingual, pharyngeal, and tubal tonsils. The occurrence of tonsillar tissue in the oral cavity in ectopic locations, its prevalence, and its developmental mechanisms that belong to its formation remain unclear. In this report, we describe a rare case of bilateral symmetric ectopic oral tonsillar tissue located at the ventral surface of the tongue along with two solitary cases arising from the floor of the mouth. The role of immune system and its aberrant response leading to ectopic deposits desires further studies. As an ectopic tonsil may simulate a benign soft tissue tumor, this case series highlights the importance of this entity in our clinical differential diagnosis of oral soft tissue masses. Masashi Kimura, Toru Nagao, Terumi Saito, Saman Warnakulasuriya, Hiroyuki Ohto, Akihito Takahashi, Kanji Komaki, and Yoshiyuki Naganawa Copyright © 2015 Masashi Kimura et al. All rights reserved. Intraradicular Splinting with Endodontic Instrument of Horizontal Root Fracture Mon, 12 Jan 2015 06:36:15 +0000 Introduction. Root fractures, defined as fractures involving dentine, cementum, and pulpal and supportive tissues, constitute only 0.5–7% of all dental injuries. Horizontal root fractures are commonly observed in the maxillary anterior region and 75% of these fractures occur in the maxillary central incisors. Methods. A 14-year-old female patient was referred to our clinic three days after a traffic accident. In radiographic examination, the right maxillary central incisor was fractured horizontally in apical thirds. Initially, following local infiltrative anesthetics, the coronal fragment was repositioned and this was radiographically confirmed. Then the stabilization splint was applied and remained for three months. After three weeks, according to the results of the vitality tests, the right and left central incisors were nonvital. For the right central incisor, both the coronal and apical fragments were involved in the endodontic preparation. Results. For the right central tooth, both the coronal and apical root fragments were endodontically treated and obturated at a single visit with white mineral trioxide aggregate whilst the fragments were stabilized internally by insertion of a size 40 Hedstrom stainless-steel endodontic file into the canal. Conclusion. Four-year follow-up examination revealed satisfactory clinical and radiographic findings with hard tissue repair of the fracture line. Ersan Çiçek, Neslihan Yılmaz, and Mustafa Murat Koçak Copyright © 2015 Ersan Çiçek et al. All rights reserved. Late Developing Supernumeraries in a Case of Nonsyndromic Multiple Supernumerary Teeth Sun, 11 Jan 2015 13:36:08 +0000 Objective. This case report presents 3-year follow-up of a case of nonsyndromic multiple supernumerary teeth (NSMST) with 11 supernumerary teeth, 2 of which showed subsequent formation. Case Report. A 10-year-old girl was referred to the dental clinic with the chief complaint of delayed eruption. Radiographic examination showed 9 retained supernumerary teeth. The treatment plan consisted of extraction of the supernumerary teeth and associated primary teeth in order to allow the permanent teeth to erupt. After 2 years of follow-up, 2 additional supernumerary teeth were observed. Conclusion. Regular follow-up for late forming supernumeraries is crucial for NSMST cases. Mine Bozkurt, Tugba Bezgin, Ayşegül Tüzüner Öncül, Rukiye Göçer, and Şaziye Sarı Copyright © 2015 Mine Bozkurt et al. All rights reserved. Novel Techniques with the Aid of a Staged CBCT Guided Surgical Protocol Tue, 06 Jan 2015 11:24:43 +0000 The case report will present some novel techniques for using a “staged” protocol utilizing strategic periodontally involved teeth as transitional abutments in combination with CBCT guided implant surgery. Staging the case prevented premature loading of the grafted sites during the healing phase. A CBCT following a tenting screw guided bone regeneration procedure ensured adequate bone to place an implant fixture. Proper assessment of the CBCT allowed the surgeon to do an osteotome internal sinus lift in an optimum location. The depth of the bone needed for the osteotome sinus floor elevation was planned. The staged appliance allowed these sinus-augmented sites to heal for an extended period of time compared to implants, which were uncovered and loaded at an earlier time frame. The staged protocol and CBCT analysis enabled the immediate implants to be placed in proper alignment to the adjacent fixture. After teeth were extracted, the osseointegrated implants were converted to abutments for the transitional appliance. Finally, the staged protocol allowed for soft tissue enhancement in the implant and pontic areas prior to final insertion of the prosthesis. Evdokia Chasioti, Mohammed Sayed, and Howard Drew Copyright © 2015 Evdokia Chasioti et al. All rights reserved. Epidermal Cyst of Parotid Gland: A Rarity and a Diagnostic Dilemma Tue, 06 Jan 2015 06:19:39 +0000 Epidermal cysts are common skin lesions but they occur very rarely in the oral cavity, especially in the salivary glands. Very few cases have been reported in the literature and, here, we present one such rare case of epidermal cyst in the right parotid gland in a 62-year-old female patient. Anuradha Ganesan and Gautham Kumar Nandakumar Copyright © 2015 Anuradha Ganesan and Gautham Kumar Nandakumar. All rights reserved. An Alternative Technique for Fabrication of Frameworks in an Immediate Loading Implant Fixed Mandibular Prosthesis Mon, 05 Jan 2015 12:33:11 +0000 The oral rehabilitation of edentulous patients with immediate loading has become a safe procedure with high predictability. The success is related to immediate fabrication of a passive fit framework to attach the implants. Based on these considerations, this case report shows an alternative technique for mandibular rehabilitation using implants immediately loaded, where the framework was fabricated using cylinders with internal reinforcement and precast pieces, electrowelding, and conventional welding providing esthetics and function to the patient in a short period of time. André Gustavo Paleari, Cristina Dupim Presoto, Juliano Alencar Vasconcelos, José Maurício dos Santos Nunes Reis, Lígia Antunes Pereira Pinelli, Regina Helena Barbosa Tavares da Silva, and Cristiane Campos Costa Quishida Copyright © 2015 André Gustavo Paleari et al. All rights reserved. Changes in Caries Risk and Activity of a 9-Year-Old Patient with Niemann-Pick Disease Type C Thu, 01 Jan 2015 13:59:58 +0000 Objective. This case report describes the changes in caries risk and activity and dental treatment of a 9-year-old patient who presented with signs and symptoms of Niemann-Pick disease type C (NPC). Treatment. The preventive dental treatment included instructions to caregivers for oral hygiene and diet. A calcium hydroxide pulpotomy and restorative dental treatments were performed in a dental office with desensitization techniques and behavioral management. The patient was attended every 3 months for the control of dental plaque biofilm, for topical fluoride application, and for observing the pulpotomized tooth. Results. The bacterial plaque biofilm was being adequately controlled by the caregiver. After 2 years, the clinical and radiographic examination of the pulpotomized tooth showed the absence of internal root resorption and bone rarefaction, and clinical examination showed tooth sensitivity, dental pain, and gingival swelling. Conclusion. The pulpotomy prevented clinical and radiographic success. Dentists must be aware of and be able to identify systemic and local aspects associated with caries risk of children with NPC disease. Furthermore, dentists must employ stringent preventive measures and provide instructions to caregivers to reduce caries risk. Késsia Suênia Fidelis Mesquita-Guimarães, Andiara De Rossi, Aldevina Campos Freitas, Paulo Nelson-Filho, Raquel Assed da Silva, and Alexandra Mussolino de Queiroz Copyright © 2015 Késsia Suênia Fidelis Mesquita-Guimarães et al. All rights reserved. Digital Device in Postextraction Implantology: A Clinical Case Presentation Mon, 29 Dec 2014 07:19:20 +0000 Aim. The aim of this work is to describe a case of immediate implant placement after extraction of the upper right first premolar, with the use of CAD/CAM technology, which allows an early digital impression of the implant site with an intraoral scanner (MHT 3D Progress, Verona, Italy). Case Report. A 46-year-old female was referred with a disorder caused by continuous debonding of the prosthetic crown on the upper right first premolar. Clinically, there were no signs, and the evaluation of the periapical radiograph showed a fracture of the root, with a mesial well-defined lesion of the hard tissue of the upper right first premolar, as the radiolucent area affected the root surface of the tooth. It was decided, in accordance with the patient, that the tooth would be extracted and the implant (Primer, Edierre implant system, Genoa, Italy) with diameter of 4.2 mm and length of 13 mm would be inserted. After the insertion of the implant, it was screwed to the scan abutment, and a scan was taken using an intraoral scanner (MHT 3D Progress, Verona, Italy). The scanned images were processed with CAD/CAM software (Exocad DentalCAD, Darmstadt, Germany) and the temporary crown was digitally drawn (Dental Knowledge, Milan, Italy) and then sent to the milling machine for production with a composite monoblock. After 4 months, when the implant was osteointegrated, it was not necessary to take another dental impression, and the definitive crown could be screwed in. Conclusion. The CAD/CAM technology is especially helpful in postextraction implant for aesthetic rehabilitation, as it is possible to immediately fix a provisional crown with an anatomic shape that allows an optimal healing process of the tissues. Moreover, the removal of healing abutments, and the use of impression copings, impression materials, and dental stone became unnecessary, enabling the reduction of the chair time, component cost, and patient’s discomfort. However, it is still necessary for scientific research to continue to carry out studies on this procedure, in order to improve the accuracy, the reliability, and the reproducibility of the results. A. E. Borgonovo, F. Rigaldo, D. Battaglia, D. Re, and A. B. Giannì Copyright © 2014 A. E. Borgonovo et al. All rights reserved. Maxillary Chronic Osteomyelitis Caused by Domestic Violence: A Diagnostic Challenge Thu, 25 Dec 2014 10:05:46 +0000 Maxillary osteomyelitis is a rare condition defined as inflammation of the bone primarily caused by odontogenic bacteria, with trauma being the second leading cause. The present report documents a rare case of maxillary osteomyelitis in a 38-year-old female who was the victim of domestic violence approximately a year prior to presentation. Intraoral examination revealed a lesion appearing as exposed bony sequestrum, with significant destruction of gingiva and alveolar mucosa in the maxillary right quadrant, accompanied by significant pain, local edema, and continued purulence. Teeth numbers 11, 12, 13, 14, and 15 were mobile, not responsive to percussion, and nonvital. Treatment included antibiotic therapy for seven days followed by total enucleation of the necrotic bone tissue and extraction of the involved teeth. Microscopic findings confirmed the clinical diagnosis of chronic suppurative osteomyelitis. Six months postoperatively, the treated area presented complete healing and there was no sign of recurrence of the lesion. Tamyris Inácio Oliveira, Marina Lara de Carli, Noé Vital Ribeiro Junior, Alessandro Antônio Costa Pereira, Dimitris N. Tatakis, and João Adolfo Costa Hanemann Copyright © 2014 Tamyris Inácio Oliveira et al. All rights reserved.