Case Reports in Dentistry最新文献

Gingival recession is a prevalent condition impacting extensive populations, resulting in functional and aesthetic issues. Root coverage periodontal plastic surgery techniques have been utilized for the management of gingival recession for an extended period. To overcome the limitations and disadvantages of the previous approaches, the current innovative technique was introduced requiring no specific instruments, providing direct vision of the surgical site, reducing the chances of damaging the adjacent anatomical structures, preserving the interdental papilla, and releasing the muscle tension of the flap base increasing the success of root coverage surgery.

Performing endodontic treatment on calcified root canals is highly challenging and time-intensive. Even with the assistance of a dental operating microscope, the probability of iatrogenic errors is high. The aim of this report is to present successful endodontic treatments for severely calcified maxillary anterior teeth using a 3D endodontic sleeveless guide, providing a basis for upcoming validation through more comprehensive research. A 25-year-old male patient was referred to the dental office with a chief complaint of pain and swelling of his Tooth 2.2 who explained a previous history of trauma. On clinical examination, periapical swelling was observed, and the tooth demonstrated tenderness to percussion and palpation in the periapical region. Radiographic findings included a severely obliterated pulp chamber and a calcified root canal with periapical radiolucency. In order to perform the root canal treatment with an endodontic guide, an optical impression was carried out using an intraoral scanner. Data from the impression and CBCT files were aligned and sent to the dental laboratory. A virtual copy of a drill was superimposed onto the scans in an optimal position that provided access to the root system, using Exoplan software. A digital model was created and exported as an STL file and transferred to a 3D printer to produce a template. Despite several limitations, successful root canal treatment was conducted. At the 6-month follow-up visit, the patient reported no symptoms, and periapical radiography showed a diminished periapical lesion. Static endodontic guidance provides an opportunity to have more reliable and predictable outcomes in treating complex root systems, even in the presence of minor issues such as transportation and file separation.

Background: Traditional impression techniques for customized post-and-core restorations often encounter challenges such as bubble and void formation, requiring a high level of skill from practitioners. Recent advancements in digital technology, particularly intraoral scanners (IOSs), have improved restoration processes, though capturing post spaces with IOS remains problematic due to their deep and narrow nature.

Case presentation: This report details the use of digital impressions for post-and-core restorations in both anterior and posterior teeth. By designing a scan post that conforms to the shape of the post space, accurate data capture of the post space is achieved. The integration of IOS with computer-aided design/computer-aided manufacturing (CAD/CAM) technology enables the creation of post-and-core restorations that precisely fit the root canal morphology. This approach results in a thin and evenly distributed cement layer, thereby reducing the risk of tooth fracture.

Conclusion: This technique effectively overcomes the limitations of traditional silicone impressions for customized post-and-core restorations. It offers a viable restoration method for single-rooted teeth and addresses challenges related to acquiring impressions for split cast post-and-cores. However, further laboratory research and clinical trials are necessary to thoroughly evaluate the accuracy and reliability of this method.

A 41-year-old female patient in apparent good health presented to the dental emergency department with a 6-week history of painless, nonpruritic left facial swelling, and dotted with purplish patches. She had consulted different physicians and dentists and received several ineffective treatments. After ruling out an oral cause, standard blood tests were initially prescribed. They showed an isolated elevation of creatine phosphokinase (CPK). Muscular weakness of the left arm and leg, pain on mobilization of the left thigh, and erythematous plaques on the left body then appeared. Infectious, granulomatous, and autoimmune diseases were investigated. Magnetic resonance imaging (MRI) showed diffuse muscle infiltration, suggestive of myositis. Myositis-specific dot immunoassay identified antinuclear matrix protein 2 (NXP2) autoantibodies, enabling the diagnosis of dermatomyositis. The inaugural orofacial manifestations of dermatomyositis can be confused with pathologies of dental cause, such as cellulitis. In the absence of local warning signs, oral health professionals must consider a systemic etiology and rapidly refer the patient to avoid patient wandering.

Multifocal epithelial hyperplasia (MEH) represents a benign condition associated with human papillomavirus. This condition is notably uncommon and primarily affects specific demographic groups, particularly children and adolescents. Within Yemen, similar to other Asian regions, the condition remains relatively uncommon. The lesions typically manifest intraorally on the labial and buccal mucosa as well as the tongue. In this report, we present two cases, where MEH was observed on the vermillion surface of the lips in adult patients. Several possible risk factors were identified in these cases, including socioeconomic disadvantage, khat chewing, and liver dysfunction. These findings emphasize the importance of considering MEH in the differential diagnosis of papillary lesions affecting the vermillion surfaces of the lips.

Background: Osteocutaneous flaps are the standard approach for performing reconstruction after a mandibulectomy. Soft tissue reconstruction alone may be performed for tumor progression or patient burden; however, it may cause a loss of oral function and issues concerning cosmetic appearance. We performed secondary revision surgery using the tensor fascia lata. This report presents a contour revision surgery for one case in which optimal flap selection was not possible during immediate reconstruction due to various reasons.

Methods: A 63-year-old woman with idiopathic thrombocytopenic purpura and left lower gingival cancer (pT4a N3, M0, Stage IVa) underwent left hemimandibulectomy and left neck dissection. Reconstruction was performed with a deep inferior epigastric perforator flap. Two years after the surgery, we performed a flap volume reduction and created a tensor fascia lata sling to correct a significant irregularity of the mandibular contour. The mandibular contour was greatly improved after revision surgery, and controlled occlusion was possible. A quality-of-life assessment indicated an improved cosmetic appearance.

Conclusion: This method is relatively simple and less invasive than bone grafting. It potentially solves some problems associated with mandibular reconstruction using only soft tissue.

Background: Molar root-incisor malformation (MRIM) is a rare dental anomaly characterized by root malformations, abnormal pulp chamber development, and dental developmental defects. Primarily affecting the permanent first molars, MRIM can also involve the primary second molars and permanent maxillary central incisors. The etiology of MRIM remains unclear, though it has been associated with environmental and systemic factors. Early diagnosis and intervention are essential for preventing further complications.

Cases: This report presents five pediatric cases diagnosed with MRIM at our pediatric dentistry clinic between 2016 and 2025. Case 1: A 10-year-old male patient presented for a routine examination. MRIM was detected in Teeth 16, 26, and 36, with enamel depressions on Teeth 11 and 21. No systemic disease or family history of dental anomalies was noted. Case 2: An 8-year-old female patient presented with esthetic concerns due to dental crowding. MRIM affected multiple teeth (16, 26, 36, 46, 13, 23, 11, 21, 31, and 41). The patient had a history of pelvicaliectasis and nephrological follow-up. Case 3: A 12-year-old female patient was referred due to suspected root anomalies. MRIM was observed in all permanent teeth except anterior incisors and third molars. A history of hemolytic uremic syndrome was noted. Case 4: An 11-year-old male patient presented with MRIM involving molars and canines. A neonatal history of severe hypertension and NICU admission was reported. No familial dental anomalies were found. Case 5: A 9-year-old female patient diagnosed with Williams syndrome and other systemic conditions exhibited MRIM in multiple teeth. Structural anomalies such as high-arched palate, ankyloglossia, and deep bite were also observed.

Conclusion: The cases demonstrate the variability of MRIM in pediatric patients, with distinct radiographic and clinical features observed across the cohort. The absence of similar findings in family members suggests that a direct genetic basis is unlikely. Instead, the findings support a possible association between MRIM and systemic conditions, particularly nephrological diseases and complex medical histories. Early and accurate diagnosis, along with close follow-up, is vital in managing MRIM and preventing future complications. A comprehensive medical history and thorough radiographic evaluation of all tooth groups remain essential for accurate diagnosis and treatment planning.

Segmental odontomaxillary dysplasia (SOD) is a rare nonheritable unilateral developmental disorder characterized by dental, bone, and soft tissue abnormalities. A 13-year-old female patient presented with mild facial asymmetry. Clinical examination revealed right maxillary enlargement and gingival overgrowth. Radiologic examination revealed retention of primary teeth showing pulp chamber obliteration and irregular root resorption, agenesis of the second premolar, impaction of the first premolar, bone enlargement, and increased trabecular bone density with vertically oriented trabeculae. The combined imaging findings facilitated clear differentiation from common imaging mimickers, such as fibrous dysplasia and hemifacial hyperplasia. Bone histopathological examination revealed irregular bony trabeculae lacking an osteoblastic layer, accompanied by numerous basophilic reversal lines. This case underscores the importance of a multidisciplinary approach, combining clinical, radiologic, and histopathological evaluation in distinguishing SOD from other conditions with overlapping radiologic features.

Background: Oral-Facial-Digital Syndrome Type 1 (OFD1) is a genetic disorder marked by diverse malformations of the oral cavity, face, and digits.

Case: This case report presents a female patient who was first referred to the Department of Pedodontics at Istanbul University at 18 months of age due to the absence of teeth in the upper molar region and who has been followed up until 4 years and 11 months. The patient, born prematurely to a consanguineous union, had a history of low birth weight, asphyxia, and a prolonged 2-month intensive care unit stay. Clinical examination revealed multiple dysmorphic features, including facial anomalies such as dolichocephaly, macrocephaly, saddle nose deformity, droopy ears, and thin hair and eyebrows. Intraoral evaluation demonstrated misalignment of the dental arches, abnormal tooth positioning, a bifid lobulated tongue, and residual sutures from previous cleft palate surgery. Although the upper primary central incisors were present, the lower incisors were initially absent, with subsequent follow-ups showing their delayed eruption. At 39 months, further evaluation revealed malposed and rotated upper primary dentition, while certain lower deciduous central incisors remained undetectable. The patient was managed with protective dental care, regular 3-month follow-ups, and comprehensive parental education on oral hygiene, alongside coordinated consultations with orthodontic services.

Conclusion: This report highlights the clinical heterogeneity of OFD1 and underscores the importance of early diagnosis, multidisciplinary management, and continuous monitoring to improve oral health outcomes in affected patients.

The article describes the effectiveness of an integrated digital approach combining orthodontic and restorative phases in dental esthetic treatment, focusing on minimally invasive procedures. A 55-year-old woman with dental esthetic concerns underwent a comprehensive treatment plan. Initial evaluation included digital impressions of both arches using an intraoral scanner, followed by a 15-week sectional clear aligner therapy to correct dental misalignments prior to minimally invasive lithium disilicate veneers. A digital wax-up was proposed to the patient and used as a guide to perform gingivectomy and minimal tooth reduction. The aligner therapy effectively corrected the misalignment and crossbite, optimizing tooth positioning for minimally invasive veneer preparation. Digital planning allowed precise enamel reduction and gingival reshaping. The final placement of lithium disilicate veneers resulted in significant esthetic improvement, confirmed by clinical evaluations and patient satisfaction. The integration of digital technologies in orthodontic and restorative dentistry enhances esthetic treatment planning and execution. Combining sectional clear aligner therapy with precise digital wax-ups minimizes invasive procedures, improves surgical precision, and ensures predictable outcomes. The digital workflow also facilitates patient education and communication, demonstrating treatment goals and results effectively.