International Journal of Research and Reports in Dentistry

Esthetic Root Coverage: Using a Modified CAF in Combination with PRF, A Case Report

Maya Mhaske — 2023-03-13

Introduction: The multiple gingival recessions can lead to functional and aesthetic problems in patients. Advanced flaps are the simplest, yet are not predictable procedures for managing such conditions. The results of root coverage can be enhanced by combining the coronally advanced flap (CAF) with different regenerative techniques.

Aims: To determine the benefits of platelet-rich fibrin membrane (PRF) along with modified CAF for the treatment of Grade II Multiple gingival recession.

Methodology: A patient with Millers' class II gingival recession in three adjacent anterior teeth having a minimum 3-4 mm width of attached gingiva., Patient was treated by using modified CAF with PRF. The clinical parameters, evaluated were , vertical gingival recession depth (VGRD), gingival recession width (GRW), probing depth (PD), clinical attachment level (CAL), were recorded at baseline, and from 1 month to 3 months

Results: VGRD, GRW, PD, CAL, improved significantly from baseline to 1 month and from 1 month to 3 months

Conclusion: The use of PRF along with modified CAF is beneficial for the treatment of mild to moderate Millers Class II gingival recessions.

Prosthetic Rehabilitation in Carcinoma of the Tongue and Oral Pelvis: Presentation of a Clinical Case

S. Bucolo — 2023-03-31

Aims: The authors want to describe a case of prosthetic rehabilitation in a 50 years old woman who has undergone a removal surgery of a neoplastic lesion that involved the oral pelvis and the lingual border. The inherent literature regarding the prosthetic rehabilitation of post-irradiated bones is also evaluated.

Presentation of Case: A 50-year-old Caucasian woman with a history of smoking and alcohol consumption has come to our attention with an ulcerative lesion of the left lingual pelvis.

Discussion: The patient’s clinical, radiological, and anamnestic data enabled the preoperative staging of the oral cavity’s neoplasm, which has been treated with a transmandibular conservative surgical resection of the lesion associated with a mRND and bilateral neck dissection (LV. I to III); this was then followed by an immediate surgical reconstruction with a radial antebrachial bundle-cutaneous free flap.

Conclusion: One year after surgery, excluding the presence of recurrences through MR with contrast, the dental residues have been removed, and rehabilitation with an implanted prosthesis has been completed. Aesthetic outcome was remarkable. Both the preoperative multi-specialist evaluation and the definition of a common rehabilitation program represent essential prerequisites in order to avoid some possible and serious complications of the treatment. Postoperative radiotherapy for oral cancer is now universally associated with implant-prosthetic rehabilitation therapy.

Dental Evaluation Discloses Undetected Systemic Condition: A Case Report

V. Rajashekar Reddy — 2023-04-11

Aim: The significance of dental examination in identifying the underlying systemic condition.

Case Presentation: A 10 year old female patient reported with the complaint of pain since 1 week, also presence of milk teeth till this age. On Examination, short stature, macroglossia, retained deciduous teeth and delayed development of permanent dentition when compared with dental age and chronological age were revealed. Considering the clinical and radiographic condition thyroid dysfunction was suspected which is the second most common endocrine system glandular disorder, and it can manifest in any system of the body, including the mouth. Excess or deficiency of these hormones has a negative impact on the oral cavity. Based on dental features, we present this case of a child with undiagnosed hypothyroidism.

Conclusion: Hashimoto’s disease is the common cause of hypothyroidism in children and adolescents. Since oral manifestations of hypothyroidism are uncommon, which may lead to in correct diagnosis and subpar patient care. Therefore, it is important for the dentist to know the oral manifestations of systemic disease to promptly identify the underlying condition.

Diagnostic Clue: Oral Manifestations in a Case of Acute Myeloid Leukemia

Ruchi Harish — 2023-05-04

Aims: Many systemic diseases and conditions find manifestations in the oral cavity, which if not promptly diagnosed can have grave consequences. Therefore, the aim of this case report is to stress the importance of an interdisciplinary approach by the periodontist, hematologist, and medical expert to minimize the time to establish diagnosis during the initial presentation of Acute myeloid leukemia (AML), which in this case were oral manifestations.

Presentation of Case: This case report describes a 15 year old female who presented with enlarged gums with pain and bleeding. Diagnostic workup included complete blood count with differential leukocyte count followed by bone marrow biopsy and cytochemistry. These tests aided in diagnosing the condition as acute myeloid leukemia.

Discussion: Oral signs of leukemia include gingival enlargement, which appears bluish red in color and tends to bleed on slightest provocation. Immature leukocytes in the gingival tissues and chemotherapy induced immunosuppression makes the patients more vulnerable to tissue breakdown and secondary infections, all of which were evident in the present case.

Conclusion: Both, oral health care and medical professionals should work in sync in order to carry out prompt diagnosis and render timely treatment for the underlying pathology.

Surgical Management of a Maxillary Peripheral Ossifying Fibroma

Rucha R. Pandya — 2023-06-06

Peripheral ossifying fibroma (POF) is a fibromatic and non-neoplastic enlargement of the gingiva that exhibits regions of calcification/ossification. The present case shows a peripheral ossifying fibroma of the maxilla. The lesion was evident on the attached gingiva of maxillary posterior teeth extending from canine to first molar teeth. For management, fibroma was surgically excised and L-PRF membrane was placed over the underlying exposed bone under local anesthesia,. Histological examination was done to confirm the diagnosis of Peripheral Ossifying Fibroma. L-PRF membrane as a biomaterial to cover the exposed areas of the bone after surgical excision is an effective option for better secondary intention healing and it provides acceptable results for tissue regeneration.

Naturopathic Drug Erythema Multiforme Major: A Rare Case Report

Saraswathi K. Gopal — 2023-07-13

Erythema multiforme (EM) is an acute self-limiting hypersensitive mucocutaneous lesion with varied etiologies. It is classified as a spectrum of disorders with Erythema multiforme minor, Erythema multiforme major. Herpes virus infection is considered to be involved in more than 90% of cases. Drug-associated EM is rare and reported to be less than 10%. EM affects most commonly teenagers and young adults with more predilection to males. Oral lesions are seen on the lips and buccal mucosa which appear as erythematous macules, and bloody encrustations involving lips with classic target-like lesions. Here is a case report of erythema multiforme major which was induced by naturopathic medications in a middle-aged woman who presented with classic target lesions and was effectively treated with systemic corticosteroids which showed complete remission and no recurrence had been noted to date.

Severe Impaction of the Primary Maxillary Second Molar Along with Horizontal Impaction of the Permanent First Premolar - A Rare Case Report

Sonal Gupta — 2023-08-18

Aim: The purpose of this case report is to present a case of a totally impacted maxillary second molar and horizontally impacted first premolar.

Background: Impaction of deciduous teeth is an uncommon event. Various factors which lead to the impaction of a deciduous tooth include ankylosis, congenitally missing permanent teeth, defects in periodontal membrane, trauma, defects in eruptive forces or a combination of all these factors.

Report: A 12-year-old male patient reported to the department with a chief complaint of pain in the upper left back teeth region. On clinical examination, first premolar tooth was missing. Panoramic and maxillary occlusal radiographs revealed a horizontally impacted first premolar close to the inferior wall of the maxillary sinus and a vertically impacted second deciduous molar embedded within bone close to the inferior wall of the maxillary sinus between 2^nd premolar and 1^st permanent molar.

Conclusion: The complete impaction of deciduous teeth is a rare condition and very few cases have been reported in the literature. This case reports a totally impacted maxillary second deciduous molar along with a horizontally impacted 1^st premolar tooth and its surgical management.

Submandibular Sialolithiasis: Multiverse Presentation of Four Cases

Jayanti Humbe — 2023-10-05

Sialolithiasis is caused by the development of a calculus in the salivary gland or duct, often observed in the oral region. This disease is most common in adults or young adults and rarely develops in children. Among reported all the cases of sialolithiasis, only 3% are seen in the pediatric population. The clinical presentation of sialolithiasis typically consists of a painful swelling of the involved salivary gland at meal times. These characteristic clinical signs often lead to an easy diagnosis. Most commonly affected is the submandibular gland 92%, followed by the parotid 6% and sublingual and minor salivary glands 2%. Here, we report the 4 cases of sialolithiasis of the submandibular gland with multiverse presentation.

Comparing the Efficacy of CTG Versus Periocol® - GTR Membrane in the Treatment of Isolated Gingival Recession Defects: Two Case Reports

Manisha Daruka — 2023-10-27

Gingival recession is an apical displacement of gingival tissue which leads to root surface exposure causing aesthetic problem, attachment loss, hypersensitivity, and root caries. Connective Tissue Graft (CTG) is a gold standard procedure while GTR is also an effective and predictable surgical approach for recession coverage. Periocol^® is sterile, type I bioresorbable collagen membrane of fish origin. The aim of this study is to comparatively evaluate the treatment of Miller class I and class II recession defects of maxillary anteriors by using CTG or PerioCol^®- Guided Tissue Regeneration (GTR) membrane.

To the author’s knowledge this is the first study comparing the efficacy of CTG with Periocol^®GTR membrane. Two patients were selected and subjected to two different techniques i.e CTG and Periocol^® - GTR membrane. Evaluation was done on the basis of percentage gain in root coverage and increase in the width of keratinized gingiva.

Optimal results were achieved in both the cases regarding clinical measurements of recession coverage although greater coverage was seen in patient treated with Periocol^®. Both the treatment modalities can be utilized for gingival recession coverage but with limitations in both. Recession coverage with Periocol^®can be used as another option besides CTG.

A 10-Year Retrospective Analysis of Oral Leukoplakia: An Institutional Study

Nidhi Kaushal — 2023-02-22

Oral Leukoplakia (OL) is a potentially malignant disorder, which is widespread amongst Indian population due to use of smokeless tobacco. It is a diagnosis of exclusion from other oral white lesions.

Objectives: To analyze the cases of Oral Leukoplakia in relation to demographic details and clinicopathologic features.

Materials and Method: Records of OL of last 10 years (2012-2021) from departmental archives were retrieved. 213 cases were assessed and analyzed to determine the distribution according to age, gender, anatomical sites, tissue abuse habits and histopathological grading. Descriptive statistics were applied.

Results: Out of 213 patients, there was a male predilection (87.7%) with mean age of occurrence being 4-5^th decade (29.5%). The most common site of occurrence was buccal mucosa (49%). Among all these, 3.2% of cases showed malignant transformation.

Conclusion: Among 213 patients assessed, malignant transformation rate of 3.2% was observed in our study. To prevent progress of oral cancer, early detection is important because survival is influenced by the extent of disease at the time of diagnosis.

Prognostic Value and Clinical Significance of LAMP3 (CD208) Expression in Oral Squamous Cell Carcinoma: An Immunohistochemical Study

Maya R. Nishad — 2023-05-12

Context: Early detection of Oral Squamous Cell Carcinoma (OSCC) can improve treatment outcomes and prognosis as OSCC development is an intricate complex mechanism with multifactorial causes. LAMP3 (Lysosome Associated Membrane Protein 3) serves as a useful marker for the prognosis and monitoring of OSCC. It is induced progressively upon the maturation of human dendritic cells. Growing evidence shows that LAMP3 is over-expressed in various human tumors and resistant to therapies suggesting LAMP3 could become a molecular marker for the prognosis of various cancers.

Aims: This study aimed to examine the protein level of LAMP3 expression in OSCC tissue samples and determine the relationship between LAMP3 and clinical characteristics of OSCC patients by immunohistochemical (IHC) analyses.

Settings and Design: Descriptive observational study.

Methods: This study included 35 histopathologically diagnosed cases of OSCC and 35 samples of normal oral mucosa obtained from the Department of oral and maxillofacial pathology with demographic and clinicopathological documents. LAMP3 expression was measured by IHC staining.

Statistical Analysis Used: Statistical package for the social software version 23.

Results: The protein levels of LAMP3 were significantly higher in OSCC tissues than in normal tissues (p<0.001). Also, high LAMP3 expression was notable to the degree of tumor differentiation and advanced TNM staging, and metastases staging.

Conclusions: The significantly greater LAMP3 expression in OSCC indicates LAMP3's role in carcinogenesis of oral mucosa suggesting LAMP3 might be a novel prognostic marker and an anticancer target to predict disease pathogenesis in OSCC patients.

Water Sorption and Solubility of Silorane Based Composite Compared to Universal Composite

Suliman Abdullah Alnujaidi — 2023-06-02

Aim of Study: Investigate and compare the water sorption and solubility properties of a silorane-based composite with a universal composite. Silorane-based composites have gained attention due to their unique composition and claimed superior hydrophobicity compared to traditional universal composites. However, limited research exists comparing their water sorption and solubility characteristics.

The Study Guidelines: For water sorption and solubility testing. Specimens of both silorane-based composite and universal composite were fabricated and subjected to immersion in distilled water at 37°C for predetermined time intervals. The water sorption and solubility were measured by weighing the specimens before and after immersion and calculating the percentage change in mass. Statistical analysis was performed using independent t-tests to determine significant differences between the two composite groups.

Results: Showed that the silorane-based composite exhibited significantly lower water sorption compared to the universal composite at all tested time intervals (p < 0.05). The solubility of the silorane-based composite was also significantly lower than that of the universal composite (p < 0.05). These findings suggest that the silorane-based composite has better resistance to water sorption and solubility than the universal composite.

Conclusion: This research demonstrates that the silorane-based composite exhibits lower water sorption and solubility compared to the universal composite. These findings provide valuable insights for clinicians and researchers in the field of dental materials and may contribute to the development of more durable and hydrophobic composite materials for restorative dentistry.

A Digital Microscopic Evaluation of the Induction of Dentinal Micro-cracks after Canal Preparation with Rotary and Reciprocating NiTi Systems in vitro

Suliman Abdullah Alnujaidi — 2023-07-01

Aim of the Study: This study aims to assess the induction of dentinal microcracks by different NiTi systems and to compare rotary and reciprocating systems.

Methodology: Fifty teeth were selected and divided into five groups. Each group was instrumented according to the manufacturer's specifications and was performed by a single operator. The teeth were then sectioned and viewed under a digital microscope. The study aimed to compare the performance of four different instruments.

Results: No cracks were detected in the control group. The Hyflex EDM produced the highest number of cracks in 4mm (70%), and the highest number of cracks in total (43.3%). ProTaper Universal produced the least number of cracks (16.6%). WaveOne and WaveOne Gold both produced cracks (30%).

Conclusion: Within the limitation of this in vitro study, all the instruments produced microcracks. The Hyflex EDM produced higher cracks in the mid-root section. There was no significant difference in the incidence of microcracks between the four systems or between rotary and reciprocating systems.

Post COVID-19 Mucormycosis in Mandible-Case Report of Two Rare Cases

Sanjay Yadav — 2023-02-28

Mucormycosis, also known as black fungus, is a fulminant fungal infection that is reported most often in diabetic and immunocompromised individuals is a life-threatening, invasive fungal infection. After the COVID-19 pandemic, there was a significant rise in the Mucormycosis cases reported in the Maxillofacial region which was attributed to the unbalanced use of steroids to avoid the cytokine storm in covid patients. The majority of the cases reported were of rhinocerebral/orbital or maxillary areas. Very few reports describing the Muromycosis involving mandible have been published on the online database. So here, in this case, report a brief of two cases of Mucormycosis involving the mandible have been described its clinical presentation and histopathologic features.

Complex Odontoma Impeding Eruption of Permanent Maxillary Central Incisor: A Case Report

Mandakini S. Mandale — 2023-03-21

Odontomas are benign odontogenic tumours made up of epithelial and mesenchymal cells. They are mostly associated with disorders of tooth eruption, causing impaction and/or delayed tooth eruption, and sometimes accidental findings on routine radiological examination. The purpose of this article is to present and discuss the case of a 21-year-old male patient who complained of obstructing the eruption of the right maxillary permanent central incisor. Radio-opaque calcified masses were revealed on a radiograph and masses were surgically removed.

Case Report on Ectopic Third Molar in Maxillary Sinus

Sghaier Jihed — 2023-04-22

Ectopic tooth in the maxillary sinus is a rare occurrence. There are multiple etiologies of this condition, including developmental disruption, pathological process, iatrogenic, and in rare cases no recognized reason.

Ectopic teeth in the maxillary sinus are noticed by accident during routine radiological examinations.

A 38-year-old married female reported to the Department of oral medicine and oral surgery at the University Dental Clinic of Monastir-Tunisia. She has been experiencing pain in the left side of the face and a chronic headache for two months.

Orthopantography and computed tomography are used to identify the existence of an ectopic tooth within the left maxillary sinus.

The Modified Caldwell-Luc Technique was executed to remove the tooth.

The patient remained free of the presenting symptoms three months later.

Although the existence of an ectopic tooth in the maxillary sinus is rare, it should be evaluated and detected as soon as possible. An ectopic tooth in the maxillary sinus needs to be extracted since it might cause cyst development if left untreated. The modified Caldwell-Luc method, which offers a clear view into the maxillary sinus, is the standard approach.

Oral Desquamations of Clinical Interest: A Report of 2 Cases

Saraswathi K. Gopal — 2023-05-19

In oral medicine, dermatologic diseases have special attention as oral mucosal lesions may be a clinical feature or the only sign of various mucocutaneous diseases. Dentists are often the first to be consulted by patients who develop acutely painful oral ulcerations associated with these mucocutaneous lesions, and this could be neglected by dentists due to a lack of information and/or an improper diagnosis, leading to a significant deterioration in the quality of life of patients. This present article describes two variants of vesiculobullous lesions with a brief review, as they are a distinct group of oral disorders characterised by formations of vesicles or bullae. The dental practitioner attempting to diagnose the oral ulcers and lesions is often confronted with several diseases having similar and identical clinical appearances. Also, the clinical identification of intact vesicles and bullae in the oral cavity is really a challenge due to regular irritation and the friable nature of the oral mucosa, which makes the diagnosis of vesiculobullous lesions even more difficult as the differential diagnosis of the disease also includes ulcerative, immunological, neoplastic, and systemic diseases. So, here we present two diagnosed cases of vesiculobullous lesions affecting middle aged women who presented with an overlapping clinical presentation and a varying etiological factor. They were discussed with the aim of making a closer attempt to understand their clinical presentation, pathogenesis, diagnostic criteria, and early, effective management protocols for a better prognosis.

Intra-osseous Schwannoma of Mandibular Symphysis: A Rare Case Presentation

Priyankar Singh — 2023-06-13

Aim: To describe a rare presentation of intra-osseous schwannoma of mandible.

Presentation of Case: A rare representation of diffuse non-tender swelling at parasymphysis of mandible with bicortical expansion and negative aspiration on FNAC. A complete wide surgical enucleation of soft, doughy mass was done through intra-oral papilla preservating flap followed by suitable dissection preserving the vital nerves and vessels in the vicinity was done. Histopathologically the tissue tumor mass arranged in Antoni A pattern showing Verocay bodies formed by streaming fascicles of spindle shaped schwann cells forming palisade arrangement around central acellular, eosinophic areas.

Discussion: Neurilemmomas is a typical histopathological finding with typical histological features includes Antoni A areas, Antoni B areas, or both. Antoni A regions have high cellularity and are composed of densely packed spindle cells arranged in palisades. On the other hand, Antoni B regions have more myxoid structures and two palisading rows of aligned nuclei in an eosinophil zone.

Conclusion: Intraosseous lesions located in the peripheral region with non-specific clinical and radiographic features often lead to diagnostic confusion. Most of the lesions located in the environs of the teeth are odontogenic in origin. Yet, other possibilities like intraosseous scwhannomas must be considered.

Implant Supported Metal Reinforced Overdenture with Ball Attachments: A Case Report

Akanksha Goel — 2023-06-23

Prosthetic management of mandibular edentulous arch has always been a challenge. Implant-supported overdentures have been a common treatment modality for edentulous patients and have shown good clinical results. Implant supported overdentures offer many advantages over conventional complete dentures. These include decreased bone resorption, reduced prosthesis movement, better esthetics, improved tooth position, better occlusion, increased occlusal function and maintenance of the occlusal vertical dimension. The present article illustrates design and fabrication technique of the implant-retained mandibular overdenture using ball attacments.

Surgical Removal of Transmigrated Mandibular Canine: A Case Report

Uma Mahindra — 2023-08-01

Introduction: Mandibular canine transmigration is a rare occurrence and is an occasional diagnosis. The majority of patients have no symptoms, and these canines are frequently discovered during a radiological examination prior to orthodontic treatment. The exact aetiology is unknown, and treatment of impacted transmigrated canine can be challenging for a practitioner if it is diagnosed at later stages. Early detection of impacted canines and prompt treatment is utmost important to ensure facial harmony and improved function.

Aims: To determine the management of rare case of an impacted mandibular canine that had transmigrated to the opposite side.

Place of Study: Department of Oral and Maxillofacial Surgery, CSMSS Dental College and Hospital, Chhtrapati Sambhaji Nagar (Aurangabad).

Methodology: A patient with transmigrated mandibular canine with crowding in mandibular anterior teeth where orthodontic repositioning of tooth was not possible, was surgically removed by an intraoral approach followed by placement of Platelet Rich Fibrin (PRF) in the defect and that was followed by orthodontic treatment.

Results: PRF placed in the defect enhanced the healing process as PRF is rich in growth factors that promotes early healing and bone formation.

Conclusion: The rare phenomenon of transmigration of the mandibular canine crossing the mandibular midline should be carefully evaluated and proper treatment modality according to the case should be considered for the management. Early detection and treatment is necessary to preserve adjoining tissues, and dentition, resulting in improved aesthetic and function. Surgical removal of the transmigrated canine under local anaesthesia appears to be the best form of treatment.