Case Reports in Dentistry最新文献

A 22-year-old female patient consulted the Odontology Department of the Mohammed V Military Hospital in Rabat, Morocco, for a recurrent abscess in relation to the left maxillary central incisor (#21). The dental history of the tooth began with necrosis following trauma a few years before. A conventional endodontic root canal treatment was performed, but several infectious episodes occurred, treated only with antibiotics. The radiographic examination showed an adequate root filling and a large apical lesion in Tooth #21. Tooth #21 was diagnosed as chronic apical periodontitis. After orthograde retreatment, clinical signs have not resolved, and the patient has consulted for a recurrent abscess. Given this atypical clinical situation, an extraradicular infection was suspected and the decision for endodontic surgery was made. The histopathological diagnosis revealed actinomycotic infection. The aim of this case report is to draw practitioners' attention to this rare infectious etiology, which does not respond to conventional endodontic treatment, and to expose the diagnostic and therapeutic approach required to treat apical actinomycosis.

Reports describing long-term outcomes of the lesion sterilization and tissue repair (LSTR) technique in primary molars are limited. This paper presents a distinctive case in which a primary molar with complete root development and furcation involvement-usually an indication for conventional pulpectomy-was instead treated with LSTR, a technique generally recommended in advanced root resorption. The case adds evidence on the potential indications and clinical versatility of this approach in pediatric dentistry. A pediatric patient with uncooperative behavior presented with discomfort in a primary molar. Clinical and radiographic examination revealed pulp necrosis, complete root formation, and a furcation lesion. Although pulpectomy was the conventional indication for such findings, LSTR was chosen as a conservative alternative. Treatment consisted of the placement of an antibiotic mixture in the pulp chamber to disinfect and sterilize the root canal system without mechanical instrumentation, with the objective of controlling infection and promoting tissue repair. At the 5-year follow-up, the tooth remained functional and symptom-free, with radiographic evidence of healing and tissue regeneration, demonstrating favorable long-term outcomes. This case shows that LSTR can provide favorable long-term outcomes even in situations where pulpectomy would traditionally be indicated. It supports LSTR as a less invasive and effective option for preserving primary molars until their natural exfoliation.

Background: The discovery of a cervicofacial swelling is a common concern among the pediatric population with a broad range of potential diagnoses. While infectious origins related to dental infection are frequent, it is crucial not to overlook other systemic causes. Among these causes, cervical tuberculous lymphadenitis (CTL) stands out as one of the most common forms of extrapulmonary tuberculosis. This condition poses a significant diagnostic challenge in children, as it is often asymptomatic and can lead to a misdiagnosis.

Case presentation: The aim of this paper is to highlight, through a case report, the diagnostic approach to a lower mandibular swelling in a 10-year-old boy initially diagnosed as cellulitis of dental origin. However, further investigation revealed CTL, confirmed by lymph node biopsy, leading to a 6-month regimen of four drugs for treatment. This uncommon presentation emphasizes the importance of thorough investigation, as the overlap in symptoms with dental infection could potentially lead to misdiagnosis. Dentists can play a crucial role in detecting tuberculosis in cases of cervicofacial swelling. By doing so, they can ensure early diagnosis and promptly refer the patient for appropriate management.

Conclusion: The case report underscores the importance of considering tuberculosis in the differential diagnoses of cervicofacial swellings in children, emphasizing comprehensive clinical, radiological, and histopathological assessment for accurate diagnosis and effective treatment.

Introduction: This case report highlights the clinical application of stamp and injection molding techniques for the restoration of young permanent teeth, as efficient, esthetic, and less invasive alternatives to conventional restorative approaches. However, each has distinct limitations that should be taken into consideration for optimal clinical outcomes.

Report: The first case was an anxious 14-year-old girl, who presented to the Postgraduate Clinic of Paediatric Dentistry Department (NKUA), for the restoration of a right upper first permanent molar. Intraoral examination confirmed an extensive occlusal carious lesion involving the distobuccal cusp. Given the need for direct esthetic and functional restoration, the injection molding technique was selected as the most appropriate treatment approach ensuring precise anatomical replication and seamless restoration with the least clinical time and effort, reducing the stress of the patient. The second case was a 9-year-old girl, also examined at the clinic with carious lesions on the occlusal surfaces of the first permanent mandibular molars, but without extensive tissue loss. Given the nature of the lesions, the stamp technique was chosen as the preferred method of restoration, allowing for quick and efficient restoration by replicating the tooth's original morphology. Both techniques provided functional and esthetic results, proving their effectiveness in pediatric restorative dentistry while minimizing chairside time and preserving natural tooth structure.

Conclusion: Stamp and injection molding techniques offer promising alternative solutions for direct composite restorations of posterior permanent teeth in young patients. Their ability to provide predictable, esthetic, and efficient restorations underscores their clinical significance. However, careful case selection, meticulous application, and periodic recall examinations remain essential to optimize their outcomes and ensure long-term success.

Hereditary sensory and autonomic neuropathies (HSANs) are rare inheritable syndromes of unknown etiology. They typically appear in early childhood and are categorized into six different types based on their symptoms. HSAN-V is characterized by loss of pain and thermal perception, Charcot joints, painless fractures, scoliosis, oral lesions, and absent corneal reflexes. The HSAN-V phenotype has a propensity to progress to autoamputation, varying degrees of hypohidrosis, and moderate hyperactivity and perception delay. In this case report, we focused on oral findings, prosthodontic treatments, and oral rehabilitation of a 9-year-old girl with HSAN type V.

This case report describes the management of a palatoradicular groove on a lateral incisor tooth (#12) in a nonperiodontitis patient. Despite the commencement of endodontic treatment, the tooth showed no signs of resolution and was referred to the Oral Health Centre of Western Australia for specialist management. Tooth 12 presented with a periodontal probing depth of 7 mm at the mid-palatal site with suppuration. Nonsurgical periodontal therapy adjunct with the application of 0.5% chlorhexidine gel was completed, followed by the completion of endodontic treatment one week prior to regenerative therapy. A minimal access papilla-sparing regenerative technique (MAPSRT), a novel, site-specific modification, was used for the management of the palatoradicular groove. Periodontal instrumentation, odontoradiculoplasty, placement of fissure sealant material and application of an enamel matrix derivative combined with bone grafting material were performed during regenerative therapy. Tooth 12 was restored with a full-coverage monolithic zirconia crown 6 months after regenerative therapy. This procedure had a successful outcome with a reduction in probing depth on the mid-palatal site of Tooth 12 to 3 mm, bone remodelling in the defect areas and minimum scarring at the 6-month review appointment. This case highlights the importance of an interdisciplinary approach in the management of periodontal destruction associated with palatoradicular grooves.

Lateral root perforations are serious iatrogenic complications that can compromise the outcome of endodontic treatment. The current case report presents the successful treatment of simultaneous double lateral root perforations in the mandibular canine and first premolar using a nonsurgical approach guided by cone beam computed tomography (CBCT) and mineral trioxide aggregate (MTA). Perforations that were not detectable with periapical radiographs were confirmed using CBCT, and the treatment planning was performed based on the millimetric measurements provided by CBCT. The treatment protocol included rubber dam isolation, microscopic assistance, effective irrigation, calcium hydroxide intracanal medication, and definitive sealing of the perforation sites with MTA. The 1-year follow-up revealed asymptomatic teeth with normal function and radiographic evidence of periapical healing. This case highlights that CBCT-guided MTA repair provides a predictable, minimally invasive solution for managing iatrogenic lateral root perforations, though its success is contingent upon a meticulous approach and regular follow-up.

A variety of carcinogenic agents and the innovation of diagnostic methods have a huge impact on the biological profile of numerous tumors over time which reflect in their diagnosis and behavior. The ability to predict the tumors' behavior, mainly the malignant ones, and develop personalized therapy could change the lifestyle of the patients. The unpredictable histopathologic profile of plasmacytoma, for example, and its linked clinical behavior suggest that the fluctuations are linked to its behavior and prognosis as well. We introduce in this case a unique type of plasmacytoma with valuable clinical data and follow-up that may support literature with conspicuous documented cases of this malignant tumor. Indeed, this entity has obvious invasive and destructive features and yet a good prognosis. A good understanding of this malignancy will extremely enhance the long-term healing of the patients. This paper presents a destructive plasmacytoma with peculiar histopathologic features and yet has a good prognosis during our follow-up. We observed a multinodular mass in the right mandible extending above the sternocleidomastoid muscle in a 58-year-old female patient who was referred to the oral and maxillofacial department in the faculty. After half-mandible excision and right neck resection, the lesion was diagnosed as a plasmacytoma with amyloid deposition, and the patient was referred to an oncologist. And the patient is still under follow-up without any recurrence. Despite the low risk of extramedullary plasmacytoma progressing into multiple myeloma, the clinical management is still a challenge because of the potential for recurrence. Understanding the behavior of this tumor and its management strategies is crucial to obtain the best prognosis for the patients.

Nonvital tooth bleaching is a treatment designed to enhance the cosmetic appearance of discolored teeth that have lost vitality. This procedure has become increasingly popular in contemporary dentistry due to its effectiveness. Among the various chemical agents used for this purpose, sodium perborate, when combined with hydrogen peroxide, has proven to be one of the most efficient solutions for achieving noticeable whitening outcomes. Sodium perborate is a stable oxidizing agent, frequently mixed with hydrogen peroxide to form a bleaching paste. This paste is then placed directly into the pulp chamber of a nonvital tooth. The oxidation reaction that occurs helps to break down organic pigments within the tooth, thereby reducing discoloration without causing harm to the surrounding dental tissues. Research has shown that the combined use of sodium perborate and hydrogen peroxide can effectively restore a tooth's natural color, with a low incidence of complications such as root resorption or external cervical resorption. This method has been proven to be both clinically successful and generally safe, though it is crucial to carefully monitor the concentration of the bleaching agents and the duration of their application to prevent excessive bleaching or harm to the tooth's structure. Nonvital tooth bleaching has emerged as a valuable technique for teeth that have undergone root canal treatment, providing a noninvasive and efficient alternative to more extensive restorative procedures. This review discusses the underlying mechanisms, efficacy, safety, and potential risks associated with nonvital tooth whitening using sodium perborate and hydrogen peroxide, offering a thorough overview of its role in modern dental practice.

Dental avulsion is one of the most severe forms of dental trauma, often requiring urgent intervention. The prognosis of replantation depends heavily on the extraoral time and the storage conditions of the avulsed tooth. This study is aimed at presenting and analyzing a clinical case of delayed replantation of a maxillary central incisor in a prepubertal patient, highlighting the therapeutic decisions, challenges, and long-term outcomes. A 14-year-old patient suffered avulsion of two maxillary incisors during a sports accident. One tooth was recovered 22 h posttrauma and stored in milk before replantation. Endodontic treatment was performed ex vivo, and the tooth was replanted 30 h after the incident. Despite initial clinical success, radiographic signs of inflammatory root resorption were observed at the 1-year follow-up. This case demonstrates that although delayed replantation carries a high risk of complications such as root resorption and ankylosis, it remains a viable option, especially in young patients due to its role in preserving alveolar bone and mitigating psychological and esthetic impacts.