Cases reported "Tooth Diseases"

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1/6. Denture possibilities for patients with mental disorders.

    patients with mental disorders, due to their specific physical and social status, often lack the possibility for appropriate dental treatment. The objective of our study aims at creating an adequate approach and prospective for currative plan casual. We represent two clinical cases, treated in a different way and we conclude, that every separate patient requires individual approach, from the first contact, through diagnosing and decision making for plan of treatment. Our experience implies that the mental status of the patients is not a reason for refusal of dental treatment.
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2/6. Management of complex multi-space odontogenic infections.

    The successful management of multi-space orofacial odontogenic infections involves identification of the source of the infection, the anatomical spaces encountered, the predominant microorganisms that are found during the various stages of odontogenic fascial space infection, the impact of the infectious process on defense systems, the ability to use and interpret laboratory data and imaging studies, and a thorough understanding of contemporary antibiotic and supportive care. The therapeutic goals, when managing multi-space odontogenic infections, are to restore form and/or function while limiting patient disability and preventing recurrence. Odontogenic infections are commonly the result of pericoronitis, carious teeth with pulpal exposure, periodontitis, or complications of dental procedures. The second and third molars are frequently the etiology of these multi-space odontogenic infections. Of the two teeth, the third molar is the more frequent source of infection. diagnostic imaging modalities are selected based on the patient's history, clinical presentation, physical findings and laboratory results. Periapical and panoramic x-rays are reliable initial screening instruments used in determining etiology. magnetic resonance imaging and computed tomography are ideal imaging studies that permit assessment of the soft tissue involvement to include determining fluid collections, distinguishing abscess from cellulitis, and offering insight as to airway patency. Antibiotics are administered to assist the host immune system's effort to control and eliminate invading microorganisms. Early infections, first three (3) days of symptoms, are primarily caused by aerobic streptococci which are sensitive to penicillin. amoxicillin is classified as an extended spectrum penicillin. The addition of clavulanic acid to amoxicillin (Augmentin) increases the spectrum to staphylococcus and other anaerobes by conferring beta-lactamase resistance. In late infections, more than three (3) days of symptoms, the predominant microorganisms are anaerobes, predominantly peptostreptococcus, fusobacterium, or bacteroides, that are resistant to penicillin. clindamycin is an attractive alternative drug for first line therapy in the treatment of these infections. The addition of metronidazole to penicillin is also an excellent treatment choice. Alternatively, Unasyn (ampicillin/Sublactam), should be considered. The mainstay of management of these infections remains appropriate culture for bacterial identification, timely and aggressive incision and drainage, and removal of the etiology. It is usually preferable to drain multi-space infections involving the submandibular, submental, masseteric, pterygomandibular, temporal, and/or lateral pharyngeal masticator spaces, as early as possible from an extraoral approach. trismus and airway management are important considerations and may preclude the selection of other surgical approaches. The patients with multi-space infections should be hospitalized and patient care provided by experienced clinicians capable of management of airway problems, in administration of parenteral antibiotics and fluids, utilization of interpretation of laboratory and diagnostic imaging studies, and control of possible surgical complications.
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3/6. Holistic approach of a child with cystic fibrosis: a case report.

    The pediatric dentistry Clinic staff of the Federal University of Santa Catarina (UFSC) treated a 5-year-old patient who had multiple dental treatment necessities. He also had cystic fibrosis (CF). As CF is an incurable disease that affects the mucous glands, especially the ones related to the lungs and digestive organs, the patient presented both chronic respiratory and intestinal problems. Such problems resulted in a severely compromised nutritional status. patients who have CF may present problems in oral health because they receive food supplementation that is rich in carbohydrates. Behavioral changes of such patients when in contact with health professionals are also a point to consider because these changes may make the treatment difficult. That is the reason why oral complications imposed by the disease, as well as the psychological aspects related to it, need to be discussed so that treatment is given to the patient aiming at physical and emotional comfort.
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4/6. Recognition and management of somatoform disorders.

    Many clinicians have encountered patients with a somatoform disorder without recognizing the clinical presentation. somatoform disorders can confound a diagnosis, consume inordinate amounts of treatment time, and may cause treatment failure. Recognition and management of somatoform disorders in prosthodontic patients is discussed in this clinical report to assist practitioners in avoiding initiation of prosthodontic treatment for patients with physical symptoms that are caused by a psychologic disorder rather than organic disease.
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5/6. Benign cementoblastoma: a clinical case of conservative surgical treatment of the involved tooth.

    The benign cementoblastoma (BC) or ''true'' cementoma is a rare benign neoplasm arising from the odontogenic ectomesenchyme and representing about 1% to 6.2% of all odontogenic tumors. The BC more frequently affects young males in an age range of 20-30 years, occurring in the mandible about 3 times more than in the maxilla, and it is always physically attached to the tooth roots. This tumor is often asymptomatic until it produces pain, expansion or swelling of the jaw segment or compression of the inferior alveolar nerve. early diagnosis is essential to save the tooth by enucleating the tumor, filling the root canals and apicectomy or curettage of the affected roots. A case of BC embedding the mandibular first right molar and resorbing the vestibular cortical bone, in a 48 year-old male, is reported. The radiographic examination showed a well-defined mixed-density unilocular mass, confluent with both the tooth roots of the mandibular first molar and surrounded by a radiolucent rim. A combined endodontic-surgical treatment was performed with the aim to remove the tumor while saving the tooth. Histological findings, differential diagnosis and surgical treatment of the tumor are discussed and compared with similar cases in the literature.
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6/6. Oral health services for adult rehabilitation patients: three illustrative cases.

    Recent research has shown that the actual capability of physical medicine and rehabilitation units to provide oral health services is less than the need as perceived by rehabilitation administrators. Three cases have been selected to illustrate the nature and diversity of health benefits that can be provided by a complete oral health service which focuses on rehabilitation patients. The advantages of offering a comprehensive oral health service include not only improvement of the oral health of the patient but also often directly aids the patients' achievement of overall rehabilitation goals. Furthermore, by synergistic interaction with the other rehabilitation disciplines, an oral health service can appreciably enhance the quality and the scope of the rehabilitation program itself. Additionally, a new adaptive device for oral grasping, designed for use by patients who lack the use of their upper extremities, is illustrated. The device is intended to provide the patient with a range of functions including recreational participation in board games as well as vocational activities which require the lifting or grasping of objects.
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