John K. Brooks

Junctional epidermolysis bullosa associated with hypoplastic enamel and pervasive failure of tooth eruption: Oral rehabilitation with use of an overdenture

This report describes a previously unreported case of generalized hypoplastic enamel and failure of eruption of the permanent maxillary teeth and only partial eruption of the permanent mandibular teeth in an 18-year-old male diagnosed with junctional epidermolysis bullosa. Similar anomalies were reported to have affected the deciduous dentition. Beginning at 4 years of age, oral rehabilitation has been conservatively managed with the fabrication of various maxillary complete overdentures. The use of this prosthesis has provided an economical, nonsurgical treatment option when oral soft tissue permits and with relative ease of construction.

An unusual case of idiopathic internal root resorption beginning in an unerupted permanent tooth.

A rare case of idiopathic internal root resorption detected in an unerupted mandibular premolar is described. The resorptive process continued following eruption, and the tooth became symptomatic. Endodontic therapy was then performed. Closer inspection of unerupted teeth for internal resorption is recommended.

Intraoral proliferative myositis: Case report and literature review

Proliferative myositis is a rare, benign, reactive intramuscular lesion of fibroblastic/myofibroblastic origin; an identical lesion in a subcutaneous or fascial location is referred to as proliferative fasciitis. The rapid growth rate and unusual histopathologic features have frequently been mistaken for a malignant process and have promoted unnecessary invasive procedures. Here we present only the third oral case of proliferative myositis, arising from the tongue of a 65‐year‐old man.

Retrieval of Extensive Gutta-percha Extruded into the Maxillary Sinus: Use of 3-dimensional Cone-Beam Computed Tomography

INTRODUCTION Close proximity of the maxillary sinus to the roots of maxillary teeth can predispose to the inadvertent deposition of endodontic products into the maxillary sinus. One such material is thermoplasticized injectable gutta-percha, which has gained popularity of late. As a consequence of overfilling, some patients warrant surgical retrieval. METHODS A case report of extreme overextension of gutta-percha within the maxillary sinus after endodontic retreatment on tooth #14 was provided. The distobuccal and palatal canals had been obturated with gutta-percha master cones and backfilled with thermoplasticized injectable warm gutta-percha. The mesiobuccal canal had only been filled with thermoplasticized injectable warm gutta-percha, the origin of the extrusion. Imagery with 3-dimensional cone-beam computed tomography was performed for localization of the gutta-percha. RESULTS The patient underwent a Caldwell-Luc approach for removal of the extruded material. The gutta-percha was successfully removed intact, and the patient had an unremarkable postoperative course. However, the patient continues to have mild tenderness in the sinus region. CONCLUSIONS The featured case exemplified the consequence of overinstrumentation and ensuing inadequate apical stop. In these situations, the obturation of a maxillary tooth with thermoplasticized injectable gutta-percha, without master cones, can potentially result in overfilling and deposition into the antrum. Use of 3-dimensional cone-beam computed tomography could enhance endodontic diagnosis, serve as an aid for visualization of foreign materials within the sinus and contiguous soft tissue structures, and improve clinical outcome.

Lateral periodontal cysts arising in periapical sites: a report of two cases.

INTRODUCTION The lateral periodontal cyst is an uncommon odontogenic developmental lesion and chiefly arises in the alveolar bone between the roots of a pair of erupted teeth or lateral to a tooth root. Two atypical cases of the lateral periodontal cyst occurring in periapical sites are reported. METHODS Both lesions presented as an incidental radiographic finding, appearing as an apical radiolucency with well-circumscribed sclerotic borders. One lesion, initially suspected to be of pulpal origin, persisted after endodontic therapy; the other case was first considered to be an odontogenic keratocyst. A biopsy was performed on each patient for lesional identity. RESULTS Histopathologic assessment of each lesion was consistent with a lateral periodontal cyst and revealed thin, nonkeratinized epithelial linings containing nodular plaques and clear cells. The cyst walls were thickened and had minimal inflammation. CONCLUSIONS The featured cases show that the lateral periodontal cyst is not always confined to the interradicular region and can masquerade as a lesion of endodontic origin. Aberrant cases warrant long-term surveillance.

The Marcus Gunn phenomenon: Discussion and report of a case

A detailed clinical description of the Marcus Gunn phenomenon is featured. Related ophthalmologic aberrations associated with mandibular movement are briefly discussed. A report of a case of Marcus Gunn phenomenon, which was significant for a paternal history of bilateral cleft lip and palate, is presented. The general and the dental considerations in the management of this disorder are summarized. Protective eye shields are recommended for use during dental procedures.

Electronic cigarette explosion associated with extensive intraoral injuries

With the rise in popularity of usage of various electronic smoking devices, there have been increasing reports of explosions, often resulting in complex injuries to the head and neck. To promote the awareness of this new phenomenon, a case report is provided regarding an 18-year-old male who had an electronic cigarette explode in his mouth. He presented with severe damage to the anterior dentition (fractured teeth, avulsions, luxation), had fractured the premaxilla and anterior nasal spine, and sustained lacerations to the upper lip, labial mucosa, gingivae, tongue, hard palate, and facial skin.

Successful Nonsurgical Endodontic Outcome of a Severely Affected Permanent Maxillary Canine with Dens Invaginatus Oehlers Type 3

INTRODUCTION The morphogenic complexities of dens invaginatus (DI) Oehlers type 3 in maxillary canines offer significant endodontic challenges. METHODS A case report is provided of a 14-year-old female patient who presented with an anomalous-looking permanent maxillary canine associated with a sinus tract. Pulp testing revealed a normal response on the distal aspect of the tooth, whereas the mesial segment tested nonresponsive. A radiolucent lesion was seen on the mesiolateral radicular area adjacent to the severely distended pulp chamber. A gutta-percha point inserted into the sinus tract traced to this same region. The diagnosis was normal pulp coincident with DI Oehlers type 3 with pulp necrosis and chronic apical abscess. RESULTS Despite a concerted effort to limit the root canal therapy to only the necrotic canal, its proximity to the normal canal obviated this possibility, entailing endodontic treatment of the entire root canal system. The necrotic pulp space was subjected to sustained irrigation with 5.25% sodium hypochlorite and then completed with 17% ethylenediaminetetraacetic acid. A bolus of gutta-percha was used to create an apical barrier, and then the remainder of the enlarged pulp space was obturated with injectable thermoplasticized gutta-percha. At a 4.5-year recall, there was no clinical and radiographic evidence of infection. CONCLUSIONS Endodontic success was accomplished with meticulous efforts of disinfection. Thermoplasticized gutta-percha can offer utility for obturation of anatomically complicated pulp spaces. The use of the dental operating microscope is an invaluable aid for discernment of the intricacies of teeth affected with DI type 3 variant and can enhance clinical outcomes.

Oral anomalies associated with the oculocerebrorenal syndrome of Lowe: case report with multiple unerupted teeth and pericoronal radiolucencies.

The oculocerebrorenal syndrome of Lowe (OCRL) is a rare X-linked recessive disorder, chiefly characterized by ocular involvement, mental retardation, and kidney disease. A literature review is provided, detailing the diversity of oral anomalies associated with the OCRL syndrome. Reported abnormalities include delayed tooth eruption, odontogenic cyst formation, and constricted dental arches. In addition, we present an unusual case of an 18-year-old male affected with the OCRL syndrome and fetal alcohol syndrome. The oral radiographic examination was significant for multiple impacted permanent teeth, many with pericoronal radiolucencies, and an underdeveloped mandible.

Gingival and cutaneous xanthomatosis associated with primary biliary cirrhosis: Report of a case

The first comprehensive case report of intraoral xanthomatosis associated with primary biliary cirrhosis is detailed. The lesions were present along the free gingival margin and labial vestibule. Crevicular fluid was noted to be tinged yellow. Generalized cutaneous eruptions were also seen. The xanthomas were attributed to the underlying hyperlipoproteinemia. Advanced progression of the hepatic disease necessitated a liver transplant. Disappearance of both oral and skin lesions were subsequently observed.