Case Reports in Dentistry The latest articles from Hindawi Publishing Corporation © 2015 , Hindawi Publishing Corporation . 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. Severe Hyponatremia due to Phlegmonous Trismus Thu, 25 Dec 2014 00:10:21 +0000 We describe a patient with dysphagia and trismus associated with lower jaw inflammation due to phlegmon who developed severe hyponatremia from water intoxication due to excessive water intake after diaphoresis caused by abnormally hot weather. A 63-year-old woman presented with severe swelling of the floor of the mouth and trismus. As she had spasms and numbness of the extremities and restlessness and water intoxication caused by excessive water intake was suspected, she was hospitalized for the treatment of inflammation and electrolyte disorder. Although swelling of the floor of the mouth subsided over time after antimicrobial therapy, vomiting, diarrhea, and numbness of the extremities continued. On day 5 of hospitalization, severe vomiting and diarrhea recurred, and serum sodium levels decreased to 108 mEq/L. Decrease in water intake is essential in the treatment of hyponatremia. However, in patients with severe vomiting and diarrhea who can swallow only liquids because of hot weather and eating disorder, the risk of sodium depletion is high. It is important to restore electrolyte balance and fluid volume through supplementation with sodium, chlorine, potassium, and glucose among others, the reduction of intravenous fluid volume, and diuresis in order to correct the sodium level slowly. Yoshihiro Momota, Tomio Iseki, and Tadashi Ohkubo Copyright © 2014 Yoshihiro Momota et al. All rights reserved. Fragment Reattachment after Atypical Crown Fracture in Maxillary Central Incisor Wed, 24 Dec 2014 11:40:00 +0000 Background. Fracture by trauma is one of the most common types of dental injury in the permanent dentition among children and teenagers. Aim. The aim of this study was to report the treatment performed to an atypical dental trauma case in a maxillary central incisor of a young patient by means of reattachment of the tooth fragment. Case Description. A 12-year-old male patient suffered a vertical crown fracture to the maxillary right central incisor. After clinical and radiographic examinations, a conservative restorative treatment which consisted in the reattachment of the tooth fragment with flow resin was performed in order to preserve the dental element and to obtain maximum aesthetics. Conclusion. The reattachment of fractured fragment is a fast and easy technique that can be used successfully as an option to restore dental element which suffered trauma. Clinical Significance. This technique restores the aesthetics and function of the dental element with minimal discomfort to the patient. Vanessa Torraca Peraro Vaz, Cristina Dupim Presoto, Keren Cristina Fagundes Jordão, André Gustavo Paleari, Andrea Abi-Rached Dantas, José Claudio Martins Segalla, and Osmir Batista de Oliveira Junior Copyright © 2014 Vanessa Torraca Peraro Vaz et al. All rights reserved. Oral and Dental Findings of Dyskeratosis Congenita Wed, 24 Dec 2014 00:10:12 +0000 Dyskeratosis congenital (DC) is a rare condition characterized by reticulate skin hyperpigmentation, mucosal leukoplakia, and nail dystrophy. More serious features are bone marrow involvement with pancytopenia and a predisposition to malignancy. The purpose of this case report is to describe the oral and dental findings in children with DC syndrome. A 10-year-old male diagnosed with DC was admitted because of extensive caries and toothache. Inadequate oral hygiene and extensive caries were observed in oral examination of the patient. Plaque accumulation was seen in gingival border of maxillary teeth. Papillary atrophy on the tongue was observed. Short and blunted roots of mandible incisors and upper and lower molars were determined on the radiographic examination. Dryness on the lips and commisuras, ectropion on his eyes, and epiphora were observed. Hematologic tests were performed and showed aplastic anemia at the age of 2. At the age of 4, the bone marrow transplantation was performed. Dermatological findings occurred after the bone marrow transplantation. The skin of the patient was thin, dry, and wrinkled in some areas. He had palmoplantar hyperkeratosis and syndactylia on his fingers. Endodontic treatment procedures were applied and other extensive caries are still being restored. The patient will be given full preventive care during regular follow-up. Oral hygiene was improved to the optimum level. Mine Koruyucu, Pelin Barlak, and Figen Seymen Copyright © 2014 Mine Koruyucu et al. All rights reserved. Compound Composite Odontoma and Its Management Sun, 21 Dec 2014 12:06:56 +0000 Odontomas are odontogenic benign tumors composed of dental tissue. Majority of these lesions are asymptomatic and are often detected on routine radiographs. They can be thought of as “tooth hamartomas" with the lesion consisting of various tooth components. They are divided histologically into complex odontomas and compound odontomas. This paper describes the case of a compound odontoma in a 13-year-old girl diagnosed due to the retention of the primary right mandibular second molar. A surgical excision was performed without disturbing the unerupted premolar. The results achieved indicate that early diagnosis of odontomas enables adoption of less complex treatment, a better prognosis, and displacement or devitalisation of adjacent tooth. Morawala Abdul, Kapila Pragati, and Chunawala Yusuf Copyright © 2014 Morawala Abdul et al. All rights reserved. Rare Periodontal Ligament Drainage for Periapical Inflammation of an Adjacent Tooth: A Case Report and Review of the Literature Sun, 21 Dec 2014 11:20:19 +0000 Aim. To report a case with an unusual drainage route of periapical inflammation exiting through the gingival sulcus of an adjacent vital tooth and review probable factors determining the diversity of the discharge routes of periapical inflammation. Summary. An 18-year-old male patient presented with periodontal abscess of tooth 46, which was found to be caused by a periapical cyst with an acute abscess of tooth 45. During endodontic surgery, a rarely reported drainage route for periapical inflammation via the gingival sulcus of an adjacent vital tooth was observed for the first time. Complete periodontal healing of the deep pocket of tooth 46 and hiding of the periapical cyst of tooth 45 followed after root canal treatment and periapical surgery with Bio-Oss Collagen implantation on tooth 45. The drainage routes of periapical inflammation are multivariate and the diversity of drainage pathways of periapical inflammation is mainly related to factors such as gravity, barriers against inflammation, and the causative tooth itself. Hongmei Guo, Wei Lu, Qianqian Han, Shubo Li, and Pishan Yang Copyright © 2014 Hongmei Guo et al. All rights reserved. Craniodentofacial Manifestations in a Rare Syndrome: Orofaciodigital Type IV (Mohr-Majewski Syndrome) Sun, 21 Dec 2014 00:10:25 +0000 Background. The orofaciodigital syndromes (OFDS) are a heterogeneous group of syndromes that affect the face, oral cavity, and the digits. OFDS type IV (OMIM %258860) is rare and characterized by broad nasal root and tip, orbital hypertelorism or telecanthus, micrognathia, hypoplastic mandible, and low-set ears. Oral symptoms may include cleft lip, cleft or highly arched palate, bifid uvula, cleft or hypoplastic maxillary and mandibular alveolar ridge, oral frenula, lingual hamartoma, and absent or hypoplastic epiglottis. Dental anomalies are common and generally include disturbances in the number of teeth. Case Report. This report presents a six-year-old girl, referred with the chief complaint of missing teeth. She was diagnosed as having OFDS type IV based on clinical findings. Her parents reported three deceased children and two fetuses that had the same phenotype. She was the seventh child of consanguineous parents who were first cousins. Conclusion. This is a very rare syndrome. Many reported OFDS type IV cases have consanguineous parents, consistent with an autosomal recessive trait. Manifestation of cleft palate in the healthy sibling may be mild expression of the disorder or an unrelated isolated cleft. Meltem Ozdemir-Karatas, Didem Ozdemir-Ozenen, P. Suzanne Hart, and Thomas C. Hart Copyright © 2014 Meltem Ozdemir-Karatas et al. All rights reserved. Fraser Syndrome-Oral Manifestations and a Dental Care Protocol Sun, 21 Dec 2014 00:10:24 +0000 Fraser syndrome is a rare genetic malformation with an autosomal recessive pattern of inheritance and an incidence of consanguinity ranging from 15% to 25%. A 5-year-old male patient who is a carrier of Fraser syndrome initiated treatment in the pediatric dentistry sector. The patient was fed parenterally since birth, experienced recurring bouts of chronic lung disease, and was referred to the pediatric dentistry sector by the medical team. Radiographic examination revealed the presence of all permanent teeth. Supragingival dental calculus, halitosis, and gingival inflammation were also observed. Dental calculus was removed by manual scraping, and chemotherapeutic agents were used, chlorhexidine 0,12%, chlorhexidine gel 2%, and PVP-I, to control the bacterial flora. The patient is still being monitored after an 8-year follow-up period, the complications associated with periodontal disease decreased, and since the initiation of treatment, the patient has not needed to be hospitalized because of chronic lung disease. This study reports the case of a patient diagnosed with Fraser syndrome and describes the clinical manifestations (general and oral). Talita Lopes de Oliveira and Giselle Rodrigues de Sant’Anna Copyright © 2014 Talita Lopes de Oliveira and Giselle Rodrigues de Sant’Anna. All rights reserved. Cartilaginous Choristoma of the Gingiva: A Rare Clinical Entity Thu, 18 Dec 2014 13:06:08 +0000 Choristomas are rare entities which are aggregates of microscopically normal cells or tissues in aberrant locations. They are a “heterotopic” rest of cells, as they appear as a tumor-like mass. Herein we report a case of cartilaginous choristoma in a 54-year-old male who presented with a swelling on right lower gingiva. The histopathological examination revealed features of a well circumscribed mass of mature cartilage in a dense fibrous connective tissue stroma. Ramalingam Suganya, Narasimhan Malathi, Subramani Vijaya Nirmala, Chinnaswami Ravindran, and Harikrishnan Thamizhchelvan Copyright © 2014 Ramalingam Suganya et al. All rights reserved. Unilateral Fusion of Maxillary Lateral Incisor: Diagnosis Using Cone Beam Computed Tomography Thu, 18 Dec 2014 09:01:49 +0000 Objective. The objective of this paper is to report a dental fusion case focusing on clinical and radiographic features for the diagnosis. Method. To report a case of right maxillary lateral incisor fusion and a supernumerary tooth, the anatomy of the root canal and dental united portion were assessed by cone beam computed tomography (CBCT). Results. The clinical examination showed dental juxtaposition with the absence of interdental papilla and esthetic impairment in the right maxillary lateral incisor region. The periapical radiography did not provide enough information for the differential diagnosis due to the inherent limitations of this technique. CBCT confirmed the presence of tooth fusion. Conclusion. CBCT examination supports the diagnosis and provides both the identification of changes in tooth development and the visualization of their extent and limits. Iury Oliveira Castro, Carlos Estrela, Vinícius Rezende Souza, Lawrence Gonzaga Lopes, and João Batista de Souza Copyright © 2014 Iury Oliveira Castro et al. All rights reserved. Numb Chin Syndrome as First Symptom of Diffuse Large B-Cell Lymphoma Tue, 16 Dec 2014 00:10:22 +0000 Numb chin syndrome is a rare sensory neuropathy of the mental nerve characterized by numbness, hypoesthesia, paraesthesia, and very rarely pain. Dental causes, especially iatrogenic ones, maxillofacial trauma, or malignant neoplasm are etiologic factors for this rare syndrome. Many malignant and metastatic neoplasms are causing this syndrome, like primary osteosarcoma, squamous cell carcinoma, and mandibular metastasis of primary carcinoma of breast, lung, thyroid, kidney, prostate, and nasopharynx. Haematological malignancies like acute lymphocytic leukaemia, Hodgkin and non-Hodgkin lymphoma, and myeloma can cause this neuropathy. The authors report a case of a 71-year-old woman in which the numb chin syndrome was the first symptom of the diffuse large B-cell lymphoma, which caused infiltration and reabsorption of the alveolar ridge and lower mandibular cortex. A biopsy of the mass was performed on fragments of tissue collected from the mandibular periosteum, medullary and cortical mandibular bone, and inferior alveolar nerve. Mario Carbone, Francesco Della Ferrera, Lucio Carbone, Gaia Gatti, and Marco Carrozzo Copyright © 2014 Mario Carbone et al. All rights reserved. Mini-Implants: New Possibilities in Interdisciplinary Treatment Approaches Sun, 14 Dec 2014 09:55:51 +0000 The introduction of mini-implants has broadened the range of tooth movements possible by fixed appliance therapy alone. The limits of fixed orthodontic treatment have become more a matter of facial appearance than anchorage. Many complex cases which would previously have required surgery or functional appliances can now be treated with fixed appliance therapy using mini-implants. A mutilated dentition case where mini-implants were used to provide anchorage for intrusion of molars and retraction of anterior teeth is reported here to illustrate this point. Biju Sebastian Copyright © 2014 Biju Sebastian. All rights reserved. Treatment of Odontogenic Myxoma: A Multidisciplinary Approach—6-Year Follow-Up Case Sun, 14 Dec 2014 07:28:51 +0000 The most aggressive diseases that affect the oral environment are considered tumors of the jaw. The surgical treatment is preferably done by surgical resection of the lesion, resulting in a great loss of tissue and esthetics. Multidisciplinary planning is required for the rehabilitation of these cases. Autogenous grafting techniques or vascularized flaps allow ridge reconstruction for implant placement, restoring function, and esthetics. This paper reports a 6-year follow-up case of an odontogenic myxoma treated with wide resection and mandibular bone reconstruction for posterior rehabilitation with dental implants. João Gustavo Oliveira de Souza, Jonathas Daniel Paggi Claus, Felipe Damerau Ouriques, Luiz Fernando Gil, José Nazareno Gil, Antonio Carlos Cardoso, and Marco Aurélio Bianchini Copyright © 2014 João Gustavo Oliveira de Souza et al. All rights reserved. Dental Management of a 14-Year-Old with Cockayne Syndrome under General Anesthesia Wed, 10 Dec 2014 00:10:54 +0000 Cockayne’s syndrome is a rare, autosomal recessive disorder characterized clinically by cachectic dwarfism, cutaneous photosensitivity, loss of adipose tissue, mental retardation, skeletal and neurological abnormalities, and pigmentary degeneration of the retina. Dental caries is a common finding. Dental rehabilitation of a 14-year-old male with Cockayne’s syndrome is presented. Divya Gaddam, Mukesh Singh Thakur, Niranjani Krothapalli, and Saujanya Kaniti Copyright © 2014 Divya Gaddam et al. All rights reserved. Familial Case of Cherubism from South India: Differential Diagnosis and Report of 2 Cases Mon, 08 Dec 2014 00:10:25 +0000 Cherubism is a rare familial multilocular cystic lesion of the jaws. The condition clinically appears as a bilateral symmetric swelling of the cheeks in children and is the primary reason for referral. It is a rare lesion of the jaws that has a dominant pattern of inheritance. We report two cases of cherubism, that of a boy and his mother suggestive of a strong familial incidence. A variety of lesions of the jaw mimic this condition and hence the differential diagnosis has been emphasised. Varun Muthuraman and Soundarya Srinivasan Copyright © 2014 Varun Muthuraman and Soundarya Srinivasan. All rights reserved. Treatment Algorithm for Ameloblastoma Sun, 07 Dec 2014 13:03:13 +0000 Ameloblastoma is the second most common benign odontogenic tumour (Shafer et al. 2006) which constitutes 1–3% of all cysts and tumours of jaw, with locally aggressive behaviour, high recurrence rate, and a malignant potential (Chaine et al. 2009). Various treatment algorithms for ameloblastoma have been reported; however, a universally accepted approach remains unsettled and controversial (Chaine et al. 2009). The treatment algorithm to be chosen depends on size (Escande et al. 2009 and Sampson and Pogrel 1999), anatomical location (Feinberg and Steinberg 1996), histologic variant (Philipsen and Reichart 1998), and anatomical involvement (Jackson et al. 1996). In this paper various such treatment modalities which include enucleation and peripheral osteotomy, partial maxillectomy, segmental resection and reconstruction done with fibula graft, and radical resection and reconstruction done with rib graft and their recurrence rate are reviewed with study of five cases. Madhumati Singh, Anjan Shah, Auric Bhattacharya, Ragesh Raman, Narahari Ranganatha, and Piyush Prakash Copyright © 2014 Madhumati Singh et al. All rights reserved.