Case Reports in Dentistry https://www.hindawi.com The latest articles from Hindawi © 2017 , Hindawi Limited . All rights reserved. Unusual Etiology and Diagnosis of Oroantral Communication due to Late Implant Failure Tue, 03 Oct 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/2595036/ Oroantral communication (OAC) rarely occurs long after implant placement. The present report describes the rare etiology and the difficulty of the diagnosis of an uncommon OAC occurring 10 years after the implant placement in the posterior maxilla. The difficulty of the diagnosis lies in the absence of clinical symptoms of sinusitis and presence of multiunit prosthesis hiding implant failure. This case report supports the need for sinus check-up during a routine implant examination. Rabah Nedir, Nathalie Nurdin, Marion Paris, Marc El Hage, Semaan Abi Najm, and Mark Bischof Copyright © 2017 Rabah Nedir et al. All rights reserved. Prosthetic Rehabilitation of Child Victim of Avulsion of Anterior Teeth with Orthodontic Mini-Implant Thu, 28 Sep 2017 13:05:25 +0000 http://www.hindawi.com/journals/crid/2017/8905965/ The treatment of choice in cases of avulsed permanent teeth is the immediate reimplantation. However, this conduct does not always work favorably, either by failures in the initial approach or by inappropriate interventions. In this sense, the aim of this study is to present an alternative prosthetic rehabilitation with the use of orthodontic mini-implants in the anterior region. This case reports a ten-year-old child with history of avulsion of superior central incisors. The therapeutic approach was planned to promote physiological teeth contacts and acceptable esthetics and phonetics. First, the occlusal-gingival insertion of two orthodontic mini-implants was performed in the alveolar ridge, and, immediately after that, two provisional crowns were attached to the implants. The interventions achieved satisfactory cosmetic and functional results. After one-year follow-up, the adjacent periodontal tissues remained without signs and/or symptoms of inflammation. The provisional crowns presented no mobility and fractures. During radiographic examination, a healthy bone tissue appearance was observed. The simplicity of mini-implant installation makes them a promising alternative for temporary prosthetic rehabilitation of patients undergoing growth and development. The technique provides positive aesthetic and functional results that may reflect on self-esteem and social inclusion of children and adolescents. Natalice Sousa de Oliveira, Gabriella Lopes de Rezende Barbosa, Lincoln Dias Lanza, and Henrique Pretti Copyright © 2017 Natalice Sousa de Oliveira et al. All rights reserved. Tooth Reattachment and Palatal Veneer on a Multidisciplinary Approach of Crown Fractures in Upper Central Incisors Tue, 26 Sep 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/4702635/ Dental trauma is more common in young patients and its sequelae may have great impact on the esthetics, functions, and phonetics. This paper reports a case of trauma in both central incisors in a young 17-year-old patient who was treated using adhesive tooth fragment reattachment on tooth 2.1 and a palatal indirect composite veneer on tooth 1.1. Regarding the available literature and fracture extension, the treatment approach proposed for this case provided good functional and esthetic outcomes. Clinical and radiographic results after 1 year were successful. This case demonstrates the importance of establishing a multidisciplinary approach for successful dental trauma management. Vanessa Machado, Ricardo Alves, Luísa Lopes, João Botelho, and José João Mendes Copyright © 2017 Vanessa Machado et al. All rights reserved. Atypical Afta Major Healing after Photodynamic Therapy Wed, 20 Sep 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/8517470/ The aim of this study is to report a case of atypical Afta Major healing in a patient with recurrent aphthous stomatitis (SAR) with a type of photodynamic therapy. A female patient with SAR affected for about 2 years reported a history of hypothyroidism treated with Levothyroxine. The oral cavity clinical examination showed several major symptomatic ulcers, previously treated with topical and systemic therapies without any benefit. The largest of them is present for more than 40 days, in spite of topical cortisone applications, with significant pain symptoms reported by the patient. It was decided to perform a session of photodynamic therapy with a device that emits a LED light used in combination with a photosensitive reagent (Toluidine blue). The dye was applied on the entire surface of the lesion beyond the margins and even encroaching on healthy tissue. The light diode was turned on with a wavelength of 630 nm with cycles from 30 seconds, 10 consecutive times above it. After a few days, a curious phenomenon happened: healing of Afta Major starting from the center, which was almost completely healed towards the borders of the lesion. No previous literature reports this type of healing. Photodynamic therapy could be a successful treatment for SAR. Cinzia Casu and Carla Mannu Copyright © 2017 Cinzia Casu and Carla Mannu. All rights reserved. Pulpo-Periodontal Regeneration: Management of Partial Failure Revascularization Sun, 17 Sep 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/8302039/ The aim of this work is to present a case of management of an open apex on a lower molar by using tissue engineering, with two endodontic procedures in the same tooth. We had to resort to pulp regeneration on the distal root and apexification with MTA on the mesial roots after the failure of regenerative therapy on those ones. The management consisted in scheduling regular follow-ups combined with X-rays. After 24 months, the radiological control has shown pulpo-periodontal regeneration associated with walls thickening and distal root elongation and periapical ad integrum healing. Said Dhaimy, Sara Dhoum, Hind Amarir, Hafsa El Merini, Sellama Nadifi, and Amal El Ouazzani Copyright © 2017 Said Dhaimy et al. All rights reserved. Mandibular Canines with Two Roots and Two Root Canals: Case Report and Literature Review Wed, 13 Sep 2017 07:25:46 +0000 http://www.hindawi.com/journals/crid/2017/8459840/ Usually, the mandibular canine only has one root and one root canal. However, there has been a noticeable increment in evidence showing variations in its morphology, such as the presence of two roots and two root canals. The aim of this article was to present a case of a mandibular canine with two roots and two root canals and to review the available literature on this anatomic variation. Root canal treatment of tooth #43 with such morphology was performed in a 47-year-old woman. Careful inspection of the preoperative radiograph indicated the presence of more than one canal. The 12-month follow-up showed normal periapical tissues, with no pain or tenderness. Literature review revealed that the overall prevalence of such root canal configuration is 5.7%, with a strong preference for female sex (87.5%). Although mandibular canines with two roots and two root canals are not common, clinicians should always anticipate the presence of possible variations. Therefore, timely diagnosis and meticulous exploration of such mandibular canines allow for planning of an individualized treatment protocol, tailored to their peculiar morphology, focused on avoiding excessive weakening or even perforation of the roots. Hugo Plascencia, Álvaro Cruz, Gerardo Gascón, Beatriz Ramírez, and Mariana Díaz Copyright © 2017 Hugo Plascencia et al. All rights reserved. Plummer Vinson Syndrome: A Rare Syndrome in Male with Review of the Literature Mon, 28 Aug 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/6205925/ Introduction. Plummer Vinson syndrome also known as Paterson Brown-Kelly syndrome is a syndrome associated with the triad of symptoms comprising microcytic hypochromic anemia, oesophageal strictures, and dysphagia. PVS is commonly found in women of middle age especially in the fourth and fifth decade of life and is rarely reported in males. Case Report. The authors report a case of 43-year-old male patient who presented with the classic symptoms of Plummer Vinson syndrome. Conclusion. Dentists have to be familiar with symptoms of PVS and a thorough clinical examination of the patient is necessary for early diagnosis and treatment. As PVS is a precancerous condition with high malignant potential, early diagnosis is of utmost importance for better prognosis. Clinical Significance. Mutual interaction of systemic and oral health has largely been underestimated by many patients in the developing countries and hence this report includes a note on importance of adequate medical history taking and its relevance to the dental health and treatment. Priyadarshini Karthikeyan, Nalini Aswath, and Ramesh Kumaresan Copyright © 2017 Priyadarshini Karthikeyan et al. All rights reserved. The Protocol of Fixed Reconstruction for Severely Worn Teeth Combined with Anterior Deep Bite Wed, 23 Aug 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/9378091/ Full mouth reconstruction is one of the most effective methods to restore severe worn teeth that have suffered reduced vertical dimension. Although the use of the overlay splint restoration for a trial period allowing the patient to adapt to an increased vertical dimension is the recognized method, the specific protocol from the transitional splint to the fixed reconstruction is yet to be established. This case report describes a 50-year-old female patient who has severely worn teeth combined with an anterior deep bite and chewing pain. The protocol of the treatment process is described. Ya-Wen Zhao, Rong Gao, and Hui-Qiang Sun Copyright © 2017 Ya-Wen Zhao et al. All rights reserved. A Step-by-Step Conservative Approach for CAD-CAM Laminate Veneers Sun, 13 Aug 2017 09:29:59 +0000 http://www.hindawi.com/journals/crid/2017/3801419/ The use of CAD/CAM technology has allowed the fabrication of ceramic restorations efficiently and with predictable results. Lithium disilicate is a type of glass ceramic material that can be used for the elaboration of laminate veneers, being monolithic restorations which require characterization through a covering ceramic in order to achieve acceptable esthetic results. The next case report shows a predictable clinical protocol for the rehabilitation of the anterior teeth through the preparation of CAD/CAM veneers (e.max CAD, Ivoclar Vivadent, Liechtenstein) which have been characterized by a nanofluorapatite ceramic (e.max Ceram, Ivoclar Vivadent, Liechtenstein) through the layering technique. Gerardo Durán Ojeda, Ismael Henríquez Gutiérrez, Álvaro Guzmán Marusic, Abelardo Báez Rosales, and José Pablo Tisi Lanchares Copyright © 2017 Gerardo Durán Ojeda et al. All rights reserved. Dental Implant in the Canalis Sinuosus: A Case Report and Review of the Literature Tue, 08 Aug 2017 06:45:47 +0000 http://www.hindawi.com/journals/crid/2017/4810123/ The canalis sinuosus is a neurovascular canal, a branch of nerve of infraorbital canal, through which the anterior superior alveolar nerve passes and then leans medially in course between the nasal cavity and the maxillary sinus, reaching the premaxilla in the canine and incisor region. The purpose of this article is to report a case with the presence of canalis sinuosus, in order to alert and guide professionals and discuss the morphology of this anatomical variation avoiding trans- and postsurgical disorders in dental implants. A 51-year-old female was attended to in a radiology clinic, reporting paresthesia in the right upper lip region and painful symptomatology after the installation of an implant in the corresponding region. The case revealed the presence of canalis sinuosus in imaging exams. The knowledge of this anatomical variation is essential for professionals, because attention to this region prevents irreversible damage. Therefore, the use of imaging examinations is recommended during the planning stages and treatment and after surgery in patients undergoing surgery in this area. José Alcides Arruda, Pedro Silva, Luciano Silva, Pâmella Álvares, Leni Silva, Ricardo Zavanelli, Cleomar Rodrigues, Marleny Gerbi, Ana Paula Sobral, and Marcia Silveira Copyright © 2017 José Alcides Arruda et al. All rights reserved. Revascularization in Immature Permanent Teeth with Necrotic Pulp and Apical Pathology: Case Series Thu, 03 Aug 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/3540159/ Introduction. To present and discuss the results of five clinical cases treated using the revascularization protocol, showing clinical and radiographic monitoring. Necrotic immature teeth with periapical pathology present a challenge to dentists because the techniques used in apexification leave the tooth susceptible to fracture, since the root does not continue to grow in length and the canal walls are thin. Revascularization has emerged as an alternative to resolve these deficiencies, enabling apical closure, continued development of the roots, and thickening of the dentinal walls. Case Series. Five clinically and radiographically diagnosed necrotic immature permanent teeth were treated using revascularization treatment. The therapeutic protocol involved accessing the pulp chamber; irrigating copiously with NaOCl; applying a triple antibiotic paste as intracanal dressing; then provisionally sealing it. After 3 weeks, the canal was cleaned and the apex irritated with a size 15 K-file to induce blood that would serve as a scaffold for pulp revascularization. MTA was used to seal the chamber before final obturation (composite or metallic crown). Conclusion. The discussion of the results leads to debate about different restorative materials and other published protocols. López Carmen, Mendoza Asunción, Solano Beatriz, and Yáñez-Vico Rosa Copyright © 2017 López Carmen et al. All rights reserved. Cosmetic Remodeling of the Smile: Combining Composite Resin and Ceramics over Teeth and Implants Thu, 03 Aug 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/8698010/ The aim of this paper is to describe a restorative approach to the cosmetic remodeling of the teeth of a young adult patient with right maxillary lateral hypodontia and left lateral microdontia. A conservative restorative management was proposed to improve smile esthetics by combining direct composite resins and ceramics. Initially, periodontal therapy and dental bleaching were performed. Subsequently, direct composite resins were applied to the central incisors and canines to reestablish the sizes and shapes of these teeth. Finally, ceramics were placed on the implant and the microdontia to unite with the new alignment and color of the anterior teeth. Thus, conservative remodeling to improve the harmony of the smile was provided. Leonardo Fernandes da Cunha, Ubiracy Gaião, Rafael Coutinho Silva, Carla Castiglia Gonzaga, and Gisele Maria Correr Copyright © 2017 Leonardo Fernandes da Cunha et al. All rights reserved. Restorative Rehabilitation of a Patient with Dental Erosion Sun, 30 Jul 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/9517486/ Dental erosion is the chemical dissolution of the tooth structure. Factors like eating disorders and gastrointestinal diseases are recognized as intrinsic factors for dental erosion. Advanced stages of dental erosion extensively damage the tooth morphology, consequently affecting both esthetics and functions. Reports indicate the growing prevalence of erosion, and hence knowledge of restorative rehabilitation of tooth erosion is an integral part of the contemporary dental practice. This clinical report describes an adult patient with gastroesophageal reflux induced dental erosion involving the palatal surface of the maxillary anterior teeth. The extensive involvement of the palatal surfaces compromised the esthetics, incisal guidance, and functional occlusal efficiency. Indirect all-ceramic restorations were utilized to restore the esthetics and occlusal reconstruction. In conclusion, patients affected by severe dental erosion require prosthetic rehabilitation besides the management of the associated medical condition. Mohammed Thamer AlShahrani, Satheesh B. Haralur, and Mohammed Alqarni Copyright © 2017 Mohammed Thamer AlShahrani et al. All rights reserved. A CAD/CAM Zirconium Bar as a Bonded Mandibular Fixed Retainer: A Novel Approach with Two-Year Follow-Up Thu, 27 Jul 2017 08:21:04 +0000 http://www.hindawi.com/journals/crid/2017/1583403/ Stainless steel alloys containing 8% to 12% nickel and 17% to 22% chromium are generally used in orthodontic appliances. A major concern has been the performance of alloys in the environment in which they are intended to function in the oral cavity. Biodegradation and metal release increase the risk of hypersensitivity and cytotoxicity. This case report describes for the first time a CAD/CAM zirconium bar as a bonded mandibular fixed retainer with 2-year follow-up in a patient who is subjected to long-term treatment with fixed orthodontic appliance and suspected to have metal hypersensitivity as shown by the considerable increase of nickel and chromium concentrations in a sample of patient’s unstimulated saliva. The CAD/CAM design included a 1.8 mm thickness bar on the lingual surface of lower teeth from canine to canine with occlusal rests on mesial side of first premolars. For better retention, a thin layer of feldspathic ceramic was added to the inner surface of the bar and cemented with two dual-cured cement types. The patient’s complaint subsided 6 weeks after cementation. Clinical evaluation appeared to give good functional value where the marginal fit of digitized CAD/CAM design and glazed surface offered an enhanced approach of fixed retention. Maen Zreaqat, Rozita Hassan, and Abdul Fatah Hanoun Copyright © 2017 Maen Zreaqat et al. All rights reserved. Aberrations Causing Neurovascular Damage in the Anterior Maxilla during Dental Implant Placement Thu, 13 Jul 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/5969643/ When dental implants are being considered for placement in the maxillary central incisor region, proximity to the nasopalatine canal and its contents needs to be accounted for. The morphology of the canal changes with age. The availability of CBCT has allowed the in-depth analysis of this important variable anatomy. However, an associated important anatomical structure can be easily overlooked: the “canalis sinuosus.” This is a neurovascular canal carrying the anterior superior alveolar (ASA) nerve and artery. CBCT frequently shows the canalis sinuosus (CS) as a wide canal lateral to the nasal cavity and also under the anterior part of the nasal floor in close proximity to the NPC. The CS distributes both neural supply and vascular supply to the maxillary anterior teeth which on CBCT sagittal analysis are seen as very fine circular canals having nondistinct walls. The author presents a case history of dental implant placement in the anterior maxilla which resulted in neurovascular disturbance as a result of invasion of the nasopalatine duct and injury to its contents together with the unidentified injury to an aberrant well-defined neurovascular canal inferior to the canalis sinuosus. Shane J. J. McCrea Copyright © 2017 Shane J. J. McCrea. All rights reserved. Comment on “World’s First Clinical Case of Gene-Activated Bone Substitute Application” Wed, 12 Jul 2017 09:09:05 +0000 http://www.hindawi.com/journals/crid/2017/4383926/ Albert A. Rizvanov and Ruslan F. Masgutov Copyright © 2017 Albert A. Rizvanov and Ruslan F. Masgutov. All rights reserved. Diagnostic Workup and Treatment of a Rare Apocrine Hidrocystoma Affecting the Oral Mucosa: A Clinical and Histological Case Report Tue, 11 Jul 2017 07:43:32 +0000 http://www.hindawi.com/journals/crid/2017/9382812/ Apocrine hidrocystomas are rare benign cystic tumors originating from the secretory portion of apocrine sweat glands. To the best of our knowledge, there is no evidence currently available reporting the presence of apocrine hidrocystomas in the oral cavity. Therefore, this case report aims to describe the clinical and histological features of an apocrine hidrocystoma affecting the oral mucosa. A 69-year-old male patient presented with a 1-year history of a solitary, well-circumscribed, submucosal mass in the left posterior buccal mucosa. The clinical examination revealed a yellowish soft, fluctuant, and painless lesion with no clinical signs of erythema or ulcerations of the overlying epithelium. The entire lesion was excised and histopathological analysis confirmed the diagnosis of apocrine hidrocystoma. No recurrence was observed after a 1-year follow-up. Pier Paolo Poli, Luca Creminelli, Valeria Moramarco, Alessandro Del Gobbo, Franco Ferrante, and Carlo Maiorana Copyright © 2017 Pier Paolo Poli et al. All rights reserved. Comprehensive Treatments for Congenitally Missing Teeth and Generalized Diastema Mon, 10 Jul 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/3254873/ Congenitally missing teeth and/or hypodontia is a prevalent dental anomaly. There are different treatment options available for these conditions such as space maintenance, restoring the space by resin-bonded-fixed-partial-dentures (RBFPDs), and dental implants. This study addresses the comprehensive treatments for congenitally missing tooth and diastema using interdisciplinary approaches. One patient was treated with small-diameter-implants and the other one was treated using an intraoral scanner to make digital impression and fabricating RBFPDs with CAD/CAM system. Both patients were completely satisfied. Mehran Bahrami, Fariba Saleh Saber, and Amirreza Hendi Copyright © 2017 Mehran Bahrami et al. All rights reserved. Selectable Implant Removal Methods due to Mechanical and Biological Failures Wed, 05 Jul 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/9640517/ Dental implant has been restoring the function and esthetics lost from missing tooth. However, biomechanical implant complications are the major cause of failing implants. Therefore, implant removal is one of the indispensable dental treatments. The 70-year-old male and 66-year-old female who had discomfort on posterior implants region came to Department of Periodontology. Conventional method using trephine bur and the new, nontraumatic method using a fixture removal kit were used for implant removal, respectively. Two different methods are commonly used for implant removal. Each has advantages and disadvantages; thus, the applied surgical method must consider a patient’s intraoral condition, posttreatment plan, and the level of surgeon’s skill and experience. In conclusion, strategically executing the most optimal implant removal method plays a pivotal role in maximizing the success rate of implant reinstallation that follows afterwards. Jong-Bin Lee Copyright © 2017 Jong-Bin Lee. All rights reserved. Differences in Healing of a Horizontal Root Fracture as Seen on Conventional Periapical Radiography and Cone-Beam Computed Tomography Tue, 04 Jul 2017 09:09:27 +0000 http://www.hindawi.com/journals/crid/2017/2728964/ Different locations and healing patterns of horizontal root fractures bear different prognoses. Conventional periapical radiographs have been routinely used for the evaluation of the locations and healing of horizontal root fractures, with the limitation of presenting two-dimensional images. The three-dimensional imaging technology, cone-beam computed tomography (CBCT), has recently gained interest in dental traumatology, in particular for locating and diagnosing root fractures. However, the assessment of healing patterns of horizontal root fracture using CBCT compared to conventional radiographs has not been established. This case report describes the different healing patterns evaluated by two-dimensional radiographs and CBCT of a horizontally root-fractured maxillary right central incisor treated with mineral trioxide aggregate (MTA) with a two-year follow-up. The findings suggest that the healing patterns of horizontal root fractures seen on conventional radiographs and CBCT may be different. Ronnachat Rothom and Patchanee Chuveera Copyright © 2017 Ronnachat Rothom and Patchanee Chuveera. All rights reserved. Orthodontic Treatment and Maxillary Anterior Segmental Distraction Osteogenesis of a Subject with Williams–Beuren Syndrome and Isolated Cleft Palate: A Long-Term Follow-Up from the Age of 5 to 24 Years Tue, 04 Jul 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/7019045/ Williams–Beuren syndrome (WBS) is a rare multisystem disorder caused by a hemizygous deletion of the elastin gene on chromosome 7q11.23. WBS patients have characteristic skeletal features and dental anomalies accompanied by mental retardation, a friendly outgoing personality, and mild to moderate intellectual disability or learning problems. In this case report, we present the combined orthodontic and surgical treatment of a WBS patient with an isolated cleft palate through a long-term follow-up from the age of 5 to 24 years. During the period of active treatment, comprehensive orthodontic treatment combined with maxillary anterior segmental distraction osteogenesis and prosthetic treatment using dental implants were effective in dramatically improving the patient’s malocclusion. The patient’s mental abilities and the cooperation shown by the patient and her family were crucial for the success of this complex and long-term treatment course. Tetsutaro Yamaguchi, Tatsuo Shirota, Mohamed Adel, Masahiro Takahashi, Shugo Haga, Ryo Nagahama, Misato Nakashima, Mayu Furuhata, Takaaki Kamatani, and Koutaro Maki Copyright © 2017 Tetsutaro Yamaguchi et al. All rights reserved. Ten-Year Follow-Up of a Fragment Reattachment to an Anterior Tooth: A Conservative Approach Tue, 27 Jun 2017 06:51:37 +0000 http://www.hindawi.com/journals/crid/2017/2106245/ This report describes the 10-year follow-up data of a patient who underwent fragment reattachment to the maxillary central incisor after coronal fracture with pulp exposure as well as the procedures followed for functional and esthetic adjustments. A 9-year-old female patient presented at the clinic of dentistry at the State University of Rio de Janeiro with a coronal fracture and pulp exposure of the right maxillary central incisor that had occurred immediately after an accident. The intact tooth fragment was recovered at the accident site and stored in milk. The treatment plan followed was to perform direct pulp capping and tooth fragment reattachment. When the patient was 14 years old, adhesion between fragment and remaining tooth was lost, and fragment reattachment was performed. Five years later, the same tooth presented clinical discoloration and absence of sensitivity during pulp vitality tests. Subsequently, a new treatment plan was formulated, which included endodontic treatment, followed by nonvital tooth bleaching and light-cured composite resin restoration. An esthetic and natural-looking restoration was achieved. Tooth fragment reattachment is not a temporary restorative technique and requires functional and esthetic adjustments over time to maintain the biomimetic characteristics of traumatized anterior teeth and predictable outcomes. Luiz Mendes, Laisa Laxe, and Leandro Passos Copyright © 2017 Luiz Mendes et al. All rights reserved. Resin Nanoceramic CAD/CAM Restoration of the Primary Molar: 3-Year Follow-Up Study Tue, 20 Jun 2017 07:22:06 +0000 http://www.hindawi.com/journals/crid/2017/3517187/ This case report presents the clinical use of a resin nanoceramic CAD/CAM restoration of a primary second molar without successor in the form of a permanent second premolar tooth in a patient. Three-year follow-up of the case revealed that resin nanoceramic CAD/CAM restoration of the primary molar without successor achieved both aesthetics and function. Despite the high cost of treatment, this type of restoration should be considered if the retained tooth is expected to maintain functionality over the long term. Akif Demirel, Tuğba Bezgin, Funda Akaltan, and Şaziye Sarı Copyright © 2017 Akif Demirel et al. All rights reserved. Periodontics, Implantology, and Prosthodontics Integrated: The Zenith-Driven Rehabilitation Tue, 20 Jun 2017 06:03:58 +0000 http://www.hindawi.com/journals/crid/2017/1070292/ A customized treatment plan is important to reach results that will satisfy the patient providing esthetics, function, and long-term stability. This type of oral rehabilitation requires professionals from different dental specialties where communication is a major key point. Digital Smile Design allows the practitioners to plan and discuss the patient’s condition to establish the proper treatment plan, which must be driven by the desired zenith position. The ideal gingival position will guide the professionals and determine the need to perform surgical procedures or orthodontic movement before placing the final restorations. In this article, the zenith-driven concept is discussed and a challenging case is presented with 4-year follow-up where tooth extraction, immediate implant placement, bone regeneration, and a connective tissue graft were performed. Fausto Frizzera, Mateus Tonetto, Guilherme Cabral, Jamil Awad Shibli, and Elcio Marcantonio Jr. Copyright © 2017 Fausto Frizzera et al. All rights reserved. Management of Oromandibular Dystonia: A Case Report and Literature Update Mon, 19 Jun 2017 10:10:09 +0000 http://www.hindawi.com/journals/crid/2017/3514393/ Oromandibular dystonia (OMD) is a movement disorder characterized by involuntary, paroxysmal, and patterned muscle contractions of varying severity resulting in sustained spasms of masticatory muscles, affecting the jaws, tongue, face, and pharynx. It is most commonly idiopathic or medication-induced, but peripheral trauma sometimes precedes the condition. We present a case report of a 26-year-old female patient who suffered repetitive bouts of hemifacial muscle contractions for 2 years on closing the mouth which interfered in patient’s well-being and quality of life by hampering her ability to eat and talk and to the extent of inability to breath due to contractions of her neck muscles. Prompt diagnosis of a chronic oromandibular dystonia jaw closing type led to the control of the spasmodic muscle contractions within 24 hours and alleviation of patients fear of morbidity. Suma Gn and Adrita Nag Copyright © 2017 Suma Gn and Adrita Nag. All rights reserved. Rehabilitation of Nose following Chemical Burn Using CAD/CAM Made Substructure for Implant Retained Nasal Prosthesis: A Clinical Report Sun, 18 Jun 2017 06:42:52 +0000 http://www.hindawi.com/journals/crid/2017/2784606/ Insufficient knowledge of medical chemicals and their improper use have destructive effects. Accidental exposure to chemicals on facial tissue may result in large facial defect. For ages the tradition of piercing nose is common but improper use of unknown chemical for piercing has deleterious effect. Mostly rhinectomy defects are acquired caused by trauma or malignant diseases. Prosthetic rehabilitation is the preferred treatment of choice for any large rhinectomy defects as medical and surgical interventions are ineffective in developing esthetics. Main concern with the prosthesis for such defects is retention. This article describes rehabilitation of a patient with large size nasal defect created by chemical burn in childhood during piercing. Implant retained customized silicone nasal prosthesis was fabricated using simple O-ring attachments and innovative modified polyamide acrylic resin substructure acting as skeleton. Saurabh Chaturvedi, Tushar Bhagat, A. K. Verma, Vishwanath Gurumurthy, Mariyam Ali, Preeti Vadhwani, and Mudita Chaturvedi Copyright © 2017 Saurabh Chaturvedi et al. All rights reserved. Clinical Comparison of the Subepithelial Connective Tissue versus Platelet-Rich Fibrin for the Multiple Gingival Recession Coverage on Anterior Teeth Using the Tunneling Technique Tue, 13 Jun 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/4949710/ The aim of this study was to evaluate and compare, clinically, the efficiency of the subepithelial connective tissue graft (SCTG) and platelet-rich fibrin (L-PRF) using the tunnel technique to cover the multiple gingival recessions on anterior teeth, in the same patient. Within the limits of this study, we conclude that both SCTG and L-PRF proved to be reliable options for the treatment of gingival recessions, efficiently supporting the biological and aesthetic demand, stimulating the periodontal tissues’ health, and bringing reliable and highly predictable results. Victor Fabrizio Cabrera Pazmiño, Miguel Agusto Riquelme Rodas, Carlos David Barrios Cáceres, Guillermo Gustavo Renault Duarte, Melanie Vanesa Cano Azuaga, Bruna Luísa de Paula, Eliana Aparecida Caliente, Simone Soares, and Elcia Maria Varize Silveira Copyright © 2017 Victor Fabrizio Cabrera Pazmiño et al. All rights reserved. Nasolabial Cyst: A Case Report with Ultrasonography and Magnetic Resonance Imaging Findings Sun, 11 Jun 2017 08:10:50 +0000 http://www.hindawi.com/journals/crid/2017/4687409/ Nasolabial cysts are uncommon nonodontogenic lesions that occur in the nasal alar region. These lesions usually present with asymptomatic swelling but can cause pain if infected. In this case report, we describe the inadequacy of conventional radiography in a nasolabial cyst case, as well as the magnetic resonance imaging (MRI) and ultrasonography (US) findings in a 54-year-old female patient. Ali Ocak, Suayip Burak Duman, Ibrahim Sevki Bayrakdar, and Binali Cakur Copyright © 2017 Ali Ocak et al. All rights reserved. Vertical and Transverse Management with Transpalatal Arches in an Adult with Class III Malocclusion Wed, 31 May 2017 09:05:20 +0000 http://www.hindawi.com/journals/crid/2017/4062105/ The transpalatal arch might be one of the most common intraoral auxiliary fixed appliances used in orthodontics in order to provide dental anchorage. The aim of the present case report is to describe a case in which an adult patient with a tendency to class III, palatal compression, and bilateral posterior crossbite was treated with double transpalatal bars in order to control the torque of both the first and the second molars. Double transpalatal arches on both first and second maxillary molars are a successful appliance in order to control the posterior sectors and improve the torsion of the molars. They allow the professional to gain overbite instead of losing it as may happen with other techniques and avoid enlarging of Wilson curve, obtaining a more stable occlusion without the need for extra help from bone anchorage. R. M. Yañez-Vico, M. Cadenas de Llano Perula, and E. Solano-Reina Copyright © 2017 R. M. Yañez-Vico et al. All rights reserved. Surgical Orthodontic Treatment of a Patient Affected by Type 1 Myotonic Dystrophy (Steinert Syndrome) Wed, 31 May 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/7957961/ Myotonic dystrophy, or Steinert’s disease, is the most common form of muscular dystrophy that occurs in adults. This multisystemic form involves the skeletal muscles but affects also the eye, the endocrine system, the central nervous system, and the cardiac system. The weakness of the facial muscles causes a characteristic facial appearance frequently associated with malocclusions. Young people with myotonic dystrophy, who also have severe malocclusions, have bad oral functions such as chewing, breathing, and phonation. We present a case report of a 15-year-old boy with anterior open bite, upper and lower dental crowding, bilateral crossbite, and constriction of the upper jaw with a high and narrow palate. The patient’s need was to improve his quality of life. Because of the severity of skeletal malocclusion, it was necessary to schedule a combined orthodontic and surgical therapy in order to achieve the highest aesthetic and functional result. Although therapy caused an improvement in patient’s quality of life, the clinical management of the case was hard. The article shows a balance between costs and benefits of a therapy that challenges the nature of the main problem of the patient, and it is useful to identify the most appropriate course of treatment for similar cases. Laura Cacucci, Beatrice Ricci, Maria Moretti, Giulio Gasparini, Sandro Pelo, and Cristina Grippaudo Copyright © 2017 Laura Cacucci et al. All rights reserved.