Rett syndrome is a neurodevelopmental genetic X-linked disorder. It is predominantly found in females with a prevalence rate of 1&#x2009;:&#x2009;9000. Rett syndrome patients are usually healthy the first months of their lives. The syndrome goes into a deceleration phase where motor, behavioral, and cognitive skills are impaired. Regarding their oral health, bruxism is one of the common oral manifestations found among Rett syndrome patients. We present a case of an 8-year-old patient with Rett syndrome who presented to the dental clinic for oral rehabilitation. The patient was evaluated and treated under general anesthesia with multiple extractions, restorations, and crown installments. Oral rehabilitation of Rett syndrome is important for those patients, and proper evaluation and treatment are the most efficient when performed under general anesthesia.

Wisam Al-Hathlol

Raed Bokhari

Nada Alzahrani

Elaf Alkuwaiti

Challenges in the Dental Management of Rett Syndrome under General Anesthesia: A Rare Disease

Microstomia is an abnormally reduced oral aperture. In the literature, it is not classified by any particular size criteria, rather defined by its effects on function and esthetics. Prosthodontic management of edentulous patients with microstomia is a challenging task. Use of conventional methods for recording an impression and fabricating prosthesis is not effective in such patients. To fabricate well-fitting prosthesis, accuracy of impression recording important anatomic landmarks is essential. Formation of an exacting custom tray and diagnostic cast is critical for final impression accuracy. Provision of a well-fitting prosthesis in microstomia patient will restore esthetics, comfort, and function with oral and systemic patient wellbeing. This paper presents a case report of managing an edentulous microstomia patient with sectional removable prosthesis. Furthermore, it proposes a novel classification system for microstomia patients according to severity of the condition.

Maria S. Abbasi

Naseer Ahmed

Adil Bin Irfan

Samar Al-Saleh

Tariq Abduljabbar

Fahim Vohra

Management of Edentulous Microstomia Patient: A Case Report and Classification System

Hereditary Angioedema (HAE) is a rare disease characterized by a deficiency or a reduced function of the plasma protein C1 esterase inhibitor (C1-INH), which is involved in the downregulation of several inflammatory pathways. Patients affected by HAE suffer from episodic swellings of subcutaneous or submucosal tissues. Swellings can be caused by stress or dental and surgical procedures and can be life-threatening if the airways are involved. We have reported a clinical case of a patient affected by HAE type I who underwent oral surgery procedures under a short-term prophylaxis with C1-INH plasma-derived concentrate. The patient underwent a cyst removal, multiple tooth extractions, and an excisional biopsy with a prophylaxis with C1-INH plasma-derived concentrate and was hospitalized for 36 hours after the surgery to be monitored for possible HAE attacks. During the hospitalization, the patient did not show signs of swelling nor of HAE attacks. At 14 and 28 days after the surgery, the patient presented a good surgical healing. The prophylactic intravenous infusion of C1-INH concentrate was successful in preventing acute HAE attacks after oral surgery procedures.

Chiara Cinquini

Simonetta Santarelli

Alberto Marianelli

Marco Nisi

Mario Gabriele

Antonio Barone

Oral Surgery Procedures in a Patient Affected by Hereditary Angioedema Type I

The ideal retrieval protocol of separated instruments reverts the case to the initial situation prior to the fracture incidence while preserving the tooth hard tissue and the integrity of the supporting structures. When a patient presented for emergency treatment of tooth #37 diagnosed with acute suppurative apical periodontitis, radiographic examination revealed a fractured instrument extruded into the periapex. The treatment options for retrieval were limited to replantation. The initial emergency treatment which consisted of orthograde pus drain, radicular disinfection, and intracanal calcium hydroxide dressing completely resolved patient&#x2019;s symptoms. The follow-up radiographs revealed an interesting finding: gradual shift in the separated fragment position into the radicular space allowing a successful nonsurgical removal of the broken instrument. In conclusion, the reaction of periodontal tissues to an extruded instrument fragment remaining in situ may be favourable; thus, a risk and benefit analysis approach is essential to fractured instrument retrieval.

Ahmed Elhakim

Tarek Mohamed Abd El-Wahab

A Rare Case of Orthograde Retrieval of Extruded Instrument following Periapical Tissue Healing

Eruption of tooth into place other than tooth-bearing region is defined as ectopic eruption. Although ectopic eruption of tooth is rare, there have been cases in the maxillary sinus, mandibular condyle, nasal cavity, chin, palate, and orbital floor. Due to ectopic teeth&#x2019;s rarity and lack of consensus for &#x0131;ts treatment, incidence was entitled to be added to literature and discussed. It was reported that odontogenic tumors and cysts can develop around the ectopic tooth. Thus, ectopic teeth can be followed up regularly in case of no signs and symptoms. If the patient has unusual orofacial pain, undiagnosed nasal discharge, maxillary sinusitis, preauricular pain, preauricular fistula, trismus, and lip paresthesia, the patient should be evaluated in terms of ectopic tooth. Whether the patient has signs and symptoms related to ectopic tooth, early intervention for the removal of ectopic tooth along with accompanying lesion is the treatment of choice. Specialists choose intervention way based on their experience. When selecting the intervention, minimally invasive and less morbid way should be preferred. Intraoral approach rather than extraorally should be the first choice to prevent unesthetic scar and damage to facial nerve.

Mert Akbas

Z&#x00FC;lfikar Karab&#x0131;y&#x0131;k

Altan Varol

Ectopic Tooth in Mandibular Canal, Maxillary Sinus, and Mandibular Condyle

We present the first, to our knowledge, case of a dedifferentiated low-grade central osteosarcoma (LCOS) of the mandible. A 48-year-old Japanese woman underwent enucleation under general anesthesia after a diagnosis of ossifying fibroma. At the second recurrence, the pathological diagnosis after biopsy was of sarcoma with MDM2(+) and CDK4(+) immunohistochemical staining results. Hemimandibulotomy, supraomohyoid neck dissection, and free-flap reconstruction with a rectus abdominal flap were performed. A retrospective reevaluation of the first specimen with additional immunohistochemical staining for MDM2 and CDK4 yielded a final diagnosis of dedifferentiated LCOS. The patient showed no recurrence or lung metastasis 3 years after the final surgery.

Kenji Yamagata

Naomi Ishibashi-Kanno

Ryota Matsuoka

Fumihiko Uchida

Satoshi Fukuzawa

Hiroki Bukawa

Dedifferentiated Low-Grade Central Osteosarcoma of the Mandible

After surgical excision of tumors involving the maxilla, depending on their location and size, maxillary defects can have harmful consequences, both esthetic and functional. These effects disrupt all the functions of the manducatory system, namely breathing, swallowing, and especially phonation, thus affecting negatively the patient&#x2019;s psychological state. Despite the evolution of reconstructive surgical techniques and the development of microsurgery, conventional obturator prostheses are still relevant. In fact, these prostheses restore the main functions of chewing, phonation, and swallowing. They also provide the patient with a satisfactory esthetic appearance. Moreover, they have an advantage in regard to oncology, making the possibility of surveying much easier. Maxillary defects are characterized by their highly polymorphic aspect, having a great impact on the nature of prosthetic rehabilitation. The aim of this work was to present the different clinical and laboratory steps of prosthetic rehabilitation of an acquired maxillary defect following excision of a mucoepidermoid carcinoma.

Karim Chebbi

Khaoula Bouaziz

Oumaima Tayari

Azza Berkaoui

Mohamed Ali Bouzidi

Jamila Jaouadi

Palatal Obturator after Maxillectomy following Squamous Cell Carcinoma

Cerebral palsy is a neurological and motor condition characterised by muscle balance and posture impairments. Bruxism and malocclusion were frequently observed in patients with cerebral palsy, in contrast to other oral anomalies. The report outlines how severe awake bruxism is managed in a 16-year-old Korean boy who has nonverbal spastic cerebral palsy and global developmental delay. The treatment protocol involved the fabrication of soft occlusal splints of three and four millimetres in thickness, followed by the placement of stainless-steel crowns on all first permanent molars whilst video recording and a bruxism diary was kept. Fixed restorations demonstrate increased endurance in withstanding bruxism force in persons who are dependent on their caretaker.

N. Ismail

S. H. Hamzah

I. Wan Mokhtar

A Pragmatic Approach to the Management of Severe Awake Bruxism in an Adolescent with Cerebral Palsy and Global Developmental Delay

Edentulous patients require an adequate rehabilitation so that the alveolar ridge in the interforaminal region be restored for subsequent implant-supported overdentures. The ultimate goal of distraction is to reconstruct the alveolar ridge to a suitable height and width compatible with Atwood class 2 in an appropriate direction allowing the sagittal interalveolar relation to be normally restored. <i>Methods</i>. A 65-year-old man presented with a grade 4 Mandibular atrophy as per Atwood classification which resulted in unsatisfactory treatment with full dentures. Endo-Distractor Krenkel® device was used for anterior mandibular vertical distraction osteogenesis. Four mandibular implants (ITI Straumann, Basel, Switzerland) measuring diameter <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.036pt" style="vertical-align:-0.6304703pt" id="M1" height="9.62521pt" version="1.1" viewBox="-0.0498162 -8.99474 21.036 9.62521"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g190-234" d="M633 674L603 694L553 619C506 650 449 665 390 665C181 665 50 499 50 319C50 208 100 116 171 56L118 -22L145 -45L201 35C251 3 311 -15 374 -15C560 -15 710 120 710 335C710 447 656 541 584 600L633 674ZM217 123C177 176 150 256 150 344C150 534 254 629 367 629C425 629 477 609 517 566L217 123ZM541 537C581 482 610 406 610 305C610 150 542 21 391 21C333 21 277 45 240 92L541 537Z"/></g><g transform="matrix(.013,0,0,-0.013,13.405,0)"><path id="g117-34" d="M535 323V373H52V323H535ZM535 138V188H52V138H535Z"/></g></svg><span class="irelop"/><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="15.63pt" style="vertical-align:-0.6304703pt" height="9.62521pt" version="1.1" viewBox="24.6181838 -8.99474 15.63 9.62521"><g transform="matrix(.013,0,0,-0.013,24.668,0)"><path id="g113-53" d="M456 178V225H360V632H320C217 496 115 347 20 206V178H280V106C280 40 276 34 189 27V0H445V27C364 34 360 39 360 106V178H456ZM280 225H82C149 335 214 431 278 520H280V225Z"/></g><g transform="matrix(.013,0,0,-0.013,30.908,0)"><path id="g113-47" d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z"/></g><g transform="matrix(.013,0,0,-0.013,33.872,0)"><path id="g113-50" d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z"/></g></svg></span> mm and length <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="18.448pt" style="vertical-align:-0.2064009pt" id="M2" height="8.8423pt" version="1.1" viewBox="-0.0498162 -8.6359 18.448 8.8423"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-77" d="M541 160L512 170C485 116 462 88 439 67C411 41 376 35 318 35C272 35 238 37 224 48C207 61 205 85 212 121L290 533C305 611 308 615 391 622L397 650H139L133 622C217 615 221 612 206 533L126 118C111 41 103 34 23 26L17 0H474C489 31 528 124 541 160Z"/></g><g transform="matrix(.013,0,0,-0.013,10.817,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="14.861pt" style="vertical-align:-0.2064009pt" height="8.8423pt" version="1.1" viewBox="22.0301838 -8.6359 14.861 8.8423"><g transform="matrix(.013,0,0,-0.013,22.08,0)"><use xlink:href="#g113-50"/></g><g transform="matrix(.013,0,0,-0.013,28.32,0)"><path id="g113-55" d="M137 343C167 482 260 545 321 574C357 591 397 603 429 609L423 641C382 634 335 622 295 608C189 570 37 457 37 238C37 84 125 -12 242 -12C362 -12 447 89 447 209C447 311 374 393 267 393C247 393 226 386 204 376L137 343ZM227 337C318 337 361 256 361 173C361 105 336 22 258 22C176 22 126 120 126 240C126 266 127 291 132 310C155 323 189 337 227 337Z"/></g></svg></span>mm were inserted after the required retention period. Standardized prosthetic treatment was completed with titanium bar retained over dentures. <i>Results</i>. A distraction of 11 mm was achieved within 18 days followed by a retention period of 4 months. No signs of infection nor distractor anchorage loosening were detected, and minimal lingual tilting has occurred. <i>Conclusion</i>. Distraction is possible on severely atrophic mandibles. The quality of bone reconstruction is satisfactory for both functional and esthetic results.

Salah Sakka

Ali Al Rafedah

Nasser Alqhtani

Adel Alenazi

Distraction Osteogenesis of Severely Resorbed Mandible

Dental transposition is a severe disturbance of tooth position and its eruptive sequence. It may affect any tooth, and it may occur at any location within the dental arch, although some teeth may be more frequently affected than others. There are several types of dental transposition, and their classification depends on the type of teeth involved. The aetiology of transposition is not very clear and has always been the subject of controversies, and it is still not completely understood. The prevalence of dental transposition and the factors related to this dental anomaly have been well documented in the literature. When treating dental transposition, many factors which may affect the treatment results must be considered, such as aesthetics, occlusion, treatment duration, patient comfort, patient cooperation, and periodontal support. Various treatment options are currently available for the treatment of dental transposition. Successful treatment outcomes depend on the patient&#x2019;s age, concern about facial and dental aesthetics, motivation of the patient, functional requirements, type of malocclusion, and the position of the root apices. The present case report is aimed at outlining the orthodontic treatment of a young adult patient diagnosed with bilateral maxillary canine-lateral incisor transposition.

Mandla Dominic Nyakale

Orthodontic Treatment of Bilateral Transposition of Maxillary Canines and Lateral Incisors

About this journal

<p><em>Case Reports in Dentistry</em> 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.</p>


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<p><em>Case Reports in Dentistry</em> maintains an Editorial Board of practicing researchers from around the world, to ensure manuscripts are handled by editors who are experts in the field of study.</p>


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Case Reports in Dentistry - Table of contents 2022

title

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.

Case Reports in Dentistry