Case Reports in Dentistry https://www.hindawi.com The latest articles from Hindawi © 2017 , Hindawi Limited . All rights reserved. Radiographic Enlargement of Mandibular Canal as an Extranodal Primary Non-Hodgkin’s Lymphoma Early Sign in an Asymptomatic Patient Sun, 19 Feb 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/9193165/ Non-Hodgkin’s lymphoma (NHL) is a lymphoproliferative disorder, from a subgroup of heterogeneous hematologic malignancies; the term “extranodal” refers to malignant involvement of tissues other than lymph nodes, tonsils, spleen, pharyngeal lymphatic ring, or thymus. Only 0.6% of all NHL are at mandible alone, and it may involve the inferior alveolar canal. We describe a case of bilateral enlargement of the mandibular canal without symptomatology, which was shown in a panoramic radiograph and cone beam computed tomography in a rehabilitation routine exam, as an early sign of primary extranodal NHL. Luciana Munhoz, Felipe Pereira Marcos Marsan, and Emiko Saito Arita Copyright © 2017 Luciana Munhoz et al. All rights reserved. Cone Beam CT in Diagnosis and Surgical Planning of Dentigerous Cyst Wed, 15 Feb 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/7956041/ Diagnosis and preoperative planning are critical in the execution of any surgical procedure. Panoramic radiography is a routine method used in dentistry to assist clinical diagnosis; however, with this technique 3D anatomical structures are compressed into 2D images, resulting in overlapping of structures which are of interest in the diagnosis. In this study we report the case of a patient who presented with a dentigerous cyst of expressive dimensions in the body of the mandible region. The surgery was planned and executed after observing the margins of the lesion by Cone Beam Computed Tomography (CBCT). We conclude that CBCT is a precise method to help diagnosis; it provides greater accuracy in surgical treatment planning through 3D image display, allowing more effective results. Naira Figueiredo Deana and Nilton Alves Copyright © 2017 Naira Figueiredo Deana and Nilton Alves. All rights reserved. The Diagnosis and Treatment of Multiple Factitious Oral Ulcers in a 6-Year-Old Boy Wed, 15 Feb 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/1986834/ Factitious ulcers are characterized by self-inflicted lesions with multifactorial origin. These lesions are frequently found in head, neck, and hands. This report shows a 6-year-old boy diagnosed with factitious oral ulcers that occurred after the self-biting of buccal vestibule and nail-scratching of gingival tissue. Clinically, a significant swelling was observed, hard on palpation, located at the right lower third of the face, next to the posterior area of the mandible. In the intraoral examination, ulcers at different healing stages were noted on the swelling area. During the anamnesis, the father reported a change in his familial structure that triggers psychological stress, providing the clues to the presumptive diagnosis of factitious oral ulcers. We prescribed the topical use of Gingilone® three times a day to control the local pain and inflammation. At 7-day follow-up, we noticed the reduction of extraoral swelling and the initial healing of the ulcers. The presumptive diagnosis was confirmed at 30-day follow-up, with the lasting remission of oral lesions. The treatments of factitious oral ulcers should be individually tailored for each patient, focused on a multidisciplinary approach, including psychotherapy and periodic clinical control. To the best of our knowledge, gaps of evidence lead to the lack of standardized clinical protocols on this issue. Priscilla Santana Pinto Gonçalves, Daniela Alejandra Cusicanqui Mendez, Paulo Sérgio da Silva Santos, José Humberto Damante, Daniela Rios, and Thiago Cruvinel Copyright © 2017 Priscilla Santana Pinto Gonçalves et al. All rights reserved. Free Gingival Graft to Increase Keratinized Mucosa after Placing of Mandibular Fixed Implant-Supported Prosthesis Wed, 15 Feb 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/5796768/ Insufficiently keratinized tissue can be increased surgically by free gingival grafting. The presence or reconstruction of keratinized mucosa around the implant can facilitate restorative procedure and allow the maintenance of an oral hygiene routine without irritation or discomfort to the patient. The aim of this clinical case report is to describe an oral rehabilitation procedure of an edentulous patient with absence of keratinized mucosa in the interforaminal area, using a free gingival graft associated with a mandibular fixed implant-supported prosthesis. The treatment included the manufacturing of a maxillary complete denture and a mandibular fixed implant-supported prosthesis followed by a free gingival graft to increase the width of the mandibular keratinized mucosa. Free gingival graft was obtained from the palate and grafted on the buccal side of interforaminal area. The follow-up of 02 and 12 months after mucogingival surgery showed that the free gingival graft promoted peri-implant health, hygiene, and patient comfort. Clinical Significance. The free gingival graft is an effective treatment in increasing the width of mandibular keratinized mucosa on the buccal side of the interforaminal area and provided an improvement in maintaining the health of peri-implant tissues which allows for better oral hygiene. Danny Omar Mendoza Marin, Andressa Rosa Perin Leite, Lélis Gustavo Nícoli, Claudio Marcantonio, Marco Antonio Compagnoni, and Elcio Marcantonio Jr. Copyright © 2017 Danny Omar Mendoza Marin et al. All rights reserved. A Case of Bisphosphonate-Related Osteonecrosis of the Jaw in a Patient with Subpontic Osseous Hyperplasia Tue, 14 Feb 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/9659761/ Subpontic osseous hyperplasia (SOH) is a growth of bone occurring on the edentulous ridge beneath the pontics of fixed partial dentures (FPDs). This report describes a case of bisphosphonate- (BP-) related osteonecrosis of the jaw (BRONJ) in a SOH patient followed by deciduation of the bony lesion. A 73-year-old woman visited a dental clinic after experiencing pain and swelling beneath the pontics of a FPD that had been inserted 15 years ago. The pontics were removed, but the symptoms persisted and she was referred to our hospital. There was an osseous bulge and gum swelling around the edentulous ridge of teeth 18 and 19, as well as bone exposure. As she had been taking an oral BP for 6 years, we diagnosed this case as stage 2 BRONJ. Following BP withdrawal, the bony lesion detached from the mandible. The tissue was diagnosed as sequestrum based on the histopathological findings. Two months after deciduation, epithelialization over the area of exposed bone was achieved and no recurrence has been observed. Chiaki Tsuji, Hiroshi Watanabe, Hidenori Nakayama, Mitsuo Goto, and Kenichi Kurita Copyright © 2017 Chiaki Tsuji et al. All rights reserved. Restoration: Implant with Devastated Platform through Metal Post Mon, 13 Feb 2017 07:46:19 +0000 http://www.hindawi.com/journals/crid/2017/3150656/ Case Presentation. Implant prostheses are a successful treatment for replacing missing teeth. However, this treatment modality can have biological and mechanical complications causing serious problems for the dentist, as demonstrated in this clinical case. The patient presented with a fractured screw and a severely damaged implant hex connection that corresponded to the second premolar, upper left, stating that she unsuccessfully tried to remove the prosthetic screw, which was most likely to have been loose. After clinical and radiographic review, it was decided to remove small fragments of the fractured prosthetic screw inside the implant head. Removal by conventional methods was unsuccessful but was eventually achieved through use of a bur. Then it was possible to make a cast post (gold-palladium) and develop a fixed prosthesis (silver-palladium), which were attached with luting cement. A cast post (gold-palladium) was made and a fixed prosthesis was developed (silver-palladium), which were attached with luting cement, the same ones that can present mechanical complications such as fractures between the third and fourth thread of the implant, loosening of the abutment, and/or the prosthetic screw in individual crowns, most frequently in partially edentulous patients, mainly in the premolar and molar regions of the maxilla. Conclusion. Therefore the present technique used in this case is very simple, noninvasive, and useful to readers. Luna Salinas Tatiana and Del Valle Lovato Juan Copyright © 2017 Luna Salinas Tatiana and Del Valle Lovato Juan. All rights reserved. A Giant-Cell Lesion with Cellular Cannibalism in the Mandible: Case Report and Review of Brown Tumors in Hyperparathyroidism Thu, 09 Feb 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/9604570/ A small radiolucent area in the mandible was discovered in a 58-year-old woman with no oral complaints. The patient’s history included only hypertension. The lesion was considered as an inflammatory cyst and was enucleated. Three months later, a CT revealed the presence of a cyst-like lesion in the mandible with thin expanded buccal cortical plate, localized erosion, and a polylobate appearance on the lingual aspect of the cortical plate. The histological diagnosis of the lesion was central giant-cell granuloma (CGCG). The lesion was thoroughly enucleated. Nevertheless, another X-ray carried out six months later revealed multiple bilateral osteolytic areas throughout the jaw. In addition, widespread cortical plate erosion was observed, as well as signs of root resorption and periodontal enlargement. There was no sign of neurological involvement, although the nerves appeared to be dislocated. After full blood chemistry analysis and detailed collection of radiographs, the final diagnosis was brown tumors in primary hyperparathyroidism. This case report demonstrates how dental clinicians may be the first-line specialists who identify a complex systemic disease before other clinicians. Finally, it highlights the role of cellular cannibalism in predicting the clinical aggressiveness of brown tumors as well as in other giant-cell lesions. Lorenzo Azzi, Laura Cimetti, Matteo Annoni, Diego Anselmi, Lucia Tettamanti, and Angelo Tagliabue Copyright © 2017 Lorenzo Azzi et al. All rights reserved. Treatment of Class III Malocclusion: Atypical Extraction Protocol Mon, 06 Feb 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/4652685/ The treatment of Angle Class III malocclusion is rather challenging, because the patient’s growth pattern determines the success of long-term treatment. Early diagnosis and treatment are still highly discussed issues in orthodontic literature. This type of early intervention has been indicated more frequently in order to eliminate primary etiological factors and prevent an already present malocclusion from becoming severe. However, when a patient is diagnosed in adulthood, manipulation of the bone bases becomes extremely limited, as there is no longer any potential for growth. Treatments are restricted to dental compensations when possible or orthognathic surgery. However, owing to the high cost and inherent risk of the surgical procedure, this treatment option is often denied by the patient; in such a case, the orthodontist has little choice but to perform, where possible, compensatory treatments to restore a functional occlusion and improve facial esthetics. This article reports a case of Class III malocclusion in a patient who opted for compensatory treatment with lower molar extraction that allowed for correction of the midline and the overjet. Good facial esthetics and functional normal occlusion were achieved at the end of the treatment. Fernando Pedrin Carvalho Ferreira, Maiara da Silva Goulart, Renata Rodrigues de Almeida-Pedrin, Ana Claudia de Castro Ferreira Conti, and Maurício de Almeida Cardoso Copyright © 2017 Fernando Pedrin Carvalho Ferreira et al. All rights reserved. Clinical Application of the PES/WES Index on Natural Teeth: Case Report and Literature Review Sun, 05 Feb 2017 11:05:03 +0000 http://www.hindawi.com/journals/crid/2017/9659062/ The use of reliable indices to evaluate the aesthetic outcomes in the aesthetic area is an important and objective clinical aid to monitor the results over time. According to the literature various indices were proposed to evaluate aesthetic outcomes of implant-prosthetic rehabilitation of the anterior area like Peri-Implant and Crown Index [PICI], Implant Crown Aesthetic Index [ICAI], Pink Esthetic Score/White Esthetic Score [PES/WES], and Pink Esthetic Score [PES] but none of them was related to prosthetic rehabilitation on natural teeth. The aim of this study is to verify the validity of PES/WES index for natural tooth-prosthetic rehabilitation of the anterior area. As secondary objective, we proposed to evaluate the long-term predictability of this clinical application, one of which is presented below, following the analysis of the most currently accepted literature. Alessandro Lanza, Fabrizio Di Francesco, Gennaro De Marco, Felice Femiano, and Angelo Itro Copyright © 2017 Alessandro Lanza et al. All rights reserved. Differential Diagnosis of Parotid Lipoma in a Breast Ca Patient Tue, 31 Jan 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/9741828/ Lipomas are common benign tumors usually detected on the torso, neck, upper thighs, and upper arms. However, they are rarely found in the parotid gland region. Because of their rarity at this site, they are not often considered in the differential diagnosis of parotid tumors. This report describes a rare case of a lipoma in the superficial lobe of parotid gland. A 71-year-old female patient admitted to our department complaining about swelling and pain in the posterior area of the left mandibular region since one month. Her medical history included mastectomy after breast CA fifteen years ago. Clinical examination revealed a smooth-surfaced, soft, and painful mass, with well-defined margins in the left mandibular region. Differential diagnosis of metastasis, inflammatory neck swellings, and benign salivary gland tumors were considered for the patient. Advanced imaging methods such as ultrasonography and contrast tomography revealed that the lesion was a lipoma of parotid gland. A surgical intervention under general anesthesia was planned for the removal of the mass; however patient refused the surgical treatment. Patient was placed on six-month periodic recall. This article reviews the radiographic appearance and differential diagnoses of lipoma in this rare location. Melda Misirlioglu, Yagmur Yilmaz Akyil, Mehmet Zahit Adisen, and Alime Okkesim Copyright © 2017 Melda Misirlioglu et al. All rights reserved. Disseminated Histoplasmosis with Oral Manifestation in an Immunocompetent Patient Tue, 31 Jan 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/1323514/ A case of disseminated histoplasmosis (DH) in a 60-year-old female patient is reported from Jaipur, Rajasthan, India. The patient presented with multiple papules on the skin surrounding the lips, face, torso, trunk, and back. She also complained of growth in the palate. Histoplasmosis was confirmed by biopsy and histopathology of skin and palatal lesions. This case report highlights the presenting features and occurrence of histoplasmosis in nonendemic region in India. Debopriya Chatterjee, Aishwarya Chatterjee, Manoj Agarwal, Meetu Mathur, Setu Mathur, R. Mallikarjun, and Subrata Banerjee Copyright © 2017 Debopriya Chatterjee et al. All rights reserved. Oral Health Characteristics and Dental Rehabilitation of Children with Global Developmental Delay Mon, 30 Jan 2017 09:31:34 +0000 http://www.hindawi.com/journals/crid/2017/5486327/ Global developmental delay (GDD) is a chronic neurological disturbance which includes defects in one or more developmental domains. The developmental domain can be motor, cognitive, daily activities, speech or language, and social or personal development. The etiology for GDD can be prenatal, perinatal, or postnatal. It can be diagnosed early in childhood as the delay or absence of one or more developmental milestones. Hence the role of pedodontist and pediatricians becomes more crucial in identifying this condition. The diagnosis of GDD requires a detailed history including family history and environmental risk factors followed by physical and neurological examinations. Investigations for GDD include diagnostic laboratory tests, brain imaging, and other evidence-based evaluations. GDD affects multiple developmental domains that not only have direct bearing on maintenance of oral health, but also require additional behavior management techniques to deliver optimal dental care. This paper describes two different spectra of children with GDD. Since the severity of GDD can vary, this paper also discusses the different behavior management techniques that were applied to provide dental treatment in such children. Saurabh Kumar, Deepika Pai, and Runki Saran Copyright © 2017 Saurabh Kumar et al. All rights reserved. A Novel Procedure for the Immediate Reconstruction of Severely Resorbed Alveolar Sockets for Advanced Periodontal Disease Mon, 30 Jan 2017 08:13:05 +0000 http://www.hindawi.com/journals/crid/2017/9370693/ Background. Several clinical techniques and a variety of biomaterials have been introduced over the years in an effort to overcome bone remodeling and resorption after tooth extraction. However, the predictability of these procedures in sockets with severely resorbed buccal/lingual plate due to periodontal disease is still unknown. Case Description. A patient with advanced periodontitis underwent extraction of upper right lateral and central incisors. The central incisor exhibited complete buccal bone plate loss and a 9 mm vertical bone deficiency on its palatal side. The alveolar sockets were filled with collagen sponge and covered with a nonresorbable high-density PTFE membrane. Primary closure was not attained and any rigid scaffold material was not used. Histologic analysis provided evidence of new bone formation. At 12 months a cone-beam computed tomographic scan revealed enough bone volume to insert two conventional dental implants in conjunction with minor horizontal bone augmentation procedures. Clinical Implications. This case report would seem to support the potential of the proposed reconstructive approach in changing the morphology of severely resorbed alveolar sockets, minimizing the need for advanced bone regeneration procedures during implant placement. Mario Aimetti, Valeria Manavella, Luca Cricenti, and Federica Romano Copyright © 2017 Mario Aimetti et al. All rights reserved. Self-Inflicted Trauma Secondary to Local Anaesthesia in Children Mon, 30 Jan 2017 06:48:26 +0000 http://www.hindawi.com/journals/crid/2017/4969484/ Long acting local anaesthetics and inferior alveolar nerve block in children can cause loss of sensation and proprioception in a large area supplied by that particular nerve. Similar to the maxilla in mandible also, adequate level of anaesthesia can be achieved in the desired site of treatment by using a short acting local anaesthetic. Early return of normal sensory feedback after using short acting anaesthetics can be helpful in preventing self-harm. Srikrishna Vempaty and James Robbins Copyright © 2017 Srikrishna Vempaty and James Robbins. All rights reserved. Management of the Amniotic Band Syndrome with Cleft Palate: Literature Review and Report of a Case Thu, 26 Jan 2017 08:06:59 +0000 http://www.hindawi.com/journals/crid/2017/7620416/ Amniotic Band Syndrome (ABS) is a group of congenital malformations that includes the majority of typical constriction rings and limb and digital amputations, together with major craniofacial, thoracic, and abdominal malformations. The syndrome is caused by early rupture of the amniotic sac. Some of the main oral manifestations include micrognathia, hyperdontia, and cleft lip with or without cleft palate, which is present in 14.6% of patients with this syndrome. The purpose of this report was to describe the clinical characteristics and the oral treatment provided to a 6-month-old male patient affected with ABS with cleft lip and palate. Carolina Cortez-Ortega, José Arturo Garrocho-Rangel, Joselín Flores-Velázquez, Socorro Ruiz-Rodríguez, Miguel Ángel Noyola-Frías, Miguel Ángel Santos-Díaz, and Amaury Pozos-Guillén Copyright © 2017 Carolina Cortez-Ortega et al. All rights reserved. An Asymptomatic and Overelongated Styloid Process Thu, 26 Jan 2017 00:00:00 +0000 http://www.hindawi.com/journals/crid/2017/7971595/ Elongation of the styloid process is a rare condition. Only 4% of patients have clinical symptoms where elongated styloid process (ESP) occasionally irritates or disrupts adjacent anatomical structures, which is called Eagle syndrome. This present report was aimed at reporting an asymptomatic ESP with unusual width and length. Emrah Soylu, Ahmet Altan, Ahmet Ercan Sekerci, and Nıhat Akbulut Copyright © 2017 Emrah Soylu et al. All rights reserved. Morquio’s Syndrome: A Case Report of Two Siblings Mon, 16 Jan 2017 09:38:28 +0000 http://www.hindawi.com/journals/crid/2017/6176372/ Morquio syndrome or MPS IVA is a rare type of lysosomal storage disease associated with highly specific dental abnormalities. We present two siblings with enamel hypoplasia and skeletal abnormalities. A diagnosis of mucopolysaccharidosis type IVA was reached based on the clinical, radiographic, and dental findings of the patients. The dental findings are useful diagnostic aid for the early diagnosis of this debilitating disorder. Sathish Muthukumar Ramalingam, Daya Srinivasan, Sandhya ArunKumar, Joe Louis ChiriyanKandath, and Sriram Kaliamoorthy Copyright © 2017 Sathish Muthukumar Ramalingam et al. All rights reserved. Soft Tissue Schwannomas of the Hard Palate and the Mandibular Mentum Wed, 04 Jan 2017 14:00:31 +0000 http://www.hindawi.com/journals/crid/2017/7401631/ Schwannomas are benign, slow growing, encapsulated tumours that originate from the Schwann cells. Intraoral schwannomas are rare, and most of these tumours involve the tongue. They are rarely located in the hard palate or in the facial soft tissue. Herein, we present the clinical and histological features as well as the prognoses of two male patients with schwannoma, one of which was localized to the hard palate and the other to the facial soft tissue around the mandibular mentum and caused swelling. Cennet Neslihan Eroglu, Serap Keskin Tunc, and Omer Gunhan Copyright © 2017 Cennet Neslihan Eroglu et al. All rights reserved. Traumatic Foreign Body into the Face: Case Report and Literature Review Tue, 03 Jan 2017 08:16:23 +0000 http://www.hindawi.com/journals/crid/2017/3487386/ This paper describes a case of mouth opening limitation, secondary to a facial trauma by cutting-piercing instrument, whose fragments had not been diagnosed in the immediate posttrauma care. Description of an unusual surgical maneuver and a literature review are presented. Maysa Nogueira de Barros Melo, Lidyane Nunes Pantoja, Sara Juliana de Abreu de Vasconcellos, Viviane Almeida Sarmento, and Christiano Sampaio Queiroz Copyright © 2017 Maysa Nogueira de Barros Melo et al. All rights reserved. Mandibular Symmetrical Bilateral Canine-Lateral Incisors Transposition: Its Early Diagnosis and Treatment Considerations Thu, 29 Dec 2016 13:37:35 +0000 http://www.hindawi.com/journals/crid/2016/5043801/ Bilateral mandibular tooth transposition is a relatively rare dental anomaly caused by distal migration of the mandibular lateral incisors and can be detected in the early mixed dentition by radiographic examination. Early diagnosis and interceptive intervention may reduce the risk of possible transposition between the mandibular canine and lateral incisor. This report illustrates the orthodontic management of bilateral mandibular canine-lateral incisor transposition. Correct positioning of the affected teeth was achieved on the left side while teeth on the right side were aligned in their transposed position. It demonstrates the outcome of good alignment of the teeth in the dental arch. Yehoshua Shapira, Tamar Finkelstein, Rana Kadry, Shirley Schonberger, and Nir Shpack Copyright © 2016 Yehoshua Shapira et al. All rights reserved. Geminated Maxillary Lateral Incisor with Two Root Canals Thu, 29 Dec 2016 07:30:30 +0000 http://www.hindawi.com/journals/crid/2016/3759021/ This paper reports a case of gemination in a maxillary lateral incisor with two root canals and crown-root dilaceration. A 16-year-old male patient was referred for endodontic treatment of the maxillary left lateral incisor and evaluation of esthetic and functional complaints in the anterior region. The patient reported trauma to the anterior primary teeth. There was no spontaneous pain, but the tooth responded positively to the vertical percussion test and negatively to the pulp vitality test. Clinical examination showed esthetic and functional alterations and normal periodontal tissues. CBCT imaging confirmed the suspicion of gemination and crown-root dilaceration and also revealed the presence of two root canals and periapical bone rarefaction. The root canals were instrumented with Reciproc R40 and 1% NaOCl irrigation and were filled by lateral condensation of gutta-percha and AH Plus sealer. The tooth was definitely restored with composite resin to recover esthetics. Continued follow-up over 6 months has shown absence of pain or clinical alterations as well as radiographic image suggestive of apical repair. Nayara Romano, Luis Eduardo Souza-Flamini, Isabela Lima Mendonça, Ricardo Gariba Silva, and Antonio Miranda Cruz-Filho Copyright © 2016 Nayara Romano et al. All rights reserved. An Unusually Large Irritation Fibroma Associated with Gingiva of Lower Left Posterior Teeth Region Wed, 28 Dec 2016 10:03:33 +0000 http://www.hindawi.com/journals/crid/2016/5202181/ Fibroma is a benign tumor of oral cavity, with usually the tongue, gingiva, and buccal mucosa being the most common sites. Females are twice more likely to develop fibroma than males. The intraoral fibroma typically is well demarcated; and its size can vary from millimeter to few centimeters. Intraorally the growth is attached to the mucosa by means of a peduncle. Fibroma is generally slow growing, painless, smooth surface lesion and the color is slightly paler than the adjacent healthy tissue. Treatment usually requires total excision and recurrence is rare. Here we present a case of 37-year-old female patient reported to the Department of Oral Medicine and Radiology with the chief complaint of a growth in the lower left posterior teeth region 3 months earlier. Ashish Lanjekar, Sunita Kulkarni, Sonali Akhade, Sonal Sonule, and Usha Rathod Copyright © 2016 Ashish Lanjekar et al. All rights reserved. A Case of Primary Combined Squamous Cell Carcinoma with Neuroendocrine (Atypical Carcinoid) Tumor in the Floor of the Mouth Tue, 27 Dec 2016 09:25:43 +0000 http://www.hindawi.com/journals/crid/2016/7532805/ The combined squamous cell carcinoma (SCC) with neuroendocrine (atypical carcinoid (AC)) tumor is extremely rare in the head and neck. We present here the first case of SCC with AC arising in the floor of the mouth of 65-year-old man. The tumor is comprised of two components of SCC and AC in the biopsy specimen. Neuroendocrine tumor component was classified as AC from the punctate necrosis and 2–10>/10 HPF. Immunohistochemical staining was HMW-CK/34B (+) and P63 (+) in SCC and synaptophysin (+) and CD56 (+) in AC. The pathological diagnosis of SCC with AC was made from both the morphological and immunological exam. Concurrent chemoradiotherapy was performed with radiotherapy 70.2 Gy and chemotherapy of CDDP and VP-16. Although the treatment effect was complete response both of primary tumor and of neck metastases, the recurrence of the primary tumor was after 6 months. Bilateral modified radical neck dissection and tumor resection of the floor of the mouth with reconstructive surgery of anterior lateral thigh free flap were performed. Although the primary and neck tumor did not recur, the multiple lung metastases and mediastinum lymph node metastases occurred at 6 months after surgery. Kenji Yamagata, Kazuhiro Terada, Fumihiko Uchida, Naomi Kanno, Shogo Hasegawa, Toru Yanagawa, and Hiroki Bukawa Copyright © 2016 Kenji Yamagata et al. All rights reserved. Comprehensive and Conservative Management of Talon Cusp: A New Technique Mon, 26 Dec 2016 11:48:53 +0000 http://www.hindawi.com/journals/crid/2016/5843231/ Talon cusp is a common dental anomaly affecting maxillary central incisors. Gradual grinding of this additional cusp is commonly followed now. Advocated below is a new technique explaining the use of air abrasion and putty index during the stepwise reduction of the cusp. The technique is advantageous in preventing patient discomfort and tracking the amount of reduction in a predictable way. Ankit Arora, Padmaja Sharma, and Surendra Lodha Copyright © 2016 Ankit Arora et al. All rights reserved. A Rare Pathological Entity of Multiple Calcified Hyperplastic Dental Follicles Mon, 26 Dec 2016 08:38:23 +0000 http://www.hindawi.com/journals/crid/2016/4190827/ Multiple calcified hyperplastic dental follicles (MCHDF) are an extremely rare condition which has been categorized as a separate pathological entity very recently. It was initially described by Sandler et al. Gardner and Radden proposed this as a separate pathological entity. This disease is characterized by multiple unerupted teeth with abundant calcifications and rests of odontogenic epithelium in enlarged dental follicles. Sumith Gunawardane and Kanchana Kapugama Copyright © 2016 Sumith Gunawardane and Kanchana Kapugama. All rights reserved. Fibrous Dysplasia versus Juvenile Ossifying Fibroma: A Dilemma Thu, 22 Dec 2016 13:48:52 +0000 http://www.hindawi.com/journals/crid/2016/6439026/ Fibrous dysplasia (FD) is a condition characterized by excessive proliferation of bone forming mesenchymal cells which can affect one bone (monostotic type) or multiple bones (polyostotic type). It is predominantly noticed in adolescents and young adults. Fibrous dysplasia affecting the jaws is an uncommon condition. The most commonly affected facial bone is the maxilla, with facial asymmetry being the chief complaint. The lesion in many instances is confused with ossifying fibroma (OF). Diagnosis of these two lesions has to be done based on clinical, radiographic, and microscopic findings. Here, we present a case of fibrous dysplasia of maxilla in a nine-year-old boy mimicking juvenile ossifying fibroma. Sreelakshmi N. Nair, Raghavendra Kini, Prasanna Kumar Rao, Gowri P. Bhandarkar, Roopashri Rajesh Kashyp, Manjunath Rai, Neel Naik, and Athul Santhosh Copyright © 2016 Sreelakshmi N. Nair et al. All rights reserved. Excision of Mucocele Using Diode Laser in Lower Lip Wed, 21 Dec 2016 14:15:51 +0000 http://www.hindawi.com/journals/crid/2016/1746316/ Mucoceles are nonneoplastic cystic lesions of major and minor salivary glands which result from the accumulation of mucus. These lesions are most commonly seen in children. Though usually these lesions can be treated by local surgical excision, in our case, to avoid intraoperative surgical complications like bleeding and edema and to enable better healing, excision was done using a diode laser in the wavelength of 940 nm. Subramaniam Ramkumar, Lakshmi Ramkumar, Narasimhan Malathi, and Ramalingam Suganya Copyright © 2016 Subramaniam Ramkumar et al. All rights reserved. Regional Odontodysplasia with Generalised Enamel Defect Wed, 21 Dec 2016 14:14:52 +0000 http://www.hindawi.com/journals/crid/2016/4574673/ Regional odontodysplasia (ROD) is uncommon developmental anomaly, which tends to be localised and involves the ectodermal and mesodermal tooth components. A five-year-old female was referred to Department of Child Dental Health at the Leeds Dental Institute regarding malformed primary teeth. On examination 64, 74, and 72 had localised hypomineralized enamel defect. The crown of 55 was broken down with only the root remaining below the gingival level. 54 has a yellowish brown discolouration with rough irregular surface. The upper anterior teeth show mild enamel opacity. Radiographically, 55 and 54 had thin radioopaque contour, showing poor distinction between the enamel and dentine and the classic feature of a wide pulp chamber. 15, 16, and 17 were developmentally delayed and were displaying the characteristic “ghost appearance.” Comprehensive dental care was done under local anaesthesia and it included extraction of the primary molars affected by ROD, stainless steel crown on 64, and caries prevention program. Fifteen months following the initial assessment the patient’s oral condition remains stable and she is under regular follow-up at the department. Paediatric dentists should be aware of this anomaly as it involves both dentitions and usually requires multidisciplinary care. A. M. Al-Mullahi and K. J. Toumba Copyright © 2016 A. M. Al-Mullahi and K. J. Toumba. All rights reserved. Solitary Plasmacytoma in the Mandible Resembling an Odontogenic Cyst/Tumor Mon, 19 Dec 2016 14:28:24 +0000 http://www.hindawi.com/journals/crid/2016/3629047/ A 46-year-old male patient referred to Department of Oral Medicine, with the primary chief complaint of a painless swelling in the right side of mandibular. A panoramic radiograph revealed a well-defined, multilocular radiolucent bony lesion with thin and straight septa in the right side of mandible extending from distal of canine to mesial of third molar. Histological examination showed a solid proliferation of atypical plasmacytoid cells, which was indicative of plasmacytoma. A systemic workup for the final diagnosis was performed to rule out multiple myeloma. Fatemeh Rezaei, Hesamedin Nazari, and Babak Izadi Copyright © 2016 Fatemeh Rezaei et al. All rights reserved. Reestablishing the Function and Esthetics in Traumatized Permanent Teeth with Large Apical Lesion Sun, 18 Dec 2016 06:22:31 +0000 http://www.hindawi.com/journals/crid/2016/3830813/ Dental trauma is a challenge for dental integrity and can lead to pulp necrosis. The clinical case reports the diagnosis of a maxillary right central incisor traumatized and its multidisciplinary treatment. Calcium hydroxide material was used to perform the processing apexification. An apical surgery was carried out to remove the apical periodontitis and to return the aesthetics to the patient; internal and external tooth whitening in maxillary right central incisor was performed. We conclude that surgery associated with the root filling in the central incisor led to a successful completion. Moreover, it is of utmost importance to demonstrate the interaction between the various areas of dentistry. Alexandra Rubin Cocco, Ângelo Niemczewski Bobrowski, Rudimar Antônio Baldissera, Luiz Fernando Machado Silveira, and Josué Martos Copyright © 2016 Alexandra Rubin Cocco et al. All rights reserved.