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Case Reports in Dentistry publishes case reports and case series in all areas of dentistry, including periodontal diseases, dental implants, oral pathology, as well as oral and maxillofacial surgery.
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Long-Term Retention of Avulsed Maxillary Incisors with Replacement Root Resorption: A 9-Year Follow-Up
The purpose of this case report is to present a case of long-term retention of avulsed upper maxillary incisors with external replacement root resorption in a 15-year-old boy. The avulsed teeth, #11, 21, and 22, were stored under dry conditions for 40 min and replanted. Endodontic treatment was initiated after two weeks, and the nonrigid splint was removed after 3.5 months. A year after replantation of the teeth, replacement root resorption was detected radiographically. For the following 9 years, the resorption progressed slowly, but the teeth were maintained without any adverse effects on esthetic appearance. Under dry storage conditions, replacement root resorption was expected. In this case, the patient was a growing 15-year-old boy; thus, replantation was performed despite a possible poor prognosis. Consequently, root resorption progressed. Nevertheless, maintenance of the tooth crowns led to satisfying results for the patient both esthetically and psychologically. Ankylosis or replacement root resorption is a complication occurring after replantation of avulsed teeth, which could require additional treatment. However, in young patients, replantation could be considered to maintain the teeth until growth is complete.
Peri-Implant Tissue Adaptation after Implant Rehabilitation with Shoulderless Abutments with 24 Months of Follow-Up
An 11-year-old girl presented with agenesis of the maxillary lateral incisors. Orthodontic treatment was performed to close the midline diastema and create adequate space between the central incisors and canines to replace the missing maxillary lateral incisors on both sides. Two-piece implants were placed, and shoulderless abutments were prepared following the “biologically oriented preparation technique” (BOPT) protocol. The soft tissues were allowed to heal directly on the prosthetic emergence profile of the interim crown restorations after implant exposure. Two months later, the gingival tissue adapted to the prosthetic components in a specular manner. No complications were noted at 24 months. The BOPT protocol, originally described for natural teeth, may be applied to dental implants with shoulderless abutments.
Case Reports of a New Method for Differential Diagnosis of Calcified Carotid Artery Atheroma
Introduction. Early diagnosis of calcified atheromas may decrease morbidity and mortality caused by brain and cardiovascular diseases, in which atherosclerosis is the main etiological factor of these pathologies. Dental examinations with the aim of detecting this pathology have been in progress since 1981, such as panoramic radiography, considered the most widely studied method for this diagnosis. However, some limitations of this exam have been reported with reference to inability to visualize the cervical region and difficulty of establishing a precise diagnosis because of many structures and calcifications that have similar radiographic characteristics. Case Report. The present study to describe a dental radiographic technique for establishing the differential diagnosis of calcified atheromas regarding other calcifications and reporting 3 clinical cases that demonstrate its effectiveness in different clinical situations. Discussion. Manzi Projection can promote a differential diagnosis of calcified atheromas in dental practice and consequently subsidize the clinician for referring the patient to the physician.
Autotransplantation of Two Immature Third Molars with the Use of L-PRF
Tooth autotransplantation is a procedure which provides the extraction of an erupted or impacted tooth and its repositioning to another site in the oral cavity. This Case Report describes a successful case of two autotransplantations of open-apex mandibular third molars in place of the hopeless first mandibular molars with the use of L-PRF in a growing patient. A 15-year-old male patient was referred to the Dental Clinic for the extractions of the two hopeless mandibular first molars. Autotransplantation was considered the best treatment option for both sites 36 and 46, because the presence of two impacted mandibular third molars (38 and 48) with an incomplete root formation. Teeth 36 and 46 were extracted and replaced with teeth 38 and 48. The patient had an uneventful healing. At follow-up visits, the two autotransplanted teeth showed physiologic mobility, absence of inflammation and discomfort, and absence of infection; probing depth values were within normal range, and the vitality tests were positive. After 2 years, the teeth in position 36 and 46 showed absence of infection and mobility, and positive pulp vitality tests and the radiographic examinations exhibited closure of the root apices as well as absence of any periapical radiolucency or root resorption. Tooth autotransplantation is a good treatment option in case of tooth loss offering an alternative to traditional or implant-supported prosthesis especially for growing patients.
Use of Cone Beam Computed Tomography for Identification of a Distant Causative Tooth: An Unusual Case of an Apical Lesion from a Maxillary Premolar Mimicking That from Maxillary Incisors
The article describes an unusual case of an apical lesion at the first premolar with spontaneous pain and swelling around the root and tooth mobility at the maxillary right central and lateral incisors. The patient was a 45-year-old man with a chief complaint of discomfort at the maxillary right central and lateral incisors for one year. Oral examination showed spontaneous pain, swelling, and tooth mobility of the maxillary right central and lateral incisors. Intraoral and panoramic radiographs showed clear apical radiolucency at these sites, although there were no carious incisors. Neither tooth had periodontal pockets, and there was no bleeding on probing sites. A cold thermal examination revealed normal responses of the vital dental pulp. Initial panoramic radiography showed an apical lesion of the maxillary right first premolar, which was root filled and without inflammatory symptoms. A cone beam computed tomography (CBCT) revealed that the apical lesion of the premolar had extensively spread to the anterior through the palatal side, circumventing the palatal side of the adjacent canine, and reached the apical areas of the central and lateral incisors. We treated the apical lesion of the first premolar, and the radiolucent regions had almost disappeared after three years with regard to not only the apical lesion in the first premolar and incisors but also the primary symptoms on the incisors without endodontic treatment. This case shows that CBCT is an effective alternative that allows appropriate treatment to be selected more reliably.
Comprehensive Management of Ectodermal Dysplasia with Interceptive Orthodontics in a Young Boy Who Was Bullied at School
Aim. The management of hypohidrotic ectodermal dysplasia with oligodontia in Class-I malocclusion in late mix dentition. Case Report. An 11-year-old boy with ED was treated and managed by means of interceptive orthodontic treatment accompanied by direct and indirect restorative methods in a successful manner. The patient was prepared to receive definitive oral rehabilitation with dental implants for the missing teeth when the patient reaches a suitable age. The patient was followed for 5 years from the beginning of treatment. Conclusion. Management of the child with ectodermal dysplasia with oligodontia was a real challenge. Early diagnosis, necessary investigation, and providing age-appropriate multidisciplinary treatment were key steps in successful outcomes. The objectives were not only just orthodontic or paedodontics but also prosthetic and psychological.