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Case Reports in Dentistry 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.
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Interdisciplinary Management of Bilateral Congenital Lateral Incisor Agenesis
Management of lateral incisor agenesis is a real challenge and needs a strong collaboration between surgical, aesthetic, and orthodontic dentistry. This case report managed upper lateral incisor agenesis with an orthodontic treatment leading to open spaces and placement of cuspids in lateral incisor area to avoid implant placement in maxillary anterior region. Temporary rehabilitation phase, using resin injected tray and removable partial denture, has been placed to maintain mesiodistal dimensions and restore aesthetic during pre-implant analysis and osseointegration. Once osseointegration was fully obtained, keratinized tissue augmentation has been obtained using connective tissue graft. Then, temporary implant fixed crowns allowed soft tissue modeling during interim rehabilitation. Finally, screw-retained permanent crowns were placed to fully restore aesthetic and function. This case goal was to optimize final results and reach patient complete satisfaction using orthodontic treatment combined with implant rehabilitation, and coupled with interdisciplinary management and well-time sequencing treatment.
Replacing Missing Maxillary Lateral Incisors by CAD/CAM PMMA Cantilever Bridges
Introduction. Management of missing maxillary lateral incisors can be a challenging endeavour for dentists. Whether from agenesis or tooth loss, several treatment modalities are currently present to tackle this task to ensure satisfactory aesthetics. Most patients, especially younger patients are more likely to prefer fixed prosthodontic rehabilitation. Among these options is the computer-aided design and computer-aided manufacturing polymethyl methacrylate (CAD/CAM PMMA) cantilever bridge. Case Descriptions. These two clinical cases describe the management of missing lateral maxillary incisors in two Tunisian female patients with different etiologies, using CAD/CAM PMMA cantilever bridge. Conclusions. CAD/CAM technologies allow for a fairly quick and simple try-in thanks to their high accuracy as well as being predictable, minimally invasive, and affordable treatment options. This type of restoration can be put to use for mid- to long-term solutions to missing maxillary lateral incisors. However, its success depends mainly on patient selection regarding age, general health, occlusal context, and proper indication.
Micro-CT Evaluation of Spontaneous Apexification of an Immature Tooth following Trauma
This case reports on the micro-computerised tomography (CT) images of a periapical calcified dome following spontaneous apexification as a subsequence of trauma. An immature, maxillary central incisor was found to be non-vital one month following trauma. The tooth had minimal signs of structural damage; however, there was radiographic evidence of spontaneous apexification. The tooth suffered a second traumatic episode two years later and was decoronated to facilitate bone retention during osseous development. The patient presented with swelling and pain 36 months later, and the tooth root was extracted. The root was embedded in resin, and cross-sectional images were obtained using micro-CT. Analysis of the images provided insight into the structure of the calcified dome that formed following the first traumatic injury.
A Modified Enucleation and Deflation to Treat Large Ameloblastoma in the Mandible
Objective. Treatment of large ameloblastoma with a conservative method. Case Presentation. Ameloblastomas are benign tumors of odontogenic origin. These tumors are locally invasive with a high recurrence rate. This case report will present a conservative approach to treating large ameloblastoma in the mandible using modified enucleation and deflation technique. The patient presents with a recurrence of large unicystic ameloblastoma. The following patient is treated with the two-stage enucleation and deflation technique. One-year post-treatment follow-up shows satisfactory healing, with good bone regeneration in the defected area, showing no signs of recurrence. Conclusion. The technique that will be discussed in this case report provides an alternative treatment for ameloblastomas of the mandible. This approach can avoid radical operative procedures, such as jaw resection and bone reconstruction.
Mineral Trioxide Aggregate as an Apexogenesis Agent for Complicated Crown Fractures in Young Permanent Incisor
Traumatic dental injuries are extremely common in children, and trauma to developing permanent teeth can disrupt root maturation; vital pulp therapy is an appropriate treatment for these teeth. This case report describes a 9-year-old boy who suffered dental trauma while playing football, resulting in an enamel–dentin fracture with pulp exposure in the left central incisor with an open apex (Cvek’s stage 3) and an enamel–dentin fracture in the right central incisor with an open apex (Cvek’s stage 3). Apexogenesis with mineral trioxide aggregate was performed to preserve the neurovascular bundle, allowing normal radicular formation in the left central incisor. During a 2-year follow-up, the tooth showed no signs and symptoms, and radiographic examinations revealed no evidence of radiolucent lesions in the periapical region. This case study provides compelling evidence that the utilization of the described agent yields significant efficacy in treating traumatic fractures accompanied by pulp exposure.
Repair of an Extensive External Cervical Resorption Lesion Using Intentional Replantation with Crown Rotation
Treatment of large external cervical resorption (ECR) lesions may be compromised, rendering the tooth unrestorable. Intentional replantation is a potential treatment option depending on the site and extent of ECR. We present a case of a large ECR successfully managed with intentional replantation with rotation of the tooth. The female patient consulted the hospital clinic, with an extensive palatal ECR on the maxillary lateral incisor. Routine planar radiographs and cone-beam computed tomography demonstrated a larger palatal than the ECR lesion (Heithersay Class III and Patel’s Class 2Bp) not amenable to nonsurgical treatment. Intentional replantation after short-term extrusion was planned. The defect was restored, then a palatal ferrule was achieved by rotating the tooth by 180°. At the 18-month follow-up, the periradicular and periodontal tissues remained healthy, and no other symptoms were reported. In conclusion, this successful video-illustrated clinical case highlights the benefits of intentional replantation in saving teeth with advanced ECR.