Chi-Kung Lin

Successful Therapeutic Experience of Posterior Disk Displacement without Reduction - A Case Report

Posterior disk displacement (PDD) is a rare subtype of temporomandibular joint disorder, with the incidence rates ranging from 0.6-2.6%. Sudden unilateral open bite with occlusal change is a major clinical symptom and may be accompanied with pain in the affected joint. For posterior disk displacement (PDD) patients, mouth opening may be slightly restricted and the joint sound is not remarkable. This study presents the case of a patient with PDD without reduction. The reduction of displaced disk was performed by using anterior repositioning splint and intermaxillary elastic traction. Although there is no standard treating guideline, the conservative treatment can achieve good outcome and should be considered first before any other invasive approaches.

A Modified Zitelli Bilobed Flap for Esthetic Repair in an Oral Commissure Defect Patient- A Case Report

Lip and oral commissure defects are a great challenge to surgeons due to the anatomical complexity of this crucial area. These defects may result from tumor excision, trauma or post-burn contractures. Primary closure of the wound by the remaining tissues can be used for small surgical defects. Tissue switch, neighboring tissue transfer, and local flaps can be used for large surgical defects. Here, we finished the reconstruction of an oral commissure defect using a modified Zitelli bilobed flap. The result seems to have provided both excellent color and texture, matches with adjacent tissues, effective transfer of adjacent skin and soft tissues from areas of abundance to areas of deficiency, and minimization of the donor site deformity while also, most importantly, maintaining the function and esthetic integrity of the oral commissure. We herein provide the treatment experience for clinical applications.

Surgical Extraction in a Patient with Hereditary Hemorrhagic Telangiectasia - A Case Report

Hereditary hemorrhagic telangiectasia (HHT) is a rare inherited, autosomal dominant, mucocutaneous disease. The reported prevalence is approximately 1 in 5,000-10,000 per year. Its clinical characteristics are recurrent epistaxis, vascular hamartomas on the skin and oral mucosa, and arteriovenous malformations of soft tissues. Dentists play a vital role in diagnosing HHT because they are the first one to identify its signs. HHT is clinically diagnosed on the basis of the Curacao criteria; in other words, a diagnosis is made when three of the following four criteria are met: epistaxis, telangiectasias, visceral arteriovenous malformation, or a family history of the disease. Here, we report our dental therapeutic experience of managing a patient with HHT.

Benign Paroxysmal Positional Vertigo post Osteotome Sinus Floor Elevation - A Case Report

Benign paroxysmal positional vertigo (BPPV) is a disorder originating in the inner ear and is very uncomfortable for a patient, but it can be managed efficiently and effectively. It may be an uncommon complication after certain jaw bone related surgeries, such as an osteotome sinus floor elevation (OSFE). OSFE allows ridge augmentation and immediate implant placement to be completed concurrently. The procedure can occasionally cause membrane perforations or postoperative infections, but the rare complication, BPPV, happens if continuous malleting is applied. Immediate identification and proper management can eradicate discomforts resulting from BPPV. Possible preventive strategies, diagnostic examinations, and available treatment modalities for this rare sequela are discussed. Here we present the case of a patient who suffered from BPPV several hours later after OSFE and obtained relief through some medical aids and physiotherapeutic techniques.

Warthin Tumor at Right Parotid Gland-A Case Report

Warthins tumor is alike cystadenoma lymphomatosum, adenolymphoma, and cystadenolymphoma. The tumor is a benign neoplasm predominantly found in the parotid gland. This tumor usually causes minimal pain, but the patient may complain of earaches. The tumor is removed surgically and is easily performed due to its superficial location. This is a case we are presenting: a 72-year-old man visited our clinic primarily complaining of swelling at the right parotid gland area. MRI revealed well-defined margins of the tumor in the superficial lobe of the right parotid gland and heterogeneous contrast enhancement. We performed a superficial parotidectomy followed up with a pathological examination confirming Warthins tumor. We report a typical case of Warthins tumor and a literature review.

Management of Synchronous Oral Cancers in a Liver Transplant Recipient - A Case Report

There is a high incidence of head and neck malignancies in liver transplant recipients. Surgical removal of these malignancies is controversial. We present the case of a 42-year-old patient who had synchronous squamous cell carcinoma both in the upper and lower jaws and was treated with radiation therapy combined with Cetuximab, with satisfactory results.

Left Submandibular Gland Sialolithiasis Caused by a Fish-Bone-A Case Report

The most common pathogenesis of sialolith formation is an abnormality in calcium metabolism, salt precipitation and crystallized mineral accumulation. Sialolithiasis is observed mainly in submandibular gland, accounting for 85% of cases. There are several causes of this high incidence in the submandibular gland. One of the most prevalent reasons is that the Whartons duct is the longest salivary duct (5 cm in length) with sharp curves and a narrow duct (diameter=2-4mm). Moreover, the Whartons duct opens into the floor of the mouth near the incisors, making it difficult for a foreign body to stimulate or obstruct it. This study reports a rare case in which a foreign body (i.e., a fish bone) in the submandibular gland progressed to sialolithiasis, subsequently inducing sialoadenitis.

Tooth Extraction of a Patient with Porphyria: A Case Report

Porphyrias are a group of rare inherited metabolic disorders of heme synthesis. A patient with porphyria presented with sudden attack by varying triggers, such as infection, drug, and stress. Patients with porphyria must be carefully perioperatively managed and drug selection should be appropriate. Here we report a 51-yearold patient with porphyria suffering from a periodontal abscess who received a tooth extraction. The patient showed full recovery and was free of symptoms after treatment.

Right-face Cellulitis Attributable to a Nonodontogenic Infection in a Patient with Diabetes Mellitus - A Case Report

Odontogenic infections often occur with dental caries and periodontal disease and commonly have local and systemic implications. Diagnosing a nonodontogenic orofacial infection related to an odontogenic infection is difficult. Both odontogenic and nonodontogenic infections may extend to potential fascial spaces in the orofacial area or deep in the head and neck. The latter complication is often life threatening. Here, we report a case in which a 54-year-old male with diabetes mellitus (DM) had painful swelling of the right cheek. No odontogenic infection source was found after oral examination. Cellulitis was diagnosed, and the infection was determined to be in the right buccal, submandibular, and submental space. After sufficient antibiotic treatment, pus was drained from the right oral commissure, and Klebsiella pneumonia was determined. The patients history showed that he had DM and suffered a scratch to his oral right commissure as a result of an accident, which explained the nonodongenic cellulitis.

Use of Modified Bone-splitting Technique in Removal of Mandibular Cyst - A Case Report

Mandibular cysts were removed by conventional methods of decortication, enucleation, curettage, or marsupialization. The Modified Bone-splitting technique is recommended as a reliable technique for removal of mandibular cysts regarding exposure, feasibility, and safety. This paper presents a cystic lesion involving the mandibular nerve and this modified technique, which was performed as an approach for exposure and excision of a mandibular cyst. Bone cortices were repositioned after radicular cyst enucleation in order to prevent wound dehiscence. Postoperative panorex revealed good healing, with rapid mineralization of the defect and good stability. Recurrence was not recorded and no complication, such as numbness, occurred during the three-year follow-up period.