Case Reports in Dentistry最新文献

Peripheral ossifying fibroma (POF) is a benign swelling of the gingival connective tissue commonly associated with dental biofilm and biofilm-retentive dental appliances. In the present case report, we described three cases of POF with different clinical presentations and treatment approaches. The treatment consisted of the removal of supra- and subgingival calculus, followed by a flap surgery with excision of the entire lesion ensuring the inclusion of the periosteal bed. The first patient developed POF during her pregnancy that remained clinically noticeable postpartum. The second case represented a rare case of POF appearing on the palatal aspect of the anterior maxilla of an African American male. The third case represented POF that developed on the mandible, and contrary to the first two cases, it was excised using a diode laser and not a scalpel blade. All patients showed uneventful healing during follow-up appointments; however, poor patient compliance did not allow for evaluation of long-term healing responses and possible recurrence of the lesion. Within the limitations of this clinical report, it is evident that the periodontal surgical approach was effective in managing POF with stable short-term clinical outcomes.

In addition to affecting oral functions such as temporomandibular joint function, mastication, and speech, malocclusion caused by skeletal maxillary prognathism also entails sociopsychological implications. Surgical orthodontic treatment to improve occlusion and oral function and to correct esthetic disharmony is important to improve patients' quality of life. We report the case of a 32-year-old woman who visited our hospital with a chief complaint of proclined upper front teeth. Clinical examination revealed maxillary overgrowth and severe labial inclination of the maxillary incisors with palatal gingival recession. The incisal protrusion was corrected with a maxillary anterior alveolar osteotomy-a surgical orthodontic method that could improve the overbite without causing excessive lingual inclination, while also minimizing orthodontic movement of the maxillary anterior teeth. This treatment is generally indicated in cases of maxillary prognathism with a relatively stable occlusal relationship in the molar region. As a result of the treatment, the patient's chief complaint improved and a long-term functional occlusion was achieved. This paper outlines the pre- and posttreatment skeletal and occlusal changes.

Excessive display of the gums when smiling, known as gummy smiles, can lead to aesthetic concerns and emotional discomfort for individuals. In recent times, there has been a notable rise in the popularity of gummy smile surgery as a cosmetic procedure aimed at addressing this problem. A novel technique known as lip repositioning has emerged and gained recent popularity, either on its own or in conjunction with other approaches. In specific situations, it offers a simpler, less intricate alternative to more extensive surgical procedures, resulting in a pleasing and satisfactory camouflage effect while reducing postoperative complications. This case report illustrates the effective treatment of a gummy smile in a patient with excessive gum exposure using a lip repositioning technique. The procedure involved the removal of a partial thickness strip of mucosa lining in the maxillary buccal vestibule, without including the labial frenulum, and suturing the lip lining to the gum line. Our aim was to present lip repositioning as an effective method for reducing excessive gum exposure and addressing any unevenness in a minimally invasive manner. We sought a solution that offers long-lasting results over time while minimizing the chances of the issue recurring, with a 14-month follow-up.

Scissor bite does not correct spontaneously. It gradually worsens by overeruption, negatively affecting masticatory function. It is intended with this manuscript to evaluate the different treatment strategies to correct this malocclusion in adult patients, exploring treatment with clear aligners, bite ramps, and MS (miniscrews), especially in this case of a patient with unilateral right scissor bite, with high dental compensation in the three planes of space, asymmetrical sagittal dental position, overeruption on the scissor bite condition, and a high mandibular arch constriction and maxillary expansion. A comprehensive literature research was performed from 2002 until March 2023. PubMed and BVS databases were used, with the following keywords: "scissor bite OR brodie bite" AND "malocclusion" AND "treatment OR correction OR therapeutics". Since correcting skeletal asymmetries after the growth completion is challenging, adult patient cases often involve a combined orthodontic-surgical approach. In the present clinical case, the severe limitations to decompensating tooth positions for a surgical treatment, with the necessity to perform lower asymmetric extraction and a must longer orthodontic treatment, were the major reasons to avoid the surgical approach, after the scissor bite correction. In spite of this, the efficiency of the clear aligners and auxiliaries like bite ramps, MS, and elastics in successfully correcting a complex scissor bite in an adult patient was demonstrated, with significant esthetic and functional commitment, demonstrated by the case reliability PAR (peer assessment rating) index.

Introduction: Extensive comminuted fractures are associated with tooth loss that ultimately leads to dimensional changes in the hard and soft tissues of the alveolar ridge. Reconstruction of the lost mandibular anterior ridge is very complex due to the natural curvature of the region. Case Presentation. In this case report, the combination of the modified shell technique with autologous bone plates and the guided bone regeneration (GBR) technique was performed on an 18-year-old patient after a comminuted fracture, to ensure new bone formation in the anterior ridge with a natural curvature. After the treatment progressed without complications, three dental implants were placed. Annual cone beam computed tomography (CBCT) images were obtained and evaluated using the GNU Image Manipulation Program (GIMP© 2.10). This allowed measurements of the buccal and lingual bone around the implants, showing the annual bone loss in a twelve-year observation period. Discussion. The treatment of the comminuted fracture and the combination of the modified shell technique with autologous bone plates, the GBR technique, and implant placement can be considered successful. The three dental implants were osseointegrated in 2010, with the buccal bone level averaging 1.31 mm below the implant shoulder and the lingual bone level 1.57 mm above the implant shoulder. In 2021, the measurements showed a bone loss of 0.99 mm at the buccal implant shoulder and 0.69 mm at the lingual implant shoulder.

Conclusion: The combination of the modified shell technique with autologous bone plates and the GBR technique is a reliable method to ensure new bone formation in the anterior ridge. The use of CBCT is an excellent method to evaluate bone resorption around dental implants, but due to minimal bone resorption in the observation period, an annual CBCT examination is exaggerated.

Stafne's bone defect is a developmental anatomic bone defect in the lingual side of the mandible in the area of the mandibular angle that is filled with proliferation or translocation of adjacent structures such as salivary gland tissue. The etiology is still undefined, and two hypotheses are proposed: one is the glandular related to the submandibular or sublingual glands and the second is ischemic that affects the vascularization of the mandibular lingual. Usually, Stafne's bone defect is accidentally detected on panoramic radiographs during dental treatments as a well-limited radiolucency image with a clear peripheral regular condensation border, located below the mandibular canal. The differential diagnosis includes traumatic bone cyst, odontogenic and nonodontogenic cystic lesions, nonossifying fibroma, focal osteoporotic bone marrow defect, and other lesions. A case of Stafne's bone defect on a 60-year-old male patient extending in the lingual posterior part of the mandibular region was presented. The panoramic radiograph revealed a well-limited radiolucency image with a clear peripheral regular condensation border, located below the mandibular canal. The lesion was discovered in a routine radiographic exam: the cone beam computed tomography gave us more details about the localization, the shape and size, and the relation with the mandibular canal, and the magnetic resonance imaging identifies the nature of the inside soft tissue. The final diagnosis was a Stafne's bone defect resulting of a depression of the lingual cortical plate filled with expansion of the submandibular gland.

The osseodensification (OD) technique differs from conventional milling for dental implant installation in that it preserves the prepared bone and compacts it toward the apex and lateral walls of the socket, resulting in bone compaction. By enabling autografting, bone expansion, and high implant insertion torques, OD has become an increasingly popular option. The aim of this clinical case report is to demonstrate the predictability of combining OD with guided bone and tissue regeneration (GBR/GTR) techniques for bone expansion in the maxilla with reduced thickness, while avoiding other reconstructive surgeries. The report presents the treatment of a 32-year-old female patient who had cosmetic concerns regarding the anterior maxillary region. The patient was using an adhesive prosthesis with pontic on tooth 13 fixed between teeth 12 and 14. After the case was planned, it was decided that bone expansion in the region would be performed using the OD technique. The implant installation (AR Torque, 3.5 × 11.5 mm, Conexão®) and guided bone regeneration (GBR) were done with the assistance of L-PRF (Stick Bone, associated with L-PRF membrane). Following the osseointegration period, a provisional resin crown was fabricated, and a collagen matrix membrane (Mucoderm®) was used to increase vestibular soft tissue volume and shape the patient's gingival profile. After a period of 120 days, the final crown was created and observed for a span of 5 years. The results showed stability of the case along with maintaining its esthetic and satisfactory function. The use of the osseodensification technique coupled with a connective tissue graft substitute has been anticipated for a long time. It has proven to be an excellent alternative to autogenous grafts.