Transplantation of one tooth to another site in the same individual can be considered an attractive alternative to dental implants or fixed prostheses. This study reports the treatment results of a 16-year-old female with severe crowding in upper and lower arches and a fractured mandibular premolar with a poor prognosis. The crowding of the lower left quadrant was relieved by the extraction of the first premolar. This extracted tooth with a complete root was transplanted to the right quadrant with the fractured tooth. Platelet-rich fibrin can stimulate and accelerate periodontal healing. The platelet concentrate of this patient was prepared and applied to the socket wall at the time of surgery. The acceptable occlusion and the excellent 4-year prognosis of the transplanted tooth are presented.

Root perforation may occur at any stage of endodontic treatment and is mostly due to iatrogenic injury and may compromise the outcome of endodontic treatment. Repairing a perforation is difficult and the prognosis depends on various factors such as time, site and size of perforation, and the patient's overall health status. Hence, choosing the most appropriate material can be critical for the dentist. In this case report of a strip-perforation repair, an mineral trioxide aggregate-like material (cold ceramic) that has been shown in previous studies to have favorable properties, was successfully used.

Ameloblastoma is a benign tumor of odontogenic epithelium which is slow growing, locally invasive, expansive that may result with asymmetries of the face. Conservative treatment of odontogenic tumors with marsupialization is not common but can be done successfully in those with cystic pattern. The aim of this case and literature review is to propose marsupialization as an initial procedure for its treatment. We have presented a case of an ameloblastoma involving 56-year-old male patient. Orthopantomography and computed tomography showed the lesion extended between the right molar region and left molar region of mandible with both buccal and lingual expansion and root resorptions. On clinical examination, expansions of mandible and slight tooth mobilities were seen. An incisional biopsy was carried out and histopathologic examination revealed ameloblastoma although clinical features of lesion were more suggestive of cyst. Our case was treated by obturator marsupialization with a good healing. This case and review of the literature discusses the available treatment option according to macroscopic features of jaw lesions and emphasizes on the importance of the most conservative treatment option. Conservative treatment preserves integrity of bones while radical treatment can leave major cosmetic and functional sequelae such as pathologic fractures, complication with reconstruction plates.

It may not be possible to treat large maxillofacial defects by surgical reconstruction alone. Prosthetic rehabilitation is invariably required to restore esthetics and function. Achieving adequate retention, stability, and support in these maxillofacial prostheses is a challenging task. This clinical report describes prosthetic rehabilitation of a midfacial defect following surgical resection of squamous cell carcinoma. The intraoral defect was restored with a maxillary obturator prosthesis with salivary reservoir, and the extraoral defect was restored with magnet-retained facial prosthesis having an acrylic resin framework and an overlying silicone facial prosthesis.

One of the most challenging esthetic concerns in dentistry is conservative replacement of the missing anterior teeth. Although implants are considered to be a better treatment option for rehabilitation of such patients, resin-bonded bridges (RBBs) can conservatively restore the missing teeth and have thus gained popularity over the years. It consists of an artificial tooth with a wing-like extension that is cemented to the adjacent teeth. There are various types of RBBs among which Maryland bridge is the simplest and the popular most due to its micromechanical retention enabled by acid etching of both tooth and metal retainer. It can be fabricated by various techniques and materials. In this case reports, we have discussed about two unique designs of Maryland bridge fabricated by two different materials (Porcelain-fused metal and Graphene) and utilizing two different techniques (conventional and digital).

The restoration of speech, deglutition, mastication, and respiration in patients with bimaxillary resection involving the maxillae, hard and soft palates, and paranasal sinuses poses a significant challenge. This clinical report describes the prosthodontic management of a patient with bilateral maxillectomy caused due to post-COVID-19 mucormycosis. A patient-specific implants (PSI) that matched the remnants of the zygoma complex was designed to improve the patient's severely impaired speech and swallowing. The patient's postsurgical anatomy was first visualized using three-dimensional computed tomography data. Following that, a customized zygoma-supported titanium framework was designed to support the prosthesis based on the data. Two weeks after the framework was installed, an open-tray impression was made and the prosthesis was fabricated. These findings suggest that PSI-retained prosthesis can be considered in cases with severely compromised maxillary bone anatomy, impaired oral functioning, and no viable conventional reconstruction options.

Saprophytic molds such as Mucor, Rhizopus, and Absidia cause mucormycosis, a fungal infection. These saprophytic fungi are common in the environment and have a strong proclivity for invading major blood arteries, causing tissue ischemia, necrosis, and infarction. They have been linked to immunocompromised individuals with a history of diabetic ketoacidosis, corticosteroid medication, HIV infection, malignant lymphomas, and patients currently receiving and recovering from COVID-19 treatment. The foregoing is the case of a 78-year-old COVID-19 recovered male who presented with a primary complaint of upper tooth movement for 1 month and maxillary segmental mobility. The maxillary alveolar process was resected, and histopathological reports revealed mucormycosis, which was treated with antifungal medication and nasolabial flap surgery. For the past 6 months, he has been disease-free. Early detection and treatment may offer a higher chance of successfully minimizing this debilitating condition.

The etiopathology of maxillary sinusitis of dental origin (MSDO) is well established, and chronic apical periodontitis is the second most common cause of all dental-induced sinusitis incidents. The literature presents no common treatment protocols for MSDO and very few studies address the impact of root canal treatment (RCT) in its management. The literature presents cases of maxillary sinusitis resolution after performing a multivisit nonsurgical endodontic treatment, yet none described complete healing of MSDO as a result of single-visit nonsurgical RCT. This paper reports a case series of maxillary sinusitis of endodontic origin (MSEO) associated with upper maxillary molars that were successfully treated with single-visit nonsurgical antiseptic RCT. In all cases, the clinical symptoms subsided within a week after endodontic treatment. Control cone-beam computed tomography (CBCT) scan showed healing of periapical bone and total resolution of maxillary sinusitis symptoms. MSDO treatment protocol should start with nonsurgical antiseptic RCT. Single-visit nonsurgical endodontic treatment can be effective in MSEO management. CBCT is a method of choice in MSEO diagnostics. Endodontists are well trained and well equipped to treat MSDO, and the cooperation between ear, nose, and throat specialists, maxillofacial surgeons, and endodontists is crucial for both: good diagnostics and treatment.

Basaloid squamous cell carcinoma (BSCC) is an exceptional, aggressive variant of squamous cell carcinoma (SCC) because of its unique histological feature and an ominous clinical behavior. Recently, it has been recognized as a high-grade SCC. The most preferential site of occurrence is the upper aerodigestive tract. Because of its aggressive behavior and tendency to metastasize, BSCCs are considered to have poor prognosis. We present a BSCC case in a 60-year-old male, which was clinically diagnosed as an aggressive inflammatory lesion with a differential diagnosis of granulomatous lesion, involving the mandibular anterior gingiva. Till now, only 17 cases of BSCC with gingival involvement have been reported in the literature. Here, we present one additional case of BSCC involving gingiva.

Mandibular tooth extractions for camouflage treatments in borderline Class III patients may end up with unpleasing esthetic results which may lead the patient seeking further complicated retreatments. In this case report, we presented a patient's retreatment with a combined orthodontic and orthognathic surgery treatment plan. The treatment strategy involved an innovative temporary anchorage device (TAD)-based method for total mandibular arch mesialization instead of space reopening for first lower premolar replacement with implants. In the current case report, orthognathic management of a Class III adult female is discussed. The patient had a history of an esthetically unsuccessful previous camouflaged orthodontic treatment with two lower premolar extractions. She was prepared for orthognathic surgery using an innovative custom-made sliding jig based on miniscrews for total mandibular arch mesialization with the aim of dental arch decompensation. After gaining the optimal dental arch discrepancy, the patient had orthognathic surgery (maxillary advancement and mandibular setback and advancement genioplasty). Total mandibular dental arch mesialization with the aim of dental arch discrepancy preparation was successfully conducted using TADs. By means of the innovative miniscrew-anchored sliding jig, the patient's satisfactory esthetic and occlusal results were obtained in 22 months. With innovative application of the miniscrews, more practical and reasonable alternatives are available to replace conventional and complicated treatment plans such as space reopening for implants in patients with unsuccessful previous orthodontic therapies.

One of the causes of treatment failure is calcification in the canal pathway, which prevents complete access to proper working length, and one of the most difficult and challenging cases of root canal treatment has been reported. In some cases, the dentist will not be able to open the calcified canal. Therefore, the prognosis of root canal treatment in these cases has been reported poor, and the dentist will offer a plan for possible treatments, including tooth extraction or apical surgery. The presented case is one example of those cases with a periapical lesion, which as a temporary treatment, the pulp chamber was filled with cold ceramic. This material, which is an MTA-like (Mineral Trioxide Aggregate) bioceramic with proper sealing ability, has been introduced as a root-end filling material. After 6 years of which the patient returned, he did not express any pain or discomfort during these 6 years. Furthermore, in radiograph that was taken, periapical lesion relative healing and bone regeneration were amazingly seen.

The aim of the present study was to describe two clinical cases showing postoperative pain associated with the use of plastic carrier obturation system and apical bone fenestration. The patients were treated by surgical access and apicoectomy through a modern technique (using magnification and microsurgical approach), thus removing the direct contact between obturation material and submucosal connective tissue. The surgical interventions were carried on without the occurrence of any complication. Postsurgical adverse sequelae were negligible. After few weeks from the surgery, all symptoms disappeared. Radiographic healing was observed after 48 months. The presence of apical bone fenestration could be the cause of persistent pain after root canal treatment. The contact between plastic carrier and submucosal connective tissue could be the direct cause of spontaneous pain even in absence of periapical infection. Since the clinical diagnosis could be difficult, the use of tridimensional radiology could be justified. Surgical approach, by the removal of the contact between the carrier and connective tissues, can be considered a viable option to treat these particular affections.

Based on our collective experiences with gap management around immediate dental implants, we have proposed a classification of gap type based on the location in relation to implant periphery. Seven types are proposed, and all but one type should heal without gap grafting provided that flap-less surgery and atraumatic extraction have been achieved. The exception is our Type II gap where the implant has been placed too far buccally leaving a gap only on the lingual/palatal. In this case, the lingual/palatal gap need not be grafted, but the buccal aspect of the implant should best to augmented to avoid the complications.

Tooth nonvitality is one of the frequently seen consequences of dental trauma that causes the arrest of root development. Amniotic membrane has received a lot of attention for its use in transplantation and regeneration procedures. This article reports a unique and novel case of successful regenerative endodontic procedure done using amniotic membrane in a traumatized immature right maxillary central incisor of an 8-year-old girl. The clinical and radiographic evaluation done during the recall visits at 1, 3, 6, 9 and 12 months showed a progressive root growth with apical closure.

The use of computer-aided design/computer-aided manufacturing technology simplifies the laboratory and clinical steps for the fabrication of implant prostheses. It also reduces additional costs for the prosthetic components and technical procedures. This article describes a modified impression technique using an impression metal jig to enhance the accuracy of final impression and also to eliminate the need for the try-in of resin pattern of the milled bar.

Canalicular adenoma (CA) is a rare, benign salivary gland tumor that has special tendency to occur in the upper lip. Buccal mucosa is the second most common site. It occurs more often in older patients with peak prevalence in the seventh decade of life. A definitive female predominance has been reported. According to the latest English published literature, 531 cases of CA have been reported. We present a case of CA of the hard palate that presented in a 29-year-old female patient. The histopathological and immunohistochemical findings showed typical features of CA and intense expression of pan-cytokeratin and S-100 protein. We also review its differential diagnosis from other salivary gland tumors.

To ensure single dental implant stability, there are some approaches. The stabilization of a single-piece implant by welding it to a titanium needle allows immediate loading and promotes the final osseointegration. The aim of this case report study was an evaluation of long-term clinical outcomes of immediate loading in cases with bone atrophy in the canine region by welding single implant to a titanium needle. In two cases with maxillary atrophic anterior bone, single-piece titanium implants were used. As support structure, a Scialom-type stabilization titanium needle was used (diameter 1.2 mm and suitable length to obtain a bicortical positioning). These two elements were joined together using a Mondani intraoral welder. The implants immediately loaded by temporary restorations. The cases were followed for 24 years, and clinical outcomes were assessed. The use of this method, in the cases with maxillary atrophic anterior bone, allows immediate loading with a fixed acrylic prosthesis at the end of the surgical session. Clinical outcome was successful for 24 years. This approach is a successful method that allows immediate loading in atrophic bone.

Absence or loss of facial structures causes functional deficits and enormous psychological distress, so rehabilitation is necessary. However, facial prostheses have some difficulties due to mobile underlying tissues and retention. We used dental implant instead of conventional maxillofacial implant and safe on four prosthetic systems which is used in over dentures for retention of auricular prosthesis.

Among oral pathologic lesions, odontomas are the most common odontogenic tumor of the jaws and generally asymptomatic. They are mostly diagnosed as a result of routine radiographic investigation. In this report, we describe a very rare occurrence of bilateral complex odontoma in the region of the mandibular second premolar. Conservative surgical procedure was planned, and removal of the odontomas was carried out through the socket after extraction of the deciduous second molars, and the diagnosis was confirmed with a histopathological study.

Achondroplasia is the most common cause of dwarfism, which is inherited as an autosomal dominant disorder, caused by genetic mutation in fibroblast growth factor 3, leading to defective maturation of chondrocytes. It is known to be associated with various oral and dental manifestations such as delayed dental development, midfacial hypoplasia and constricted maxilla with a relatively large mandible, resulting in skeletal/dental Class III malocclusion, posterior crossbite, anterior reverse jet and anterior overbite. However, the association of achondroplasia with talon cusp and supernumerary teeth has never been reported in the literature. Wehereby reported a case of achondroplasia associated with such unusual findings. Moreover, all the three variants of talon cusp, i.e., “true talon,”“semitalon” and “trace talon” are observed in the present case, which makes it a unique one. Further double talon cusps were noticed in the palatal aspect of maxillary central incisors.

Osseous choristoma is a rare, benign lesion of the oral cavity. This report presents a case of osseous choristoma in the submental region of a 30-year-old female subject. Her chief complaint was a painless swelling in the submental region. Panoramic radiography showed a well-defined, round, radiopaque lesion near the inferior border of the left mental region. The lesion was diagnosed as an osseous choristoma based on the histopathological examination of the surgical specimen. This paper is an attempt to bring forward a unique occurrence of osseous choristoma, which would further help the medical fraternity in improvising their knowledge, diagnosis, and treatment of this entity.

Adenomatoid odontogenic tumor (AOT) is an uncommon benign odontogenic lesion, with debatable histogenesis and variable histopathology. A systematic and diverse insight into the evolution, clinical presentation, histology, and immunohistochemical findings of this lesion is reviewed and presented. We reviewed the data published from 2000 to 2014 of approximately 255 cases that revealed a significant change in the incidence of predominant site involved, in contrast to the findings published by Reichart. We have also included the chronological order of events leading to the coining of the term AOT, which shows the curiosity that has been dedicated to understanding the lesion. Immunohistochemistry is considered to be a hallmark in pathology for learning the molecular pathogenesis and giving a correct final diagnosis. Several markers have been used to investigate and understand this lesion, and a compilation of the findings has been tabulated.

Intrusive luxation is the most severe type of dental injury with a complex healing sequence. Pulp necrosis, root resorption (surface, inflammatory and replacement resorption), and defects in marginal periodontal bone healing are the main complications. Treatment strategies can be either active, by repositioning (surgical or orthodontic extrusion), or passive, by spontaneous re-eruption based on the thorough evaluation of the case. This paper reports a case of delayed repositioning of severely intruded permanent maxillary central incisors accompanied by complicated crown fractures after 3 months. After thorough clinical and radiographic evaluations, and based on guidelines, the teeth were surgically repositioned and splinted for 6 weeks. One week after the initial intervention, the endodontic treatment for both permanent maxillary incisors were initiated using calcium hydroxide. 6 months later, the teeth were ready for MTA plug and gutta-percha root canal filling. During the follow-up period, the teeth had remained functional and esthetically acceptable. Further yearly observations are planned at least for 5 years.

Stafne bone cavities (SBCs) are uncommon well-demarcated defects of the mandible, which often occur in the posterior portion of the jaw bone and are usually asymptomatic. Furthermore, SBC is found in men aged 50-70-year-old. Anterior mandibular variants of SBC are very rare. This article describes a case of anterior SBC in a 45-year-old man that resembled endodontic periapical lesions. Upon histopathological examination, it turned out to be a normal salivary gland tissue.

Wisdom tooth operations are sometimes accompanied by complications. This case report shows complications during upper jaw third molar removal. Expectable problems during oral surgery should be planned to be solved in advance. Displacement of the third molar during oral surgeries as a considerable complication is rarely discussed scientifically. A good design of flap, adequate power for extraction, and clear view on the surgical field are crucial. Three-dimensional radiographic diagnostics in terms of cone beam computed tomography is helpful after tooth displacement into the infratemporal fossa.

Ellis-van Creveld (EVC) syndrome, a form of skeletal and chondroectodermal dysplasia, is an autosomal recessive disorder characterized by a tetrad of disproportionate dwarfism, postaxial polydactyly, ectodermal dysplasia, and heart defects. In the present article, we hereby present a case of a 13-year-old girl of Indian ethnicity with EVC syndrome with a remarkable number of classical oral and dental features, with unusual findings such as taurodontism and talons cusp. Such dental findings were reported in few cases only. Despite the fact that oral manifestations play an important role in the diagnosis of EVC, only a few detailed reports have been published in the dental literature.

Successful treatment of a large implant periapical lesion (IPL) that caused paraesthesia and perimandibular abscess. IPL is a pathologic phenomenon that rarely involves implants. This event first described in 1992 with an incidence rate of 0.26-9.9% and the origin is not well known. The most likely suggested causes are presence of preexisting bone pathology, contamination of implant surface, bone overheating during implant surgery, vascular ischemia, excessive tightening of the implant, fenestration of the buccal plate and different implant surface designs. In the present case report, we describe relatively large periapical lesions involving several implants caused severe abscess accompanied by transient inferior alveolar nerve paraesthesia and its successful management. A brief review of the literature and a discussion of possible causes and different treatment plans are also included.

Surgical procedure for removal of impacted teeth is a challenge for clinicians as it involves accuracy in the diagnosis and localization of the dental elements. The cone-beam computed tomography (CBCT), compared to the conventional radiography, has a greater potential to provide complementary information because of its three-dimensional (3D) images, reducing the possibility of failures in surgical procedures. Two 10-year-old boys presented with aesthetic issues associated with the juxtaposition of ectopic teeth with the permanent ones. Both two-dimensional and 3D preoperative radiographic diagnostic sets were produced. The occlusal and panoramic radiographs were not enough for proper localization of impacted incisors. Thus, the CBCT was used as a surgical guide. After 2 years of longitudinal following, no lesion was recorded, and the orthodontic treatment has proven successful. In all cases, CBCT contributed to both diagnosis and correct localization of supernumerary teeth, aiding the professional in the treatment planning, and consequently in the clinical success. The surgeries were completely safe, avoiding damage in noble structures, and providing a better recovering of the patients.

The purpose of this report is to present a rare case of a fused mandibular lateral incisor with supernumerary tooth with a follow-up for 18-months. A 35-year-old female patient was referred to our clinic with an extraoral sinus tract in the chin. The intraoral diagnosis revealed the fusion of her mandibular lateral incisors. Vitality pulp tests were negative for mandibular right central and lateral incisors. Radiographic examinations showed a fused tooth with two separate pulp chambers, two distinct roots, and two separate root canals. There were also periapical lesion of fused teeth and mandibular right central incisor, so endodontic treatment was carried out the related teeth. Radiographic examination revealed a complete healing of the lesion postoperatively at the end of 18-months. This paper reports the successful endodontic and restorative treatment of unilateral fused incisors. Because of the abnormal morphology of the crown and the complexity of the root canal system in fused teeth, treatment protocols require special attention.

Sialolithiasis is a common disease of the major salivary glands, characterized by the obstruction of a salivary gland or its excretory duct due to the formation of calcareous concretions. Sialoliths usually measure from 1 mm to <10 mm. They rarely measure more than 15 mm, and infrequently giant salivary gland calculi >15 mm have been reported in the literature. The submandibular gland and its duct appear to be the most susceptible sites for this disease. In this article, we report two unique cases, including a giant bilateral case, measuring 50 mm in length and 5 mm in width on the right side and one, 30 mm in length, and 5 mm in width on the left side; and another case, measuring 83 mm in length. The diagnostic and therapeutic approaches consisted of transocclusal radiography with the conservative transoral surgical technique in both cases. The follow-up showed the normal function of the relevant salivary glands. To the best of our knowledge and belief, similar cases have not been reported in the literature.

Resorption of tooth structures can occur as a result of physiological, pathological, and idiopathic factors. Early diagnosis and appropriate treatment can prevent its serious complications. This case report presents surgical endodontic management of a trauma-induced perforating external root resorption, which was diagnosed with the help of cone beam computed tomography. Following root canal treatment, intentional replantation of the tooth was performed so as to expose the opening of the resorption defect to allow for complete debridement and closure. Eighteen months follow-up showed arrest of root resorption, and progressive healing of the defect.

Adenoid ameloblastoma with dentinoid is a rare odontogenic tumor. Granular cell ameloblastoma also is a less common histological subtype of ameloblastoma. In this report, the patient was a 31-year-old male. The lesion was located in the right mandible and was unicystic with well-defined borders. The tumor tissue was showing a combination of follicular, plexiform, and desmoplastic patterns of ameloblastoma with wide areas of granular cells, fibrous stroma, glandular pattern, and dentinoid calcified. Very few cases of distinct forms of ameloblastoma that show the formation of dentinoid has been reported. However, there are no cases of adenoid granular cell ameloblastoma with dentinoid reported.

Agenesis of permanent canines is a rare condition, and that of both maxillary and mandibular permanent canines is extremely rare. It may occur either isolated or in association with other dental anomalies. Reports of such cases are very scarce in the literature. Need for early diagnosis of such conditions should be emphasized because of functional, esthetic, and psychological problems which should be evaluated and treated appropriately. The present paper presents a report of bilaterally missing permanent maxillary and mandibular canines. This case might contribute in the future studies of incidence of agenesis of permanent canines.

Pharmacological sedation is one of the effective ways of prevention of gag reflex development in patients experiencing anxiety and fright before dental treatment. We are reporting a case where we could successfully eliminate exaggerated gag reflex (intravenous [IV] Gagging Severity Index) in a dental patient using IV sedation with dexmedetomidine. IV administration of dexmedetomidine provided elimination of gag reflex at a depth of sedation for the patient with the Richmond Agitation-Sedation Scale score of −2 and −1. The patient received dexmedetomidine 1.0 μg/kg for 10 min and then a continuous infusion of dexmedetomidine 0.4 μg/kg/h. The use of dexmedetomidine for sedation may be an alternative to other pharmacological agents in patients with dental anxiety accompanied by exaggerated gag reflex.

Ameloblastoma is a locally invasive tumor derived from odontogenic epithelium. An uncommon variant of ameloblastoma is granular cell type, which cannot distinguish from other ameloblastoma subtypes by clinical and radiographic findings alone. Only review of it's microscopic features allows distinction from other subtypes. The purpose of this article is to present a case of granular cell ameloblastoma. This subtype should be distinguished from the other histopathologic subtypes because of it's higher recurrence rate and more aggressive biological behavior. Radiographic and histologic findings as well as treatment are also discussed.