Case Reports in Dentistry The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. Implant-Retained Obturator for an Edentulous Patient with a Hemimaxillectomy Defect Complicated with Microstomia Sun, 23 Oct 2016 13:08:59 +0000 Patient. A 68-year-old man was operated on for squamous cell carcinoma (T3N3M0) of the maxilla creating the hemimaxillary surgical defect on right side. The remaining arch was completely edentulous. There was remarkable limitation in the oral opening with reduced perimeter of the oral cavity due to radiation and surgical scar contracture. This article describes prosthetic rehabilitation by modifying the design of the obturator and achieving the retention with dental implant. Discussion. Severe limitation in the oral opening may occur in clinical situations following the postsurgical management of oral and maxillofacial defects. The prosthetic rehabilitation of the surgical defect in such patients becomes a challenging task due to limited access to the oral cavity. This challenge becomes even more difficult if the patient is edentulous and there are no teeth to gain the retention, stability, and support. Conclusion. In severe microstomia prosthesis insertion and removal can be achieved with modification of the maximum width of the prosthesis. Dental implant retention is useful treatment option in edentulous patients with maxillary surgical defect provided that sufficient bone volume and accessibility are there for implant placement. Pravinkumar G. Patil and Smita Nimbalkar-Patil Copyright © 2016 Pravinkumar G. Patil and Smita Nimbalkar-Patil. All rights reserved. A Conservative Approach to a Peripheral Ameloblastoma Thu, 20 Oct 2016 14:36:20 +0000 Peripheral Ameloblastoma (PA) is the rarest variant of ameloblastoma. It differs from the other subtypes of ameloblastoma in its localization: it arises in the soft tissues of the oral cavity coating the tooth bearing bones. Generally, it manifests nonaggressive behavior and it can be treated with complete removal by local conservative excision. In this study we report a case of PA of the maxilla in a 78-year-old female patient and we describe the four different histopathological patterns revealed by histological examination. After local excision and diagnosis, we planned a long term follow-up: in one year no recurrence had been reported. The choice of treatment is illustrated in Discussion. Rocco Borrello, Elia Bettio, Christian Bacci, Marialuisa Valente, Stefano Sivolella, Sergio Mazzoleni, and Mario Berengo Copyright © 2016 Rocco Borrello et al. All rights reserved. A Rare Primary Neuroendocrine Tumor (Typical Carcinoid) of the Sublingual Gland Thu, 20 Oct 2016 13:00:33 +0000 A typical carcinoid is extremely rare in the oral cavity. We here present a case of a typical carcinoid arising in the sublingual gland of a 62-year-old woman. The tumor was removed by primary excision with 10 mm surgical margins and submandibular dissection. Examination of the tumor showed medium-sized tumor cells that were positive for CD56 and chromogranin A, with no necrosis, and with a mitotic count less than 1/10 HPF. A pathological diagnosis of typical carcinoid was made from both morphological and immunological examinations. One year after excision surgery, there was no tumor recurrence or neck metastasis. Kenji Yamagata, Kousuke Ohki, Fumihiko Uchida, Naomi Kanno, Shogo Hasegawa, Toru Yanagawa, and Hiroki Bukawa Copyright © 2016 Kenji Yamagata et al. All rights reserved. The Effect of Mineral Trioxide Aggregate on the Periapical Tissues after Unintentional Extrusion beyond the Apical Foramen Thu, 20 Oct 2016 06:24:53 +0000 Introduction. Single-step apexification procedures using mineral trioxide aggregate (MTA) have been reported as favorable treatment options for teeth with an open apex, posing greater benefits compared to the other available medicaments. However, controlled apical placement of MTA is a challenging procedure to perform using orthograde approach. This case series describes the outcome of the unintentional extrusion of MTA into periradicular tissues during apexification, in three separate cases. Methods. Three adult patients reported to the Department of Conservative Dentistry and Endodontics for the management of maxillary incisors with open apices. After isolation, conventional access, and cleaning and shaping procedures, one-step MTA apexification was performed. On subsequent radiographs, a considerable amount of MTA was seen to be extruded in all the three cases. Results. During follow-up examination the teeth were seen to be asymptomatic in all cases and radiographically demonstrated repair of the periapical lesion. Conclusion. The results of these cases suggest that extrusion of MTA into the periapical tissues does not cause any detrimental effect, which could be attributed to the biologic properties of MTA. Pradnya S. Nagmode, Archana B. Satpute, Ankit V. Patel, and Pushpak L. Ladhe Copyright © 2016 Pradnya S. Nagmode et al. All rights reserved. Peri-Implant Bone Loss and Peri-Implantitis: A Report of Three Cases and Review of the Literature Wed, 19 Oct 2016 14:12:15 +0000 Dental implant supported restorations have been added substantially to the clinical treatment options presented to patients. However, complications with these treatment options also arise due to improper patient selection and inadequate treatment planning combined with poor follow-up care. The complications related to the presence of inflammation include perimucositis, peri-implant bone loss, and peri-implantitis. Prevalence rates of these complications have been reported to be as high as 56%. Treatment options that have been reported include nonsurgical therapy, the use of locally delivered and systemically delivered antibiotics, and surgical protocols aimed at regenerating the lost bone and soft tissue around the implants. The aim of this article is to report on three cases and review some of the treatment options used in their management. Vanchit John, Daniel Shin, Allison Marlow, and Yusuke Hamada Copyright © 2016 Vanchit John et al. All rights reserved. Necrotizing Sialometaplasia of the Hard Palate in a Patient Treated with Topical Nonsteroidal Anti-Inflammatory Drug Wed, 19 Oct 2016 11:11:38 +0000 Necrotizing sialometaplasia is a rare, benign, self-limiting, necrotizing process involving the minor salivary glands, mainly the mucoserous glands of the hard palate. It is thought to be the result of an ischemic event of the vasculature supplying the salivary gland lobules. Some predisposing factors such as smoking, use of alcohol, denture wearing, recent surgery, traumatic injuries, respiratory infections, systemic diseases bulimia, and anorexia have been described. Herein we present a case of necrotizing sialometaplasia of the hard palate in a patient without known predisposing factors, in our opinion, resulting from the use of topical anti-inflammatory drug. After diagnosis, the patient underwent treatment with chlorhexidine gluconate and a full palatal acrylic guard to protect the exposed bone from food residues during meals. After the sixth week the lesion regressed. Alessandro Gatti, Emanuele Broccardo, Giuseppe Poglio, and Arnaldo Benech Copyright © 2016 Alessandro Gatti et al. All rights reserved. Prosthetic Management of a Child with Hypohidrotic Ectodermal Dysplasia: 6-Year Follow-Up Sun, 16 Oct 2016 15:29:17 +0000 Ectodermal dysplasia (ED) is a genetically heterogeneous condition resulting from clinical anomalies of structures derived from the ectoderm, such as the hair, nails, sweat glands, and teeth. This clinical report presents the case of a child diagnosed with hypohidrotic ED at 2 years of age; clinical and imaging evaluation was performed with 6-year follow-up, and we present details of the prosthetic dental care, with a 12-month follow-up. The patient’s masticatory capacity had improved, leading to the child gaining 4 kg. In conclusion, prosthetic management was noninvasive and appeared to lead to developmental benefits for the patient. Antonione Santos Bezerra Pinto, Moara e Silva Conceição Pinto, Cinthya Melo do Val, Leonam Costa Oliveira, Cristhyane Costa de Aquino, and Daniel Fernando Pereira Vasconcelos Copyright © 2016 Antonione Santos Bezerra Pinto et al. All rights reserved. Giant Cell Fibroma in a Two-Year-Old Child Sun, 16 Oct 2016 15:22:48 +0000 The giant cell fibroma is a benign nonneoplastic fibrous tumor of the oral mucosa. It occurs in the first three decades of life in the mandibular gingiva, predominantly, showing predilection for females. This article reports a case of giant cell fibroma in a 2-year-old girl, which is an uncommon age for this lesion. The patient was brought for treatment at the Research and Clinical Center of Dental Trauma in Primary Teeth, where practice for the Discipline of Pediatric Dentistry (Faculty of Dentistry, University of São Paulo, Brazil) takes place. During clinical examination, a tissue growth was detected on the lingual gingival mucosa of the lower right primary incisors teeth. The lesion was excised under local anesthesia and submitted to histological examination at the Oral Pathology Department of the Faculty of Dentistry, University of São Paulo, which confirmed the diagnosis of giant cell fibroma. There was no recurrence after 20 months of monitoring. This instance reinforces the importance of oral care from the very first months of life in order to enable doctors to make precocious diagnosis and offer more appropriate treatments for oral diseases, as well as to promote more efficient oral health in the community. Anna Carolina Volpi Mello-Moura, Ana Maria Antunes Santos, Gabriela Azevedo Vasconcelos Cunha Bonini, Cristina Giovannetti Del Conte Zardetto, Cacio Moura-Netto, and Marcia Turolla Wanderley Copyright © 2016 Anna Carolina Volpi Mello-Moura et al. All rights reserved. Successful Fitting of a Complete Maxillary Denture in a Patient with Severe Alzheimer’s Disease Complicated by Oral Dyskinesia Sun, 16 Oct 2016 09:10:44 +0000 There is an increasing population of elderly patients suffering from Alzheimer’s disease (AD), the most common form of dementia. In dentistry, a critical problem associated with these patients is the use of a new denture, as AD patients often refuse dental management and are disturbed by minor changes in their oral environment. Some AD patients have further complications associated with oral dyskinesia, a movement disorder that can make dental management difficult, including the stability of a complete denture. In this case, we successfully fitted a complete maxillary denture using modified bilateral balanced occlusion after multiple tooth extractions under intravenous sedation in a 66-year-old woman with severe AD complicated by oral dyskinesia. Following treatment, her appetite and food intake greatly improved. Providing a well-fitting complete denture applied by modified bilateral balanced occlusion, which removes lateral interference using zero-degree artificial teeth for movement disorder of the jaw in patients with severe AD complicated by oral dyskinesia, helps improve oral function. Hiromitsu Morita, Akie Hashimoto, Ryosuke Inoue, Shohei Yoshimoto, Masahiro Yoneda, and Takao Hirofuji Copyright © 2016 Hiromitsu Morita et al. All rights reserved. Diastema Closure in Anterior Teeth Using a Posterior Matrix Thu, 13 Oct 2016 12:18:33 +0000 Presence of diastema between anterior teeth is often considered an onerous esthetic problem. Various treatment modalities are available for diastema closure. However, not all diastemas can be treated the same in terms of modality or timing. The extent and the etiology of the diastema must be properly evaluated. Proper case selection is of paramount importance for a successful treatment. In this case report, diastema closure was performed with direct composite restorations. One bottle etch-and-rinse adhesive was used and a single shade was used to close the diastemas. Contoured sectional posterior matrix was used to achieve anatomic contouring of the proximal surfaces of the teeth. This was followed by finishing and polishing using polishing discs. Patient was kept on recall every 6 months. Conclusion. Diastema closure with correct anatomic contouring is easy to perform using the contoured sectional matrices. At 14-month recall, no clinical signs of failure like discoloration or fracture were evident. Also, patient did not complain of any sensitivity. Thus, direct composite restorations serve as durable and highly esthetic restorations leading to complete patient satisfaction. Ayush Goyal, Vineeta Nikhil, and Ritu Singh Copyright © 2016 Ayush Goyal et al. All rights reserved. Eminectomy for Habitual Luxation of the Temporomandibular Joint with Sedation and Local Anesthesia: A Case Series Thu, 13 Oct 2016 07:59:04 +0000 Eminectomy which is one of the popular and most effective treatments for habitual temporomandibular joint luxation was first described by Myrhaug in 1951. There are few reports which described eminectomy being performed under local anesthesia and conscious sedation. We present a case series of habitual luxation of the TMJ treated by eminectomy performed under local anesthesia and conscious sedation and general anesthesia. Five patients were examined and found to have recurrent luxation of the TMJ. The age of patients ranged from 18 to 93 years. Bilateral eminectomy of the TMJ was performed for two patients, and unilateral eminectomy was performed for three patients. Two were examined under intravenous propofol sedation and local anesthesia, while three patients were examined under general anesthesia. One patient died from ileus one month after surgery. The follow-up period except for the case that died from ileus ranged from 12 to 33 months. No recurrent dislocation of the TMJ has been identified. Based on our experience and two other series in the literature, eminectomy with sedation and local anesthesia can be considered and might be a good option in elderly patients. Joe Iwanaga, Yoshiaki Nakamura, Jingo Kusukawa, and R. Shane Tubbs Copyright © 2016 Joe Iwanaga et al. All rights reserved. A Conservative Esthetic Approach Using Enamel Recontouring and Composite Resin Restorations Wed, 12 Oct 2016 13:20:13 +0000 Conservative clinical solutions, predictable esthetic, and immediate outcomes are important concepts of restorative dentistry. The aim of this case study was to recognize the selective enamel removal as an interesting conservative alternative to achieve optimal esthetic results and discuss the clinical protocol. This clinical report described an alternative esthetic and conservative treatment to transform the long and sharp aspect of the maxillary canines with a slightly aggressive aspect into features of slightly curved teeth with delicate lines. An accurate diagnostic and esthetic analysis of the smile was initially performed. The selective enamel removal was performed, and direct composite restoration was strategically placed. Clinical assessment showed good esthetic outcomes, enabling a smile harmony with an immediate, simple, and lower-cost technique. Practitioners should be exposed to conservative approaches to create esthetic smiles based on the selective enamel removal technique combined with composite resin. Paula Mathias, Emily Vivianne Freitas da Silva, Thaiane Rodrigues Aguiar, Aline Silva Andrade, and Juliana Azevedo Copyright © 2016 Paula Mathias et al. All rights reserved. Our Experience in the Management of Traumatic Wound Myiasis: Report of 3 Cases and Review of the Literature Wed, 12 Oct 2016 12:25:00 +0000 Compromised health and hygiene can lead to many complications and one among them is traumatic wound myiasis. Myiasis is the invasion of living tissues by larvae of flies. Three cases of traumatic orofacial wound myiasis and treatment strategies followed for the management of them are reported in this paper. Anand Deep Shukla, Abhay T. Kamath, Adarsh Kudva, Deepika Pai, and Nilesh Patel Copyright © 2016 Anand Deep Shukla et al. All rights reserved. Peripheral Calcifying Epithelial Odontogenic Tumour Mimicking a Gingival Inflammation: A Diagnostic Dilemma Tue, 11 Oct 2016 13:06:15 +0000 The calcifying epithelial odontogenic tumour (CEOT) is an extremely rare benign neoplasia, accounting for approximately 1% of all odontogenic tumours. CEOT can have two clinical manifestations: central or intraosseous (94% of the cases) and peripheral or extraosseous (6% of the cases). Although the latter is less common, the peripheral variant has been described as an insidious lesion, since it is usually asymptomatic and may be erroneously mistaken with gingival hyperplasia, hamartomas, or even metastasis of malignant neoplasia. We report a case of a young male patient presenting with a peripheral CEOT in the mandibular posterior region, mimicking a located gingival inflammation. Danielle Lima Corrêa de Carvalho, Alan Motta do Canto, Fernanda de Paula Eduardo, Letícia Mello Bezinelli, André Luiz Ferreira Costa, and Paulo Henrique Braz-Silva Copyright © 2016 Danielle Lima Corrêa de Carvalho et al. All rights reserved. Treatment of an Erratic Extraction Socket for Implant Therapy in a Patient with Chronic Periodontitis Tue, 11 Oct 2016 09:46:52 +0000 As implant therapy becomes more commonplace in daily practice, preservation and preparation of edentulous sites are key. Many times, however, implant therapy may not be considered at the time of tooth extraction and additional measures are not taken to conserve the edentulous site. While the healing process in extraction sockets has been well investigated and bone fill can be expected, there are cases where even when clinicians perform thorough debridement of the sockets, connective tissue infiltration into the socket can occur. This phenomenon, known as “erratic healing,” may be associated with factors that lead to peri-implant disease and should be appropriately managed and treated prior to surgical implant placement. This case report describes the successful management of an erratic healing extraction socket in a 62-year-old Caucasian male patient with chronic periodontitis and the outcomes of an evidence-based treatment protocol performed prior to implant therapy. Careful preoperative analysis and cone beam computed tomography imaging can help detect signs of impaired healing in future implant sites and prevent surgical complications. Yusuke Hamada, Srividya Prabhu, and Vanchit John Copyright © 2016 Yusuke Hamada et al. All rights reserved. A Case of Lacrimo-Auriculo-Dento-Digital Syndrome with Multiple Congenitally Missing Teeth Mon, 10 Oct 2016 15:01:08 +0000 Lacrimo-auriculo-dento-digital (LADD) syndrome is an extremely rare disorder which may occur sporadically or inheritably as an autosomal dominant condition. It is characterized by defects in the lacrimal apparatus, ear problems, and dental and digital abnormalities. However, specific symptoms vary greatly among the cases with a high degree of overlap with other similar genetic disorders. Here, we describe a 7-year-old boy with LADD syndrome, clinical and radiological findings, dental treatment undertaken, and its differential diagnosis. Lumbini Pathivada, Munagala Karthik Krishna, and Mandeep Rallan Copyright © 2016 Lumbini Pathivada et al. All rights reserved. Concrescence: Cone-Beam Computed Tomography Imaging Perspective Sun, 09 Oct 2016 12:23:56 +0000 Concrescence is a form of twinning, formed by the confluence of cementum of two teeth at the root level. The diagnosis of concrescence has largely relied on the conventional 2D imaging. The 2D imaging has inherent limitations such as distortion and superimposition. Cone-Beam CT eliminates these limitations. The aim of this article was to describe a case of dental abnormality using Cone-Beam CT imaging modality. Volumetric data demonstrated confluence of left mandibular third molar with a paramolar, a supernumerary tooth. To our knowledge, this is the second case in the dental literature reported demonstrating the use of Cone-Beam CT in the diagnosis of concrescence. Ali Zakir Syed, LeelaSubhashini Choudary Alluri, Dhiraj Mallela, and Troy Frazee Copyright © 2016 Ali Zakir Syed et al. All rights reserved. Orthodontic Traction of Impacted Canine Using Cantilever Sun, 09 Oct 2016 11:41:15 +0000 The impaction of the maxillary canines causes relevant aesthetic and functional problems. The multidisciplinary approach to the proper planning and execution of orthodontic traction of the element in question is essential. Many strategies are cited in the literature; among them is the good biomechanical control in order to avoid possible side effects. The aim of this paper is to present a case report in which a superior canine impacted by palatine was pulled out with the aid of the cantilever on the Segmented Arch Technique (SAT) concept. A 14.7-year-old female patient appeared at clinic complaining about the absence of the upper right permanent canine. The proposed treatment prioritized the traction of the upper right canine without changing the occlusion and aesthetics. For this, it only installed the upper fixed appliance (Roth with slot 0.018), opting for SAT in order to minimize unwanted side effects. The use of cantilever to the traction of the upper right canine has enabled an efficient and predictable outcome, because it is of statically determined mechanics. Cláudia Nakandakari, João Roberto Gonçalves, Daniel Serra Cassano, Taísa Boamorte Raveli, Jonas Bianchi, and Dirceu Barnabé Raveli Copyright © 2016 Cláudia Nakandakari et al. All rights reserved. Bimaxillary Aneurismal Bone Cyst in Patient with End Stage Renal Disease and Hyperparathyroidism: A Rare Case Report and Review of the Literature Wed, 05 Oct 2016 14:05:32 +0000 Aneurismal bone cyst (ABC) is a rare bony lesion occurring predominantly in long bones. Its jaws’ involvement is uncommon and the simultaneous involvement of both jaws is very rare. This report is about a 27-year-old female experiencing renal failure with ABC involving her maxilla and mandible. The progressive lesion was treated surgically and there was no recurrence after 18 months of follow-up. Sedigheh Bakhtiari, Mahin Bakhshi, Fatemeh Mashhadiabbas, Hasan Mir Mohammad Sadeghi, Zahra Elmi Rankohi, and Somayeh Rahmani Copyright © 2016 Sedigheh Bakhtiari et al. All rights reserved. Removal of Separated Endodontic K-File with the Aid of Hypodermic Needle and Cyanoacrylate Mon, 03 Oct 2016 14:13:59 +0000 A wide range of accidents might happen during the treatment of the root canal system, where the instrument separation is one of the most unpleasant occurrences. Several techniques have been developed to facilitate the removal of the fragments; however, they generally require specific devices that not always are available to the clinician. The aim of this case report is to present a simple alternative technique to remove from the root canals manual instruments fractured during the treatment. The case has its outline based on a 31-year-old patient who sought the clinic to have her maxillary first left premolar rehabilitated. The clinic and radiographic examinations revealed the need of endodontic retreatment and the presence of a fragment of a K-file instrument localized at the apical third of the palatine canal. The retreatment was initiated by the removal of the obturation materials followed by several unsuccessful attempts to take out the fractured instrument. Hence, it was chosen to perform the fragment removal using a hypodermic needle and cyanoacrylate adhesive. The fragment easily came out, which reinforces the technique adopted as a safe, simple, and low cost mean to solve the problem of fractured instruments using only items already present in the endodontic arsenal. Luciana Maria Arcanjo Frota, Bernardo Almeida Aguiar, Maria Gerusa Brito Aragão, and Bruno Carvalho de Vasconcelos Copyright © 2016 Luciana Maria Arcanjo Frota et al. All rights reserved. Sinus Augmentation by Platelet-Rich Fibrin Alone: A Report of Two Cases with Histological Examinations Mon, 03 Oct 2016 12:40:42 +0000 In sinus floor augmentation of an atrophic posterior maxilla, platelet-rich fibrin (PRF) has been used as a graft material. We herein report two cases with histological evaluations of PRF after the surgery. The first case was a 28-year-old female with an atrophic right posterior maxilla who was treated with sinus floor augmentation and simultaneous implant placement using PRF as the sole graft material in our hospital. Twenty-four months after surgery, the implant was unfortunately removed because of occlusal overloading by parafunctional habits. During implant replacement, a tissue sample was obtained from the site of augmentation with PRF and was evaluated histologically. The second case was a 58-year-old man with severe alveolar atrophy of the right maxilla who underwent lateral sinus augmentation using only PRF in a two-stage procedure in our hospital. Samples were obtained at the second-stage surgery and histological examinations were performed. As a result, new bone formation was confirmed histologically in both cases. Our findings show that the use of PRF as a graft material during sinus floor augmentation induces natural bone regeneration. Naofumi Aoki, Takeo Kanayama, Michinori Maeda, Koichiro Horii, Hironori Miyamoto, Keinoshin Wada, Yasutaka Ojima, Tsukasa Tsuchimochi, and Yasuyuki Shibuya Copyright © 2016 Naofumi Aoki et al. All rights reserved. Late-Developing Supernumerary Premolars: Analysis of Different Therapeutic Approaches Wed, 28 Sep 2016 14:33:11 +0000 This case series describes the different potential approaches to late-developing supernumerary premolars (LDSP). LDSP are supernumerary teeth (ST) formed after the eruption of the permanent dentition; usually they develop in the premolar region of the upper and lower jaw. The choice to extract or to monitor the LDSP depends on many factors and has to be carefully planned due to the several risks that either the monitoring or the extraction could provoke. These four cases of LDSP showed different treatment plan alternatives derived from a scrupulous assessment of the clinical and radiographic information. Sergio Paduano, Roberto Rongo, Alessandra Lucchese, Domenico Aiello, Ambrosina Michelotti, and Cristina Grippaudo Copyright © 2016 Sergio Paduano et al. All rights reserved. Value of Magnetic Resonance Imaging for Diagnosis of Dentigerous Cyst Tue, 27 Sep 2016 09:49:22 +0000 Odontogenic cysts have a high prevalence in the dental clinic population, with dentigerous cyst being one of the most frequent ones and whose aetiology involves accumulation of fluid between the reduced enamel epithelium and the crown of an unerupted tooth. In the diagnostic process of these lesions, one should consider complementary imaging exams such as conventional radiography and computed tomography, which are commonly used for providing anatomical information on the tissues compromised by the lesion, but not on the nature of it. Magnetic resonance imaging (MRI) scans are noninvasive modalities which, due to their unique acquisition characteristics, can provide distinct information on the nature of the lesion. This study reports on a case of dentigerous cyst in the mandible of a 9-year-old patient, documented by means of different imaging modalities. MRI played an important role in both diagnosis of the lesion and differential diagnosis between neoplastic lesions presenting similar imagenological behaviour under other techniques of radiography. Antonione Santos Bezerra Pinto, André Luiz Ferreira Costa, Neiandro dos Santos Galvão, Thásia Luiz Dias Ferreira, and Sérgio Lúcio Pereira de Castro Lopes Copyright © 2016 Antonione Santos Bezerra Pinto et al. All rights reserved. Ectopic Thyroid at the Base of the Tongue of a Young Patient Mon, 26 Sep 2016 08:39:51 +0000 Lingual thyroid is defined as an ectopic thyroid gland tissue located in the midline of the tongue base and it is uncommonly observed in clinical practice and is rare in children. This paper describes the surgical treatment of ectopic thyroid at the base of the tongue in a child. The chief complaint of the 12-year-old, melanodermic female patient was the difficulty to swallow for 15 days. The intraoral physical examination barely showed a nodular lesion at tongue base. The CT scan showed a round, well defined hyperdense lesion of approximately 25.8 mm at its largest diameter, with infiltrative growth in the posterior region of the base of the tongue. The proposed treatment was complete resection of the lesion. The histopathological diagnosis was lingual thyroid. After the diagnosis was established, the patient was referred to an endocrinologist for exams and medical follow-up. Lingual thyroid is a rare condition and its diagnosis in children is even rarer. Its approach should be transdisciplinary and should take into consideration the hormonal aspects of the patient in addition to the clinical condition of the lesion. In the presented case, the removal of the alteration was performed via conservative surgical procedure followed by immediate referral of the patient to the endocrinologist for a follow-up. Paulo Henrique de Souza Castro, Luiz Evaristo Ricci Volpato, Julia Tramujas, and Alvaro Henrique Borges Copyright © 2016 Paulo Henrique de Souza Castro et al. All rights reserved. Quality of Life Following Early Orthodontic Therapy for Anterior Crossbite: Report of Cases in Twin Boys Thu, 22 Sep 2016 14:27:26 +0000 Anterior crossbite (AC) refers to a condition in which the maxillary anterior teeth are placed lingually in their relationship with the mandibular anterior teeth. This dental condition results in visible incisor differences that are associated with higher levels of dissatisfaction with appearance and have potential to negatively impact on oral health-related quality of life (OHRQoL) of the children. The aim of this paper was to report two cases of interceptive orthodontic treatment of twin children with anterior crossbite and its impact on OHRQoL of these children. Although AC affects negatively psychosocial aspects of OHRQoL of the children, the interceptive orthodontic treatment of children with AC was essential to improve their OHRQoL. Eluza Piassi, Leonardo Santos Antunes, Marcia Rejane Thomas Canabarro Andrade, and Lívia Azeredo Alves Antunes Copyright © 2016 Eluza Piassi et al. All rights reserved. Cementoblastoma Relating to Right Mandibular Second Primary Molar Thu, 22 Sep 2016 12:37:43 +0000 Cementoblastoma is a benign lesion of the odontogenic ectomesenchymal origin. It rarely occurs in primary dentition. This report describes a case of a cementoblastoma relating to the right mandibular second primary molar in a 7-year-old girl. Her panoramic radiograph revealed a well-defined radiopaque lesion with a radiolucent border extending from the distal surface of the mandibular right first primary molar to the distal surface of mandibular second primary molar. The tumor was attached to the mesial root of primary second molar and was excised along with the teeth involved and sent for histopathological evaluation, which showed irregular trabeculae of mineralized tissue interspersed with fibrovascular connective tissue, trabeculae of mineralized tissue with prominent reversal lines, and peripheral rimming of the mineralized tissue with blast cells. On a six-month follow-up, there has been no recurrence of the lesion. Sivakumar Nuvvula, Swapna Manepalli, Abinash Mohapatra, and Sreekanth Kumar Mallineni Copyright © 2016 Sivakumar Nuvvula et al. All rights reserved. Hard and Soft Tissue Management of a Localized Alveolar Ridge Atrophy with Autogenous Sources and Biomaterials: A Challenging Clinical Case Wed, 21 Sep 2016 12:26:55 +0000 Particularly in the premaxillary area, the stability of hard and soft tissues plays a pivotal role in the success of the rehabilitation from both a functional and aesthetic aspect. The present case report describes the clinical management of a localized alveolar ridge atrophy in the area of the upper right canine associated with a thin gingival biotype with a lack of keratinized tissue. An autogenous bone block harvested from the chin associated with heterologous bone particles was used to replace the missing bone, allowing for a prosthetic driven implant placement. Soft tissues deficiency was corrected by means of a combined epithelialized and subepithelial connective tissue graft. The 3-year clinical and radiological follow-up demonstrated symmetric gingival levels of the upper canines, with physiological peri-implant probing depths and bone loss. Thus, the use of autogenous tissues combined with biomaterials might be considered a reliable technique in case of highly aesthetic demanding cases. C. Maiorana, D. Andreoni, and P. P. Poli Copyright © 2016 C. Maiorana et al. All rights reserved. Interdisciplinary Management of Maxillary Canine Buccal Ectopia Associated with Peg Shaped Lateral Incisor Tue, 20 Sep 2016 12:02:52 +0000 Aligning a displaced maxillary canine into the dental arch is one of the most complicated problems in orthodontics. In cases of extremely high displacement, the tooth is frequently removed surgically. Because of the upper canines’ significance to dental esthetics and functional occlusion, such a decision is a very serious one. The purpose of this report is to illustrate an interdisciplinary approach involving both orthodontic management and conservative tooth restoration. The case was treated through an orthodontic nonextraction fixed appliance mechanotherapy for successful alignment of buccally ectopic upper left canine followed by a conservative direct composite tooth buildup of peg lateral incisor associated with the upper left ectopic canine in a 16-year-old adolescent North Indian female. Posttreatment records demonstrated good alignment of the displaced tooth and restoration of normal anatomy of the peg shaped lateral incisor. Karuna Singh Sawhny and Asheesh Sawhny Copyright © 2016 Karuna Singh Sawhny and Asheesh Sawhny. All rights reserved. Root Canal Stripping: Malpractice or Common Procedural Accident—An Ethical Dilemma in Endodontics Thu, 08 Sep 2016 12:08:49 +0000 Root canal stripping is defined as an oblong, vertical perforation that appears especially in the middle section of curved root canals during endodontic treatments with nickel-titanium (Ni-Ti) instruments. Its occurrence may drastically affect the outcome of the treatment, transforming a common otherwise efficient endodontic procedure into a complication such as tooth extraction. In order to discuss the ethical and legal consequences, two cases of dental strip perforations are herewith presented. Due to the existence of risk factors for dental strip perforation, experience of the clinician and the use of magnification and modern imagistic methods (CBCT) may avoid or reduce the frequency of this type of accidents. Under correct working circumstances, dental stripping should not be regarded as a malpractice but as a procedural accident. However, the patient must always be informed, before and during the endodontic procedure, about the event and the possible complications that may occur. Ionela Elisabeta Ciobanu, Darian Rusu, Stefan-Ioan Stratul, Andreea Cristina Didilescu, and Corina Marilena Cristache Copyright © 2016 Ionela Elisabeta Ciobanu et al. All rights reserved. Medication-Related Osteonecrosis of Jaws: A Low-Level Laser Therapy and Antimicrobial Photodynamic Therapy Case Approach Wed, 07 Sep 2016 16:44:45 +0000 Medication-related osteonecrosis of the jaws (MRONJ) can be considered an inability of the alveolar bone to respond to an injury, which frequently leads to severe local and systemic complications. Once the problem is installed, dentist must use all therapeutic approaches recommended. This manuscript reports a successful management of MRONJ handled with antibiotics, conservative debridement, low-level laser therapy (LLLT), and photodynamic therapy (PDT) up to 12 months. As healing of MRONJ may be very slow, combined therapeutic approaches are required. Besides the recommended conventional treatment protocol, LLLT and PDT are important tools to contribute to healing and improvement of patient’s quality of life. Mariana Comparotto Minamisako, Guilherme Henrique Ribeiro, Mariáh Luz Lisboa, Mabel Mariela Rodríguez Cordeiro, and Liliane Janete Grando Copyright © 2016 Mariana Comparotto Minamisako et al. All rights reserved.