Case Reports in Dentistry最新文献

The authors present a case concerning an adult male patient who developed multiple sites of root caries adjacent to the area where he habitually held a sugar-free nicotine lozenge that contained mannitol and maltodextrin. The root caries occurred despite the patient's excellent oral hygiene, exemplary dietary habits, and clinically normal salivary flow. Between 1999 and 2008, he had only required two restorations to repair carious lesions. This patient had a 20+-year habit of using smokeless tobacco before switching to a cessation aid nicotine lozenge in May of 2008. A full-mouth series of radiographs taken in November 2009 revealed carious lesions on virtually every posterior tooth. The nicotine lozenge's principal ingredients were mannitol (75.7%) and maltodextrin. According to the United States' current Food and Drug Administration (FDA) guidelines, manufacturers can advertise these lozenges as sugar-free. Thus, it is assumed by the public that these types of products are incapable of "causing a cavity." However, this case report presents evidence suggesting that frequent use of sugar-free nicotine lozenges may be associated with dental caries.

The article presents a case of a 13-year-old adolescent male patient who started orthodontic treatment at the age of 12. Before treatment, he was diagnosed with narrow maxilla, proclination of upper incisors, deep overbite, distal occlusion bilaterally with significant sagittal overjet in frontal area, skeletal Class II, and hypodivergent growth pattern. During treatment, the patient is in his pubertal growth spurt. About 2 months after intermaxillary Class II elastics (1/4 heavy, 6.5 Oz) were applied, he complained of pain during mastication, wide opening of the mouth, and sometimes during protrusive and lateral movements in the right TMJ. The TMJ X-ray examination did not reveal abnormal morphological changes. Occlusion was evaluated by an electromyographic device, Teethan. The result was typical for Class II malocclusion. During the bilateral palpation of the zones of TMJ and opening of the mouth and chewing, the patient reported pain on the right side. There was no clicking in the joint. The elastic wear was stopped, and soon afterwards, the pain disappeared. These complaints point to a possible relationship between orthodontic treatment and TMJ pain. However, the disappearance of complaints after the removal of the Class II elastics points that the temporomandibular joint disorder (TMD) symptoms are reversible and resolved.

Introduction: Self-inflicted gingival injuries typically occur in patients with psychological disorders and rarely in normal individuals. This article is aimed at reporting an unusual case of gingival recession caused by a fingernail-scratching habit. Case Report: A 5-year-old female patient presented to the Pediatric Dentistry Department at the Ibn Sina Center for Consultation and Dental Treatment in Rabat, Morocco, with complaints of gingival recession localized in her four maxillary primary incisors. After a detailed medical and personal history and clinical examination, the diagnosis of self-inflicted gingival injury was established. The treatment plan included oral hygiene instructions, the application of analgesic and antiseptic gel, and behavioral management. Regular follow-ups over a period of 16 months were crucial for monitoring the patient's progress, which eventually led to the cessation of the habit with no recurrence. Discussion: Self-inflicted oral injuries in pediatric patients pose diagnostic challenges. The development of such habits in psychologically normal children is difficult to explain, suggesting the need for a comprehensive approach. Managing self-inflicted injuries is complex and requires a personalized strategy that may include psychotherapy, family support, and regular monitoring. Conclusion: This case highlights the importance of taking a comprehensive history and adopting a multidisciplinary approach to diagnose and manage self-inflicted gingival injury, achieving positive outcomes.

Background: The aim of this case was to understand and treat the intricate root canal anatomy observed in complex maxillary first premolars, particularly those exhibiting three root canals, emphasizing the significance of understanding root canal morphological variations in their treatment. Conclusions: This case reported the methods of treating three-root canal maxillary first premolars, including warm vertical compression technique, root canal microsurgery, and the application of rubber dam. The utilization of dental operating microscopes, various surgical strategies, and key assessments of X-rays and cone beam computed tomography (CBCT) scans were all essential steps for achieving accurate and safe root canal therapy.

Dental caries remains the most prevalent chronic disease globally, and its management should adhere to the principles of minimal intervention dentistry. This study reports a series of successful cases involving the selective removal of carious tissue in permanent molars, with follow-up periods of up to 21 years. Six permanent molars with severe and deep carious lesions were treated with selective caries removal and restored with high-viscosity glass ionomer cement. Clinical examination revealed that the teeth were free from pain and sensitivity. Follow-up assessments were conducted at 7 and 21 years posttreatment. Treatment success was defined by the absence of clinical and radiographic signs, symptoms of pulp alterations, and lesion arrest. Successful minimally invasive approaches were observed with selective removal of carious tissue and maintenance of pulp vitality for up to 21 years.

Proliferative verrucous leukoplakia (PVL) is an aggressive and distinct oral disorder with a high potential for malignant transformation (MT). It presents as multifocal lesions that progress over time and frequently recur, often developing carcinomas. Accurately diagnosing PVL is crucial to distinguish it from other oral mucosa lesions that have a lower risk of cancer progression. However, due to the diverse histological features observed in PVL, identifying clinical criteria and histological patterns that can be applied by unfamiliar professionals is challenging. In this study, we present a case of PVL associated with dysplasia in a 53-year-old female patient. The patient exhibited macular and leukoplakic nonscrapable lesions disseminated throughout the oral cavity, with continuous growth. The diagnosis of PVL was established during an 18-month follow-up. This case highlights the difficulties faced by both clinicians and pathologists in diagnosing PVL, emphasizing the need for careful evaluation and accurate diagnosis, particularly in patients with unusual oral lesions, and highlighting the discrepancies observed in the application of available protocols to our particular case. Distinguishing PVL from similar conditions can be challenging due to overlapping clinical signs and indistinct histopathological features.

A 45-year-old female patient was referred to the Department of Cosmetic Dentistry, Damascus University, seeking to improve dental aesthetics. The clinical examination showed a low smile line and microdontia in the maxillary arch. The treatment plan consisted of applying no-prep veneers with gingival modification, which is described in the biologically oriented preparation technique (BOPT) as a gingitage technique. The gingitage of the sulcus was performed using a yellow ring diamond flame with an inclination of 45 degrees, which causes it to bleed and creates a space between the internal wall of the sulcus and the axial wall of the tooth. After a 12-month follow-up, the gingiva was free of inflammation, recession, and plaque, and there was no increase in probing depth, according to the modified gingival index (MGI), gingival recession index (GRI), Silness-Loe plaque index (PI), and the community periodontal index of treatment needs (CPITN), respectively. The porcelain veneers were intact, with no chippings, cracks, and marginal discoloration. The patient was satisfied with her new smile.

Graphite tattoos are rarely reported because they are mainly caused by an accidental injury or habits during childhood that cause a pencil to penetrate the oral mucosa. Unlike other pigmentations, it stains layers that are deeper than the subepithelial and mucosal layers, and in most cases, it takes the form of a grayish black macule. This case report describes depigmentation with the denudation technique that was followed by a novel approach of using platelet-rich fibrin to cover exposed bone. A 41-year-old male patient presented with an aesthetic complaint from a grayish black staining on the labial gingiva near the maxillary central and lateral incisors. The lesion was diagnosed as a graphite tattoo due to the patient's history of sticking his gum with pencils when he was young. The entire pigmented gingiva was surgically removed and covered with two layers of PRF membrane to protect the exposed bone surface and provide an extracellular matrix for migration of gingival fibroblasts. Healing patterns were observed at 1, 2, 4, and 8 weeks, and satisfactory clinical and aesthetic results were obtained. Creeping attachment was observed at 8 years postop, and there was no recurrence for a long-term period of 13 years.

Aim. The aim of this case report is to present the successful endodontic management of an abnormally long right maxillary canine diagnosed with symptomatic irreversible pulpitis, highlighting the technical adaptations employed during treatment. Summary. Technical adaptations included modifying the handle of the endodontic hand file and utilizing a side-vented microcannula for irrigation using positive and negative pressure technique. Despite the challenges posed by the abnormal tooth length, the procedure achieved a working length of 40.7 mm, and periapical radiography confirmed the master gutta-percha reaching full working length. Notably, the patient remained asymptomatic during the six-month follow-up, highlighting the efficacy of the treatment. This article also reviews the current literature, examining comparable cases and techniques documented in scholarly sources.

Bone resorption following tooth loss might compromise retention, stability, and support of conventional removable prostheses, and for this reason, implant-supported overdentures are suggested as a viable alternative for completely edentulous patients. Bars, telescopic attachments, or stud attachments have been used to provide retention through a different mechanism of action based on specific design characteristics. The purpose of this report is to thoroughly describe the applied protocol for the fabrication of an implant overdenture supported by two bars incorporating stud attachments. A 67-year-old male patient presented to the Postgraduate Clinic of the National and Kapodistrian University in Athens seeking dental rehabilitation. The remaining teeth were characterized with poor prognosis, mainly due to their periodontal status. The proposed treatment plan included the placement of four implants in the maxilla and two implants in the mandible and the fabrication of implant-supported overdentures. The diagnostic stages revealed adequate prosthetic space that would enable the fabrication of a bar substructure for the maxillary overdenture. To combine the benefits of bars and stud attachments, two bars with four attachments were fabricated. Evaluation of the delivered prosthesis revealed adequate retention, support, and stability achieved with minimal palatal coverage. Patient's reported satisfaction and quality of life were increased. Recall appointments at one, six, and twelve months did not reveal any adverse effects or patient's complaints. According to the present case report, different types of attachments may be used after careful study of each case. More studies are needed to report on different aspects of the chosen treatment plan.