11/29. Papillary squamous cell carcinoma presenting on the gingiva.BACKGROUND: Papillary squamous cell carcinoma (PSCC) is a rare variant of squamous cell carcinoma. PSCC can occur as either an in situ or invasive tumor. The sites of occurrence in order of the most to least prevalent are the larynx, oropharynx, and nasopharynx. We present an unusual case of PSCC occurring on the gingiva. methods: A 72-year-old white female presented with a chief complaint of tooth mobility in the right posterior mandible. Clinical examination revealed a Miller's Class 2 mobility of tooth #28 along with an erythematous, papillary appearance of the lingual gingiva on teeth #27, #28, and #29. Her dental history revealed treatment of tooth #28 with locally delivered antibiotics. Her medical history revealed a diagnosis of breast cancer 8 years prior to examination that was treated with partial mastectomy and radiation therapy. An initial differential clinical diagnosis of verrucous carcinoma or metastatic carcinoma was made. RESULTS: Surgical therapy included extraction of tooth #28 and an excisional biopsy of the lesion on the lingual gingiva. Microscopic evaluation of the gingival specimen revealed a neoplastic papillary proliferation of the surface epithelium with a thick layer of parakeratin, deep parakeratin-lined crypts, and a thickened spinous cell layer along with islands and strands of malignant epithelium. The microscopic appearance of the lesion was characteristic for PSSC. The patient's tumor was removed via a block resection that included teeth #27 through #31 and a radical neck dissection. CONCLUSIONS: This is a case report of PSCC occurring on the gingiva. This report demonstrates that, even though oral cancers involving the periodontium are a relatively rare occurrence, periodontists cannot be complacent about the diagnosis of periodontal bone loss. It also highlights the importance of utilizing a histopathologic examination to confirm the clinical diagnosis for any suspicious lesion.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
12/29. Skeletal anchorage for orthodontic correction of maxillary protrusion with adult periodontitis.Because the number of adult patients seeking orthodontic treatment is increasing, orthodontists are becoming more likely to encounter patients with adult periodontitis. However, it is sometimes difficult to establish anchorage because of poor periodontal tissues in patients with adult periodontitis. This article reports the successful use of skeletal anchorage to treat a maxillary protrusion case complicated by severe adult periodontitis. A female patient aged 50 years seven months showed a skeletal Class II jaw base relationship. A spacing of five mm in the upper anterior teeth with an overjet of 7.5 mm and overbite of four mm was observed. She had generalized horizontal bone loss in both arches, with vertical bone loss in the posterior segment. After periodontal treatment, miniplates were placed in the zygomatic process, and retraction and intrusion of the maxillary incisors were performed. After active treatment for 21 months, the upper incisors had been inclined 9.5 degrees lingually, intruded two mm at the apex, and good anterior occlusion was achieved. Acceptable occlusion and periodontal tissue were maintained after a retention period of two years. Our results suggest that skeletal anchorage is useful for retraction and intrusion of upper incisors in cases of maxillary protrusion with severe adult periodontitis.- - - - - - - - - - ranking = 0.61869942370176keywords = jaw (Clic here for more details about this article) |
13/29. Localized periodontitis as a long-term effect of oral piercing: a case report.Recent years have seen a dramatic increase in the number of published articles on short-term complications of oral piercing, possibly reflecting an increase in the popularity of this practice. Long-term effects of oral piercing, however, have had minimal documentation. This case report of a 28-year-old woman with piercing of the tongue and lower lip demonstrated localized severe periodontitis as a destructive long-term outcome related to oral piercing. The patient reported that she had worn 2 tongue rings and a mandibular labrette (lip piercing) in the form of a bar for 12 years. Plaque and calculus accumulation, severe inflammation, tooth mobility, severe horizontal radiographic bone loss, and deep pocketing were observed in teeth affected by the jewelry.- - - - - - - - - - ranking = 0.015430470993705keywords = lower (Clic here for more details about this article) |
14/29. osteomyelitis and pathological mandibular fracture related to a late implant failure: a clinical report.This clinical report describes an unusual consequence of peri-implantitis and subsequent implant failure in a 72-year-old man. Following uneventful implant removal, osteomyelitis developed at the implant site, which subsequently weakened the mandible sufficiently for a pathological fracture to occur. The patient was treated successfully by use of an intensive oral hygiene regime, antibiotics, and conservative management. The consequences and management of implant failure are discussed, as well as issues relating to the management of osteomyelitis and pathological bone fracture.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
15/29. Oral post-surgical complications following the administration of bisphosphonates given for osteopenia related to malignancy.BACKGROUND: This case report seeks to illustrate the clinical consequences of the administration of bisphosphonate therapy to prevent osteopenia secondary to malignancy in one patient. methods: A 69-year-old white female with a history of breast cancer with metastasis presented with pain in the upper left quadrant and periodontal pocketing of at least 6 mm in each of the four quadrants of the oral cavity. One week following surgery on the lower right region, lingual bone exposure was noted, and several attempts at achieving healing over the course of 15 months proved unsuccessful. RESULTS: Upon referral to a surgeon at the louisiana State University Medical Center, new orleans, louisiana, a potential causative factor was finally identified. The drug zoledronic acid, a bisphosphonate given for prevention of osteoclastic activity of bone metastasis, secondary to breast cancer, was identified as the possible cause of inhibition of healing, most likely from regional vascular insufficiency. The drug was immediately discontinued. The patient is healing very slowly with the aid of hyperbaric therapy; she has been unable to achieve smoking cessation, which is deterring thorough healing of the exposed bony area on the lower right lingual side. CONCLUSIONS: physicians and dentists alike must become increasingly aware of impaired oral healing following the use of bisphosphonates given for malignancy-related osteopenia. A dental exam should be performed before bisphosphonate therapy, as recommended for radiation therapy related to malignancy.- - - - - - - - - - ranking = 0.030860941987409keywords = lower (Clic here for more details about this article) |
16/29. Intentional replantation for a periodontally involved hopeless incisor by using autologous platelet-rich plasma.The aim of the present case is to describe the use of autologous platelet-rich plasma (PRP) in an intentional replantation procedure for a periodontally involved lower right central incisor with 18 months follow-up. Brief information is also given on the preoperative preparation of PRP in the dental office. PRP preparation is a new biotechnology, and the prepared material contains thrombocyte concentrates and high levels of growth factors. This material promotes healing time in a range of various sites. In this case, a tooth with severe periodontal breakdown was treated with PRP with intentional replantation procedure. This tooth was previously treated with root canal treatment and root planing. The tooth was extracted, and was replanted with autologous PRP. Clinical and radiographic follow-up for 18 months demonstrated new bone formation around the apical portion of the root and all clinical parameters indicated a trend of healing. The mobility of this previously grade III mobile incisor returned to normal limits. We speculate that intentional replantation with PRP application may induce wound healing and may induce bone formation.- - - - - - - - - - ranking = 0.015430470993705keywords = lower (Clic here for more details about this article) |
17/29. Aggressive periodontal destruction and herpes zoster in a suspected AIDS patient.An unusual case of spontaneous and rapidly destructive lesions involving the periodontal structures is described in a 54 year old, bi-sexual patients suspected of having AIDS. Concomitant with the periodontal breakdown, the patient developed a severe case of herpes zoster involving the area of the face innervated by the 5th cranial nerve. The dermal lesions involved the face, nose, eyes and scalp. Similar lesions were noted on the gingival and palatal mucosa on the same side of the jaw as the skin lesions. The differences between this type of periodontal destruction and more conventional forms of periodontitis are discussed.- - - - - - - - - - ranking = 0.61869942370176keywords = jaw (Clic here for more details about this article) |
18/29. Osseo-integrated implant treatment of a patient with rapidly progressive periodontitis. A case report.The case report presented describes placement of osseointegrated fixtures in a patient with a probable history of rapidly progressive periodontitis. A 12-year history is presented. The post-operative sequelae of placing fixtures in a fully edentulous maxilla and partially edentulous mandible were the worst seen by the Implant Team at Emory University. The hypothesis presented is that patients with aggressive forms of periodontal disease should be subjected to appropriate mechanical and antimicrobial therapy to produce a healthy oral flora before any implants are placed.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
19/29. osteomyelitis associated with chronic periodontitis: a report of three cases.Correctly differentiating between periodontal abscess (localized, acute suppurative infection of the periodontium) and osteomyelitis (the extension of an infection into the bone medullary cavity) is crucial since the former may not require antibiotics for resolution, while the latter will. Initial assessment and treatment of osteomyelitis should be based on clinical examination, radiographic interpretation, and experience. Three case histories of osteomyelitis are presented, ranging from a periodontally well-localized case to one involving a hemimandible and crossing the midline. Successful early diagnosis and case management may benefit from scintigraphic interpretation and culture-and-sensitivity studies.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
20/29. Diagnostic problems of periodontitis-like lesions caused by eosinophilic granuloma.eosinophilic granuloma is the localized and mildest form of histiocytosis X. It is a destructive osseous lesion characterized by large numbers of eosinophils and histiocytes. The etiology of the disease is unknown. Frequently the jaws, including the periodontium, are involved and the disease stimulates severe localized periodontitis. A case of eosinophilic granuloma of the jawbone is presented. The pertinent clinical features are emphasized and possible problems in the interpretation of clinical periodontal features are discussed.- - - - - - - - - - ranking = 1.2373988474035keywords = jaw (Clic here for more details about this article) |
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