Case Reports in Dentistry最新文献

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.

This case report of a 67-year-old patient shows reconstruction of the edentulous maxilla with all-on-four implant treatment involving soft tissue esthetics. Reconstruction of the edentulous maxilla involving soft tissue esthetics is a challenging clinical procedure and should be treated with an interdisciplinary approach. In this case report, complete-arch guided soft tissue healing with an immediate interim prosthesis was applied following all-on-four implant placement. The immediate interim prosthesis helped achieve rapid prosthetic rehabilitation and guided soft tissue healing, resulting in an improved esthetic outcome, patient satisfaction, and acceptance for the treatment. Effective communication between surgeons, prosthodontists, and dental technicians made the process easy and successful during both implant placement and prosthetic rehabilitation.

Regional odontodysplasia (RO) is a rare developmental anomaly involving both mesodermal and ectodermal dental tissues. It is characterized by hypoplasia and hypomineralization of enamel and dentin affecting a group of neighboring teeth and may involve primary, permanent dentition or both. Wide pulp chambers and thin, poorly defined hard tissue outlines, described as "ghost teeth," are typical radiographic features. A case of the long-term management of a young girl suffering from RO in the left maxilla is described in the present report. The patient was 3 years old when first presented in the clinic and was treated for the subsequent 12 years by a multidisciplinary team comprised of a pediatric dentist, orthodontist, and prosthodontist. The report encompasses a detailed description of the clinical and radiographic findings of the patient. It also describes the prosthodontic treatment applied to alleviate the aesthetic handicap brought by the extraction of the affected teeth, as well as the orthodontic interventions to establish the normal eruption and settlement of the remaining dentition. A continuing and steady follow-up of RO cases is necessary in order to keep pace with the needs arising from the loss of affected teeth and to ensure the normal growth of the oral issues.

The prevalence of dental trauma, particularly in permanent maxillary anterior teeth, is high and can significantly impact a patient's quality of life. Furthermore, the growing desire of elderly patients to maintain their teeth has led to an increased need for the performance of complex dental treatments. Traumatic injuries often lead to root resorption, pulp necrosis, as well as wide root canals and open apices due to disruption of tooth development. Therefore, precise strategies are required for working length determination, cleaning, and shaping, along with obturation. A 64-year-old female patient came with a chief complaint of a gradually darkening front upper tooth. The patient has a history of traumatic injury where she fell and hit her upper left central incisor. The tooth is clinically darkened, and radiographic examination revealed a periapical lesion, wide root canal, and slightly convergent apex as Stage IV Cvek classification as well as external root resorption. Endodontic treatment was done on Tooth 21 using a hybrid technique with a combination of brushing and balanced-force motion in the cleaning and shaping procedure. The treatment was completed with warm vertical compaction obturation and followed by internal and external bleaching as well as direct restoration. Endodontic treatment utilizing a hybrid cleaning and shaping technique, combined with bioceramic sealer and warm vertical compaction obturation, is effective in posttraumatized elderly teeth resulting in the healing of periapical lesions. Internal bleaching successfully addressed the coronal discoloration followed by direct composite restoration achieving a favorable aesthetic outcome.

Bisphosphonate-induced oral mucosal ulcers are rare adverse events distinct from medication-related osteonecrosis of the jaw. This case demonstrates successful conservative management through the modification of drug administration in an older adult care facility. A 91-year-old woman with dementia developed bilateral floor of the mouth and sublingual ulceration that persisted for 2 weeks. Histopathological examination excluded malignancy and confirmed a drug-induced etiology. Management involved correcting the minodronic acid administration technique without discontinuing therapy, which resulted in complete resolution within 4 weeks. This case underscores the importance of appropriate medication administration education and pharmacist involvement in the care of older adults to prevent and manage drug-related oral diseases.

Introduction: In aesthetic crown lengthening (ACL) surgery, conventional suturing techniques, such as interrupted or vertical mattress sutures, involve piercing both buccal and palatal tissues. This preliminary case series introduces a new suturing approach, "the horizontal mattress sling suture" (HMSS), that eliminates the need to pierce palatal tissues and thus avoids the requirement for palatal anesthesia.

Clinical consideration: Three healthy patients with excessive gingival display sought treatment at the Department of Periodontics at the University of Jordan. ACL surgery was performed following comprehensive dental and radiographic examinations, as well as periodontal prophylaxis. The HMSS, which combines the horizontal mattress and sling suture techniques, was employed to secure the buccal flap. Follow-up visits were scheduled at 2 weeks and at 3, 6, and 12 months postsurgery.

Results: All three cases showed uncomplicated healing with no adverse effects. Patients experienced manageable pain during the initial days postsurgery, readily controlled with routine analgesics. None of the patients reported any complications or expressed any concerns, and all were satisfied with the outcomes at each follow-up visit.

Conclusion: HMSS, a suturing technique designed for single-flap procedures, such as ACL, is a promising approach that provides a better patient experience by avoiding the necessity to anesthetize the corresponding aspect of the oral soft tissues where a flap was not elevated.

Introduction: This case report describes the multidisciplinary treatment of a patient with mandibular retrognathia and hyperdivergent skeletal pattern, condylar resorption, and severe obstructive sleep apnea (OSA).

Case presentation: A 42-year-old female patient presented with a chief complaint of mandibular retrognathia. The patient had no significant medical history, and her body mass index was 18.8. She had a +9.0 mm overjet and +1.0 mm overbite, and an Angle Class II molar relationship. Cephalometric analysis revealed SNA, SNB, and FMA of 76.0°, 67.5°, and 50.5°, respectively. Computed tomography (CT) images showed severe bilateral mandibular condylar head deformity due to resorption. Polysomnography revealed an apnea-hypopnea index (AHI) of 43.3, leading to a diagnosis of severe OSA. Correspondingly, continuous positive airway pressure (CPAP) therapy was started immediately.

Management and outcomes: After 19 months of preoperative orthodontic treatment with preadjusted edgewise appliances, Le Fort I osteotomy was performed to impact the maxilla by 3.0 mm at the anterior and 4.0 mm at the posterior nasal spine. The mandible was autorotated 8.6° counterclockwise, reducing ANB from +8.5° to +2.0°. A genioplasty was also performed. After 8 months of postoperative orthodontic treatment, the AHI decreased to 2.3, and CPAP therapy was discontinued due to significant improvement in respiratory function. CT images showed an increase in the upper airway volume after orthognathic surgery. No remarkable morphological changes were observed in the mandibular condylar head during orthodontic treatment. Favorable occlusion was maintained with no apparent relapse after 21 months of retention.

Discussion: Unlike conventional maxillomandibular advancement for OSA, the surgical method described in this case study combines counterclockwise mandibular rotation and genioplasty to simultaneously improve respiratory function and craniofacial morphology in patients with hyperdivergent and Class II skeletal pattern accompanied by mandibular condylar head deformity.

Hyperdontia is a developmental anomaly that can disrupt normal tooth eruption and occlusal harmony. Compound odontomas, although benign and often asymptomatic, may cause delayed eruption and other complications requiring surgical management. This case report details the treatment of a 22-year-old female presenting with failure of eruption of the mandibular left permanent canine. Clinical and radiographic evaluation revealed a retained deciduous canine, a compound odontoma, and a horizontally impacted supernumerary tooth. Surgical intervention under local anesthesia involved extraction of the retained deciduous and supernumerary teeth, complete removal of the odontoma, and surgical exposure of the impacted canine with placement of an orthodontic traction chain to facilitate eruption. Postoperative recovery was uneventful, with satisfactory soft tissue healing and partial eruption of the permanent canine observed at the 3-month follow-up. This case emphasizes the importance of early diagnosis and timely management of odontogenic anomalies to prevent functional and esthetic complications. Coordinated surgical and orthodontic intervention can significantly improve prognosis and treatment outcomes.