Autoimmune disorders exhibit several clinical symptoms, pathophysiological processes, and genetic components, which result in an autoimmune tautology, suggesting that they share similar etiological pathways. Systemic Sclerosis (SSc), also known as Scleroderma, is a potentially fatal systemic autoimmune connective tissue disease with a multifactorial pathogenesis and unknown etiology. The progression of the condition is characterized by substantial bone erosion at the muscle attachment sites. The co-existence of systemic sclerosis and rheumatoid arthritis in the same patient was debatable. Although some research has linked rheumatoid factor to erosive arthritis, indicating a possible overlap between the two conditions, other investigations have not supported these findings. Orofacial tissue involvement is a typical progressive systemic sclerosis (PSS) feature characterized by reduced mouth opening (microstomia), predominantly influenced by cutaneous involvement, and seldom by joint involvement. This report describes the orofacial symptoms of a 56-year-old female patient who had systemic sclerosis and rheumatoid arthritis that progressively coexisted.
OBJECTIVES:The aim of this study was to investigate the surface roughness and gloss of maxillary central incisor crowns fabricated from CAD/CAM resin-based composite after polishing with six different polishing systems. METHOD AND MATERIALS:One hundred and five maxillary central incisor crowns (n = 15 per group) were milled from a CAD/CAM resin-based composite material (Cerasmart) and divided into seven groups according to the polishing protocol: (1) Shofu Composite Polishing; (2) DiaComp; (3) OptraGloss Composite Polishing; (4) Dialite LD; (5) OptraFine; (6) Dialite ZR; and (7) no polishing (control). Surface roughness (Ra) and gloss of the facial surface of each crown were evaluated using a contact profilometer and a glossmeter. A noncontact optical profilometer was used to obtain 3D surface topography images. RESULTS:Polishing significantly reduced surface roughness and increased gloss compared with unpolished crowns. Among the polishing systems evaluated, OptraFine produced the smoothest surfaces, followed by OptraGloss, Dialite LD, Shofu Composite, and DiaComp. The highest gloss values were observed for OptraFine, followed by Dialite LD, Shofu Composite, OptraGloss, Dialite ZR, and Dia- Comp. Unpolished crowns exhibited the highest surface roughness and the lowest gloss. CONCLUSION:Ceramic and composite polishing systems significantly reduced surface roughness and increased gloss for CAD/CAM resin-based composite crowns compared with unpolished crowns. Among the ceramic and composite polishing systems evaluated, OptraFine produced the smoothest surfaces, while OptraFine and Dialite LD achieved the highest gloss values.
BACKGROUND:Implant placement in the posterior maxilla is often limited by insufficient bone height. This report demonstrates a minimally invasive, guided crestal sinus lift using the Hiossen OneCAS hydraulic system. CASE DESCRIPTION:A 74-year-old female presented with a non-restorable maxillary molar. Extraction, ridge preservation, and guided crestal sinus augmentation were performed using the Hiossen OneCAS system. Implants were simultaneously placed at the molar and premolar sites with successful osseointegration and prosthetic rehabilitation. The guided approach minimized complications and achieved favorable stability and esthetic outcomes despite limited crestal bone height (4.02 mm). PRACTICAL IMPLICATIONS:The Hiossen OneCAS system represents a feasible, minimally invasive approach for guided hydraulic sinus elevation and implant placement in atrophic posterior maxillae, reducing surgical morbidity while supporting prosthetically driven accuracy. Long-term prospective studies are needed to establish predictability and functional outcomes.
OBJECTIVE:Complex regional pain syndrome (CRPS) is a chronic pain condition characterized by disproportionate pain intensity and duration relative to the initiating event. Its occurrence in the orofacial region is extremely rare and often misdiagnosed as odontogenic, sinus, or temporomandibular pain. CASE PRESENTATION:This report describes a 41-year-old man presenting with persistent left midfacial pain following an episode of sinusitis. The pain, refractory to multiple medical and surgical interventions, was ultimately diagnosed as sympathetically maintained orofacial pain with CRPS features, based on clinical features and quantitative sudomotor axon reflex testing. The patient was treated with a series of transnasal sphenopalatine ganglion blocks. Progressive and sustained pain reduction was achieved, with pain scores decreasing from 8-9/10 to 1-2/10 after six sessions. The patient remained in remission for over 4 years, maintained on intermittent intranasal lidocaine spray without systemic medications. CLINICAL SIGNIFICANCE:This case highlights the importance of recognizing CRPS as a potential cause of persistent orofacial pain and demonstrates the effectiveness of sphenopalatine ganglion block as a minimally invasive, safe, and repeatable treatment modality. General dental practitioners are often the first to encounter such atypical pain presentations and play a key role in early recognition, referral, and collaborative management alongside orofacial pain specialists, who are trained in providing interventional therapies such as sphenopalatine ganglion block.
