Case Reports in Dentistry The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. Radiographic Follow-Up during Orthodontic Treatment for Early Diagnosis of Sequential Supernumerary Teeth Tue, 24 May 2016 13:15:41 +0000 Most supernumerary teeth are impacted and asymptomatic. Objective. The aim of this paper is to describe two cases of sequential development of supernumerary teeth in the mandibular premolar region, identified during orthodontic treatment. Reports. The first case describes the radiographic follow-up of a female patient that presented a supernumerary tooth at the age of 9 years and 10 months in the right mandibular premolar region, followed by a further supernumerary tooth in the left mandibular premolar region identified at the age of 11 years and 3 months. In the second case, the radiographic follow-up of a male patient demonstrated 3 supernumerary teeth in the premolar region at the age of 16 years. During orthognathic surgery planning at the age of 20 years and 5 months, a supplemental supernumerary tooth was found in the left mandibular region. Conclusion. Considering the late developing of supernumerary premolars, appropriate follow-up with panoramic radiographs of patients with previous experience of supernumerary teeth is essential for early diagnosis of supplemental premolars to prevent possible complications. Selma Sano Suga, Paula de Castro Kruly, Talissa Mayer Garrido, Marise Sano Suga Matumoto, Uhana Seifert Guimarães Suga, and Raquel Sano Suga Terada Copyright © 2016 Selma Sano Suga et al. All rights reserved. Altered Apical Morphology (Reverse Architecture): Use of Indirect Ultrasonic Technique for Orthograde MTA Placement in Maxillary Premolars Tue, 24 May 2016 06:58:29 +0000 Aim. To report the management and orthograde technique of MTA placement in case of reverse architecture maxillary premolars. Summary. Two cases of 17-year-old and 21-year-old female patients were referred to endodontic speciality for management of maxillary premolar having reverse architecture with wide immature open apex like a bell mouth. In both the cases, after control of intraradicular infection, it was decided to use MTA for apexification and obturation of canals. Orthograde placement of MTA is a challenging procedure in terms of length control and condensation especially in divergent irregular reverse architecture wide open apex. A novel technique with the help of finger plugger, sterilized paper point, and ultrasonic agitation for 3D compaction of MTA at apical reverse architecture was used. Thickening of the canal wall and complete apical closure were confirmed one year after the treatment. Kapoor Sonali, Agrawal Vineet Suresh, Patel Abhishek, and Patel Jenish Copyright © 2016 Kapoor Sonali et al. All rights reserved. Oral Syphilis: A Reemerging Infection Prompting Clinicians’ Alertness Wed, 18 May 2016 14:30:30 +0000 Syphilis is a rare but increasing disease. Due to changing sexual habits, presentation of oral manifestations may rise. Since syphilis may mimic other oral manifestations, diagnoses can be difficult. Clinicians need to be aware that ambiguous oral manifestations may in fact be caused by oral syphilis. Here, we present a case of extended diagnostic delay highlighting the importance of consulting an expert in infectious diseases in case of obscure oral lesions not responding to standard treatment. Despite seven visits to six different medical doctors, a patient who presented with oral syphilis was continuously misdiagnosed. After 6 months of increasing complaints and deteriorating severity of disease, the patient was referred to an oral and maxillofacial surgeon where the correct diagnosis was determined and proper treatment initiated. Sebastian Dybeck Udd and Bodil Lund Copyright © 2016 Sebastian Dybeck Udd and Bodil Lund. All rights reserved. Complex Odontoma: A Case Report with Micro-Computed Tomography Findings Tue, 17 May 2016 09:42:44 +0000 Odontomas are the most common benign tumors of odontogenic origin. They are normally diagnosed on routine radiographs, due to the absence of symptoms. Histopathologic evaluation confirms the diagnosis especially in cases of complex odontoma, which may be confused during radiographic examination with an osteoma or other highly calcified bone lesions. The micro-CT is a new technology that enables three-dimensional analysis with better spatial resolution compared with cone beam computed tomography. Another great advantage of this technology is that the sample does not need special preparation or destruction in the sectioned area as in histopathologic evaluation. An odontoma with CBCT and microtomography images is presented in a 26-year-old man. It was first observed on panoramic radiographs and then by CBCT. The lesion and the impacted third molar were surgically excised using a modified Neumann approach. After removal, it was evaluated by histopathology and microtomography to confirm the diagnostic hypothesis. According to the results, micro-CT enabled the assessment of the sample similar to histopathology, without destruction of the sample. With further development, micro-CT could be a powerful diagnostic tool in future research. L. A. N. Santos, L. J. Lopes, G. D. Roque-Torres, V. F. Oliveira, and D. Q. Freitas Copyright © 2016 L. A. N. Santos et al. All rights reserved. Immediate Nonfunctional Loading of Two Single-Maxillary Postextractive Implants: 6-Year Postloading Results of Two Case Reports Mon, 16 May 2016 08:27:02 +0000 Objectives. The aim of the study was to evaluate and compare crestal bone loss of single-maxillary immediate postextractive implants and immediate nonfunctional loading (INFL) during 72 months of follow-up. Material and Methods. Two single titanium implants (Certain Prevail, Biomet 3I, USA) were placed in two patients using INFL technique. Implant stability and crestal bone level were measured on periapical radiographs at 1, 3, and 6 months after surgery. Results. All osseointegrated implants were clinically successful after 6 years of functional loading. Conclusion. Within the limit of the present case report, the paper supports the concept that INFL of single dental implant can be a successful treatment procedure. Vincenzo Ariano, Manuele Mancini, Andrea Cardi, Roberta Condò, Loredana Cerroni, and Guido Pasquantonio Copyright © 2016 Vincenzo Ariano et al. All rights reserved. Splinting of Longitudinal Fracture: An Innovative Approach Mon, 09 May 2016 09:52:42 +0000 Trauma may result in craze lines on the enamel surface, one or more fractured cusps of posterior teeth, cracked tooth syndrome, splitting of posterior teeth, and vertical fracture of root. Out of these, management of some fractures is of great challenge and such teeth are generally recommended for extraction. Literature search reveals attempts to manage such fractures by full cast crown, orthodontic wires, and so forth, in which consideration was given to extracoronal splinting only. However, due to advancement in materials and technologies, intracoronal splinting can be achieved as well. In this case report, longitudinal fractures in tooth #27, tooth #37, and tooth #46 had occurred. In #27, fracture line was running mesiodistally involving the pulpal floor resulting in a split tooth. In teeth 37 and 46, fractures of the mesiobuccal cusp and mesiolingual cusp were observed, respectively. They were restored with cast gold inlay and full cast crown, respectively. Longitudinal fracture of 27 was treated with an innovative approach using intracanal reinforced composite with Ribbond, external reinforcement with an orthodontic band, and full cast metal crown to splint the split tooth. Rashmi Bansal, Priyanka Chowdhary, Anuraag Gurtu, Nakul Mehrotra, and Abhinav Kishore Copyright © 2016 Rashmi Bansal et al. All rights reserved. Complete Maxillary Crossbite Correction with a Rapid Palatal Expansion in Mixed Dentition Followed by a Corrective Orthodontic Treatment Thu, 28 Apr 2016 12:44:54 +0000 This case report presents the interceptive orthodontic treatment of a boy, aged 8 years 4 months with a Class I malocclusion with severe transverse maxillary deficiency and complete maxillary crossbite and correction using Haas expansion and fixed appliance. The treatment goals were to correct the posterior crossbite and anterior crossbite and restore the normality of the dentition and occlusion. In phase I, the patient was treated with a modified Haas-type palatal expander, which provided a clinically significant palatal expansion and increased the maxillary arch perimeter with favorable conditions for orthodontic treatment with fixed appliances in phase II. The optimization of E-space and the use of intermaxillary Class III elastics helped to maintain the mandibular incisors upright. A removable wraparound type appliance and a bonded lingual canine-to-canine retainer were used as retention. Although the literature has reported a high rate of relapse after palatal expansion, after 2 years 9 months of posttreatment follow-up, the occlusal result was stable and no skeletal reversals could be detected. Orlando Motohiro Tanaka, Isabelle Adad Fornazari, Ariane Ximenes Graciano Parra, Bruno Borges de Castilhos, and Ademir Franco Copyright © 2016 Orlando Motohiro Tanaka et al. All rights reserved. A New Multi-Ingredient Recipe for the Treatment of Localized Advanced Periodontal Disease following the Surgical Removal of Impacted Wisdom Teeth Wed, 27 Apr 2016 08:42:05 +0000 Periodontal disease is a chronic inflammation of the tooth supporting structures. It leads to bone and attachment loss which is irreversible. Extraction of horizontally impacted lower third molar (L3M) teeth may result in localized periodontal pockets at the distal aspect of the adjacent lower second molars (L2M). We present a case of a 21-year-old male who suffered from a swelling and pain around his lower right second molar following surgical removal of a mesioangular impacted lower right third molar. We showed that oral hygiene measures, surgical access, mixture of autogenous and synthetic bone graft, and guided tissue regeneration (GTR) were enough to control the problem. Nabil Khzam, Adam Fell, Anthony Fisher, Paul Kim, Usman A. Khan, and Mahmoud M. Bakr Copyright © 2016 Nabil Khzam et al. All rights reserved. A Rare Case of an Artery Passing through the Median Perforating Canal of the Mandible Tue, 26 Apr 2016 13:12:02 +0000 Along with the popularization of dental implant surgery, there has been considerable research on the lingual foramen using cone-beam computed tomography. Anatomical research has also revealed that the arteries entering the lingual foramina are branches of the submental and sublingual arteries. There have been no reports, however, of the submental or sublingual artery entering the mandible from the lingual foramen, perforating it, and then distributing to the inferior labial region. A 69-year-old man who donated his body to our department in 2015 was dissected. The mandible with overlying soft tissue of the mental region was resected and examined with microcomputed tomography, which showed that the canal perforated from the lingual foramen to the midline of the labial cortical plate. The canal was thus named the median perforating canal. To the best of our knowledge, there have been no other reports of a perforating artery of the mandible, so this case is thought to be rare. Hence, the existence of perforating arteries, such as in the present case, should be taken into consideration in preoperative diagnoses such as for dental implant surgery. Thus, the fusion of anatomical and radiological study is useful and necessary to understand surgical anatomy. Joe Iwanaga, Koichi Watanabe, Tsuyoshi Saga, Yoko Tabira, and Koh-ichi Yamaki Copyright © 2016 Joe Iwanaga et al. All rights reserved. Unilateral Maxillary First Molar Extraction in Class II Subdivision: An Unconventional Treatment Alternative Thu, 21 Apr 2016 09:47:45 +0000 The asymmetrical intra-arch relationship in Class II subdivision malocclusion poses challenges in the treatment planning and mechanotherapy of such cases. This case report demonstrates a treatment technique engaging unilateral extraction of a maxillary first molar and Begg fixed appliances. The outcome stability and the enhancing effect on the eruption of the third molar in the extraction segment were confirmed by a 4-year follow-up examination. J. W. Booij and Christos Livas Copyright © 2016 J. W. Booij and Christos Livas. All rights reserved. Immediate Esthetic Rehabilitation of Periodontally Compromised Anterior Tooth Using Natural Tooth as Pontic Tue, 19 Apr 2016 13:38:22 +0000 For patients who require removal of anterior teeth and their replacement various treatment modalities are available. With advancement in technology and availability of glass/polyethylene fibres, use of natural tooth as pontic with fibre reinforced composite restorations offers the promising results. The present case report describes management of periodontally compromised mandibular anterior tooth using natural tooth pontic with fibre reinforcement. A 1-year follow-up showed that the bridge was intact with good esthetics and no problem was reported. K. Pavan Kumar, Surya Kumari Nujella, S. Sujatha Gopal, and K. Karthik Roy Copyright © 2016 K. Pavan Kumar et al. All rights reserved. Seven-Year Follow-Up of Peutz-Jeghers Syndrome Mon, 18 Apr 2016 13:28:08 +0000 One of the clinicopathological criteria for diagnosing Peutz-Jeghers syndrome (PJS) is mucocutaneous pigmentation. We present a 57-year-old Iranian female patient with diffuse pigmentation in buccal and labial mucosa. The first colonoscopy revealed one 0.5 cm rectal polyp. However surveillance colonoscopies over a 7-year polyp showed over 100 colorectal polyps. Hamid Reza Mozaffari, Fetemeh Rezaei, Roohollah Sharifi, and S. Ghasem Mirbahari Copyright © 2016 Hamid Reza Mozaffari et al. All rights reserved. Implant-Prosthetic Rehabilitation in Bilateral Agenesis of Maxillary Lateral Incisors with a Mini Split Crest Wed, 13 Apr 2016 10:21:01 +0000 The reported clinical case describes the surgical procedure of ridge augmentation by using a “split crest” technique with a partial thickness flap and a subsequent implant-prosthetic rehabilitation aimed at treating a bilateral agenesis of the upper lateral incisors. In such cases with vestibule-palatal and mesial-distal scarce bone thicknesses associated with the need of a proper functional and aesthetic rehabilitation, the split crest technique is particularly suitable. In the case we reported, because of the poor bone thicknesses, we performed a minimally invasive split crest which allowed a correct insertion of the fixtures. This technique allowed us to achieve an optimal functional and aesthetic rehabilitation; moreover, we obtained a good emergency profile, ensuring the vitality of the close teeth and ensuring a good primary stability and the following osseointegration of dental implants. M. M. Figliuzzi, A. Giudice, S. Pileggi, D. Pacifico, M. Marrelli, M. Tatullo, and L. Fortunato Copyright © 2016 M. M. Figliuzzi et al. All rights reserved. Oral Rehabilitation of an Osteopetrosis Patient with Osteomyelitis Mon, 11 Apr 2016 14:07:15 +0000 Osteopetrosis is a congenital disorder characterized by increasing osteoclastic function resulting in osteomyelitis in the jaws. Orofacial findings in osteopetrosis patients are unerupted, malformed, or delayed teeth and many dental caries due to vulnerable enamel and dentin and osteomyelitis. Many reports have described that maxilla is an uncommon site of occurrence for osteomyelitis due to cortical bone morphology and collateral circulation. This report aims to discuss clinical features and prosthodontic management of a patient with clinical features of adult form of osteopetrosis and osteomyelitis in both jaws. The patient has reported better masticatory and speech efficiency with removable dentures in maxillary and mandibular jaw and also self-esteem improvement and family interaction. Tamer Celakil, Merve Dogan, Bilge Gokcen Rohlig, Gulumser Evlioglu, and Haluk Keskin Copyright © 2016 Tamer Celakil et al. All rights reserved. Management of Grossly Decayed Mandibular Molar with Different Designs of Split Cast Post and Core Sun, 10 Apr 2016 11:56:51 +0000 Mandibular molar with extensive loss of tooth structure, especially where no cavity wall is remaining, and insertion of posts in both the roots appear necessary so as to achieve proper retention for the core material. A single unit metal casting with two posts, one in the mesial root and the other in the distal divergent root, is difficult to fabricate due to difference in the path of insertion of the two posts. Multisection post and core or single cast post and core with auxiliary post can be an effective design to manage grossly decayed mandibular molars. Rashmi Bansal, Nakul Mehrotra, Priyanka Chowdhary, and Anuraag Gurtu Copyright © 2016 Rashmi Bansal et al. All rights reserved. A Case of Sublingual Ranula That Responded Successfully to Localized Injection Treatment with OK-432 after Healing from Drug Induced Hypersensitivity Syndrome Wed, 06 Apr 2016 14:12:55 +0000 A ranula is a mucus retention cyst or pseudocyst caused by leakage of mucus from the sublingual gland and generally occurs in the oral floor. In addition, drug induced hypersensitivity syndrome (DIHS) is a rare but well-recognized serious adverse effect characterized by fever, skin rashes, generalized lymphadenopathy, hepatitis, and hepatosplenomegaly and oral stomatitis. This paper presents the first case of successfully treated sublingual ranula with localized injection of OK-432 after healing from drug induced hypersensitivity syndrome, which has previously been unreported in the literature. We present the case of a 38-year-old Japanese woman with sublingual ranula that responded successfully to localized injection treatment with OK-432 after healing from drug induced hypersensitivity syndrome. She was affected with cutaneous myositis and interstitial lung disease when she was 26 years old. At the age 34 years, she received additional oral treatment of diaminodiphenyl-sulfone due to deterioration of the cutaneous myositis, which resulted in drug induced hypersensitivity syndrome (DIHS) with severe oral stomatitis. Local injection of OK-432 to the ranula may be a very safe and useful treatment method even if the patient has a history of drug allergy and has connective tissue disease such as cutaneous myositis. Kunio Yoshizawa, Akinori Moroi, Shuichi Kawashiri, and Koichiro Ueki Copyright © 2016 Kunio Yoshizawa et al. All rights reserved. Adalimumab: Another Medication Related to Osteonecrosis of the Jaws? Mon, 21 Mar 2016 09:23:13 +0000 Objective. The acronym MRONJ has been created in order to identify “Medication-Related Osteonecrosis of the Jaw,” observed after the use of Bisphosphonates, RANK ligand inhibitor, and antiangiogenic medications. Only a case of osteonecrosis of the jaw in a Chron’s disease patient following a course of Bisphosphonate and Adalimumab therapy has been recently described, so that it has been supposed that also this medication could promote manifestation of osteonecrosis. Clinical Case. On August, 2014, a 63-year-old female with a history of idiopathic arthritis treated with medical treatment with Adalimumab from 2010 to 2013 presented referring pain in the right mandible. Results. This patient presented with nonexposed osteonecrosis of the jaw after placement, on September, 2010, of four titanium fixtures in the mandible. Conclusions. The authors suggest that the biologic therapy with an anti-TNF-α antibody might promote the manifestation of osteonecrosis and compromise oral healing capacity of the bone. Andrea Cassoni, Umberto Romeo, Valentina Terenzi, Marco Della Monaca, Oriana Rajabtork Zadeh, Ingrid Raponi, Maria Teresa Fadda, Antonella Polimeni, and Valentino Valentini Copyright © 2016 Andrea Cassoni et al. All rights reserved. Different Occlusal Schemes in a Persistent Protruding Complete Denture Wearer Wed, 16 Mar 2016 11:11:54 +0000 Different types of artificial teeth and occlusal designs can be used in complete dentures. Bilateral balanced occlusion, lingualized occlusion, canine guidance, and monoplane are the main occlusal designs; however there is no agreement on which tooth arrangement is ideal for achieving success in complete dentures. This report presents an alternative for persistent involuntary protruding complete denture wearers through the use of artificial teeth with higher cusps. Due to an old and worn pair of complete dentures, the patient had the habit of protruding. New dentures were made with Biotone artificial teeth and in the trial session, the patient would still protrude. A new set was made with Premium artificial teeth, which present higher cusps. With these dentures, the involuntary protrusion did not occur. From the delivery to the follow-up sessions, the patient stopped protruding. Carolina Mayumi Iegami, Danilo de Melo Lopes, Atlas Edson Moleros Nakamae, Priscila Nakasone Uehara, and Regina Tamaki Copyright © 2016 Carolina Mayumi Iegami et al. All rights reserved. Management of Oehler’s Type III Dens Invaginatus Using Cone Beam Computed Tomography Wed, 16 Mar 2016 11:08:02 +0000 Dens Invaginatus is a dental malformation that poses diagnostic difficulties in the clinical context. This anomaly may increase the risk of pulp disease and can potentially complicate endodontic procedure due to the aberrant root canal anatomy. Compared to conventional radiographs, three-dimensional images obtained with Cone Beam Computed Tomography (CBCT) are invaluable in the diagnosis of the extent of this anomaly and in the appropriate treatment planning. Oehler’s classification (1957) for Dens Invaginatus (DI) into three types depending on the depth of the invagination has been used for treatment planning. Of the three types Type III DI is characterized by infolding of the enamel into the tooth up to the root apex and is considered as the most severe variant of DI and hence the most challenging to treat endodontically, due to the morphological complexities. This report describes a case of Oehler’s Type III DI in a necrotic permanent maxillary lateral incisor in which CBCT images played a key role in diagnosis and treatment planning. The case was managed successfully by a combination of nonsurgical and surgical endodontic therapy with orthograde and retrograde thermoplastic gutta percha obturation. Jaya Ranganathan, Mohan Kumar Rangarajan Sundaresan, and Srinivasan Ramasamy Copyright © 2016 Jaya Ranganathan et al. All rights reserved. Aesthetic Surgical Approach for Bone Dehiscence Treatment by Means of Single Implant and Interdental Tissue Regeneration: A Case Report with Five Years of Follow-Up Wed, 16 Mar 2016 07:25:02 +0000 The replacement of single anterior teeth by means of endosseous implants implies the achievement of success in restoring both aesthetic and function. However, the presence of wide endoperiodontal lesions can lead to horizontal hard and soft tissues defects after tooth extraction, making it impossible to correctly place an implant in the compromised alveolar socket. Vertical augmentation procedures have been proposed to solve these clinical situations, but the amount of new regenerated bone is still not predictable. Furthermore, bone augmentation can be complicated by the presence of adjacent teeth, especially if they bring with them periodontal defects. Therefore, it is used to restore periodontal health of adjacent teeth before making any augmentation procedures and to wait a certain healing period before placing an implant in vertically augmented sites, otherwise risking to obtain a nonsatisfactory aesthetic result. All of these procedures, however, lead to an expansion of treatment time which should affect patient compliance. For this reason, this case report suggests a surgical technique to perform vertical bone augmentation at a single gap left by a central upper incisor while placing an implant and simultaneously to regenerate the periodontal attachment of an adjacent lateral incisor, without compromising the aesthetic result. Giorgio Lombardo, Jacopo Pighi, Giovanni Corrocher, Anna Mascellaro, Jeffrey Lehrberg, Mauro Marincola, and Pier Francesco Nocini Copyright © 2016 Giorgio Lombardo et al. All rights reserved. Diagnosis and Surgical Management of Nonsyndromic Nine Supernumerary Teeth and Leong’s Tubercle Tue, 15 Mar 2016 11:43:12 +0000 Nonsyndromic multiple supernumerary teeth (ST) and Leong’s tubercle are a condition with a very low prevalence and a multidisciplinary approach is required to restore function and aesthetics. So, this case report aimed at presenting a rare case of nonsyndromic nine supernumerary teeth and Leong’s tubercle in a pediatric patient, without any evident familial history, showing its diagnosis and surgical management. Christiane V. Cruz, Andrea L. Soares, David N. Braga, and Marcelo C. Costa Copyright © 2016 Christiane V. Cruz et al. All rights reserved. Description of a Rare Case of Nodular Fasciitis of the Apical Aspect of the Upper Buccal Sulcus Tue, 15 Mar 2016 09:40:02 +0000 This report describes a rare case of nodular fasciitis (NF) of the oral cavity, discussing the clinical, histological, and immunohistochemical characteristics. Histopathologic diagnosis of this type of lesion can be challenging due to its differential diagnosis, which principally includes sarcoma. The patient presented with a painless, well-defined nodule, reported as increasing in size, located at the apical aspect of the upper left buccal sulcus. Histologically, the lesion revealed spindle cell proliferation arranged in fascicles, while immunohistochemistry demonstrated positivity for smooth muscle actin. Eight months after complete surgical excision, no signs of local recurrence have been observed. Ana Amélia Souza, Eldon Guttenberg Cariri Neto, Vera Cavalcanti de Araújo, Fabricio Passador-Santos, Maria Teresa de Seixas Alves, and Andresa Borges Soares Copyright © 2016 Ana Amélia Souza et al. All rights reserved. Chairside Fabrication of an All-Ceramic Partial Crown Using a Zirconia-Reinforced Lithium Silicate Ceramic Sun, 06 Mar 2016 11:48:04 +0000 The chairside fabrication of a monolithic partial crown using a zirconia-reinforced lithium silicate (ZLS) ceramic is described. The fully digitized model-free workflow in a dental practice is possible due to the use of a powder-free intraoral scanner and the computer-aided design/computer-assisted manufacturing (CAD/CAM) of the restorations. The innovative ZLS material offers a singular combination of fracture strength (>370 Mpa), optimum polishing characteristics, and excellent optical properties. Therefore, this ceramic is an interesting alternative material for monolithic restorations produced in a digital workflow. Sven Rinke, Anne-Kathrin Pabel, Matthias Rödiger, and Dirk Ziebolz Copyright © 2016 Sven Rinke et al. All rights reserved. Treatment of Class II Division 2 Malocclusion Using the Forsus Fatigue Resistance Device and 5-Year Follow-Up Mon, 29 Feb 2016 13:03:18 +0000 This case report presents the treatment of a 14-year-and-8-month-old boy with Class II division 2 mandibular retrusion, severe deep bite, and concave profile. The Forsus fatigue resistance device (FRD) was effective in correcting both skeletal and dental parameters. At 5-year posttreatment follow-up, the teeth were well aligned and the occlusion was stable. FRD application with appropriate treatment time can result with prominent changes in the facial profile and dentition, and the outcomes can be maintained at the long-term follow-up periods. Ezgi Atik and Ilken Kocadereli Copyright © 2016 Ezgi Atik and Ilken Kocadereli. All rights reserved. Gingival Enlargement Induced by Felodipine Resolves with a Conventional Periodontal Treatment and Drug Modification Mon, 29 Feb 2016 09:22:21 +0000 We present a case of a 47-year-old male who suffered from GE around his lower anterior teeth as soon as he started treatment with Felodipine 400 mg. We show that oral hygiene measures, antibiotics, and conventional periodontal treatment (scaling and root planing SRP) were all not sufficient to resolve the drug induced GE, which will persist and/or recur provided that systemic effect of the offending medication is still present. The condition immediately resolved after switching to a different medication. The mechanism of GE is complex and not fully understood yet. It is mainly due to overexpression of a number of growth factors due to high concentrations of calcium ions (Ca2+). This affects fibroblasts proliferation and DNA synthesis and leads to a heavy chronic inflammatory cell infiltrate. Our case was managed according to the suggested protocols in previous case studies. The unique features in our case were the immediate onset of the adverse effect after starting the medication and the absence of any underlying medical condition apart from high blood pressure. Improving the oral hygiene together with SRP and cessation of the medication resolves drug induced GE. Nabil Khzam, David Bailey, Helen S. Yie, and Mahmoud M. Bakr Copyright © 2016 Nabil Khzam et al. All rights reserved. Unilateral Absence of Mental Foramen with Surgical Exploration in a Living Human Subject Wed, 24 Feb 2016 10:41:18 +0000 The mental foramen (MF) is an important anatomic landmark of the mandible, in which the somatic afferent sensory nerve of the mandibular nerve emerges as mental nerve and blood vessels. The identification and actual location of MF are important in order to avoid sensory dysfunction or paresthesia due to mental nerve injury. In the literature there are some rare reports on the anatomical variations of the MF such as its location or presence of accessory foramina. The present report describes the absence of mental foramina on the left side of the mandible, as detected by cone-beam computed tomography before impacted tooth removal and observed directly during surgery. Murat Ulu, Elif Tarim Ertas, Fatih Gunhan, Meral Yircali Atici, and Huseyin Akcay Copyright © 2016 Murat Ulu et al. All rights reserved. Histological Features and Biocompatibility of Bone and Soft Tissue Substitutes in the Atrophic Alveolar Ridge Reconstruction Tue, 23 Feb 2016 14:06:50 +0000 The reconstruction of the atrophic alveolar ridges for implant placement is today a common procedure in dentistry daily practice. The surgical reconstruction provides for the optimization of the supporting bone for the implants and a restoration of the amount of keratinized gingiva for esthetic and functional reasons. In the past, tissue regeneration has been performed with autogenous bone and free gingival or connective tissue grafts. Nowadays, bone substitutes and specific collagen matrix allow for a complete restoration of the atrophic ridge without invasive harvesting procedures. A maxillary reconstruction of an atrophic ridge by means of tissue substitutes and its histological features are then presented. Carlo Maiorana, Mario Beretta, Davide Rancitelli, Giovanni Battista Grossi, Marco Cicciù, and Alan Scott Herford Copyright © 2016 Carlo Maiorana et al. All rights reserved. Dental Treatment of a Child with Pallister-Killian Syndrome Sun, 21 Feb 2016 14:23:39 +0000 The Pallister-Killian syndrome (PKS) is an extremely rare genetic disorder with an incidence estimated around 1/25000. PKS is a multiple congenital anomaly deficit syndrome caused by mosaic tissue limited tetrasomy for chromosome 12p. The presented report is the first confirmed case with PKS in Turkey. This report focuses on the orofacial clinical manifestations of an 6-year-old boy with PKS who was referred to the Department of Paediatric Dentistry clinic, Gazi University. It has been learned that the PKS was diagnosed 1 year after birth. Due to intellectual disability, it was decided to make the dental treatments under moderate sedation. Although significant tongue thrust and anterior open bite were determined, any oral appliances could not be applied because of the 2 epilepsy seizures in the last 2 years. The aim was to treat decayed teeth and set good oral hygiene in the patient’s mouth. Still, there is a probability for epilepsy seizures. If epileptic seizures stop permanently, we can apply an oral appliance to block tongue thrust. The patient is now under control. In cases of systemic and oral findings such as PKS, conducting medical and dental approaches together will increase the life quality of patients. Serhan Didinen, Didem Atabek, Gülay Kip, Aslı Patır Münevveroğlu, and Özlem Tulunoğlu Copyright © 2016 Serhan Didinen et al. All rights reserved. Vestibular Schwannoma Presenting as Oral Dysgeusia: An Easily Missed Diagnosis Thu, 18 Feb 2016 15:42:24 +0000 We present a case of a fifty-year-old male patient who was referred to the Oral Medicine Department with a complaint of a salty taste. History taking subsequently revealed that the patient was also experiencing intermittent numbness of his left lower lip, tinnitus, and a feeling of fullness in the left ear. Magnetic resonance imaging was performed which revealed a large vestibular schwannoma affecting the left vestibulocochlear nerve, which was treated surgically. This case shows the importance of taking a detailed history in a patient presenting with an initial complaint of oral dysgeusia. It also highlights the possibility of significant underlying pathology, presenting with initial low level, nonspecific complaints such as an altered taste, and the rationale for imaging patients who report unilateral facial hypoesthesia. Emma Brown and Konrad Staines Copyright © 2016 Emma Brown and Konrad Staines. All rights reserved. An Erupted Dilated Odontoma: A Rare Presentation Tue, 16 Feb 2016 13:52:00 +0000 A dilated odontoma is an extremely rare developmental anomaly represented as a dilatation of the crown and root as a consequence of a deep, enamel-lined invagination and is considered a severe variant of dens invaginatus. An oval shape of the tooth lacking morphological characteristics of a crown or root implies that the invagination happened in the initial stages of morphodifferentiation. Spontaneous eruption of an odontoma is a rare occurrence and the occurrence of a dilated odontoma in a supernumerary tooth is even rarer with only a few case reports documented in the English literature. We present an extremely rare case of erupted dilated odontoma occurring in the supernumerary tooth in anterior maxillary region in an 18-year-old male, which, to the best of our knowledge, is the first ever case reported in English literature. Gaurav Sharma, Amritpreet Nagra, Gurkeerat Singh, Archna Nagpal, Atul Soin, and Vishal Bhardwaj Copyright © 2016 Gaurav Sharma et al. All rights reserved.