Case Reports in Dentistry最新文献

Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of unknown etiology affecting children. Temporomandibular joint (TMJ) involvement has been reported in up to 96% of children with JIA. This paper presents a case of JIA with TMJ involvement, emphasizing the clinical features and therapeutic management of the disease. This is a case of a 10-year-old female who presented with pain localized at the left mandible angle during end-feel assessment. During examination, reduced range of motion (ROM) and limited right lateral excursion were observed. Afterwards, a comprehensive multidisciplinary evaluation led to diagnosing the patient with oligoarticular JIA involving the TMJ. Treatment modality included cognitive behavioral therapy, left-sided joint distraction exercises to reduce intra-articular pressure and relax affected masticatory muscles, and a modified CerveraTS plate. Three months of posttreatment follow-up showed pain remission, improved ROM, and enhanced right lateral excursion. Sustained therapeutic outcomes were reported after 1 and 3 years of follow-up visits. The case emphasizes the importance of early diagnosis of JIA with TMJ involvement and tailored management using functional appliances such as the CerveraTS plate which has proved its efficacy in improving mandibular function and pain resolution.

Achieving a stable passive fit is important in implant treatment, especially for restorations of screw-retained superstructures. A passive fit is often evaluated by tactile sensing of tightening a fixing screw; however, tactile sensing is a subjective procedure. Objective and quantitative assessment of passive fits can be performed by measuring the tightening torque on prosthetic screws. In this clinical case, accumulative screw tightening torques for passive fit and misfit superstructures were calculated to examine the usefulness of the proposed method. The results suggested that accumulative torques and time slopes of torques may be potentially useful parameters for quantitatively evaluating passive fits; further laboratory and/or clinical trials are necessary.

Managing defects caused by pathological root resorption in permanent teeth can be challenging. If not diagnosed and treated efficiently, progressive root resorption can result in the loss of a tooth. This paper reports the consequences and treatment of poorly managed dental trauma 3 years ago affecting maxillary central and lateral incisors of an 11-year-old male child. Intraoral periapical radiographs revealed resorption defects involving the cervical, middle and apical thirds of Tooth Numbers 12, 11, 21 and 22 (FDI numbering system). A blunderbuss canal with a wide open apex was also noted in relation to Tooth Number 22. Resorption defects involving the pulp canal space and calcification of the pulp were also noted in relation to Tooth Numbers 21 and 12, respectively. This was confirmed by a CBCT scan. A diagnosis of infection-related root resorption, invasive cervical root resorption with pulp canal calcification and internal root resorption was made in relation to Tooth Numbers 11, 22, 12 and 21, respectively. The cervical defect in relation to Tooth Number 22 was surgically debrided and filled using MTA. Nonsurgical endodontic treatment was performed in relation to Tooth Numbers 11 and 21, and apexification was performed in Tooth Number 22. Bioceramic materials like MTA and Biodentine were used to seal the resorption defects as well as obturate the entire root canals of the affected teeth. On 36 months' follow-up, the treated teeth were clinically asymptomatic, showed healing radiographically, and there was no further progression of root resorption. The outcome of this case emphasises the importance of timely management and appropriate clinical care in all traumatic dental injuries. The role of bioceramics in managing root resorptions seems to be promising.

Hypodontia with one or two permanent teeth is a common anomaly in dental clinics, while missing more than six is rare. Management of these cases is challenging because, other than the missing tooth problem, bone formation deficiency, imperfect vertical dimension of occlusion, and available tooth displacement will complicate the treatment procedure. Being in early youth and having high esthetic demands make these patients even more difficult to treat. Before starting the treatment, an exact diagnostic procedure is essential to pick the best treatment option. Also, to achieve predictable and satisfactory results, a predefined workflow is useful. The current study presents a step-by-step procedure from diagnosis to full mouth rehabilitation of an 18-year-old man who suffered from hypodontia with 21 missing permanent teeth. A diagnostic work-up was carried out and mocked up in the mouth. Dental implants were inserted, and printed provisional restorations were evaluated in terms of esthetics, phonetics, and vertical dimension. Implant-supported and tooth-supported full ceramic restorations were made based on the treatment plan. Mutually protected occlusion was designed and implemented. At the end, an occlusal splint was made to care for the restorations. The main take-away lesson from this case is that in the treatment of hypodontia patients, all treatment options should be evaluated, and a multidisciplinary approach should be followed.

This case report details the successful orthodontic management of an adult female with skeletal Class II malocclusion, protrusive facial profile with perioral muscle tension, and mild crowding using clear aligners following extraction of four first premolars. To address the inherent challenges of "roller-coaster effects," a biomechanically appropriate protocol was implemented including rational case analysis and selection, as well as attachment design, anchorage control, overcorrection strategy, and tooth movement pattern. The treatment process successfully avoided refinements and the "roller-coaster effects," accomplishing the entire therapeutic plan with the initial series of clear aligners. This study demonstrates the individualized biomechanical protocols to bridge discrepancies between virtual treatment predictions and real-world therapeutic efficacy, particularly in premolar extraction cases where uncontrolled tipping threatens predictability.

Objective: Dental trauma frequently impacts children and adolescents, leading to functional and esthetic challenges. If not managed promptly and effectively, complications may ensue. Apexification with calcium silicate cement (CSC) has been proposed as a reliable treatment for necrotic immature teeth with thick dentinal walls and open apices. While CSC effectively eliminates periapical infection and improves tooth survival, its ability to promote root lengthening in immature teeth is not consistently proven.

Materials and methods: This case series highlights five instances in four children of traumatized anterior teeth with necrotic pulps treated using bioceramic putty and bioceramic sealer-a contemporary generation of CSC-in apexification procedures spanning two to three visits.

Results: Radiographic follow-ups of 24 months demonstrated successful canal system sealing, periapical lesions healing, and notable root lengthening. Importantly, no posttreatment complications, such as pain or exacerbation, were observed, underscoring the efficacy and potential of these materials for managing necrotic immature permanent teeth.

Conclusion: Bioceramic apical barrier is recognized as an effective treatment for managing traumatized anterior teeth. Moreover, it demonstrates promising results by facilitating the healing of necrotic immature teeth and potentially supporting root lengthening.

Trial registration: ClinicalTrials.gov identifier: NCT06119477.

Aim: The aim of this study was to present three cases of COVID-19-related mucormycosis mimicking endodontic pain and to discuss the relevant dental and medical literature for this potential life-threatening disease.

Summary: Mucormycosis (previously called zygomycosis) is a rare but serious infection caused by a group of fungi called mucormycetes. Mucormycosis mainly affects people who are medically compromised and have systemic health conditions or take drugs that lower their immune response. There has been an increase in case reports/series of mucormycosis in individuals diagnosed with COVID-19. This is likely attributable to the high doses and prolonged use of corticosteroids in the treatment of hospitalized COVID-19 patients. This increase in the prevalence of the condition is of importance, primarily because the fatality rate of patients with mucormycosis is high. Moreover, rapid growth and dissemination into soft tissue and bone with angioinvasion of the fungus are common, and delays in diagnosis can be fatal. This report describes three cases of mucormycosis that were associated with COVID-19 and presented with symptoms that mimicked odontogenic pain.

Mandibular prognathism results from a complex interplay of genetic predisposition and environmental influences. In this study, we aimed to report the successful orthodontic management of a pediatric patient with mandibular prognathism that was potentially associated with a thyroglossal duct cyst in the floor of the mouth. This condition was treated with maxillary protraction therapy to improve the craniofacial morphology. A 9-year-5-month-old male patient presented with a major complaint of an anterior crossbite. Medical history revealed a congenital thyroglossal duct cyst in the floor of the mouth, which was surgically excised 8 months before the initial orthodontic consultation. Clinical and radiographic examination revealed severe mandibular prognathism characterized by maxillary hypoplasia and relative mandibular prognathia. We initiated maxillary protraction therapy using a protractor with a chin cup. Furthermore, significant skeletal improvements were observed following 30 months of active treatment: The SNA angle increased by 4.3°, the SNB angle decreased by 2.8°, the ANB angle increased by 7.1°, and the Wits appraisal improved by 14.1 mm. Long-term follow-up showed stable maintenance of these skeletal corrections at 4 years posttreatment. This case report suggested that a thyroglossal duct cyst in the floor of the mouth may be an environmental factor in mandibular prognathism pathogenesis. In addition, it demonstrates the clinical efficacy of maxillary protraction therapy in the orthopedic correction of Class III malocclusion during the active growth period.

Molar incisor hypomineralization (MIH) is a developmental defect of tooth enamel that affects the quality of the enamel. It is estimated that MIH affects between 13.1% and 14.2% of the world's population. However, in some countries, such as Tunisia (North Africa), there is a dearth of information regarding the prevalence of MIH. The range of treatment options for MIH includes preventive interventions implemented during childhood as well as conservative restorations for adult patients. This case report was aimed at providing a detailed account of the esthetic rehabilitation of a clinical case involving a young female patient who had MIH-related esthetic impairment and for whom ceramic veneers were recommended as part of a minimally invasive treatment plan.

Class III malocclusion is a dentoskeletal condition characterized by altered relationships between bones, teeth, and muscular structures. Sagittal and transversal maxillary deficiency is one of the most common patterns, negatively affecting facial esthetics and the psychosocial well-being of the patient. This case report describes an 11-year-old male patient with Class III skeletal malocclusion, a deep anterior crossbite, and a transverse discrepancy. Orthodontic treatment was performed with a mini-implant assisted rapid palatal expansion (MARPE 2S), anchored in the maxilla with two mini-implants, combined with four additional components: two for a face mask and two for the Ertty Gap III protocol, as well as a lip bumper with flanges for 5/16 heavy intermaxillary elastics in Class III mechanics for 24 h a day, attached to a soldered lingual arch. The combination of these orthopedic devices synergistically improved expansion and anteroposterior changes, resulting in significant functional, esthetic, and psychological improvements for the patient.