Case Reports in Dentistry最新文献

Oral pigmentation can arise from various factors, including physiological and pathological, or as a manifestation of an underlying systemic disease. We present an atypical case of dermal filler-related complication, in which clinical lip pigmentation was observed. This condition can pose a diagnostic challenge in accurately identifying its cause.

A calcifying odontogenic cyst (COC) is a cystic lesion originating from odontogenic epithelium, exhibiting ameloblastomatous features and containing focal accumulations of ghost cells. The standard treatment for COC typically involves enucleation followed by surgical curettage. However, if the cyst is large or closely associated with anatomical structures, decompression may be considered as a preliminary step before enucleation. A 12-year-old male patient presented with swelling in the anterior mandibular region. Radiological assessment revealed an extensive radiolucent area crossing the mandibular midline, accompanied by radiopaque areas within the lesion. The diagnosis of COC associated with compound odontoma was confirmed. The treatment plan involved decompression, followed by enucleation. After over 9 years of follow-up, the patient showed satisfactory and effective outcomes, with no signs of recurrence. This therapeutic approach minimizes the morbidity and cost associated with extensive and invasive reconstructive surgeries.

Background: Mucopolysaccharidosis (MPS) Type III (MPS III) or Sanfilippo syndrome is a rare autosomal recessive inherited metabolic disorder. This disorder is responsible for lysosomal storage disorder at the cellular aspect. Due to lysosomal enzyme perturbance leading to the alteration of macromolecule metabolisms, this cellular perturbance causes multiple severe systemic and mental outcomes. Sanfilippo syndrome is the most frequent lysosomal disorder among the different types of MPS. Case Presentation: A 9-year-9-month-old female was presented at our private clinic accompanied with her parents and referred from a general practitioner, and the preclinical examination revealed atypical craniofacial structure and skeletal features such as abnormal posture and movements adding on atypical behavioral manifestations such as temper tantrums, speech difficulties, dementia, and destructive behavior.

Actinomycosis is a rare chronic granulomatous infection and can be caused by Gram-positive anaerobic bacteria which are normal commensals of the oral cavity and pharynx. These organisms can involve different parts of the maxillofacial region, rarely affecting the jaws. Actinomycotic osteomyelitis is an infection of the jaw bones, typically associated with trauma or an underlying nonspecific infection or disease. Herein, we describe a rare case of actinomycotic osteomyelitis of the mandible in a healthy male patient. Comprehensive surgical treatment with curettage and peripheral ostectomy was performed. The diagnosis was made on the basis of clinical findings and the histological result. Antibiotic treatment from the penicillin group was prescribed for a period of 1 month. Diagnosis is often delayed and can be a challenge for clinical practice due to the lack of criteria other than definitive histopathological examination. A chronic clinical course without regional lymphadenopathy may be essential in the diagnosis. A number of diseases can present with similar symptoms, necessitating strict adherence to a correct surgical protocol; even when such an infection is suspected, histopathological examination is essential, and long-term treatment with penicillin is advised for accurate treatment of actinomycotic infection.

Class III malocclusion remains the most challenging occlusal problem to treat due to the complexity of the interrelationships of the underlying skeletal and dental structures. Camouflage orthodontic treatment is a preferred alternative method used to manage mild to moderate Class III malocclusion in nongrowing patients. The aim of this article was to demonstrate a camouflage orthodontic treatment of a 22-year-old female patient diagnosed as having a severe skeletal Class III malocclusion characterized by a straight facial profile, reverse overjet, crowded maxillary incisors, retrognathic maxilla, prognathic mandible, and a hypodivergent facial pattern. The initial diagnosis suggested orthognathic surgery, but the patient preferred the alternative treatment. The treatment approach chosen was nonextraction camouflage orthodontic treatment combined with Class III elastics. At the end of treatment, the canines and molars were in a Class I relationship, while the incisors presented a normal overjet and overbite relationship. The maxillary and mandibular midlines corresponded with each other and with the midsagittal plane, and the smile aesthetics were improved. The facial profile was slightly improved, and the vertical face height was also slightly increased with treatment. The treatment results were maintained 15 months after treatment. It was concluded that camouflage orthodontic treatment can be used as an effective alternative method to achieve acceptable dentofacial aesthetics, functional occlusion, and stability in treating an adult patient diagnosed with severe skeletal Class III malocclusion characterized by a retrognathic maxilla, prognathic mandible, and a hypodivergent facial pattern.

The authors present two cases of mouth floor hemorrhage consequences of implant placement within the atrophic anterior mandible. In one patient, the implant placement was associated with the guided bone regeneration (GBR) technique. This serious complication has been widely described in the literature, especially in the anterior mandible area. In cases of bone resorption, the edentulous ridge becomes closer to the artery, and the risk of vessel injury increases. In both patients, the hematoma rapidly spread in the loose tissues of the mouth floor, displacing the tongue posteriorly and cranially, with airway compromise. The patients were hospitalized with nasotracheal intubation to secure the airway. In both patients, the bleeding stopped spontaneously, and after a few days, the oral floor swallowing was reduced, allowing the endotracheal tube to be removed. In about 2 weeks, the hematoma completely resorbed without surgery. According to the literature, the main cause of floor of the mouth hemorrhage is the mandibular lingual cortical plate perforation during bone drilling with subsequent sublingual-submental artery injury. In fact, in the first patient presented, this surgical error was clearly noticeable on the CT scan. Differently, in the second case reported, no radiological signs of inner cortical perforation were observed, and together with a mouth floor hematoma, a blood collection was also evident on the lower lip, suggesting a different cause of bleeding. Most likely during the periosteal release incision, mandatory in GBR technique, the ascending mental artery was injured, and hematoma spread in the mouth floor through the similar incision done on the lingual flap. Firstly, the mouth floor hemorrhage caused by an injury of a vestibular soft tissue artery during GBR surgery was reported. Strategies and recommendations to avoid this life-threatening event are provided, based on the literature review and the authors' experience.

Background: Dermal fillers such as hyaluronic acid (HA) have been widely used in recent years as a less surgically invasive cosmetic treatment. Although delayed foreign body granuloma may occur as a rare adverse reaction after the procedure, detailed histological reports are still limited. When occurring on the buccal mucosa of the oral cavity, the histopathology may resemble some lesions of minor salivary gland origin due to the material properties of HA. Here we report a delayed foreign body granuloma associated with HA showing eosinophilic infiltration of the buccal mucosa, with characteristic histological and immunohistological features. Case Presentation: A 61-year-old woman presented with swelling and a burning sensation in the right buccal mucosa. On initial examination, a 25 × 20-mm mass was palpated on the anterior margin of the right masseter muscle. Examination of a biopsy specimen revealed multiple pseudoduct-like structures containing mucoid substance within the mucosal lamina propria. The mucoid substance was positively stained with Alcian blue (AB) and surrounded by CD68-positive epithelioid cells and multinucleated giant cells. Many histiocytes had infiltrated into the surrounding area, and numerous eosinophilic infiltrates were also evident. After a review of the patient's history, a diagnosis of delayed foreign body granuloma associated with HA injection was made. Conclusion: We have reported a case of delayed foreign body granuloma with eosinophilic and histiocytic infiltration following injection of HA. It was suggested that the marked eosinophilic infiltration around macrophages was due to not only an allergic reaction, but also in part to increased macrophage aggregation.

Multiple fibrolipomas of the tongue are rare benign tumors with a prevalence of 0.2% among both adults and children. Moreover, this lesion affecting an infant has not been reported in the literature. This is the first reported case of multiple fibrolipomas of the tongue in an infant. This case report describes the genetic sequencing and treatment of a 1-year-old child suffering from multiple fibrolipomas. Irregular growths on the anterior and lateral border of the tongue were reported by the mother of the child at the time of birth. The patient was presented to the hospital at the age of 1, and surgical excision of the lesions was performed under general anesthesia. The surgery was uneventful. Genetic sequencing was performed via whole exome sequencing, and two variants of the C2CD3 gene have been identified that may be associated with this condition, although causation has not yet been confirmed. Although this is a rare entity of the oral cavity, there are various differential diagnoses. Therefore, maxillofacial surgeons should perform histological diagnosis to confirm the findings. This is the first study in literature to understand the genetic sequencing of multiple fibrolipomas in an infant. Hence, the finding of this report can be utilized in further studies registering such cases.

Infantile haemangioma (IH) is the most common childhood tumour, often developing in the head and neck region. It may cause disfigurement, functional impairment, or tooth developmental issues when it is present in the oral cavity. We report a case of a 2-month-old boy referred to the paediatric dentistry team with a segmental IH involving the left periorbital, cheek, and hard palate. The patient had a maculopapular rash in the periorbital area, a telangiectatic patch on his left cheek, and papules on the left posterior hard palate. He was comanaged with the paediatric, ophthalmology, dermatology, and cardiology teams. He was treated with oral propranolol, resulting in the lesions reducing in size. Early intervention is crucial to prevent severe complications affecting the patient's appearance, function, speech, feeding, and dentition. Dentists should be familiar with the clinical presentations and preventative measures, as we may encounter such patients with oral cavity involvement.