Case Reports in Dentistry The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Neurofibroma of the Palate Thu, 17 Apr 2014 10:21:12 +0000 Neurofibroma is a benign peripheral nerve sheath tumor comprising variable mixture of Schwann cells, perineurial-like cells, and fibroblasts. Neurofibroma may occur as solitary lesion or as part of a generalised syndrome of neurofibromatosis or very rarely as multiple neurofibromas without any associated syndrome. There are two distinct variants of neurofibromatosis type I and type II. We present a case of neurofibroma of the hard palate associated with neurofibromatosis type I. The diagnosis of the lesion was made based on the clinical findings, family history, histopathology, and immunohistochemistry. Literature was reviewed and different types of neurofibroma, their incidence and frequency in the oral cavity, its association with neurofibromatosis, clinical manifestations, histopathologic characteristics, immunohistochemical analysis, behaviour, treatment, and recurrence are discussed. Tirumalasetty Sreenivasa Bharath, Yelamolu Rama Krishna, Govind Rajkumar Nalabolu, Swetha Pasupuleti, Suneela Surapaneni, and Suresh Babu Ganta Copyright © 2014 Tirumalasetty Sreenivasa Bharath et al. All rights reserved. Large Complex Odontoma of Mandible in a Young Boy: A Rare and Unusual Case Report Thu, 10 Apr 2014 09:03:25 +0000 Odontomas are the most common odontogenic tumors. They are broadly classified in to Compound Odontoma and Complex Odontoma. Among them complex odontoma is a rare tumor. Occasionally this tumor becomes large, causing expansion of bone followed by facial asymmetry. Otherwise these tumors are asymptomatic and are generally diagnosed on radiographic examination. We report a rare case of complex odontoma of mandible in a young boy. The tumor was treated by surgical excision under general anesthesia. G. Siva Prasad Reddy, G. V. Reddy, B. Sidhartha, K. Sriharsha, John Koshy, and Rehana Sultana Copyright © 2014 G. Siva Prasad Reddy et al. All rights reserved. Malignant Transformation of an Odontogenic Cyst in a Period of 10 Years Mon, 07 Apr 2014 00:00:00 +0000 Primary intraosseous carcinoma of the jaws (PIOSCC) might arise from odontogenic epithelium, more commonly from a previous odontogenic cyst. The aim of this case is to illustrate that the clinician should consider that an apparent benign dentigerous cyst can suffer malignant transformation and that all material removed from a patient must be evaluated histologically. A 44-year-old man presented in a routine periapical X-ray an impacted lower left third molar with radiolucency over its crown. Ten years later, the patient complained of pain in the same region and the tooth was extracted. After one month, the patient still complained of pain and suffered a fracture of the mandible. A biopsy was performed and carcinoma was diagnosed. The patient was treated surgically with adjuvant radio- and chemotherapy and after 8 years, he is well without signs of recurrences. This report describes a central mandibular carcinoma probably developed from a previous dentigerous cyst. Juliane Pirágine Araújo, Luiz Paulo Kowalski, Mônica Lúcia Rodrigues, Oslei Paes de Almeida, Clovis Antonio Lopes Pinto, and Fabio Abreu Alves Copyright © 2014 Juliane Pirágine Araújo et al. All rights reserved. Treatment of an Extensive Maxillary Cyst Using Nasal Airway and Balloon Catheter Devices Sun, 06 Apr 2014 06:31:47 +0000 Introduction. Large maxillary cysts occasionally expand into the maxilla and erode the maxillary sinus and nasal cavity. The Caldwell-Luc procedure is the recommended treatment for large maxillary sinus cysts. However, it is hard to preserve the nasal space in the case of large maxillary sinus cysts that penetrate into the nasal cavity. Methods. A 22-year-old man who had large maxillary sinus cysts was referred to our department for a surgical treatment. After removing the cyst from the maxillary sinus using the Caldwell-Luc procedure, we used nasal airway and balloon catheter devices to preserve the space of the inferior nasal meatus and maxillary sinus. These devices were removed 10 days postoperatively. Insertion and removal of both devices were simple and painless. Findings. The nasal airway and balloon catheter devices were useful for performing maxillary sinus surgery to remove large cysts. Our method was satisfactorily safe and was an effective minimally invasive treatment that preserved the space of the inferior nasal meatus and maxillary sinus. Atsushi Kasamatsu, Chonji Fukumoto, Morihiro Higo, Yosuke Endo-Sakamoto, Katsunori Ogawara, Masashi Shiiba, Hideki Tanzawa, and Katsuhiro Uzawa Copyright © 2014 Atsushi Kasamatsu et al. All rights reserved. Bilateral TMJ Involvement in Rheumatoid Arthritis Wed, 02 Apr 2014 08:12:00 +0000 Rheumatoid arthritis (RA) is a systemic inflammatory, slowly progressive disease that results in cartilage and bone destruction. Temporomandibular joint (TMJ) involvement is not uncommon in RA, and it is present in about more than 50% of patients; however, TMJ is usually among the last joints to be involved and is associated with many varied clinical signs and symptoms. Hence, RA of TMJ presents to the dentist with great diagnostic challenges. This report presents a case of RA with bilateral TMJ involvement with its classical radiographic findings and review literature. Pritesh B. Ruparelia, Deep S. Shah, Kosha Ruparelia, Shreyansh P. Sutaria, and Deep Pathak Copyright © 2014 Pritesh B. Ruparelia et al. All rights reserved. Endoscopic Removal of a Supernumerary Premolar in the Mandible during a Dental Implant Placement Wed, 19 Mar 2014 13:14:10 +0000 The surgical removal of supernumerary teeth is necessary in some cases, especially before the commencement of any orthodontic or implant treatment procedure. In the mandibular supernumerary premolar, a more conservative approach is required because of the presence of complications associated with conventional surgery due to the close proximity of the said premolar to the alveolar inferior and mental nerves, and the need for bone conservation for implant placement. The endoscopic surgical approach has been used for the removal of the maxillary supernumerary tooth, impacted third molar, and implants. In this case report, we present an endoscopically assisted surgical technique for the removal of an unerupted supernumerary premolar in the mandible associated with a dental implant placement procedure. Víctor Beltrán, Mario Cantín, Eduardo Borie, Ramón Fuentes, and Wilfried Engelke Copyright © 2014 Víctor Beltrán et al. All rights reserved. Unusual Gingival Enlargement: A Rare Case Report Sun, 16 Mar 2014 07:12:43 +0000 This is an atypical case report of a 20-year-old male patient who suffered from unusual unilateral, gingival enlargement together with rapidly progressive alveolar bone loss. The enlarged gingiva completely covered his left posterior teeth in both arches. The patient was diagnosed with gingival fibromatosis and aggressive periodontitis based on the clinical, histological, and radiographic findings. The gingival enlargement was treated by conventional gingivectomy under local anaesthesia. The postoperative result was uneventful. Ashutosh Dixit, Seema Dixit, and Pravin Kumar Copyright © 2014 Ashutosh Dixit et al. All rights reserved. Vertical Root Fracture: Preservation of the Alveolar Ridge Using Immediate Implants Wed, 12 Mar 2014 08:27:40 +0000 Teeth with vertical root fracture (VRF) have complete or incomplete fractures that begin in the root and extend toward the occlusal surface. The most frequent causes of VRF originate from physical trauma, occlusal prematurity, inadequate endodontic treatment, and iatrogenic causes. Diagnose is difficult and delay can cause stomatognathic system problem. The purpose of this case report was to evaluate immediate implant placement after extraction of teeth with vertical root fracture. For the 1st case, the VRF in 1st left lower molar was confirmed during surgical flap and at the same time, the tooth was removed and immediate implant was placed. For the 2nd case, the VRF 1st left lower molar was confirmed during endodontic access and at the same appointment, the tooth was removed and the immediate implant is placed. Several studies have shown that immediate implants have similar success rates when compared with late implants. Consider that this approach is a safe procedure with favorable prognosis. In cases of VRF, the main factor to be considered is the presence of adequate bone support and immediate implants can preserve the vertical bone height, adding the fact that good patient compliance reduces the number of surgical interventions and promotes the functionality of stomatognathic system. Edmar de Oliveira Oya, Debora Pallos, Humberto Osvaldo Schwartz-Filho, William Cunha Brandt, Wilson Roberto Sendyk, and Caio Vinicius Gonçalves Roman-Torres Copyright © 2014 Edmar de Oliveira Oya et al. All rights reserved. Orthodontic Management of Congenitally Missing Maxillary Lateral Incisors: A Case Report Sun, 09 Mar 2014 13:35:06 +0000 This case report describes the orthodontic treatment of a woman, aged 15 years, with permanent dentition, brachyfacial typology, with congenitally missing maxillary lateral incisors. Multibracket straightwire fixed appliance was used to open the space for dental implant placement, and treat the impaired occlusion. The missing lateral incisors were substituted with oral implants. Sergio Paduano, Iacopo Cioffi, Roberto Rongo, Antonello Cupo, Rosaria Bucci, and Rosa Valletta Copyright © 2014 Sergio Paduano et al. All rights reserved. Prosthetic Rehabilitation of a Patient with Gastroesophageal Reflux Disease: 4-Year Followup Sun, 09 Mar 2014 07:46:14 +0000 The gastroesophageal reflux disease (GERD) is one of the main causes of dental erosion. The aim of this case presented is to describe the prosthetic rehabilitation of a patient with GERD after 4 years of followup. A 33-year-old male patient complained about tooth sensitivity. The lingual surface of the maxillary anterior teeth and the cusps of the upper and lower posterior teeth presented wear. It was suspected that the feeling of heartburn reported by the patient associated with the intake of sports supplements (isotonics) was causing gastroesophageal changes. The patient was referred to a gastroenterologist and was diagnosed with GERD. Dental treatment was performed with metal-free crowns and porcelain veneers after medical treatment of the disease. With the change in eating habits, the treatment of GERD and lithium disilicate ceramics provided excellent cosmetic results after 4 years and the patient reported satisfaction with the treatment. Ricardo Coelho Okida, Daniela Micheline dos Santos, Aljomar José Vechiato Filho, Agda Marobo Andreotti, Rodrigo Antonio de Medeiros, and Marcelo Coelho Goiato Copyright © 2014 Ricardo Coelho Okida et al. All rights reserved. Maintenance of Increased Mouth Opening in Oral Submucous Fibrosis Patient Treated with Nasolabial Flap Technique Wed, 05 Mar 2014 16:02:41 +0000 Oral submucous fibrosis (OSMF) is an insidious chronic disease affecting any part of the oral cavity and sometimes the pharynx with epithelial atrophy leading to stiffness of the oral mucosa, causing trismus and inability to eat. However, a more serious complication of this disease is the risk of the development of oral carcinoma. A case of OSMF reported with initial interincisal mouth opening; 8 mm which was treated surgically with nasolabial flap technique followed by active mouth opening exercises for 6 months with Hister’s jaw exerciser. The patient could maintain mouth opening of 32 mm at the end of 18-months followup. The patient was observed closely for any malignant changes in the oral cavity. Milind Naphade, Bhushan Bhagat, Dwarkadas Adwani, and Ranjit Mandwe Copyright © 2014 Milind Naphade et al. All rights reserved. Endodontic Treatment and Esthetic Management of a Geminated Central Incisor Bearing a Talon Cusp Wed, 05 Mar 2014 06:20:55 +0000 Gemination with talon cusps is an uncommon morphologic dental anomaly, characterized by the formation of clinically wide tooth that can cause significant aesthetic and clinical problems including esthetic impairment, pain, caries susceptibility, and tooth crowding. These morphological dental anomalies have specific treatment needs due to the abnormal morphology and need virtuous radiologic diagnosis. Multidisciplinary approach can supply success of the treatment plan that can provide esthetic and occlusal requirements. In this case report, the multidisciplinary approach for the treatment of geminated tooth with talon cusp is presented with the clinical and radiographic findings. Elif Tarım Ertaş, Meral Yırcalı Atıcı, Hakan Arslan, Bilal Yaşa, and Hüseyin Ertaş Copyright © 2014 Elif Tarım Ertaş et al. All rights reserved. Treatment of Necrotic Calcified Tooth Using Intentional Replantation Procedure Tue, 04 Mar 2014 12:56:56 +0000 Introduction. If the teeth are impacted by a chronic irritant, the pulp space possibly will undergo calcific changes that may impede access opening during root canal treatment. In such cases that conventional endodontic treatment is impossible or impractical, intentional replantation may be considered as a last solution to preserve the tooth. Methods. After failing to perform conventional root canal therapy for a necrotic calcified right mandibular second premolar, the tooth was gently extracted. The root apex was resected and the root end cavity was prepared and filled with calcium enriched mixture (CEM) cement. Then, the extracted tooth was replanted in its original position. Results. After a year the tooth was asymptomatic, and the size of periapical radiolucency was remarkably reduced and no clinical sign of ankylosis was observed. Conclusion. Intentional replantation of the necrotic calcified teeth could be considered as an alternative to teeth extraction, especially for the single-rooted teeth and when nonsurgical and surgical endodontic procedures seem impossible. Nima Moradi Majd, Armita Arvin, Alireza Darvish, Sareh Aflaki, and Hamed Homayouni Copyright © 2014 Nima Moradi Majd et al. All rights reserved. True Fibroma of Alveolar Mucosa Tue, 04 Mar 2014 12:28:30 +0000 Benign fibrous overgrowths are often found in the oral cavity, almost always being reactive/irritational in nature. However, benign mesenchymal neoplasms of the fibroblasts are extremely uncommon. Here we report a case of “True Fibroma of Alveolar Mucosa” for its rarity. Shankargouda Patil, Roopa S. Rao, Sanketh Sharath, and Anveeta Agarwal Copyright © 2014 Shankargouda Patil et al. All rights reserved. The Use of Newer High Translucency Zirconia in Aesthetic Zone Tue, 04 Mar 2014 11:13:09 +0000 Loss of anterior tooth causes aesthetic and functional disharmony. Although no restorative material can approach the appearance of intact tooth enamel, glass ceramic, at the increased risk of brittle fracture, can mimic original tooth color better than the other restorative options. The newest zirconia material comes with unparalleled individualization in aesthetics and optimal physical properties. One of the basic principles of tooth preparation is conservation of tooth structure. This clinical report describes the replacement of maxillary and mandibular incisor with latest generation zirconia adhesive fixed partial denture. The authors have achieved unmatched aesthetics with newer high translucency zirconia. Zishan Dangra and Mahesh Gandhewar Copyright © 2014 Zishan Dangra and Mahesh Gandhewar. All rights reserved. Endodontic Treatment of Bilateral Maxillary First Premolars with Three Roots Using CBCT: A Case Report Tue, 04 Mar 2014 08:46:33 +0000 One of the determining factors for the success of endodontic therapy is understanding the morphological anatomy of the tooth structure and its variants in relation to its template anatomy. The internal anatomy of maxillary first premolars is particularly complex due to their variation in number of roots and canal configuration. However, the bilateral presence of three roots in a maxillary first premolar is of rare occurrence. This case report describes the unusual anatomy bilaterally detected in maxillary first premolars using Cone-Beam Computed Tomography. Sujatha Gopal, Gijo John, K. Pavan Kumar, Swarna Latha, Suma Latha, and Sowmya Kallepalli Copyright © 2014 Sujatha Gopal et al. All rights reserved. Replacement of Missing Anterior Teeth in a Patient with Temporomandibular Disorder Tue, 04 Mar 2014 08:44:55 +0000 The loss of anterior teeth leads to extreme psychological trauma, along with functional and esthetic debilitations. Healthy anterior teeth play an important role of protecting the posterior teeth during excursive mandibular movement. Loss of anterior teeth induces posterior interference with extended disocclusion time. Posterior disocclusion is critical to remove the harmful force on the teeth temporomandibular joint and eliminate muscle hypertonicity. Occlusal interference is considered as contributing factor to temporomandibular disorder (TMD) symptoms. Prosthesis design should eliminate deleterious tooth contacts. Establishing optimum anterior guidance is a key to establishing harmonious functional occlusion in addition to the correction of the esthetic and phonetic disabilities. This case report explains the steps involved in the rehabilitation of the TMD patient with loss of maxillary anterior teeth. Satheesh B. Haralur and Omar Saeed Al-Shahrani Copyright © 2014 Satheesh B. Haralur and Omar Saeed Al-Shahrani. All rights reserved. Endodontic Treatment of a Mandibular Second Premolar with Type IV Wiene’s Root Canal: A Case Report Mon, 03 Mar 2014 13:15:42 +0000 This case report describes an endodontic treatment of a mandibular second premolar with type IV root canal. A 26-year-old male patient reported pain in right mandibular second premolar. Clinical examination showed a large carious lesion with pulp exposure. Radiographs showed minimal periapical changes and slight widening of periodontal ligament space. Mandibular second premolars usually have one canal. The mandibular second premolar may present large number of anatomic variations. The clinician should be aware of the configuration of the pulp system. This case presents the diagnosis and clinical management of a mandibular second premolar with two distinct canals in the apical third of root (Type IV Wiene’s canal configuration), drawing particular attention to tactile examination of all the canal walls and obturating it with calamus 3D obturation system. Noushad Matavan Chalil, Shravan Kini, Sunil Jose, Arun Narayanan, Shahnas Salahudeen, and Faizal C. Peedikayil Copyright © 2014 Noushad Matavan Chalil et al. All rights reserved. Nonsyndromic Mandibular Symphysis Cleft Mon, 03 Mar 2014 13:05:16 +0000 Median cleft of lower lip and mandible is a rare congenital anomaly described as cleft number 30 of Tessier’s classification. In minor forms only lower lip cleft is seen. We report the case of a patient with median cleft of lower lip, severe ankyloglossia, cleft of mandibular symphysis, and residual cleft involving on right soft palate and associated with other facial clefts. These deformities were corrected in multiple stage procedure, consisting of release of the tongue from floor of the mouth and lower alveolus and fixation of the mandibular cleft done with right iliac bone graft using stainless steel miniplate. Leela Krishna Guttikonda, Koteswara Rao Nadella, Vijayalakshmi Uppaluru, Rama Mohan Kodali, and Ranganadh Nallamothu Copyright © 2014 Leela Krishna Guttikonda et al. All rights reserved. Portland Cement Use in Dental Root Perforations: A Long Term Followup Mon, 03 Mar 2014 12:47:56 +0000 Root canal and furcal perforations are causes of endodontic therapy failure and different materials that stimulate tissue mineralization have been proposed for perforation treatment. In the first case, a patient presented tooth 46 with unsatisfactory endodontic treatment and a periapical radiographic lesion. A radiolucent area compatible with a perforating internal resorption cavity was found in the mesial root. The granulation tissue was removed, and root canals were prepared. The intracanal medication was composed of calcium hydroxide and the perforation cavity was filled with Portland cement. The 11-year followup showed radiographic repair of the tissue adjacent to the perforation and absence of clinical signs and symptoms or periapical lesion. In the second case, a patient presented with edema on the buccal surface of tooth 46. The examination showed a radiolucent area in the furcation region compatible with an iatrogenic perforation cavity. The mesial root canals were calcified, and only the distal root canal was prepared. The cavity was filled with a calcium hydroxide-based paste and the distal root canal was obturated. In sequence, the perforation cavity was filled with Portland cement. The 9-year followup showed the tooth in masticatory function with radiographic and clinical aspects compatible with normality. Álvaro Henrique Borges, Matheus Coelho Bandeca, Mateus Rodrigues Tonetto, Luis Augusto Faitaroni, Elibel Reginna de Siqueira Carvalho, Juliane Maria Guerreiro-Tanomaru, and Mário Tanomaru Filho Copyright © 2014 Álvaro Henrique Borges et al. All rights reserved. Is Ultrasonography Useful in the Diagnosis of Nasolabial Cyst? Sun, 23 Feb 2014 13:40:03 +0000 Nasolabial cysts are nonodontogenic cysts that occur beneath the ala nasi. Its pathogenesis is uncertain. Because the nasolabial cyst is a soft tissue lesion, plain radiographs are useless. CT and MRI should be evaluated. In this report, a nasolabial cyst is described including its features on ultrasonography (USG) and CT exams. Ahmet H. Acar, Ümit Yolcu, and Fatih Asutay Copyright © 2014 Ahmet H. Acar et al. All rights reserved. Platelet-Rich Plasma Supplemented Revascularization of an Immature Tooth Associated with a Periapical Lesion in a 40-Year-Old Man Thu, 20 Feb 2014 08:24:04 +0000 The present case report is the first of its kind that documents the successful outcome of “revascularization,” a regeneration-based treatment protocol in a mature adult patient. It belies the myth that “revascularization” should only be done in children and young, adolescent patients. The misconception that stem cells number as well as viability in older age group patients will not allow revascularization to be successful is also contradicted by this case. The paper highlights all the mechanisms that come into play and the enhancing of regenerative response by supplementation with platelet-rich plasma (PRP). Ganesh Ranganath Jadhav, Naseem Shah, and Ajay Logani Copyright © 2014 Ganesh Ranganath Jadhav et al. All rights reserved. Irregular Periapical Radiopacity in Mandibular Premolars and Molars Thu, 20 Feb 2014 08:05:19 +0000 Increased deposition of cementum is observed in a wide number of both benign and malignant conditions. Many cases are often diagnosed during routine examination as an incidental finding. Diagnosing correctly without confusing it with other similarly appearing lesions, thus avoiding subjecting the patient to unnecessary investigations and stress, is of prime importance. We report one such case, where the patient presented with the routine complaint of a painful tooth, during the investigation of which he was also diagnosed with hypercementosis affecting the mandibular second premolars and molars bilaterally. The literature review reveals that not many cases of hypercementosis are frequently reported. S. Aravind Warrier and Divya Vinayachandran Copyright © 2014 S. Aravind Warrier and Divya Vinayachandran. All rights reserved. Mandibular First Molar with a Single Root and Single Canal Thu, 20 Feb 2014 07:05:01 +0000 Successful endodontic management of mandibular first molar with a single root and single canal is diagnosed with the aid of dental operating microscope and multiple angled radiographs. In addition all the mandibular molars and premolars were single rooted on either side. Chandrasekaran Sooriaprakas, Suma Ballal, and Natanasabapathy Velmurugan Copyright © 2014 Chandrasekaran Sooriaprakas et al. All rights reserved. Expansion/Facemask Treatment of an Adult Class III Malocclusion Wed, 19 Feb 2014 08:12:22 +0000 The orthodontic treatment of class III malocclusion with a maxillary deficiency is often treated with maxillary protraction with or without expansion. Skeletal and dental changes have been documented which have combined for the protraction of the maxilla and the correction of the class III malocclusion. Concerning the ideal time to treat a developing class III malocclusion, studies have reported that, although early treatment may be the most effective, face mask therapy can provide a viable option for older children as well. But what about young adults? Can the skeletal and dental changes seen in expansion/facemask therapy in children and adolescents be demonstrated in this age group as well, possibly eliminating the need for orthodontic dental camouflage treatment or orthognathic surgery? A case report is presented of an adult class III malocclusion with a Class III skeletal pattern and maxillary retrusion. Treatment was with nonextraction, comprehensive edgewise mechanics with slow maxillary expansion with a bonded expander and protraction facemask. Gregory W. Jackson and Neal D. Kravitz Copyright © 2014 Gregory W. Jackson and Neal D. Kravitz. All rights reserved. Esthetic Rehabilitation of a Severely Compromised Anterior Area: Combined Periodontal and Restorative Approach Thu, 13 Feb 2014 12:10:04 +0000 The complete oral rehabilitation of patients demanding a beautiful and attractive smile involves a multidisciplinary approach that includes the change of both the morphological aspect of the teeth and the architecture of gum tissues. This clinical report describes a successful interdisciplinary approach for the treatment of an esthetically compromised dentition. In a first phase, the periodontal plastic surgery was performed for root coverage and, in particular, it was decided for the execution of a coronally advanced flap for the treatment of multiple recession defects. Once complete healing of soft tissues was obtained, six lithium disilicate veneers were placed over the anterior maxillary teeth. Lithium disilicate is a glass-based ceramic which presents excellent aesthetics and allows the passage of light without creating unnatural reflections. This feature has made it possible to recreate a natural aspect of teeth that in combination with the harmonic architecture of soft tissue has permitted obtaining a beautiful and pleasant smile. Rachele Censi, Virna Vavassori, Andrea Enrico Borgonovo, and Dino Re Copyright © 2014 Rachele Censi et al. All rights reserved. Anatomical Variation of the Maxillary Sinus in Cone Beam Computed Tomography Wed, 12 Feb 2014 00:00:00 +0000 Purpose. The aim of this paper is to report a case in which the cone beam computed tomography (CBCT) was important for the confirmation of the presence of maxillary sinus septum and, therefore, the absence of a suspected pathologic process. Case Description. A 27-year-old male patient was referred for the assessment of a panoramic radiograph displaying a radiolucent area with radiopaque border located in the apical region of the left upper premolars. The provisional diagnosis was either anatomical variation of the maxillary sinuses or a bony lesion. Conclusion. The CBCT was important for an accurate assessment and further confirmation of the presence of maxillary septum, avoiding unnecessary surgical explorations. Marcelo Lupion Poleti, Luciana Maria Paes da Silva Ramos Fernandes, Christiano Oliveira-Santos, Ana Lúcia Alvares Capelozza, Luiz Eduardo Montenegro Chinellato, and Izabel Regina Fischer Rubira-Bullen Copyright © 2014 Marcelo Lupion Poleti et al. All rights reserved. A Fused Maxillary Central Incisor and Its Multidisciplinary Treatment: An 18-Year Follow-Up Tue, 11 Feb 2014 08:01:43 +0000 Fused teeth may cause aesthetic, spacing, periodontal, eruption, and caries problems. The present case report describes a 7-year-old boy patient with a chief complaint of unerupted maxillary incisor. Radiographic examination indicated a fused tooth which had two fused roots but two independent root canals. A complex management of a fused tooth is really difficult to standardize. In this case an orthodontic, endodontic, and surgical treatment (intentional replantation) allowed the tooth to be retained until 18 years following intervention. Maintenance of the root and alveolar bone in young adults at least until full skeletal maturation should be the main treatment objective. Lluís Brunet-Llobet, Jaume Miranda-Rius, Eduard Lahor-Soler, and Abel Cahuana Copyright © 2014 Lluís Brunet-Llobet et al. All rights reserved. Arteriovenous Malformation of the Oral Cavity Mon, 10 Feb 2014 14:08:01 +0000 Vascular anomalies are a heterogeneous group of congenital blood vessel disorders more typically referred to as birthmarks. Subcategorized into vascular tumors and malformations, each anomaly is characterized by specific morphology, pathophysiology, clinical behavior, and management approach. Hemangiomas are the most common vascular tumors. Lymphatic, capillary, venous, and arteriovenous malformations make up the majority of vascular malformations. Arteriovenous malformation of the head and neck is a rare vascular anomaly but when present is persistent and progressive in nature and can represent a lethal benign disease. Here we present a case report of a 25-year-old male patient with arteriovenous malformation involving the base of tongue. S. M. Manjunath, Sujan Shetty, Ninad J. Moon, Bhushan Sharma, Kiran Kumar Metta, Nitin Gupta, Sandeep Goyal, and Simranjit Singh Copyright © 2014 S. M. Manjunath et al. All rights reserved. An Immature Type II Dens Invaginatus in a Mandibular Lateral Incisor with Talon’s Cusp: A Clinical Dilemma to Confront Sun, 09 Feb 2014 06:39:00 +0000 Dens invaginatus (DI) is a malformation of teeth probably resulting from an infolding of the dental papilla during tooth development. DI is classified as type I, II, and III by Oehlers depending on the severity of malformation. The maxillary lateral incisor is the most commonly affected tooth. Structural defects do exist in the depth of the invagination pits, and as a consequence, the early development of caries and the subsequent necrosis of the dental pulp, as well as abscess and cyst formation are clinical implications associated with DI. Occasionally, we can see more than one developmental anomaly occurring in a single tooth. In such cases it becomes important to identify the anomalies and initiate a proper treatment plan for good prognosis. In this paper, an unusual case of DI which clinically presented as a huge talons cusp affecting a mandibular lateral incisor tooth is described. This case report illustrates grinding of the talons cusp followed by nonsurgical endodontic management of dens invaginatus type II with an immature apex and periapical lesions, in which Mineral Trioxide Aggregate (MTA) shows a complete periapical healing with bone formation at the site of the lesions. Anshul Gangwar, Deepa Singal, K. Y. Giri, Anshita Agarwal, and S. Sruthi Keerthi Copyright © 2014 Anshul Gangwar et al. All rights reserved.