Case Reports in Dentistry

Case Reports in Dentistry

Published by Wiley

Online ISSN: 2090-6455

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Print ISSN: 2090-6447

Disciplines: Nursing, dentistry & healthcare

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Baseline status.
Baseline status.
Cone-beam computed tomography scans obtained before the surgery.
Cone-beam computed tomography scans obtained before the surgery.
Cone-beam computed tomography scans obtained before the surgery.

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A Novel Approach for Implant Rehabilitation Combined with Immediate Bone and Soft-Tissue Augmentation in a Compromised Socket—A B2S Approach: Case Report with a 2-Year Follow-Up

March 2023

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955 Reads

Baruch S. Bernatskiy

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Aims and scope


Case Reports in Dentistry is an open access journal that publishes case reports and case series in all areas of dentistry, including periodontal diseases, dental implants, oral pathology, as well as oral and maxillofacial surgery.
As part of Wiley’s Forward Series, this journal offers a streamlined, faster publication experience with a strong emphasis on integrity. Authors receive practical support to maximize the reach and discoverability of their work.

Recent articles


Patient’s tongue at T0.
Patient’s tongue at T1.
Patient’s tongue at T2.
Products used for oral hygiene.
The Home Use of Probiotics and Paraprobiotics for the Maintenance of Tongue Eubiosis: A Case Report
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February 2025

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7 Reads

Salvatore Cannizzaro

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Carolina Maiorani

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Andrea Scribante

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Aim: Halitosis is the unpleasant odor emitted from the oral cavity during exhalation and phonation. Using oral care products containing specific probiotics and paraprobiotics, combined with lifestyle changes, this study is aimed at resolving the patient’s altered breath odor. Case Report: A 49-year-old male patient suffered from retronasal discharge, bacterial plaque on the back of his tongue, and bad breath. He underwent a professional oral hygiene session, received instructions in proper home oral hygiene techniques, and was advised on appropriate lifestyle changes. The use of oral care products based on probiotics and paraprobiotics was recommended. Sixty days later, the patient was reevaluated and was satisfied with the results, as his tongue had improved significantly, and he no longer experienced any bad sensations in his mouth. Conclusion: Systematic removal of bacterial biofilm and the use of probiotics and paraprobiotics can be useful in the prevention and treatment of halitosis.


Socket Shield Technique of an Ailing Mandibular Molar With Customized Healing Abutment: Graftless Management of the Hard and Soft Tissue Foundation Around Immediate Dental Implants

February 2025

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3 Reads

Sanjay Kumar Sah

It is an established fact that postextraction ridge resorptive changes are inevitable and are very evident in the molar areas. Resorption in the molar sites can cause a reduction in the attached gingiva and affect the long‐term success of the osseointegrated implant. To prevent significant postextraction tissue alteration, the socket shield technique (SST) was developed to preserve the buccal plate, over a decade ago. Since then, various studies showcasing modifications of the technique have been published mainly focusing on SST in conjunction with immediate implants in the anterior esthetic zone. Gluckman gave a collective term called partial extraction therapy (PET) which includes SST, pontic shield technique, and root submergence technique. He suggested using a graft material in the gap between the shield and the implant. Later, Siormpas et al. advocated a root membrane technique (RMT) and suggested that it may not be necessary to use the graft material. With the evolution of the technique, the terms SST and RMT are more similar to each other now, with the only difference in the sequence of shield preparation and implant placement. The shield is prepared first, and osteotomy is done in the former and osteotomy is done before shield preparation in the latter. The SST technique is often ignored as a possibility in the molar sites. Though technique‐sensitive, SST with immediate implants in molars with a customized healing abutment ensures the maintenance of the original hard and soft tissue volumes in the most conservative way. The following case report showcases a stepwise, graftless management approach for a nonrestorable right mandibular molar with SST and immediate implant. Long‐term randomized controlled trials (RCTs) on molar SST are encouraged to make a recommendation for routine clinical practice.


Monolithic CAD/CAM Implant-Retained Overdentures: A Solution for Limited Restorative Space

February 2025

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2 Reads

This case report applies computer-aided design and computer-aided design manufacturing (CAD/CAM) technology in fabricating an implant-retained monolithic overdenture for a patient with limited vertical restorative space. Traditionally, a vertical space of 9 to 12 mm is required for conventional overdentures; however, this patient presented with only 6 mm available. Through the integration of CAD/CAM, a novel solution was designed that optimized both function and esthetics within the constrained space.


Cyclosporin-Induced Gingival Enlargement in a Periodontitis Patient With Pemphigus Vulgaris: A Case Report

February 2025

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4 Reads

Background: Pemphigus vulgaris (PV) is a chronic autoimmune disorder affecting mucous membranes and skin, with potential life-threatening risks. It is typically characterized by blisters within the oral cavity with or without subsequent skin involvement. Given the importance of timely intervention, dental professionals are responsible for diagnosing this condition, as prompt detection and intervention greatly influence the disease progression and prognosis. Case Description: A 44-year-old male patient presented with swollen and bleeding gums, accompanied by multiple chronic ulcers in the oral cavity. He was initially diagnosed with PV in 2018; his case posed significant challenges, including drug-influenced gingival enlargement and the psychological burden of managing a chronic, relapsing condition. Management and Prognosis: The patient received treatment with an immunosuppressive medication (cyclosporin) along with long-term systemic steroids (prednisolone). In November 2022, cyclosporin was replaced with a steroid-sparing medication (methotrexate) to control drug-influenced gingival enlargement. The periodontal condition improved after 3 months of changing the medication regimen, nonsurgical periodontal therapy, and reinforced oral hygiene practices. The patient undergoes regular medical evaluations every 6 months with the dermatology department. Clinical Implications: Effective management of PV necessitates long-term systemic steroid therapy, often supplemented with immunosuppressive agents, to control the disease and minimize relapse risks. Regular clinical assessments are essential for patients receiving steroid and immunosuppressive treatment to monitor potential side effects, including cyclosporin-induced gingival enlargement. If gingival enlargement is compounded by periodontal disease, it can further complicate the management of PV. Drug-induced gingival enlargement has a favorable prognosis and is reversible upon discontinuation or substitution of the causative medication. An interdisciplinary approach involving primary clinicians, dentists, and the healthcare team is crucial to addressing the patient’s signs and symptoms effectively.


Oral Squamous Cell Carcinoma in Atrophic–Erosive Lichen Planus: 10-Year Rehabilitative Case Report

February 2025

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4 Reads

Patients with oral lichen planus can sometimes develop malignancy of the process and develop oral squamous cell carcinoma or another type of cancer. Close monitoring of the lesions and early diagnosis is important to increase patient survival. Once cancer treatment has been performed, the therapeutic options for restoring masticatory and phonatory function, in addition to resolving the aesthetic sequelae, are important. In the present clinical case, we show a patient who was treated and followed over a long period of time for both her carcinoma and her subsequent rehabilitation with implants.


Clinical features of oral metastasis from colon adenocarcinoma.
Radiological examination of oral metastasis from colon adenocarcinoma showing osteolytic lesion surrounding the first molar and second premolar associated with rhizolysis of these teeth.
Flow diagram according to PRISMA-ScR.
Oral Metastasis From Colorectal Adenocarcinoma: Report of a New Case and a Scoping Review

February 2025

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3 Reads

Objectives: This study is aimed at describing an unusual case of oral metastasis from colorectal adenocarcinoma and at performing a scoping review analyzing the available literature on such cases. Materials and Methods: We present a rare case of oral metastasis from colorectal adenocarcinoma in a 37-year-old Italian woman. Clinical oral examination showed the presence of a swollen lesion in the vestibular gingiva of the right mandibular region, associated with Grade III mobility of the second premolar. Radiographic examination revealed a radiolucency apical to the first molar and second premolar associated with the rhizolysis of these teeth. Furthermore, we conducted a scoping literature review of the PubMed, Web of Science, and Scopus databases in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines. Results: The second premolar was extracted, and an incisional biopsy of the osteolytic lesion was performed for histological and immunohistochemical examination, which revealed an adenocarcinoma fragment with mucinous characteristics and a morphology and immunophenotype compatible with caudal-related homeobox transcription factor 2 (CDX2) and cytokeratin (CK) 20. In conclusion, the lesion was indicative of oral metastasis from colorectal adenocarcinoma. Furthermore, the review of the existing literature in the English language yielded 112 cases of oral metastases from colorectal adenocarcinoma, which were included in our analysis. Conclusions: Although oral metastasis from colorectal adenocarcinoma has been reported previously, it is a rare manifestation. Clinical Relevance: Because of the rarity of oral metastasis and possible variations in the clinical and histological presentations, correct diagnosis can be challenging and requires careful clinical and histopathological evaluations with adjuvant immunohistochemical studies.


(a) A nodular lesion is present on the skin of the right labial commissure (dashed circle). (b) The intraoral aspects of the lesion cause whitish discoloration of the buccal mucosa (dashed circle).
Surgical procedure showing the segment of the angular artery affected by the atherosclerosis (black arrow).
(a–d) The H&E staining reveals a notable thickening of the intima, accompanied by the presence of cholesterol accumulations containing foam cells and a minor population of smooth muscle cells. Additionally, deposits of dystrophic calcification are evident. (e–h) Masson’s trichrome stain reveals extensive accumulations of collagen fibers within the intima layer and in the vicinity of dystrophic calcifications. (i–l) Weigert stain illustrates the presence of elastic fibers within the intima layer and in the region where the internal elastic lamina appears to be disrupted by dystrophic calcification. (m–p) Von Kossa stain highlights calcium deposits within the intima layer.
Multislice computed tomography examination of the patient showing no signs of the disease after lesion removal and the absence of other atherosclerotic changes in the head and neck. (a) Axial section of the upper jaw. (b) Soft tissue window of the axial section of the upper jaw. (c) Coronal section. (d) Three-dimensional reconstruction.
A Rare Case of Atherosclerosis of the Angular Artery Manifested as a Nodular Lesion on the Skin and Review of the Literature

February 2025

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7 Reads

Atherosclerosis is an age-related disease affecting the tunica intima of large and medium-sized arteries. Its occurrence in extracranial head and neck arteries is rare, with only five cases reported. This study is aimed at reporting the sixth case of atherosclerosis of the angular artery, a branch of the facial artery, in an elderly male patient with a history of hypertension. Morphological characterization using special stains and a literature review are included. Clinically, a painless, nodular lesion measuring 1.2 cm was observed at the right labial commissure. The lesion was excised, and atherosclerosis of the angular artery was diagnosed. After 6 months, there was no recurrence or other arterial issues. Despite its rarity in the oral and maxillofacial region, dental clinicians must be aware of this condition and its clinical manifestations, especially in elderly patients with chronic systemic diseases, to establish an accurate diagnosis.


Autotransplantation of a Third Molar to Replace Compromised Molar With the Individual Three-Dimensional Printed Ultrasonic Osteotome: A Case Report

January 2025

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16 Reads

Tooth autotransplantation is widely used to replace congenitally missing teeth or teeth with irreversible damage. This case report presents a personalized ultrasonic osteotome that enables precise preparation, minimizes bone trauma, enhances the initial stability of the transplanted tooth, and contributes to a favorable prognosis. The procedure is as follows: a 25-year-old female patient presented with a porcelain-fused-to-metal crown on Tooth #19, which had detached due to severe decay, rendering the tooth unsalvageable. Tooth #32 exhibited mesial inclination, resulting in decay of Tooth #31. After presenting treatment plan, the patient provided informed consent by signing the necessary documentation to proceed with the autotransplantation of Tooth #32 to replace Tooth #19. Tooth #32 was extracted and immediately scanned chairside using a 3Shape scanner. A custom-designed, tooth root–shaped ultrasonic osteotome was fabricated using 3D printing technology to match the shape of Tooth #32. Tooth #19 was extracted using a minimally invasive technique. The alveolar socket of Tooth #19 was prepared using the customized 3D-printed ultrasonic osteotome and a computer-aided rapid prototyping resin model. Tooth #32 was then transplanted into the socket and secured with figure-eight suspension sutures. To prevent damage to bone cells and periodontal tissues from overheating during socket preparation, the ultrasonic osteotome was designed with a porous, water-cooled system, effectively addressing this issue. After 24 months of follow-up, the transplanted tooth met success criteria, with no signs of pathological radiolucency, root resorption, or pain in the donor tooth. The alveolar socket, prepared with the personalized ultrasonic osteotome, ensured an optimal fit for the donor tooth, maintaining its stability and minimizing postoperative complications. The use of 3D printing technology to create a personalized ultrasonic osteotome represents an innovative advancement in tooth transplantation, supporting the development of digital and minimally invasive techniques in this field.


Successful Management of Palatal Developmental Groove–Associated Periodontal Defect Using Palatal Access Flap and Odontoradiculoplasty: A Case Report

January 2025

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6 Reads

This case report discusses the successful management of a deep palatal developmental groove associated with Stage III generalized Grade C periodontitis. Despite prior nonsurgical periodontal therapy, the disease progressed rapidly, necessitating further intervention. A comprehensive evaluation revealed generalized periodontitis with localized tooth-related predisposing factor due to a developmental groove in the vital upper left lateral incisor. The initial nonsurgical treatment involved scaling and root planing (SRP) coupled with systemic antibiotics. Significant improvement was observed, except for the site with the developmental groove. Surgical intervention was performed using a palatal access flap odontoplasty and radiculoplasty to eliminate the remaining pocket and enhance plaque control. The procedure successfully resolved the condition, with soft tissue healing observed at the 6-month follow-up with a residual probing depth of 3 mm. This case highlights the challenges associated with palatal developmental grooves as localized aggravating factors in periodontitis. The use of surgical techniques like odontoplasty and flap access proved effective in managing periodontal defects associated with developmental grooves, showcasing a successful outcome in this patient.


Preoperative x-ray examination. The coronal section CBCT reveals an oval opacity in the left maxillary sinus (A–C) (red arrow). The compact bone remains intact (blue arrow). The lesion exhibits characteristics of a mucocele. The parasagittal section CBCT shows an impacted wisdom tooth with a single conical root in a horizontal position (C) (yellow arrow). The tooth appears to be the optimal donor for autotransplantation.
X-ray examination after the removal of the cystic lesion. The lesion was histologically diagnosed as a mucocele. The CBCT reveals incomplete healing of the sinus mucosa (A–C) (red arrow). The preoperative position of the donor tooth can be observed (C) (yellow arrow).
Postoperative x-ray examination. The orthopantomogram (OPG) shows the position of the transplanted tooth 13 days after surgery.
Three-year follow-up. (A, B) The tooth shows no clinical signs of pathologies. The vitality was assessed using (C) electric pulp test (Woodpecker Ai-Pex, Guilin Woodpecker Medical Instruments Co., Guilin, Guangxi, China) and (D) pulse oximetry (Radical-7 Pulse CO-Oximeter, Masimo, Irvine, California, United States). (E) The x-ray examination reveals signs of hard tissue apposition in the pulp chamber without periapical lesion or root resorption (F–H) (yellow arrow) compared to the 1-year follow-up.
Revascularization of an Autotransplanted Mature Tooth After Extraoral Root Resection: A Case Report

The outcome of tooth autotransplantation depends mainly on the transplant tooth’s anatomy—the type of donor tooth and the developmental stage of root formation. Mature teeth display a higher complication rate due to lower pulp revascularization potential, requiring root canal treatment (RCT) pre- or postoperatively to avoid postoperative complications, which extends treatment duration and cost. This report details a 39-year-old patient’s autotransplantation of a mature wisdom tooth to replace the first molar after unsuccessful root canal retreatment. During the surgery, an extraoral root resection of the transplanted tooth was performed prior to placement to avoid the need to elevate the Schneiderian membrane, which displayed imperfect healing following the surgical removal of a cystic lesion in the maxillary sinus. RCT was not performed before nor after the procedure. At the 3-year follow-up, the tooth was asymptomatic. The vitality of the autotransplanted tooth was difficult to determine using standard vitality tests, which depend on patients’ subjective responses, but the use of pulse oximetry objectively confirmed this. This case not only shows the possibility of a mature tooth transplant revascularization in an older patient but also gives a possible postoperative protocol of how to objectively confirm and measure the revascularization of the autotransplanted tooth.


Implantoplasty-Aided Prosthetic Rehabilitation for the Management of Peri-Implantitis in Maxilla Reconstructed With Free Fibula Flap: A Clinical Report

January 2025

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7 Reads

For managing peri-implantitis, a variety of treatment modalities involving both surgical and nonsurgical methods including implantoplasty have been proposed. Implants that are placed in a free fibula flap are more prone to peri-implantitis due to the absence of firm, keratinized mucosa. Prosthetic design that offers adequate hygiene access should be designed whenever possible; otherwise, it may lead to the accumulation of plaque or biofilm that may lead to peri-implant diseases. Implantoplasty, which is performed in advanced peri-implantitis cases that cause exposure of implant threads, has been proposed as a reliable approach to preventing progressive peri-implant bone loss by modifying the exposed implant surface. This clinical report details the management of severe peri-implant bone loss in a maxilla reconstructed with a free fibula flap by combining soft tissue management, implantoplasty, and prosthetic rehabilitation.


Intraoral Pleomorphic Adenoma of the Minor Salivary Glands: A Case Series of 10 Cases With Emphasis on Histopathological Features

January 2025

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30 Reads

Pleomorphic adenoma (PA), the most common salivary gland tumor, presents unique challenges due to its diverse clinicopathologic features. The objective of this case series is to highlight the implication of detailed histopathological examination to guide appropriate diagnosis. This study reviews 10 cases of PA diagnosed at B.P. Koirala Institute of Health Sciences, Nepal, between 2011 and 2023. Patients ranged from 16 to 71 years, with a male-to-female ratio of 1:2.3. Most lesions (eight cases) were located on the palate, with additional cases, one on the upper lip and one on the cheek mucosa. Lesion sizes ranged from 1 to 3 cm² and durations from 2 months to 4 years. Clinically, all lesions were well encapsulated, nontender, and nonulcerated and had normal overlying mucosa. Histopathologically, cases included classical PA, myxoid, and cellular types. Common findings were ductal structures filled with eosinophilic material, a “swarm bee” appearance, plasmacytoid cells, and myxoid stroma. Squamous differentiation and psammoma bodies were observed in some cases. No osseous or cartilaginous components were detected. All cases were excised, with no recurrences reported during at least 2 years of follow-up. Hence, proper diagnosis is crucial for effective management and long-term outcomes of PA.


Clinical findings. A solitary raised lesion with a smooth surface is visible on the hard palate.
(a–d) Hematoxylin–eosin (HE) stain. Bars: (a) 500 and (b–d) 100 μm. (a) Histological examination shows a raised nodular growth covered by stratified squamous epithelium. (b) Proliferation of pale eosinophilic fibers is observed. (c) Elastica van Gieson stain shows dense and prominent elastic fibers, (d) but Masson stain shows sparse collagen fibers.
(a–d) Hematoxylin–eosin (HE) stain. Bars: (a) 500 and (b–d) 100 μm. (a) Histological examination shows a raised nodular growth covered by stratified squamous epithelium. (b) Proliferation of pale eosinophilic fibers is observed. (c) Elastica van Gieson stain shows dense and prominent elastic fibers, (d) but Masson stain shows sparse collagen fibers.
(a–d) Hematoxylin–eosin (HE) stain. Bars: (a) 500 and (b–d) 100 μm. (a) Histological examination shows a raised nodular growth covered by stratified squamous epithelium. (b) Proliferation of pale eosinophilic fibers is observed. (c) Elastica van Gieson stain shows dense and prominent elastic fibers, (d) but Masson stain shows sparse collagen fibers.
(a–d) Hematoxylin–eosin (HE) stain. Bars: (a) 500 and (b–d) 100 μm. (a) Histological examination shows a raised nodular growth covered by stratified squamous epithelium. (b) Proliferation of pale eosinophilic fibers is observed. (c) Elastica van Gieson stain shows dense and prominent elastic fibers, (d) but Masson stain shows sparse collagen fibers.
A Case of an Oral Elastofibromatous Lesion: A Clinicopathological Analysis With a Literature Review

January 2025

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2 Reads

Elastofibromatous changes of the oral mucosa, such as an elastofibroma (EF) or an elastofibromatous lesion (EFL), are not well recognized, and the second such case in Japan is reported. A 72-year-old man wearing a complete maxillary denture presented with a small nodule on the hard palate. Histopathological examination showed abundant fibrous tissue with numerous elastic fibers on Elastica van Gieson (EvG) staining. The diagnosis of an oral EFL was made. In the review of oral EF and EFL, no cases with recurrence were identified, but such lesions may resemble neoplastic lesions macroscopically. Accurate diagnosis using EvG stain is needed to recognize oral EFs and EFLs.


Clinical appearance of pigmentation of the lip, labial mucosa, and vermilion border.
Clinical appearance of pigmentation of the lip and labial mucosa.
Clinical measurements of pigmentations.
Histological H&E image showing mild acanthosis and abundant melanin in the basal layer without hyperplasia.
Lip Melanosis Postdermal Filler Injection: Second Case Report and Literature Review

January 2025

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18 Reads

Oral pigmentation can arise from various factors, including physiological and pathological, or as a manifestation of an underlying systemic disease. We present an atypical case of dermal filler–related complication, in which clinical lip pigmentation was observed. This condition can pose a diagnostic challenge in accurately identifying its cause.


Long-Term Outcomes of Surgical Decompression in Treating Calcifying Odontogenic Cyst Associated With Compound Odontoma: A 9-Year Follow-Up Case Report and Literature Review

January 2025

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13 Reads

A calcifying odontogenic cyst (COC) is a cystic lesion originating from odontogenic epithelium, exhibiting ameloblastomatous features and containing focal accumulations of ghost cells. The standard treatment for COC typically involves enucleation followed by surgical curettage. However, if the cyst is large or closely associated with anatomical structures, decompression may be considered as a preliminary step before enucleation. A 12-year-old male patient presented with swelling in the anterior mandibular region. Radiological assessment revealed an extensive radiolucent area crossing the mandibular midline, accompanied by radiopaque areas within the lesion. The diagnosis of COC associated with compound odontoma was confirmed. The treatment plan involved decompression, followed by enucleation. After over 9 years of follow-up, the patient showed satisfactory and effective outcomes, with no signs of recurrence. This therapeutic approach minimizes the morbidity and cost associated with extensive and invasive reconstructive surgeries.


Pediatric Interventions in a Sanfilippo Syndrome Patient Under General Anesthesia: A Case Report

January 2025

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18 Reads

Background: Mucopolysaccharidosis (MPS) Type III (MPS III) or Sanfilippo syndrome is a rare autosomal recessive inherited metabolic disorder. This disorder is responsible for lysosomal storage disorder at the cellular aspect. Due to lysosomal enzyme perturbance leading to the alteration of macromolecule metabolisms, this cellular perturbance causes multiple severe systemic and mental outcomes. Sanfilippo syndrome is the most frequent lysosomal disorder among the different types of MPS. Case Presentation: A 9-year-9-month-old female was presented at our private clinic accompanied with her parents and referred from a general practitioner, and the preclinical examination revealed atypical craniofacial structure and skeletal features such as abnormal posture and movements adding on atypical behavioral manifestations such as temper tantrums, speech difficulties, dementia, and destructive behavior.


Camouflage Orthodontic Treatment of a Severe Class III Malocclusion

January 2025

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72 Reads

Class III malocclusion remains the most challenging occlusal problem to treat due to the complexity of the interrelationships of the underlying skeletal and dental structures. Camouflage orthodontic treatment is a preferred alternative method used to manage mild to moderate Class III malocclusion in nongrowing patients. The aim of this article was to demonstrate a camouflage orthodontic treatment of a 22-year-old female patient diagnosed as having a severe skeletal Class III malocclusion characterized by a straight facial profile, reverse overjet, crowded maxillary incisors, retrognathic maxilla, prognathic mandible, and a hypodivergent facial pattern. The initial diagnosis suggested orthognathic surgery, but the patient preferred the alternative treatment. The treatment approach chosen was nonextraction camouflage orthodontic treatment combined with Class III elastics. At the end of treatment, the canines and molars were in a Class I relationship, while the incisors presented a normal overjet and overbite relationship. The maxillary and mandibular midlines corresponded with each other and with the midsagittal plane, and the smile aesthetics were improved. The facial profile was slightly improved, and the vertical face height was also slightly increased with treatment. The treatment results were maintained 15 months after treatment. It was concluded that camouflage orthodontic treatment can be used as an effective alternative method to achieve acceptable dentofacial aesthetics, functional occlusion, and stability in treating an adult patient diagnosed with severe skeletal Class III malocclusion characterized by a retrognathic maxilla, prognathic mandible, and a hypodivergent facial pattern.


Diagnostic Challenges in the Detection of Actinomycotic Osteomyelitis of the Mandible: A Case Report

January 2025

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13 Reads

Actinomycosis is a rare chronic granulomatous infection and can be caused by Gram-positive anaerobic bacteria which are normal commensals of the oral cavity and pharynx. These organisms can involve different parts of the maxillofacial region, rarely affecting the jaws. Actinomycotic osteomyelitis is an infection of the jaw bones, typically associated with trauma or an underlying nonspecific infection or disease. Herein, we describe a rare case of actinomycotic osteomyelitis of the mandible in a healthy male patient. Comprehensive surgical treatment with curettage and peripheral ostectomy was performed. The diagnosis was made on the basis of clinical findings and the histological result. Antibiotic treatment from the penicillin group was prescribed for a period of 1 month. Diagnosis is often delayed and can be a challenge for clinical practice due to the lack of criteria other than definitive histopathological examination. A chronic clinical course without regional lymphadenopathy may be essential in the diagnosis. A number of diseases can present with similar symptoms, necessitating strict adherence to a correct surgical protocol; even when such an infection is suspected, histopathological examination is essential, and long-term treatment with penicillin is advised for accurate treatment of actinomycotic infection.


Management Modalities of Mandible Fracture and Dental Trauma in Pediatric Patients During Mixed Dentition Phase: A Series of Case Study

January 2025

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26 Reads

The prevalence of oromaxillofacial fracture in pediatric patients is comparatively less than in adults, which could be due to several inconclusive factors, such as infrequent exposure to high-contact sports games, rash driving of vehicles and motorbikes, alcohol consumption, and fist fights for personal reasons under the influence of alcohol. More importantly, most of the time, children are under the care of their parents till they reach an age of maturity. One more thing that everyone believes even today is the elasticity nature of their bones as well as their body weight during their growing stage. All these uncertain factors, including the natural way of protection bestowed on us by nature during the childhood stage, might be the actual factors that can easily resist any form of minor trauma in pediatric patients. But sometimes, we come across children who have suffered traumatic head and neck injuries, including mandible fractures, usually falling from a height, and road site accidents while playing on the roadsides, including traffic accidents, which are inevitable. This is a case of three pediatric patients who had experienced accidental dental trauma with slight-displaced mandible fractures with slight dearrangement of normal occlusion and avulsion of permanent teeth. The cases were managed individually according to the types of trauma and injury they had sustained. Among three cases, one was a 9-year-old female pediatric patient, and the other two were male pediatric patients of 7 years old. Clinically, female patients had no mandible fracture as such except avulsion of teeth in the region of 32, 33, and 34. Both the male patients had a slight displacement of the mandible with a dearrangement of occlusion, and one male patient had a bilateral mandible fracture. So considering the nature and type of an injury they had sustained individually, different treatment modalities were employed for each individual as per their requirement for the restoration of normal occlusion, including hard and soft tissues. The prime objectives were the restoration of normal occlusion and alignment of the jawbone, including esthetic and phonetic, without impairing normal growth and development of jawbone and permanent tooth buds. The purpose of this article is to emphasize noninvasive methods of pediatric mandibular fracture reduction, restoration of normal occlusion, and management of soft tissue. Our treatment modalities show that this method can be easily applied in cases of any slightly displaced mandibular fracture in children during mixed dentition periods while taking utmost care of permanent tooth buds compared to other invasive methods of pediatric mandibular fracture management. The application of these various noninvasive treatment modalities and their clinical application for the management of slight displacement of mandibular fractures in pediatric cases were effective and clinically apparent in our study. The study also shows that various treatment modalities employed for the management were acceptable in terms of patient compliance due to noninvasive methods of management for slightly undisplaced mandibular fractures in pediatric cases.


Mouth floor hematoma and nasotracheal tube in place.
CT scan sagittal view. Nasotracheal tube with mouth floor and tongue displacement. The red arrow shows dehiscence at the lingual aspect of the fixtures. The OPT shows four implants incorrectly placed in the atrophic alveolar ridge.
CT sagittal section after removing nasotracheal tube: fixture with the correct axis of insertion without lingual cortical perforation. The buccal hematoma is still present, whereas the tongue is less displaced. The red arrow shows horizontal GBR with bone grafting materials.
Five days after implant surgery. The lingual hematoma was considerably reduced. At the buccal side, a large hematoma was still present under the mucosa.
Floor of the Mouth Hemorrhage Following Dental Implant Placement or Guided Bone Regeneration (GBR) in the Atrophic Interforaminal Mandible

December 2024

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30 Reads

The authors present two cases of mouth floor hemorrhage consequences of implant placement within the atrophic anterior mandible. In one patient, the implant placement was associated with the guided bone regeneration (GBR) technique. This serious complication has been widely described in the literature, especially in the anterior mandible area. In cases of bone resorption, the edentulous ridge becomes closer to the artery, and the risk of vessel injury increases. In both patients, the hematoma rapidly spread in the loose tissues of the mouth floor, displacing the tongue posteriorly and cranially, with airway compromise. The patients were hospitalized with nasotracheal intubation to secure the airway. In both patients, the bleeding stopped spontaneously, and after a few days, the oral floor swallowing was reduced, allowing the endotracheal tube to be removed. In about 2 weeks, the hematoma completely resorbed without surgery. According to the literature, the main cause of floor of the mouth hemorrhage is the mandibular lingual cortical plate perforation during bone drilling with subsequent sublingual–submental artery injury. In fact, in the first patient presented, this surgical error was clearly noticeable on the CT scan. Differently, in the second case reported, no radiological signs of inner cortical perforation were observed, and together with a mouth floor hematoma, a blood collection was also evident on the lower lip, suggesting a different cause of bleeding. Most likely during the periosteal release incision, mandatory in GBR technique, the ascending mental artery was injured, and hematoma spread in the mouth floor through the similar incision done on the lingual flap. Firstly, the mouth floor hemorrhage caused by an injury of a vestibular soft tissue artery during GBR surgery was reported. Strategies and recommendations to avoid this life-threatening event are provided, based on the literature review and the authors’ experience.


Multiple Fibrolipomas of the Tongue: A Rare Case Report of a Pediatric Patient With Whole Exome Sequencing of the C2CD3 Gene

December 2024

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8 Reads

Multiple fibrolipomas of the tongue are rare benign tumors with a prevalence of 0.2% among both adults and children. Moreover, this lesion affecting an infant has not been reported in the literature. This is the first reported case of multiple fibrolipomas of the tongue in an infant. This case report describes the genetic sequencing and treatment of a 1-year-old child suffering from multiple fibrolipomas. Irregular growths on the anterior and lateral border of the tongue were reported by the mother of the child at the time of birth. The patient was presented to the hospital at the age of 1, and surgical excision of the lesions was performed under general anesthesia. The surgery was uneventful. Genetic sequencing was performed via whole exome sequencing, and two variants of the C2CD3 gene have been identified that may be associated with this condition, although causation has not yet been confirmed. Although this is a rare entity of the oral cavity, there are various differential diagnoses. Therefore, maxillofacial surgeons should perform histological diagnosis to confirm the findings. This is the first study in literature to understand the genetic sequencing of multiple fibrolipomas in an infant. Hence, the finding of this report can be utilized in further studies registering such cases.


Histological Features of Delayed Foreign Body Granuloma With Epithelioid Histiocyte Aggregation and Eosinophilic Reaction due to Hyaluronic Acid Injection

December 2024

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14 Reads

Background: Dermal fillers such as hyaluronic acid (HA) have been widely used in recent years as a less surgically invasive cosmetic treatment. Although delayed foreign body granuloma may occur as a rare adverse reaction after the procedure, detailed histological reports are still limited. When occurring on the buccal mucosa of the oral cavity, the histopathology may resemble some lesions of minor salivary gland origin due to the material properties of HA. Here we report a delayed foreign body granuloma associated with HA showing eosinophilic infiltration of the buccal mucosa, with characteristic histological and immunohistological features. Case Presentation: A 61-year-old woman presented with swelling and a burning sensation in the right buccal mucosa. On initial examination, a 25×20-mm mass was palpated on the anterior margin of the right masseter muscle. Examination of a biopsy specimen revealed multiple pseudoduct-like structures containing mucoid substance within the mucosal lamina propria. The mucoid substance was positively stained with Alcian blue (AB) and surrounded by CD68-positive epithelioid cells and multinucleated giant cells. Many histiocytes had infiltrated into the surrounding area, and numerous eosinophilic infiltrates were also evident. After a review of the patient’s history, a diagnosis of delayed foreign body granuloma associated with HA injection was made. Conclusion: We have reported a case of delayed foreign body granuloma with eosinophilic and histiocytic infiltration following injection of HA. It was suggested that the marked eosinophilic infiltration around macrophages was due to not only an allergic reaction, but also in part to increased macrophage aggregation.


Management of Orofacial Infantile Haemangioma: A Case Report

December 2024

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13 Reads

Infantile haemangioma (IH) is the most common childhood tumour, often developing in the head and neck region. It may cause disfigurement, functional impairment, or tooth developmental issues when it is present in the oral cavity. We report a case of a 2-month-old boy referred to the paediatric dentistry team with a segmental IH involving the left periorbital, cheek, and hard palate. The patient had a maculopapular rash in the periorbital area, a telangiectatic patch on his left cheek, and papules on the left posterior hard palate. He was comanaged with the paediatric, ophthalmology, dermatology, and cardiology teams. He was treated with oral propranolol, resulting in the lesions reducing in size. Early intervention is crucial to prevent severe complications affecting the patient’s appearance, function, speech, feeding, and dentition. Dentists should be familiar with the clinical presentations and preventative measures, as we may encounter such patients with oral cavity involvement.


Retention of a Swallowed Dental Tool in the Small Bowel: Unusual Lodgment and Prolonged Conservative Management

December 2024

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24 Reads

Accidental ingestion of foreign bodies during dental procedures is relatively common, with the potential for serious complications, including intestinal perforations and severe pulmonary disorders. Our case report describes the prolonged, asymptomatic retention of a swallowed hex driver in the small bowel of a 38-year-old male, managed conservatively over an extended period. The patient, with a significant medical history of depression, was undergoing a dental procedure involving implant-supported restorations when the incident occurred. Initial x-rays confirmed the presence of the hex driver in the gastrointestinal tract. Despite its stationary position for over a week, it passed naturally without requiring invasive intervention. This case highlights the importance of individualized patient care and deferring recommendations for intervention in certain instances. We recommend a more individualized approach to managing ingested foreign bodies in dental settings, emphasizing the need for tailored strategies based on the patient’s specific circumstances and clinical stability.


Guided Bone Regeneration in the Posterior Mandible Using a Resorbable Metal Magnesium Membrane and Fixation Screws: A Case Report

December 2024

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32 Reads

Background: Due to bone loss, implant placement in the posterior mandible is often impossible without prior augentative procedures. The reconstruction of bone defects with horizontal and vertical components using particulated bone grafts requires the placement of a mechanically stable structure for stabilization of the grafting material. Although titanium-reinforced membranes and titanium meshes have been shown to be effective in this indication, the necessity of their removal, often in a separate surgical procedure, is seen as a disadvantage. Since the introduction of a new resorbable magnesium metal membrane and fixation screw, a mechanically stable and resorbable system might provide an alternative option for guided bone regeneration (GBR) in the posterior mandible. Case Presentation: A 61-year-old patient was presented with large edentulous areas in all posterior regions and requested fixed dentures in Areas 34–36. Tooth 33 was extracted and treated with an immediate implantation of a ceramic implant, whereas Positions 34–36 were treated with a two-stage approach. The site was augmented horizontally, with a slight vertical component using autologous and allogenic bone and a new completely resorbable magnesium metal membrane and fixation screw. During the initial healing period, the patient reported a tingling sensation at the site of the augmentation. This is an observation that is specific to the magnesium products and is potentially caused by the release of hydrogen gas as the metal degrades and is resorbed. Upon re-entry at 3 months, it was clinically observed that there was a very dense and vascularized bone that was sufficient for placing two 5.5×10 mm ceramic dental implants. Conclusion: A completely resorbable magnesium membrane and fixation screw were able to support the bony regeneration in a large GBR situation in the posterior mandible. Due to the use of a new material for GBR, different clinical observations were made compared to the standard material choices.


Journal metrics


0.7 (2023)

Journal Impact Factor™


32%

Acceptance rate


1.4 (2023)

CiteScore™


58 days

Submission to first decision


$750

Article processing charge

Editors