MyMedR

Fulltext Camouflage of Severe Skeletal Class II Gummy Smile Patient Treated Nonsurgically with Mini Implants

Qamruddin I, Shahid F, Alam MK, Zehra Jamal W

Case Rep Dent, 2014;2014:382367.

PMID: 25548686 DOI: 10.1155/2014/382367

Skeletal class II has always been a challenge in orthodontics and often needs assistance of surgical orthodontics in nongrowing patients when it presents with severe discrepancy. Difficulty increases more when vertical dysplasia is also associated with sagittal discrepancy. The advent of mini implants in orthodontics has broadened the spectrum of camouflage treatment. This case report presents a 16-year-old nongrowing girl with severe class II because of retrognathic mandible, and anterior dentoalveolar protrusion sagittally and vertically resulted in severe overjet of 13 mm and excessive display of incisors and gums. Both maxillary central incisors were trimmed by dental practitioner few years back to reduce visibility. Treatment involved use of micro implant for retraction and intrusion of anterior maxillary dentoalveolar segment while lower incisors were proclined to obtain normal overjet, and overbite and pleasing soft tissue profile. Smile esthetics was further improved with composite restoration of incisal edges of both central incisors.

Fulltext An unusual case of tooth in the floor of the orbit: the libyan experience

Shetty YN, Majid IA, Patel RU, Shammam M

Case Rep Dent, 2012;2012:954789.

PMID: 23056963 DOI: 10.1155/2012/954789

Maxillary dentigerous cysts although uncommon need to be considered in the differential diagnosis in children with painless facial swelling. We present a case of dentigerous cyst associated with maxillary deciduous canine and maxillary premolars manifesting as a unilateral swelling in canine region of the face. A ten-year-old boy came to oral and maxillofacial surgery unit with a painless left facial swelling. The local dentist had prescribed antibiotics for treatment for the facial swelling, but the swelling did not subside, and the parents brought the child to our unit in Zliten Dental College. After clinical examination and imaging, the diagnosis of dentigerous cyst was made. Caldwell-Luc approach was done, the cyst was enucleated, and primary closure was done. The patient was followed up for a period of two years and there was no evidence of any recurrence.

Fulltext Management of unilateral masseter hypertrophy and hypertrophic scar-a case report

Shetty N, Malaviya RK, Gupta MK

Case Rep Dent, 2012;2012:521427.

PMID: 22844620 DOI: 10.1155/2012/521427

Masseter muscle hypertrophy is a rare condition of idiopathic cause. It clinically presents as an enlargement of one or both masseter muscles. Most patients complain of facial asymmetry; however, symptoms such as trismus, protrusion, and bruxism may also occur. Several treatment options reported for masseter hypertrophy are present, which range from simple pharmacotherapy to more invasive surgical reduction. Keloid scar with unilateral masseter hypertrophy is a rarely seen in clinical practice. This paper reports a case of unilateral masseter hypertrophy with keloid scar in the angle of the mandible for which surgical treatment was rendered to the patient by using a single approach.

Fulltext Cracked tooth: a report of two cases and role of cone beam computed tomography in diagnosis

Kalyan Chakravarthy PV, Telang LA, Nerali J, Telang A

Case Rep Dent, 2012;2012:525364.

PMID: 23198164 DOI: 10.1155/2012/525364

Cracked tooth is a distinct type of longitudinal tooth fracture which occurs very commonly and its diagnosis can be challenging. This type of fracture tends to grow and change over time. Clinical diagnosis is difficult because the signs and symptoms are variable or nonspecific and may even resemble post-treatment disease following root canal treatment or periodontal disease. This variety and unpredictability make the cracked tooth a challenging diagnostic entity. The use of cone beam computed tomography (CBCT) in diagnosis of complex endodontic cases has been well documented in the literature. In this paper we present two cases of cracked tooth and emphasise on the timely use of cone beam computed tomography as an aid in diagnosis and as a prognostic determinant.

Fulltext Conservative Management of Dental Erosion in Adolescents with Medical Conditions

Mohd Nor H, Harun NA

Case Rep Dent, 2018;2018:3230983.

PMID: 30647975 DOI: 10.1155/2018/3230983

The prevalence of dental erosion among children and adolescents is trending higher in recent decades and is becoming a major concern. Dental erosion can be caused by either extrinsic or intrinsic acids or both. One of the established aetiological factors for dental erosion by intrinsic acid is the gastrooesophageal reflux disease. The degree of dental erosions may be influenced by any medical conditions that cause a reduction in salivary flow such as the salivary gland excision, autoimmune disease, radiation to the head and neck regions, and medications. If left untreated, the dental erosion can cause dentine hypersensitivity, loss of occlusal vertical height, and aesthetic problems. For effective management of dental erosion, the aetiology of each case must be determined, and its detection at an early stage is of prime importance. This case report illustrates the conservative management of dental erosion in two adolescent patients presented with their medical conditions and behaviour issues. The aim of the treatments was to preserve the vitality of the affected teeth. The treatments were successfully completed using a conservative approach, with the patients' medical conditions taken into consideration.

Fulltext Occurrence of Recurrent Aphthous Stomatitis (RAS) as a Rare Oral Manifestation in a Patient with Gilbert's Syndrome

Heboyan A, Avetisyan A, Skallevold HE, Rokaya D, Marla V, Vardanyan A

Case Rep Dent, 2021;2021:6648729.

PMID: 33953989 DOI: 10.1155/2021/6648729

Recurrent aphthous stomatitis is an ulcerative disease of the oral cavity and can occur in isolation or as a manifestation of many systemic diseases. It is a quite common entity and may hence often be overlooked as an isolated lesion. Gilbert's syndrome is a genetic disorder where a deficiency of an enzyme associated with the conjugation of bilirubin results in unconjugated hyperbilirubinemia. The disease is generally asymptomatic and is aggravated by certain trigger factors. No associated oral manifestations are known. In this case report, we discuss the concomitant presence of recurrent aphthous stomatitis in a patient of Gilbert's syndrome. The presence of such recurrent stomatitis may represent as an oral manifestation of Gilbert's syndrome. Early identification of these entities may improve the overall quality of life of the patient.

Fulltext Simple Orthodontic Correction of Rotated Malpositioned Teeth Using Sectional Wire and 2 × 4 Orthodontic Appliances in Mixed-Dentition: A Report of Two Cases

Sockalingam SNMP, Zakaria ASI, Khan KAM, Azmi FM, Noor NM

Case Rep Dent, 2020;2020:6972196.

PMID: 32695527 DOI: 10.1155/2020/6972196

The correction of rotated malpositioned tooth/teeth into the dental arch alignment in the mixed-dentition is often a challenging task for paediatric dentists. Failure in addressing this issue can bring about detrimental effect to the developing dentition and increases the probability of a complex orthodontic treatment in later years. Factors such as severity of the malpositioned teeth, patient's treatment compliance, limitation in specific functions of the selected appliance, availability of bone and space may dictate the success of the treatment. The combined use of a simple sectional orthodontic wire appliance and a 2 × 4 orthodontic appliance has been shown to produce a positive effect. The appliances resulted in derotation of the rotated malpositioned teeth and bringing them into arch alignment in two cases. This treatment option had eliminated the detrimental effects to the developing dentition and helped patients to enhance their smile and dental aesthetics.

Fulltext The Integration of a Dual-Wavelength Super Pulsed Diode Laser for Consistent Tissue Ablation in the Esthetic Zone: A Case Series

Kamar Affendi NH, Ahmad R, Vahidi F, Hassan MZ, Rahimi SN

Case Rep Dent, 2020;2020:8883156.

PMID: 33343944 DOI: 10.1155/2020/8883156

Introduction: A diode laser is one of the universally compact accepted laser systems used fundamentally for soft tissue applications. Most diode laser devices have a single wavelength of either 810 nm for superior coagulation or 980 nm for tissue ablation. In these case series, the use of dual wavelengths (810 nm and 980 nm) in combination with super pulsing has provided a cleaner cut (no charring) with faster healing that eases the placement of the final restoration in the esthetic zone. Case Description. The present case series describe four cases in the esthetic zone that achieved hemostasis ablation without collateral damage to enhance gingival balance of definitive restoration. The gingivoplasty and gingivectomy modes are used to achieve efficient tissue ablation. Although there is no specific mode indicated in the FDA laser requirement for gingival depigmentation, the procedure could be safely performed with the dual-wavelength diode laser.

Result: All four patients revealed a good esthetic outcome and reported no pain postoperatively. Healing was uneventful, and definitive restoration was delivered within two to four weeks postoperatively.

Conclusion: Within the limitation of these case series, the dual-wavelength super pulsed diode laser has the capacity to deliver peak powers resulting in efficient cutting and less tissue charring and also as an alternative tool for removal of gingival pigmentation. Prospective clinical research with larger sample size is needed for conclusive results.

Fulltext Facial Emphysema following Closure of Oroantral Fistulae

Nizar MAM, Nabil S

Case Rep Dent, 2021;2021:5001266.

PMID: 34394997 DOI: 10.1155/2021/5001266

Subcutaneous emphysema (SE) is a swelling which develops due to air entrapped underneath the subcutaneous tissue and facial planes causing distention of the overlying skin. SE can develop due to trauma, surgery, or infection. The diagnosis of SE is mostly based on clinical findings of crepitation upon palpation of the swelling. Once diagnosed, SE is usually managed by close observation and in some cases may require surgical decompression and antibiotic prophylaxis. We report a rare case of SE of the left malar which developed following closure of oroantral communication using the buccal fat pad.

Fulltext Use of a Modified Nance Appliance for Esthetic Rehabilitation of a Child Patient with Rare Nonfamilial and Nonsyndromic Oligodontia

Al-Ahmadi AO, Assiry AA, Khan SDAA, Marya A, Venugopal A, Karobari MI

Case Rep Dent, 2021;2021:5444257.

PMID: 34336303 DOI: 10.1155/2021/5444257

Congenital absence of more than 6 teeth except the third molar is known as oligodontia. It can affect both primary and permanent dentitions. The affected individuals usually demonstrate esthetic, functional, and psychological concerns. The present case report is about a 4-year-old female patient with multiple missing (both primary and permanent) teeth with esthetic and social problems. On extraoral examination, the patient demonstrated upper lip relapse due to missing anterior teeth. On physical examination, no other abnormality was detected in relation to the hair, appendages, or presence of a cleft. On intraoral and radiographic examination, 21 teeth were missing, which included both the primary and the permanent tooth buds. To encourage a positive behavioral change, it was decided to carry out prosthetic intervention using a modified fixed Nance appliance and acrylic teeth. After the replacement of the missing teeth, a marked improvement in the profile and esthetics was seen.

Two-Stage Mucogingival Surgery with Free Gingival Autograft and Biomend Membrane and Coronally Advanced Flap in Treatment of Class III Millers Recession

Rath A, Varma S, Paul R

Case Rep Dent, 2016;2016:9289634.

PMID: 27525131 DOI: 10.1155/2016/9289634

Introduction. Gingival recession is an apical shift of the gingival margin with exposure of the root surface. This migration of the marginal tissue leads to esthetic concerns, dentin hypersensitivity, root caries, and cervical wear. It is, paradoxically, a common finding in patients with a high standard of oral hygiene, as well as in periodontally untreated populations with poor oral hygiene. Changing the topography of the marginal soft tissue in order to facilitate plaque control is a common indication for root coverage procedures and forms a major aspect of periodontal plastic surgeries. The regeneration of a new connective tissue attachment to denuded root surface is by allowing the selective coronal regrowth of periodontal ligament cells while excluding the gingival tissues from the root during wound healing by means of a barrier membrane. Case Presentation. This case reports a two-stage surgical technique for treatment of Miller's class III defect using free gingival autograft and type I absorbable collagen membrane (BioMend®, Zimmer Dental, USA)(§). Conclusions. The 6-month follow-up of the case showed a significant increase in attached gingiva suggesting it as a predictable alternative in the treatment of Millers class III defects.

Fulltext Stevens-Johnson Syndrome following Failure of Genetic Screening prior to Carbamazepine Prescription

Nasir SA, Tan HL, Tan HJ, Hussaini HM, Ramli R

Case Rep Dent, 2017;2017:4201357.

PMID: 28473929 DOI: 10.1155/2017/4201357

Failure to screen susceptible individuals for human leucocyte allele B∗1502 leads to the onset of Stevens-Johnson syndrome (SJS). We report a case of a 27-year-old Malay female who was treated with carbamazepine following the diagnosis of trigeminal neuralgia without a genetic screening. She was prescribed 150 mg of carbamazepine initially and the dose was increased to 300 mg following the initial dose. A sudden development of skin and mucous membrane ulcers was observed and this warranted immediate hospitalization. A diagnosis of SJS was made and she was treated immediately with intravenous corticosteroids. Genetic screening prior to carbamazepine prescription is essential especially in susceptible populations.

Fulltext Fabricating CAD/CAM Implant-Retained Mandibular Bar Overdentures: A Clinical and Technical Overview

Goo CL, Tan KB

Case Rep Dent, 2017;2017:9373818.

PMID: 28396807 DOI: 10.1155/2017/9373818

This report describes the clinical and technical aspects in the oral rehabilitation of an edentulous patient with knife-edge ridge at the mandibular anterior edentulous region, using implant-retained overdentures. The application of computer-aided design and computer-aided manufacturing (CAD/CAM) in the fabrication of the overdenture framework simplifies the laboratory process of the implant prostheses. The Nobel Procera CAD/CAM System was utilised to produce a lightweight titanium overdenture bar with locator attachments. It is proposed that the digital workflow of CAD/CAM milled implant overdenture bar allows us to avoid numerous technical steps and possibility of casting errors involved in the conventional casting of such bars.

Fulltext Interceptive Correction of Anterior Crossbite Using Short-Span Wire-Fixed Orthodontic Appliance: A Report of Three Cases

Sockalingam SNMP, Khan KAM, Kuppusamy E

Case Rep Dent, 2018;2018:4323945.

PMID: 29854482 DOI: 10.1155/2018/4323945

Anterior crossbite is relatively a common presentation in the mixed dentition stage. If left untreated, it can lead to a host of problems and may complicate future orthodontic treatment. One of the major difficulties in performing anterior crossbite correction in young children is treatment compliance. In most cases, poor compliance is due to the unacceptability of the removable appliance used. This article describes three cases of successful correction of anterior crossbite of patients in mixed dentition using short-span wire-fixed orthodontic appliances. This sectional appliance provides an alternative method of correcting anterior crossbite of dental origin and offers many advantages compared to the use of removable appliances.

Fulltext Sectional Fixed Orthodontic Extrusion Technique in Management of Teeth with Complicated Crown-Root Fractures: Report of Two Cases

M P Sockalingam SN, Kong Loh Seu K, Mohamed Noor H, Irfani Zakaria AS

Case Rep Dent, 2018;2018:8715647.

PMID: 29581902 DOI: 10.1155/2018/8715647

Complicated crown-root fractures account for a small percentage of traumatic dental injuries seen in children; however, management of these injuries can be very challenging to clinicians. Factors such as complexity of the injury, patient's age and dentition stage, patient's cooperation, and parental demands may have some bearing on the type of treatment undertaken and its outcomes. In some children, these injuries may have significant impact on their quality of life. The purpose of this article is to describe two cases of complicated crown-root fracture which were successfully managed through orthodontic extrusion using a sectional fixed orthodontic technique. The basis for the treatment technique and its favourable outcomes were highlighted with its advantages and drawbacks.

Fulltext Dislodged Bonded Molar Tube into Wound during Orthognathic Surgery

Shaeran TAT, Samsudin AR

Case Rep Dent, 2018;2018:6540945.

PMID: 29971169 DOI: 10.1155/2018/6540945

Introduction: Dislodgement of orthodontic appliance into operation wounds may occur while performing orthognathic surgery. Its occurrence is commonly associated with bonded upper molar tube.

Case Report: A 25-year-old gentleman presented with recurrent upper right vestibular abscess three months following a bimaxillary orthognathic surgery. A bonded molar orthodontic tube had dislodged into the wound during the operation. The clinical presentation initially mimics an odontogenic infection until our investigations revealed that it originated from the dislodged appliance. The abscess was drained, the wound site was explored, and the molar tube and neighbouring rigid fixation plates and screws were removed. The patient recovered well following the procedure.

Conclusion: Dislodged metal orthodontic appliance in oral wound acts as a foreign body that may exert allergic reactions, infection, or inflammation. Pre- and postoperative intraoral examination of fixed orthodontic appliances including its count should be recorded in orthognathic surgery protocol.

Fulltext Maturogenesis of an Immature Dens Evaginatus Nonvital Premolar with an Apically Placed Bioceramic Material (EndoSequence Root Repair Material®): An Unexpected Finding

Sockalingam SNMP, Awang Talip MSAA, Zakaria ASI

Case Rep Dent, 2018;2018:6535480.

PMID: 29977625 DOI: 10.1155/2018/6535480

Dens evaginatus is a dental developmental anomaly that arises due to the folding of the inner dental epithelium that leads to the formation of an additional cusp or tubercle on the occlusal surface of the affected tooth. This accessory tissue projection may carry with it a narrow and constricted pulp horn extension. Occasionally, the tubercle easily fractures, thus leading to microexposure of the pulp horn and eventual pulp necrosis. Often, the pulp necrosis occurs at a time the root development of the affected tooth is incomplete. Apexification with calcium hydroxide and mineral trioxide aggregates has been the mainstay of treatment options before root canal obturation in immature nonvital permanent teeth. Lately, regenerative endodontics (maturogenesis) is becoming one of the preferred treatment modalities to manage such teeth. The current case highlights the possibility of a bioceramic material (EndoSequence Root Repair Material, BC RRM-Fast Set Putty™, Brasseler, USA) which supposed to provide apical root closure (apexification) and could also induce continuation of root growth (maturogenesis).

Fulltext Endodontic Management of a Severely Dilacerated Mandibular Third Molar: Case Report and Clinical Considerations

Arora S, Gill GS, Setia P, Abdulla AM, Sivadas G, Vedam V

Case Rep Dent, 2018;2018:7594147.

PMID: 30402298 DOI: 10.1155/2018/7594147

This article aims at providing an insight to the clinical modifications required for the endodontic management of severely dilacerated mandibular third molar. A 35-year-old patient was referred for the root canal treatment of the mandibular left third molar. An intraoral periapical radiograph revealed a severe curvature in both the canals. A wide trapezoidal access was prepared following the use of intermediate-sized files for apical preparation. Owing to increased flexibility, Hero Shaper NITI files were used for the biomechanical preparation and single cone obturation was carried out. Third molars owing to their most posterior location-limited access coupled with a severe curvature pose utmost clinical challenges require meticulous skill, advanced technology, and patience to achieve success.

Fulltext Management of Discolored Failure Root Canal-Treated Upper Lateral Incisor

Rozainah NAGN, Farah AN, Karobari MI

Case Rep Dent, 2020;2020:8202873.

PMID: 32547794 DOI: 10.1155/2020/8202873

Root canal treatment failure can be determined based on a patient's complaint and on the basis of clinical examination and radiographic findings. Most of the signs and symptoms for the failure are pain and discomfort, swelling and sinus formation at the surrounding soft tissue, and discoloration of the subjected tooth. Factors such as mechanical perforation during the procedures, overfilled or underfilled root canal, and missed or unfilled canals are the main factors for the failure outcome. This case report presents a discolored and infected upper lateral incisor which was previously root canal treated. The tooth was successfully managed under nonsurgical and surgical retreatment followed by an internal bleaching and full porcelain veneer. Apical tissue healing and acceptable tooth appearance was observed during a 12-month review.

Fulltext Management of Edentulous Microstomia Patient: A Case Report and Classification System

Abbasi MS, Ahmed N, Irfan AB, Al-Saleh S, Abduljabbar T, Vohra F

Case Rep Dent, 2022;2022:2686983.

PMID: 35154831 DOI: 10.1155/2022/2686983

Microstomia is an abnormally reduced oral aperture. In the literature, it is not classified by any particular size criteria, rather defined by its effects on function and esthetics. Prosthodontic management of edentulous patients with microstomia is a challenging task. Use of conventional methods for recording an impression and fabricating prosthesis is not effective in such patients. To fabricate well-fitting prosthesis, accuracy of impression recording important anatomic landmarks is essential. Formation of an exacting custom tray and diagnostic cast is critical for final impression accuracy. Provision of a well-fitting prosthesis in microstomia patient will restore esthetics, comfort, and function with oral and systemic patient wellbeing. This paper presents a case report of managing an edentulous microstomia patient with sectional removable prosthesis. Furthermore, it proposes a novel classification system for microstomia patients according to severity of the condition.

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