Melkersson-Rosenthal syndrome (MRS) is a rare disease characterized by a triad of clinical signs: painless orofacial edema, recurrent facial paralysis, and fissured tongue. The classic triad appears in only 8% to 45% of cases. Monosymptomatic and oligosymptomatic forms are more frequent. Diagnosis of MRS is based on clinical history and examination findings, although some microscopic examinations may contribute. The objectives of this article are to report a case of MRS in a 63-year-old man and review the literature on the condition, offering comparative analysis of characteristics, behaviors, and therapeutic approaches. The patient described unilateral, painless, recurrent tongue edema, totaling approximately 10 episodes over a 1-year period. At the initial examination, the tongue was edematous and fissured but not swollen. Later images provided by the patient confirmed tongue swelling, and a diagnosis of MRS was established based on the presence of 2 of the 3 clinical signs of the classic triad. The patient received no drug therapy, but he was educated about the nature of the condition, provided with dietary recommendations, and scheduled for regular follow-up examinations. The dentist plays an important role in the diagnostic process for MRS, since the most significant changes occur in the orofacial region. Due to the rarity and diverse clinical presentations of MRS, there are few studies on the topic, and it is difficult to establish standardized treatment protocols. Most patients do not require treatment; when intervention is necessary, it is usually due to edema, which typically responds well to corticosteroid therapy.
The coronoid process plays a key role in mandibular function, but its morphometric characteristics remain underexplored. This cross-sectional study aimed to perform a detailed morphometric analysis of the coronoid process using cone beam computed tomography (CBCT). Coronoid height, condylar height, coronoid thickness, and coronoid-zygomatic distance were mea-sured bilaterally on CBCT images of 194 women and 149 men aged 18 to 86 years. The coronoid-condylar ratio (CCR) was analyzed in terms of the coronoid-condyle index, in which a CCR of 1.07 or less (≤ 1.07) is considered normal; a CCR greater than 1.07 and up to 1.15 (1.07 < CCR ≤ 1.15) is considered suggestive of pathology and should be investigated; and a CCR greater than 1.15 (> 1.15) is considered indicative of coronoid process hyperplasia. Statistical analyses included Student t test, analysis of variance, and Tukey tests for parametric measurements and Mann-Whitney U, Kruskal-Wallis, and Bonferroni tests for nonparametric measurements. A significance level of 5% was adopted. The measurements revealed that the coronoid process height was significantly greater in men than in women, but there were no statistically significant differences between age groups. The greatest condylar heights were observed in men, but the difference from the heights in women was only significant on the right side. Condylar height measurements differed with age; values decreased significantly on both sides beginning at 35 years. The coronoid thickness and coronoid-zygomatic distance were significantly reduced in individuals 35 years and older but did not differ between the sexes. There was a predominance of CCRs ≤ 1.15 on both sides, and CCRs > 1.15 were concentrated in patients aged 54 years or older. This study provides CBCT-based morphometric reference data on the coronoid process, highlighting variations by sex and age that may support diagnosis and improve surgical planning in cases of suspected anatomical alterations.
Molar-incisor hypomineralization (MIH) poses clinical management challenges due to enamel fragility and hypersensitivity, and treatment is often more complicated in pediatric patients, who may show less cooperation. This case series describes a minimally invasive restorative approach with a semidirect occlusal replica technique that uses high-viscosity glass ionomer cement (GIC) to manage MIH-affected molars. Three children, aged 8 to 12 years, who had severe MIH affecting permanent first molars were treated using the semidirect replica technique. The procedures were focused on preserving tissue, minimizing discomfort, and restoring function. Diagnostic impressions were used to fabricate wax-ups, which were then used to produce silicone matrices that would replicate occlusal anatomy. Under conditions of relative isolation, high-viscosity GIC was applied to the molars via the matrices. All patients tolerated the procedures well, and local anesthesia was required in only 1 patient. The restorations showed anatomical accuracy and functional stability. The patients reported immediate relief of hypersensitivity, and no restorative failures or complications were observed at the 6-month follow-up examinations. The semidirect occlusal replica technique with high-viscosity GIC is a clinically feasible and effective method for restoring MIH-affected molars in the mixed dentition period, reducing chair time, delivering functional recovery, and ensuring patient comfort.
