Teeth that develop prematurely in the oral cavity are known as early infancy teeth. Riga-Fede disease (RFD) is characterized by sores on the ventral area of the tongue, lip, and mother’s breast caused by these teeth. The management is determined by the tooth’s mobility and the risk of aspiration or swallowing; if it is a supernumerary or ordinary main tooth; whether it is interfering with breastfeeding; breast and oral soft tissue damage; and the general health of the child. The clinical diagnosis of RFD was made after a 4-month-old male newborn was identified with one early infancy tooth and an ulcerated lesion on the ventral side of the tongue. The intervention consisted of preserving the early infancy tooth that showed no signs of increased mobility, adding a modest increment of composite resin cement to its incisal edge, and applying 0.12% chlorhexidine topically. The patient was monitored on a daily basis, and after 15 days, the wound was completely healed. The recommended intervention was effective, and the patient is still being followed up on after 6 months with no recurrence of the lesion.
Pyogenic granuloma (PG) is a benign inflammatory lesion that may present as a tumorlike growth. It commonly occurs over the gingiva. Other sites involved in the oral cavity are lips, tongue, and buccal mucosa. These lesions are generally <2.5 cm and are not bothersome to patients due to their painless nature. Herein, we report an elderly female presented to us with a sizeable intraoral mass associated with difficulty in articulation and mastication. On examination, we saw an enormous tumor-like growth arising from the gingiva. A diagnosis of PG was made based on histopathology. Contrast-enhanced computed tomographic scan was done to see bone involvement and to delineate the extent of the disease. Complete surgical resection of the mass was done with primary closure. PG may resemble malignancy and should always be kept as a differential in large tumor-like intraoral mass cases.
Apert syndrome is a rare genetic syndrome resulting from missense mutations in the encoding fibroblast growth factor receptor 2. This case discusses the provision of routine dental care for a 22-year-old female with Apert syndrome. This patient presented with characteristic features of the syndrome including syndactyly, craniosynostosis, midface hypoplasia, and oral features such as dental crowding, impacted teeth, malocclusion, anterior open bite, and lateral swellings of the palatine processes. These characteristic oral and craniofacial findings provide unique challenges for dental practitioners. Proper management of this case required multidisciplinary care delivered in a hospital setting. Together, general dentists and oral surgeons performed extractions and routine prophylaxis without complication for this patient.
The term “intentional replantation” refers to the removal of a tooth and its replacement in its socket. When surgical endodontics or traditional root canal treatment cannot be possible, intentional replantation is used as a last resort. Periodontal cell viability, irritant removal, successful apical seal, and procedure performed under a microscope are all factors that determine the effectiveness of intentional replantation. In this article, a case of intentional reimplantation is defined and discussed as a treatment option for a mandibular left first molar that has a separated instrument periapically beyond the apical terminus.
Elevation of deep subgingival proximal cavity margins with resin composites under direct or indirect restorations was reported to be promising in terms of esthetic and mechanical points of view. A relatively new category of restorative materials called bioactive composites was released, until now, their periodontal response when used for elevating of deep subgingival margins have not been yet investigated. Thus, the aim of this report was to compare the periodontal conditions and radiographic marginal quality of two molars having their proximal dentin/cementum margins elevated with either bioactive composite or bulk fill composite. The patient had two proximal cavities with gingival margins below cemento-enamel junction in 26 and 27. 26 was vital and its proximal gingival margin was elevated using bioactive composite while 27 was non vital and its proximal gingival margin was elevated using flowable bulk fill composite before completing the endodontic treatment. The rest of the cavities of both teeth were completed with the same type of regular bulk fill composite. Four periodontal measurements, in addition to a radiographic evaluation for the gingival margins were recorded immediately after completing the restorative work and compared to the same measurements after 6 months. It could be concluded that, regardless of the poor radio opacity of the used bioactive composite, its use for elevation of dentin/cementum margin had a better periodontal response than using flowable bulk fill.
A 55-year-old male had a panoramic radiograph taken at the University of Western Australia Dental Radiographic assessment depicted periapical lesions, caries, fractured teeth, horizontal periodontal bone loss, and a distinct ossification anterior to the cervical spine stretching from C2 to C4: (partial) Ossification of the anterior longitudinal ligament (OALL). Differential diagnosis: Osteophytes and segmental OALL. Relevant patient’s history: Motor vehicle accident with facial and dentoalveolar trauma. Subsequently, a narrative literature review was conducted to verify the prevalence and etiology of OALL. A PubMed ® search was conducted for ossified anterior longitudinal ligament, Forestier disease, and diffuse idiopathic skeletal hyperostosis (DISH). Radiology handbooks were also consulted. It was found that this ossification, first identified as senile ankylosing hyperostosis (Forestier disease), was renamed later: DISH. Its prevalence varies between 2.9 and 25%. The spinal form of DISH is characterized by OALL with involvement of the cervical spine in 76% of patients (typical C4-C5 level). Cervical spine OALL can be associated with dysphagia, obstructive sleep apnea, and pain. Segmental OALL and anterior vertebral osteophytes can be confused with DISH. Its etiology is unknown, but associations have been suggested with advanced age, obesity, and type 2 diabetes mellitus. This case emphasizes the importance to include the assessment of the cervical spine, if visible, on dental and maxillofacial radiographs, as it may prompt more targeted questions toward patients, referral to medical specialists and help diagnose conditions that have been unnoticed or misdiagnosed. of the anterior longitudinal ligament of the depicted
Aim: This case report aims to elaborate on the oral manifestations of acute leukemia in children and the extent to which the family’s supernatural beliefs contributed to the prognosis of the disease. Background: Leukemia is a malignancy of hematopoietic cells, and about 56% of cases are manifest in the oral cavity. In Indonesia, cancer is among diseases often related to a supernatural phenomenon that may hinder the patient from getting medical treatment. Case Description: An 8-year-old girl was referred to the Oral Medicine Department due to swollen and bleeding gums. There was generalized enlargement of the gingiva with a reddish-purple color covered 2/3 of the dental crown and easy to bleed. The patient was diagnosed with gingival enlargement and gum bleeding due to acute leukemia as the suspected underlying disease. The patient was scheduled for a bone marrow aspiration examination to confirm the blood disorder diagnosis, but the family refused it and believed that supernatural power was the cause of the cancer. Conclusion: Gingival enlargement and spontaneous bleeding of the gum are often the first oral signs of acute leukemia. Considering the influence of supernatural beliefs in society regarding cancer is still existing, dentists are required to be more persistent in educating patients and their families to receive definitive therapy to increase patient life expectancy. Clinical Significance: The oral manifestation of leukemia should be treated promptly to support the systemic therapeutic. Delay in diagnosis and treatment will lead to poor outcomes of the disease.
Recession is the displacement of soft-tissue margin apical to the cementoenamel junction. It becomes a matter of concern when it occurs in anterior esthetic area. Various treatment modalities have been carried out for the treatment of recession. The present case report describes the diagnosis and treatment of a female patient reporting to the department with the chief complaint of receded gums. The patient presented with multiple recessions in mandibular anterior region. After radiographic and hematological investigation, it was decided to treat the case with bridge flap technique. The technique provided with good post-operative results and patient’s acceptance of the technique.
Patients infected with coronavirus disease 2019 (COVID-19) could develop serious life-threatening conditions. The typical symptoms of this disease include dry cough, fever, myalgia, and headache. Possible mucocutaneous involvements associated with COVID-19 should be considered, especially for denture wearer patients. This article reports a COVID-19 positive patient who has denture stomatitis and oral reddish lesions appeared and developed during the infection period, this could identify unknown manifestations of COVID-19. eruptions, acute sialadenitis, and ulcerative lesions.
Primary dentition plays an important role in child’s growth and development not only in terms of mastication, esthetics, and phonetics but also in the guidance and eruption of permanent teeth. In cases of premature loss of primary teeth, correct planning and choice of a space maintainer are required to avoid future space loss. A 5-year-old female patient reported to the department of pediatric and preventive dentistry with a chief complaint of grossly decayed teeth in her mandibular right back teeth region since 6 months. Clinical examination revealed grossly decayed tooth wrt 85, radiographic examination revealed radiolucency approaching root and furcation area. Diagnosis was made as chronic irreversible pulpitis wrt 85 and extraction wrt 85 followed by Starkey’s modification of distal shoe space maintainer was planned. Space maintainers are the appliances which guide the eruption of permanent teeth. In the present case, the first permanent molar had already pierced the bone but was inside the gingiva therefore a modification of distal shoe – Starkey’s space maintainer was fabricated with an acrylic extension that aids in mastication. The Starkey’s modification of distal shoe with an acrylic extension is the most appropriate appliance to be given in cases where there is premature loss of second primary molar before eruption of first permanent molar.
Bullous pemphigoid is an autoimmune skin disease characterized by large tense blisters with solitary oral manifestation a rarity. We report a case of 48-year-old male with chief complain of wound on the left side of mouth with history of hydrochlorothiazide use. On intraoral examination, desquamation was present in palatal gingiva which was tender on palpation. Biopsy of the lesion on histopathology reported oral pemphigoid. On immunofluorescence test linear deposits of C3 and immunoglobulin G was found. This showed that importance of complete history with histopathology and immunofluorescence test is must for early diagnosis and treatment is essential for prevent further dermatological progression.
Oral chemical burn occurs when chemical substances such as acid or alkaline come in contact with the mouth, causing burns and ulcers on the oral mucosa. Sodium hydroxide (NaOH) is a strong alkaline chemical substance that is capable of penetrating very deeply, resulting in extensive tissue damage. The aim of this case report is to describe the extreme oral chemical burns caused by accidental contact with NaOH in a young adult. A 30-year-old male patient was admitted to the hospital as he had an accidental contact 7 h ago, with NaOH, while cleaning the bathroom. The patient was referred to the Oral Medicine Department due to the complaint in the oral cavity. The diagnosis was made based on history, clinical, and X-ray examination. He was treated with a compounded mouthwash containing diphenhydramine and sucralfate, applying the lips with a gauze soaked in 0,9% NaCl, and then continued with hyaluronic acid mouthwash. Intraoral examination showed there were very painful multiple ulcerations, yellowishwhite areas, and erythema throughout the oral mucosa. He complained of pain upon swallowing, difficulty in speaking, mouth opening, eating, and drinking. All oral lesions healed approximately within 2 months and there was ankyloglossia but did not present microstomia. The extreme oral chemical burns caused by NaOH in a young adult is an uncommon condition. Proper management of chemical burns will accelerate the healing process, improve quality of life, and is life-saving. Safety precautions when using chemical substances are needed to avoid chemical burns.
Tooth-related morphological anomalies are local contributors to periodontal disease. Accessory root formation is one of the rare anomalies of in incisor teeth. A 65-year-old male patient who has type II diabetes and hypertension applied to our clinic. Clinical examination has shown that the upper right central incisor tooth had an 8 mm deep periodontal pocket on the distal and a 7 mm deep periodontal pocket on the mesial aspects of the tooth. Accessory root was seen on the mesiobuccal aspect of root of the upper right lateral incisor tooth in coronal portion. The accessory root was excised with surgical operation and the bone defect in the area was regenerated. Post-surgery periodontal healing was uneventful. Periodontal pocket depth decreased to 4 mm on the 4 th month after surgery. This case discusses accessory root formation may accelerate the accumulation of dental plaques and subgingival calculus. Thus, early detection of anomalies in root morphology is important in the effective treatment of periodontitis.
Root submergence is a minimally invasive surgical technique introduced to preserve alveolar ridge volume in comparison to other partial extraction therapies that are currently mentioned in literature. This case report describes a conservative method of restoring non-restorable anteriorly fractured tooth in growing patient. The aim of this treatment method is to maintain hard tissue and soft tissue in anterior zone for future implant placement. A 13-year-old female patient presented to our primary care dental clinic with dental trauma that occurred 3 years ago. The chief complaint was to restore the badly broken teeth for esthetic purposes. The tooth was restored with a resin-bonded bridge and root submergence was done considering the need for future implant placement. Root submergence in the upper left central incisor (21) has been done to prevent buccopalatal collapse of the post-extraction bone. The root submergence technique helps in retaining the bone, thus reducing bone resorption. Considerable success has also been demonstrated in maintaining the periodontal tissues at the pontic site with this technique. This enables future dental implant placement without the need for bone augmentation. The treatment was successful and the patient is under follow-up and review visits. We did not notice any signs and symptoms of failure. This technique is minimally invasive and very successful in young patients for whom implant treatment is considered in the future.
Fibrous histiocytomas are soft-tissue tumors of both benign and malignant counterparts presenting in adults. Benign fibrous histiocytoma occurs mainly in the skin of the extremities, might involve the long bone. Its incidence in head and neck is extremely uncommon and comprises about only 1% fibrous histiocytomas whereas about 3–10% of malignant fibrous histiocytoma (MFH) occur in the head-and-neck region. Here, we are presenting a rare case of multiple gingival masses of MFH which adds to the literature about clinical and biological behavior of the rarity, emphasizing on the clinical correlation.
Dens invaginatus (DI) is an odontogenic anomaly caused by folding of enamel and dentin into pulp chamber during odontogenesis before calcification process. This is a condition that is most commonly exhibited as protrusion of a tubercle from lingual surface of anterior teeth. Management of DI varies from simple prophylactic restoration to conventional endodontic treatment or extraction which can be affected by the type of invagination, function, esthetics, and morphology of the root canal. This is the report of successful conventional endodontic treatment of a tooth affected with dens ivaginatus with a big lesion in a 30-year-old patient which was confirmed by cone beam computed tomography. Twelve months follow-up using clinical and radiographic examinations showed good apical sealing and decrease in size of periapical lesion.
Masochistic practices include self-inflicted oral injury, inflicted on onself without the notion of suicide. Hemorrhage differs from mild oozing or leakage at the point of an injury to substantial loss of blood resulting in full exsanguination. Liver clot is a rare complication associated with surgery and trauma. But this time, this complication is seen in association with masochistic practices. It has to be noted that the tissues of oral cavity are highly vascular. This case report represents a unique case or probably the first case in the occurrence of “liver clot” or “current jelly clot” in succession to the masochistic practices by the child.
Aim: The aim of this case report is to demonstrate the use of combination of open reduction followed by closed reduction in management of malunited fracture in pediatric patients. Background: The reported incidence of maxillofacial trauma is infrequent in children and adolescents. The gold standard in treating such injuries has been conservative management involving closed reduction of fractures. The line of treatment should aim at restoring the underlying skeletal tissue to their original position in a stable manner as non-invasively as possible. Case Report: The following report presents a case of 10 year old male patient who had reported with a 20 day old displaced parasymphysis fracture which had healed secondarily and was treated by open reduction followed by stabilization using an acrylic splint. Conclusion: After open reduction and mobilization of fractured segments, stable occlusion was achieved. Post-operatively, the healing was uneventful and no complications were reported. With this case, we can conclude that open reduction can be an alternative in pediatric patients when the traditional line of treatment has not delivered the desired results. Clinical Significance: With this case, we can conclude that open reduction can be an alternative line of treatment for fractures in pediatric patients when conservative management has not delivered the desired results.
Space maintainers are used when there is premature loss of primary tooth to preserve the space. Conventional band and loop is still the preferred space maintainer for a unilateral space loss. The present education is still supporting this space maintainer even though it comes with a lot of disadvantages. In this case report, a 7-year-old child who had a grossly decayed lower right primary second molar was extracted, and the Bibin appliance (B-Appliance) was delivered to maintain the space. The present invention B-appliance is a novel space maintainer and prevents supra-eruption and it also overcomes all the disadvantages of band and loop and along with that provides additional advantages. It can be placed on the same day after extraction. readymade space maintainer Bibin appliance: A
Tooth intrusion occurs when a tooth is moved more axially. The periodontal gap between the tooth and the bone cannot be seen radiographically. It is seen as one of the most severe types of traumatic injury. Depending on the age, root, dentition type growth, the prognosis, and treatment for trauma severity varies. A 3–6 mm intrusion has a strong prognosis, whereas an intrusion over 6 mm has a rather poor prognosis. The present case study focuses on the surgical repositioning of the left maxillary central incisor that has been intruded due to falling.
