Case Reports in Dentistry最新文献

External cervical resorption (ECR) is a progressive disease that occurs at the cervical region of the tooth, developing beneath the epithelial attachment. ECR is often asymptomatic and detected in routine radiographic examinations. This condition can significantly impact the long-term survival of the affected tooth. Therefore, early diagnosis and proper management are both crucial and challenging. We reported a case of ECR, managed through a synchronized and simultaneous treatment approach combining surgery and root canal therapy. The defect was restored with resin-modified glass ionomer. Nine-month clinical and radiographic follow-up showed satisfactory healing with no signs of recurrent resorption, and the tooth remained asymptomatic and functional.

Maxillary transverse deficiency is a common issue in orthodontic clinics and presents a treatment challenge in adults due to increased resistance to midpalatal suture separation. Miniscrew-assisted rapid palatal expansion (MARPE) has become an effective alternative by providing skeletal anchorage and minimizing side effects on teeth; however, little has been reported about its impact on underlying facial soft tissues. This case report follows the CARE guidelines for case reports and describes the clinical management of a young adult with maxillary transverse deformity treated with MARPE and corticopuncture, planned using tomography. The activation was performed gradually, under clinical and tomographic monitoring. The tomography showed transverse improvement with a parallel opening of the midpalatal suture of about 5 mm and no signs of adverse effects on adjacent teeth. Additionally, a 3D facial reconstruction revealed slight facial changes at the frontal level that were not clinically significant. It is concluded that MARPE expansion therapy was an effective and safe alternative for treating maxillary transverse deficiency in the adult patient in this case, with minimal impact on dental and facial structures.

Tonsilloliths are calcifications commonly formed within the palatine tonsils, with a prevalence ranging from 10% to 40%. While typically asymptomatic, tonsilloliths can occasionally lead to complications. This case report presents a 50-year-old male with incidental bilateral radiopacity in the mandibular angle region detected on an orthopantomogram with no clinical symptoms. Advanced imaging modalities, including 3-T magnetic resonance imaging (MRI), cone-beam computed tomography (CBCT), and MR-based cinematic rendering (CR), were employed for differential diagnosis of the observed radiopacity and preprocedural planning of extractions and implant placement in the context of the patient's dental pathology. The consistent visualization of tonsilloliths across various imaging modalities highlights the unique strengths of each technique in diagnosing, visualizing, and differentiating these calcifications. This multimodal approach can provide valuable insights for accurate diagnosis, effective surgical planning, and improved diagnostic confidence, even in asymptomatic patients with incidental findings.

It is challenging to treat an infected nonvital young permanent tooth endodontically because there is a lack of natural apical constriction. In order for the obturating material to be condensed, an apical barrier must be induced. Calcium hydroxide has historically been used to induce apexification. However, due to prolonged treatment time, multiple visits, and unpredictability in barrier formation, newer bioactive materials such as mineral trioxide aggregate (MTA) have been introduced for faster and more predictable outcomes. This case report presents the use of platelet-rich fibrin (PRF) as a biological internal matrix in conjunction with MTA for apexification of immature necrotic teeth. Although a single-visit procedure was initially planned, the presence of persistent exudate necessitated a multivisit approach to ensure thorough disinfection before final obturation.

Calcifying odontogenic cyst (COC) is an uncommon lesion accounting for less than 1% of all odontogenic cysts. This pathology commonly affects the anterior jaw and is prevalent in the second to third decades of life, with no sex predilection. The lesion presents with a variable clinical and radiographic presentation, which can simulate other common jaw pathologies. Therefore, histopathological confirmation stands to be diagnostic in COC. The fifth edition classification for jaw tumors of the head and neck by the World Health Organization has summarized the essential diagnostic criteria of COC as a jaw cyst occurring in the second to third decades of life with a strong predilection for the anterior mandible and histopathologically characterized by cystic architecture with numerous ghost cells. Here, we present three histopathologically confirmed cases of COC of the mandible, clinically suspected for ameloblastoma, lateral periodontal cyst, and radicular cyst, with emphasis on the characteristics, along with the possible diversity that the lesion can show in its histopathological sections.

We present the case of an 18-year-old female patient with a history of multiple operculectomies that preceded the development of mucoepidermoid carcinoma in the retromolar region. Mucoepidermoid carcinoma is a malignant glandular epithelial neoplasm characterized by mucous, intermediate and epidermoid cells. Although its etiology is so far uncertain, there are various clinical manifestations that help us understand its biological behavior. The treatment depends on the TNM staging.

Introduction: Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis, is a rare, systemic small-vessel vasculitis characterized by necrotizing granulomatous inflammation. It classically affects the upper airway, lungs, and kidneys. Oral manifestations are infrequent, occurring in approximately 6%-13% of cases, and represent the initial presentation in only about 2%.

Case presentation: A 55-year-old female was presented with a two-month history of painful, bleeding gingival hyperplasia unresponsive to routine periodontal therapy. Intraoral exam revealed "strawberry gingivitis"-diffuse, friable, erythematous granular gingival enlargement. Comprehensive workup showed elevated inflammatory markers and positive cytoplasmic ANCA (c-ANCA). Gingival biopsy demonstrated granulomatous inflammation with necrotizing vasculitis, confirming localized GPA confined to oral tissues. Multidisciplinary management was initiated with systemic immunosuppression (oral azathioprine and deflazacort) and topical therapy, alongside optimization of the patient's comorbid conditions. An antifungal and antibiotic prophylaxis regimen was also provided.

Outcomes: Following the commencement of therapy, the gingival lesions exhibited complete resolution within 3 weeks. Over a 12-month follow-up period, there was no evidence of progression to other organ involvement. The concurrent management of the patient's diabetes and hypothyroidism was instrumental in facilitating optimal healing and overall patient recovery.

Conclusions: This case distinctly underscores that GPA can present solely with oral symptoms, making early recognition by dental clinicians paramount for prompt diagnosis. The presence of "strawberry gingivitis" serves as a crucial, pathognomonic clinical sign. We propose a diagnostic and management protocol for oral GPA to improve patient outcomes.

Introduction: Friedreich's ataxia is an inherited disease affecting the nervous system and presents huge orthodontic challenges affecting the patient's coordination and muscular function.

Observation: Based on the rarity of this condition, the aim of this case report is to describe an unusual orthodontic treatment employed to manage a severe open bite in a 14-year-old male patient suffering from Friedreich's ataxia, by highlighting the clinical decisions and treatment outcomes.

Conclusion: Managing a severe anterior open bite in patients suffering from Friedreich's ataxia by skeletal anchorage mechanics for posterior teeth intrusion is advantageous considering their health condition.

Introduction: Regenerative endodontic therapy (RET) has become a preferred treatment for immature necrotic teeth. However, one of the undesirable outcomes is tooth discoloration, which can significantly affect esthetics. Internal bleaching is commonly used, but success rates can vary due to several factors, including the type of materials used during the procedure.

Case report: We report a case of a 15-year-old female patient with severe tooth discoloration following RET on a maxillary central incisor. Initial internal bleaching provided satisfactory results, but the discoloration recurred within a few months. Additionally, the tooth developed an abscess, complicating the clinical management. Endodontic retreatment was performed, but apical access was challenging. Despite successful management of the infection, the tooth discoloration persisted. The persistence of discoloration was attributed to the materials used during the RET, specifically MTA, which has been known to cause color changes over time.

Conclusions: This case highlights the challenges of managing tooth discoloration post-RET and the limitations of internal bleaching as a treatment. It underscores the importance of considering preventive strategies during the RET procedure to minimize discoloration. Alternative esthetic approaches may be necessary when bleaching fails to meet the patient's expectations.

Epulis is a general diagnostic term for benign localized tumors that occur in the gingiva. Clinical diagnosis is usually straightforward based on the location and morphology of the lesion; however, large lesions may mimic malignancy. We report a case of a large granulomatous epulis in the mandibular alveolar region. A male in his 60s presented with swelling in the right mandible. Examination revealed a well-defined, pedunculated soft tissue mass in the right mandibular gingival region. Then, 1 month after the initial visit, the lesion (55 × 35 × 20 mm) was resected under general anesthesia. Histopathological examination confirmed granulomatous epulis, and the patient has remained free of recurrence after 6 months of follow-up.