Case Reports in Dentistry

Introduction. Extraction sockets associated with buccal dehiscences and gingival recessions pose particular surgical and restorative challenges. In these cases, unassisted healing following flapless tooth extraction results in severe bone and soft tissue deformities and an aesthetic compromise. Root coverage procedures prior to ridge reconstruction may enable predictable alveolar augmentation. Case Presentation. This is the first case report describing the utilisation of modified tunnel procedure to facilitate ridge reconstruction consisting of ovate pontic and xenograft, of tooth #25 in a 38-year-old-male. The 6 months and 1-year reviews showed optimal soft tissue aesthetics, 100% root coverage of the tooth #25, and bone augmentation, which enabled placement of (3i) implant in a prosthetically driven position. The 6-year review continued to show favourable clinical outcomes. Conclusion. Compromised extraction sockets containing buccal dehiscence and associated with gingival recessions may benefit from soft tissue augmentation procedures to enhance the clinical outcome of ridge reconstruction.

Background. Delusional parasitosis (DP) is a monosymptomatic hypochondriacal psychosis where the patient has the delusion of being infested with parasites, whereas Morgellons disease (MD) is described when the patient has fixed ideation of fibers or other materials emerging from skin. Both psychological and organic causes can result into the delusion of infestation, and careful examination is required to exclude secondary causes. Oral DP can result in self-inflected mutilations of the oral mucosa. To our knowledge, oral DP is only rarely reported in the literature. Here, we describe and discuss the management of a case of overlap between oral DP and oral MD at the oral medicine (OM) clinic. Case Report. A 50-year-old male presented to the OM clinic with ulcerations of oral and perioral tissues. Patient reported inflicting wounds to himself using a shaving blade to extirpate worms and pieces of glass from underneath his oral and perioral mucosa. Clinical and laboratory investigations ruled out parasitic infestations. Self-inflected ulcers were treated with topical steroids and prophylactic antifungals, and the patient was referred for psychiatric evaluation. A diagnosis of primary DP was reached, and the patient was managed with antipsychotics. Practical Implications. Oral health care providers should be familiar with oral manifestations of psychiatric disorders and should be able to manage such patients in a multidisciplinary team of internist, dermatologist, and psychiatrist.

Minimally invasive treatment methods are of special interest in restorative dental practice, with numerous methods emerging in the last decade. Such methods are being developed to encompass various applications, an important one being the detection and treatment of caries in the early stages. White spot lesions are the earliest visible stage of the caries process. These lesions have a chalky, opaque appearance, which results in esthetic dissatisfaction. In contrast to the principles of minimally invasive dentistry, considerable amounts of sound tooth structure need to be sacrificed to get rid of these lesions. Therefore, caries infiltration has been introduced as an alternative treatment option for non-cavitated lesions. The resin infiltration technique only works in non-cavitated lesions. Replacement of lost dental tissue with resin composites remains the mainstay therapy in cases with cavity formation. This case report describes a case of caries with lesions of varying depths. In such cases, a combination of treatment methods may be used to provide satisfying esthetics with a minimally invasive approach.

Pain related to temporomandibular disorders (TMD) is a common problem that can significantly influence a patient’s quality of life. Laser photobiomodulation (PBM) has been reported as a promising method in medicine for wound and bone healing, pain relief, and treatment of the temporomandibular joint (TMJ). Our clinical case aimed to demonstrate the effectivity of PBM using 1064 nm Nd:YAG laser for the treatment of pain and restricted mandible movement in a patient with anterior disk displacement of the left TMJ, using subjective (pain on visual analogue scale - VAS) and objective outcome measures [dynamic magnetic resonance imaging (MRI)]. PBM was performed on the left condyle in four sessions using a 1064 nm Nd:YAG laser with a flat-top handpiece. Results after 10 weeks showed an increase in mouth opening and a painless joint on palpation, with no reported adverse effects. An MRI of the TMJ confirmed the left disk displacement, however, with no signs of inflammation or effusion and with less pronounced disk deformity as compared with the first MRI examination. Use of PBM with Nd:YAG laser may be an efficient method for the management of orofacial pain in patients with acute and chronic TMJ disk displacements and may reduce the recovery time.

This report presents an extremely rare case of MAML2-rearranged primary central mucoepidermoid carcinoma (MEC) of the mandible that was discovered as an incidental finding. Our review of the literature identified 36 cases of MAML2-rearranged intraosseous lesions of the jaw (30 central MECs, 5 odontogenic cysts with mucous prosoplasia, and 1 glandular odontogenic cyst). Given the therapeutic indications for a diagnosis of MEC (a malignant neoplasm), MAML2 rearrangement should be confirmed in suspected cases of central MEC.

Basaloid squamous cell carcinoma (BSCC) is a rare, distinctive, and aggressive variant of squamous cell carcinoma (SCC) primarily seen in the upper aerodigestive tract with epiglottis, soft palate, and base of the tongue being site of high preference in head and neck region. It differs from conventional SCC histologically and immunologically, is most frequently found in males in their sixth and seventh decades, and is frequently linked to alcohol and tobacco use. High stage disease with distant metastases, a high recurrence rate, and a dismal prognosis is how BSCC typically manifests. In the present article, we report four cases of BSCC.