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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.

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.

Fulltext Multiple Cemento-Ossifying Fibroma: A Sign of Hyperparathyroidism-Jaw Tumour Syndrome

Apandi NIM, Basri NN, Jalil AA, Jelon MA

Case Rep Dent, 2023;2023:4664619.

PMID: 36937223 DOI: 10.1155/2023/4664619

Hyperparathyroidism-jaw tumour (HPT-JT) syndrome is a rare autosomal dominant disease. It is caused by a gene mutation of the tumour suppressor gene CDC73 that encodes for parafibromin. This syndrome predisposes to a triad occurrence of multiple maxillary or mandibular cemento-ossifying fibroma, parathyroid adenoma or carcinoma, and renal and uterine tumours. In this study, we report a case of HPT-JT occurring in a 30-year-old male patient.

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 Cosmetic "Gold Thread Therapy": A Nuisance That Decreases the Diagnostic Quality of a Dental Panoramic Image

Ching ME, Joan LZY, Nambiar P

Case Rep Dent, 2021;2021:4077930.

PMID: 34777877 DOI: 10.1155/2021/4077930

During routine imaging of the craniofacial region, it is recognised that some "cosmetic" procedures with metallic insertions can be revealed radiographically. These objects however make it difficult to obtain a good interpretation of anatomical structures for management of diseases. A 58-year-old female patient visited a private dental facility in Kuala Lumpur for prosthodontic replacement of missing teeth. The dental panoramic image revealed generalized bone loss and numerous unusual multiple thread-like radioopacities. These gold threads made radiographic evaluation difficult and complicated the process of treatment planning for dental implant placement advocated for this patient.

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 Partial Mandibulectomy Rehabilitation of Keratocystic Odontogenic Tumour Case in Neutral Zone

Halim MS, Ariff TFTM

Case Rep Dent, 2018;2018:8918673.

PMID: 30034887 DOI: 10.1155/2018/8918673

Restoring the patient's missing dentition secondary to partial mandibulectomy of KCOT is important to improve function and aesthetics. The patient presented with a significant loss of alveolar bone which makes the fabrication of rehabilitation prosthesis a significant challenge. A neutral-zone impression technique is helpful in determining the exact space to be restored without compromising aesthetics and it avoids functional muscle displacement that may displace the prosthesis. This article describes the neutral zone impression technique to record a patient's functional muscular movement in guiding the setting of acrylic teeth and denture flange in the neutral zone area. This technique is very useful for postsurgical cases with significant loss of alveolar bone.

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 A Pragmatic Approach to the Management of Severe Awake Bruxism in an Adolescent with Cerebral Palsy and Global Developmental Delay

Ismail N, Hamzah SH, Wan Mokhtar I

Case Rep Dent, 2022;2022:5288515.

PMID: 35070457 DOI: 10.1155/2022/5288515

Cerebral palsy is a neurological and motor condition characterised by muscle balance and posture impairments. Bruxism and malocclusion were frequently observed in patients with cerebral palsy, in contrast to other oral anomalies. The report outlines how severe awake bruxism is managed in a 16-year-old Korean boy who has nonverbal spastic cerebral palsy and global developmental delay. The treatment protocol involved the fabrication of soft occlusal splints of three and four millimetres in thickness, followed by the placement of stainless-steel crowns on all first permanent molars whilst video recording and a bruxism diary was kept. Fixed restorations demonstrate increased endurance in withstanding bruxism force in persons who are dependent on their caretaker.

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 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 Orthodontically Induced External Apical Root Resorption in Class II Malocclusion

Karnati PKR, Seth P, Zamzuri ATB, Tharwani P

Case Rep Dent, 2021;2021:8290429.

PMID: 34976417 DOI: 10.1155/2021/8290429

Orthodontic-induced external apical root resorption is one of the idiopathic phenomena as an effect, with force generated through mechanotherapy as the cause and the biological tissues with their diversified variations as witness. It is also classified as iatrogenic as a result of indeterminate application of orthodontic forces with subconscious appreciation of the existing underlying conditions. Numerous factors were identified to relate to this irreversible pathologic condition, but none were proven scientifically. Genetics and salivary markers have proved the reliability with time, but the application became insignificant limiting mostly to the research field. Different assessment methods were also identified to clinically diagnose it both subjectively and objectively. Mostly, it is identified through routine radiographic stage records like orthopantomogram or certain prediction radiographs for root resorption probability assessment like in this case. This case report discusses one such encounter which was experienced after stage 1 and 2 mechanics involving quite a few teeth. Considering the biotype of the individual and tooth morphology, the ongoing treatment was terminated and recovery measures were briefed to uplift the self-esteem of the individual. Furthermore, the prognosis is compromised to be very poor with unpredictability to any other treatment modalities.

Fulltext Plummer Vinson Syndrome: A Rare Syndrome in Male with Review of the Literature

Karthikeyan P, Aswath N, Kumaresan R

Case Rep Dent, 2017;2017:6205925.

PMID: 28932606 DOI: 10.1155/2017/6205925

INTRODUCTION: Plummer Vinson syndrome also known as Paterson Brown-Kelly syndrome is a syndrome associated with the triad of symptoms comprising microcytic hypochromic anemia, oesophageal strictures, and dysphagia. PVS is commonly found in women of middle age especially in the fourth and fifth decade of life and is rarely reported in males.

CASE REPORT: The authors report a case of 43-year-old male patient who presented with the classic symptoms of Plummer Vinson syndrome.

CONCLUSION: Dentists have to be familiar with symptoms of PVS and a thorough clinical examination of the patient is necessary for early diagnosis and treatment. As PVS is a precancerous condition with high malignant potential, early diagnosis is of utmost importance for better prognosis.

CLINICAL SIGNIFICANCE: Mutual interaction of systemic and oral health has largely been underestimated by many patients in the developing countries and hence this report includes a note on importance of adequate medical history taking and its relevance to the dental health and treatment.

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 Autotransplantation of Ectopic Permanent Maxillary Incisors

Mohd Mokhtar S, Abd Jalil L, Muhd Noor N

Case Rep Dent, 2017;2017:7361924.

PMID: 28352481 DOI: 10.1155/2017/7361924

The report presents examples of successful cases of autotransplantation of ectopic teeth as donor in the treatment of clinically missing maxillary anterior teeth in young patients. The transplanted teeth were either severely ectopic, inverted, rotated or in an unfavourable position that they are commonly sacrificed as a result. Details of surgical technique as well as clinical and radiographic assessments were discussed.

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 Long-Term Follow-Up following Condylotomy in a Case of Traumatic Unilateral Anterosuperior Mandibular Condyle Dislocation

Nabil S, Kuppusamy E, Nordin R, Nazimi AJ, Ramli R

Case Rep Dent, 2019;2019:6810461.

PMID: 31218085 DOI: 10.1155/2019/6810461

Anterosuperior temporomandibular joint dislocation is rare. Manual reduction of such dislocation is difficult especially when treatment is delayed. Therefore, it has an increased likelihood of needing surgical intervention to achieve reduction. The authors report a case of an anterosuperior temporomandibular dislocation in a 19-year-old male following a motor vehicle accident. Difficulties were encountered in reducing the dislocation necessitating surgically assisted reduction. The long-term outcome following management by condylotomy is reported. This present report also reviews the literature regarding the classification and management of this uncommon dislocation.

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 Treatment of Extensively Comminuted Mandibular Fracture with the Aid of a Condylar Positioning Device

Nazimi AJ, Ezulia T, Rajaran JR, Mohd Yunus SS, Nabil S

Case Rep Dent, 2017;2017:2732907.

PMID: 29391956 DOI: 10.1155/2017/2732907

We describe a case of extensively comminuted mandibular fracture that extends bilaterally to the angle of mandible successfully treated with the use of condylar positioning device (CPD). This simple, yet effective, technique that almost exclusively described in orthognathic surgery is useful when advance surgical techniques such as pre- or intraoperative landmark identification may not be readily available. CPD technique optimizes the manual manipulations of the comminuted distal segments during fracture reduction and internal fixation. At the same time, it allows greater control of the proximal segments to avoid further surgical complication.

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.

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