Case Reports in Dentistry最新文献

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.

Introduction: Ellis-van Creveld (EVC) syndrome, also known as chondroectodermal dysplasia, is a rare autosomal recessive disorder that affects multiple embryonic tissues. It is primarily caused by mutations in the EVC gene.

Patient information: We report an 11-year-old male diagnosed with EVC syndrome, who carries a novel homozygous pathogenic mutation, c.1750delC (p.Q584Rfs∗4), in the EVC gene, identified through whole-exome sequencing (WES) and confirmed by Sanger sequencing. Clinical features included multiple aberrant frenula, disproportionate short stature, polydactyly, and dystrophic nails.

Dental management: The patient received multidisciplinary dental care, including composite restorations and prosthodontic rehabilitation with partial dentures adapted for future tooth eruption. The identification of this specific EVC mutation informed anticipatory dental planning, leading to individualized management strategies for optimal dental care.

Conclusions: This case highlights a novel EVC gene mutation, underscoring the importance of genetic analysis in guiding comprehensive pediatric dental care for EVC syndrome. Early recognition of dental manifestations, coupled with molecular confirmation, supports tailored interventions to optimize oral health outcomes.

This article describes the orthodontic treatment involving a traumatized, endodontically treated upper central incisor that underwent extensive orthodontic movement. A male patient, 13 years and 1 month old, presented with the following conditions: mesofacial, convex profile; Class II skeletal pattern; angle Class I malocclusion; crowding of lower incisors; biprotrusion; and endodontic and restorative treatment of the traumatized left maxillary central incisor. Four first premolars were extracted to reduce dental protrusion and correct crowding of the lower incisors. Low-magnitude forces were applied to the traumatized incisor and the movement time of this tooth was shorter than in the other teeth. Dental alignment and leveling, adequate overjet and overbite, and good positioning of the teeth in their bone bases were obtained. Orthodontic treatment with extensive movement of a traumatized, endodontically treated tooth was performed successfully and showed no root resorption 7.3 years postretention.

Dens invaginatus (DI) is a rare dental anomaly characterized by the infolding of enamel and dentin into the pulp cavity during tooth development. This condition often leads to complex endodontic challenges, predisposing affected teeth to caries, pulp necrosis, and chronic periapical abscesses. This case report describes the successful management of a maxillary lateral incisor with Type II DI complicated by a chronic periapical abscess, using an endodontic microsurgical approach. A 10-year-old girl presented with a chief complaint of recurrent swelling in the maxillary left incisor area. Clinical examination revealed a malformed maxillary left lateral incisor with Grade II mobility and a fluctuant gingival swelling. Periapical radiography and cone-beam computed tomography (CBCT) confirmed DI with an immature apex, significant periapical rarefaction, and fenestration of the labial cortical bone. Endodontic microsurgery treatment was performed, involving flap reflection, lesion excision, root canal irrigation with 1% sodium hypochlorite (NaOCl), and retrofilling using a calcium-silicate-based sealer (CeraSeal) and bioceramic putty (CeraPutty). The surgical site was sutured, and postoperative care instructions were provided. Histological examination confirmed a periapical cyst. Follow-up examinations revealed favorable soft tissue healing, mucosal sinus tract closure, and complete bone regeneration at the surgical site. CBCT evaluation at 3 years confirmed full buccal bone regeneration. This case demonstrates that endodontic microsurgery can be a successful treatment option for managing complex DI cases with chronic periapical abscesses when orthograde endodontic treatment is not feasible. CBCT imaging plays a pivotal role in diagnosis, treatment planning, and postoperative assessment. Further clinical research is warranted to evaluate the long-term outcomes of microsurgical management in similar developmental anomalies.

Maxillary transverse deficiency is a common clinical problem in orthodontics, and treating it becomes more challenging when a unilateral posterior crossbite exists. Different treatment modalities have been used, including slow maxillary expansion (SME), rapid maxillary expansion (RME), surgically assisted rapid palatal expansion (SARPE), and corticotomy-assisted expansion. The type of treatment depends mainly on the patient's skeletal maturity. In this case report, we describe the treatment of a 20-year-old female patient with unilateral posterior crossbite using corticotomy-assisted expansion with fixed orthodontic appliances. The crossbite was corrected, and normal overbite and overjet were achieved with Class I canine and molar relationships. The duration of correction of the crossbite was relatively shorter, and periodontal health was maintained without any complications. The technique of selective alveolar bone corticotomy is considered a less invasive procedure when compared to SARPE and MARPE, and it may provide an efficient treatment option in cases of adult unilateral maxillary transverse deficiency.

Hyaline degeneration is a common degenerative disease after tissue or cell injury. It can occur in diseases such as renal fibrosis, atherosclerosis, and oral submucous fibrosis. Homogeneous eosinophilic deposits characterize it. However, the occurrence of hyaline degeneration is rarely accompanied by calcification. We present a rare case of a 33-year-old female patient diagnosed with a calcified nodule of the upper lip mucosa, which was confirmed as a benign entity without malignancy. This report is aimed at enhancing understanding of this condition and providing a reference for future diagnosis and treatment strategies.

Full-arch implant rehabilitation is a demanding procedure where accuracy, occlusal stability, and function remain major challenges. Digital workflows have improved many steps of treatment, but the use of mandibular movement data in prosthetic design is rarely described. This report presents the rehabilitation of a 69-year-old male with terminal dentition using a complete digital approach. Six maxillary and five mandibular implants were placed with a stackable surgical guide. CBCT, intraoral and facial scans, Exocad planning, and the PIC system were combined to ensure precise implant positioning. Mandibular kinematic records from the Zebris JMA Optic system guided occlusal adjustment in both provisional and definitive prostheses. The zirconia-based restoration provided stable function, good esthetics, and high patient satisfaction, with no complications during follow-up. This case illustrates how incorporating mandibular movement records into a digital workflow can enhance the predictability and clinical outcomes of full-arch rehabilitation.