重度氟牙症的微创治疗

本文介绍了1例重度氟牙症的微创治疗．通过采用微磨除技术去除釉质表面过度矿化的白垩色结构，联合应用家庭美白治疗并进行釉质表面形态的重建。该技术无需其他修复方式即可达到改善氟斑牙美观的效果。微创处理结合牙齿家庭美白治疗可作为氟斑牙修复性治疗的一种选择方式。     

Full-mouth rehabilitation of a patient with bulimia nervosa. A case report.

Anorexia and bulimia nervosa are eating disorders seen mainly in adolescents or young patients. The dentist should be in the position to recognize early signs of the disorder and alert the patient (and the patient's parents, if necessary) of the possible physical, psychologi cal, and dental consequences. Such dental treatment may help motivate the patient to confront the problem. In this paper the full-mouth rehabilitation, using a combination of galvano- and metal-ceramic restorations, of a young patient suffering from bulimia nervosa is described.     

Takotsubo syndrome after a minimally invasive tooth extraction in a patient without dental phobia: A case report

Takotsubo syndrome (TTS) is a rare, stress-induced acute cardiac disorder. Its precipitating factors include emotionally or physically stressful events and exogenous and endogenous adrenaline. In this report, we describe a case of atypical TTS in a 73-year-old woman who reported no dental fear and required acute cardiac care in an outpatient setting. She underwent routine extraction of an upper left premolar under local anesthesia. She reported heart palpitations after the injection, and the procedure was completed in 15 min. After presenting symptoms of sweating, pale skin, vomiting, low blood pressure, and ST-segment elevation, cardiologists ordered echocardiography, coronary angiography, and ventriculography. Upon receiving a TTS diagnosis, the patient was hospitalized and administered an intra-aortic balloon pump and beta-blocker. Her symptoms resolved, and she was discharged with no sequelae. We found no precipitating factors in the progression of TTS in this case, which suggests that TTS can develop in the absence of precipitating factors. All general dentists and oral surgeons should recognize the possible risk of TTS, even during minimally invasive dental procedures, such as routine extractions in patients without dental phobia.     

Minimally invasive rehabilitation of the worn dentition: a case report utilising adhesive additive techniques and digital technologies

The management of the worn dentition presents an increasing challenge that is encountered more frequently in daily dental practice. The consequences of tooth wear tend to be multifactorial and while they may initially only involve the loss of surface enamel it can progressively lead to significant destruction of the dentition. This paper discusses the management of a tooth wear case where a significant amount of tooth structure has been lost from both the anterior and posterior teeth. Protocols for assessment, treatment planning and restorative management of the tooth wear case are presented demonstrating the use of adhesive additive techniques and digital technologies to achieve functional and aesthetic rehabilitation of the dentition.     

Full-mouth rehabilitation of a patient with gastroesophageal reflux disease: a clinical report

Gastroesophageal reflux disease (GERD) is a chronic condition caused by stomach acid regurgitating into the esophagus or oral cavity, often causing heartburn. Tooth erosion and wear are common oral manifestations of GERD. This clinical report describes the full-mouth rehabilitation of a patient with over 30 years of GERD, causing wear of maxillary and mandibular anterior teeth, along with complications associated with past restorations. Full-mouth rehabilitation of natural teeth in conjunction with dental implants was selected as the treatment option. Ideal occlusal design and optimal esthetics, along with reinforcement of oral hygiene, ensure a favorable prognosis.     

A case report of patient practising yoga leading to dental erosion

The article presents the case of a patient who was practising Yoga (Kunjal kriya) which led to dental erosion. Dental erosion can be due to extrinsic or intrinsic causes. The intrinsic causes include vomiting due to anorexia nervosa, regurgitation due to abnormality in gastro-intestinal tract or rumination. A 38-year-old male patient presented with a rare aetiology of dental erosion. He had practiced kunjal kriya one of the yogic exercises described in ancient India. In kunjal kriya the patient vomits on an empty stomach in order to clean his or her gastro-intestinal tract. The patient had practiced this form of exercise for over 12 years which had led to severe dental erosion. A proper case history should be evaluated for every patient so that they can be counselled for any factors that could be detrimental to dental health. Early diagnosis is paramount in recognising the aetiology of dental erosion so that detrimental effects on the dentition can be prevented.     

Exaggerated abrasion/erosion of human dental enamel surfaces: a case report

An atypical, rapidly proceeding abrasion/erosion of the labial enamel surfaces of the maxillary and mandibular incisors and canines in a 27-yr-old man is reported. Ultrastructural examination of a replica of the teeth showed a practically structureless enamel surface both at the initial examination and after 12 months. However, at the end of the period, minor areas of dentin tubules became visible, indicating that a substantial loss of the tooth substance had taken place. The patient's occupation involved daily environmental contact with proteolytic enzymes. In vitro study of enamel exposed to one of the actual proteolytic enzymes showed dissolution of enamel substance, and it cannot be excluded that enzymatic decomposition of the organic enamel matrix is a contributing cause of the observed exaggerated loss of tooth substance.     

Medicinal erosion: a case report

Patients, healthcare professionals, and health product manufacturers focus on the benefits that the use of a medicine or health product will bring rather than the potential side effects. A case of erosive tooth surface loss caused by the repeated and prolonged use of an acidic mouthrinse is reported. The adverse effects of health care products on the dentition and methods to minimise potential damage are discussed.     

Full-mouth rehabilitation of a case of generalized enamel hypoplasia using a twin-stage procedure

The dilemma confronting many dentists today is that innovations and well-defined specializations have greatly enlarged the treatment realm for tooth preservation as well as tooth replacement. The objectives should be preservation of the remaining tooth structure, restoration of optimum function, esthetics with least invasive procedures, cost effective, and short treatment time. The number of remaining natural teeth is one of the most widely used method for evaluating oral health and the prosthetic treatment of patients with a mutilated dentition. Though the treatment of these patients can be complex, but there are some important principles applicable in most cases. This case report demonstrates a satisfying full mouth rehabilitation using the Hobo and Takayama twin-stage procedure for a patient with esthetically and functionally compromised dentition. The final prosthesis with this twin-stage technique ensured a restoration with a predictable posterior disclusion and anterior guidance in harmony with the condylar path.     

The combination of a surgical and adhesive restorative approach to treat a deep crown-root fracture: a case report.

Most dental trauma requires immediate action to preserve the affected teeth. Furthermore, the trauma has often a great impact on the appearance and well being of the patient. In this case trauma resulted in a very deep complicated crown-root fracture of one incisor and a complicated crown fracture in another incisor of a 47-year-old woman. A combination of surgical extrusion and adhesive restoration was chosen to provide good prognosis for the teeth as well as an instant esthetic result that was well accepted by the patient. Eleven months after trauma, the treated teeth exhibited good healing and normal function.     

Augmentation in two stages of atrophic alveolar bone prior to dental rehabilitation: a case report

AIM: The aim of this report is to describe a significantly deficient case of alveolar bone that was managed by alveolar bone augmentation using a technique of distraction osteogensis and onlay bone grafting prior to dental implant placement. BACKGROUND: Injury to the teeth and alveolar ridge of the maxillary anterior region can cause a severe alveolar ridge deficiency resulting in ridge atrophy and maxillary retrognathism. The loss of these teeth and alveolar bone together with fibrotic scar formation can result in adverse changes of the interarch space, occlusal plane, arch relationship, and arch form which complicates rehabilitation and can compromise the esthetic outcome. While implant dentistry has become a new paradigm in oral reconstruction and replacement of missing teeth, ideal implant positioning can be compromised by inadequate alveolar bone in terms of bone height, width, and quality of the bone itself. Correction of osseous deficiencies with ridge augmentation allows ideal implant placement and creates a more natural soft tissue profile which influences crown anatomy and esthetics. REPORT: A 20-year-old female presented with a complaint of poor esthetics resulting from oral injuries incurred in a traffic accident six years previously. In addition to a mandibular parasymphyseal fracture, five maxillary anterior teeth and the most of the alveolar ridge were lost. Clinical examination revealed severe loss of bone in the maxillary anterior region, an absence of a labial sulcus, loss of upper lip support, and a slight over eruption of the mandibular anterior teeth. In preparation for dental implants a distraction osteogenesis surgical procedure was done to lengthen the height of the alveolar ridge. After a three-month healing period, the width of the residual ridge was found to be insufficient for implant placement. To correct this deficiency, a bone graft of a cortiocancellous block was harvested from the chin and fixed to the labial aspect of the ridge. To facilitate revascularization, small perforations were made in the cortical bone of the alveolar ridge at the recipient site before cancellous bone retrieved from the donor site was gently placed between the bone block and the ridge. The patient was then appropriately medicated and healing was uneventful. After three months, the width of the residual ridge was assessed to be adequate for endosseous implants. SUMMARY: The clinical result reported here has shown several procedures may be necessary for the rehabilitation of a trauma patient. Distraction osteogenesis per se may not always satisfactorily improve the anatomical alveolar anatomy but it has advantages over other methods of augmentation. It can improve the height and also expand the soft tissue for further bone grafting. Augmentation of the alveolar bone with an onlay bone graft often provides the desired gain of bone, allows for the ideal placement of dental implants, and improves any discrepancy between the upper and lower arches.     

Implant-supported rehabilitation of severe malocclusion due to unilateral condylar hypoplasia: case report

Unilateral condylar hypoplasia results in facial, skeletal, and dental deformity and is a condition that is often treated with surgery and orthodontics. This report describes implant-supported prosthodontic rehabilitation in a 70-year-old patient who chose not to undergo orthognathic surgery. The patient underwent full-mouth dental extraction and placement of 9 maxillary and 5 mandibular implants. She received implant-supported cantilevered fixed prostheses in both arches to improve and minimize her skeletal and dental crossbite.     

Full-mouth rehabilitation of a patient with severely worn dentition and uneven occlusal plane: a clinical report

Severe tooth wear is frequently multifactorial and variable. Successful management is a subject of interest in dentistry. A critical aspect is to determine the occlusal vertical dimension (OVD) and a systematic approach that can lead to a predictable and favorable treatment prognosis. Management of patients with worn dentition is complex and difficult. Accurate clinical and radiographic examinations, a diagnostic wax-up, and determining OVD are crucial. Using mini-implants as orthodontic anchorage may facilitate orthodontic movement of teeth to improve their position, which is necessary for favorable prosthetic treatment. A 46-year-old man was referred for restoration of his worn and missing teeth. After diagnostic work-up, provisional removable prostheses were fabricated for both jaws, evaluated clinically, and adjusted according to esthetic, phonetic, and vertical dimension criteria. Clinical crown lengthening and free gingival graft procedures were performed in appropriate areas. Drifting of the left posterior mandibular teeth was corrected using mini-implants as orthodontic anchorage. Two conventional implants were inserted in the right mandibular edentulous area. After endodontic therapy of worn teeth, custom-cast gold dowels and cores were fabricated, and provisional removable prostheses were replaced with fixed provisional restorations. Metal-ceramic restorations were fabricated, and a removable partial denture with attachments was fabricated for maxillary edentulous areas. An occlusal splint was used to protect the restorations. Full-mouth rehabilitation of the patient with severely worn dentition and an uneven occlusal plane was found to be successful after 3 years of follow-up. This result can encourage clinicians to seek accurate diagnosis and treatment planning to treat such patients.     

Interdisciplinary approach to treat dyskeratosis congenita associated with severe aplastic anemia: A case report

This paper reports on a 4‐year‐old male who had dyskeratosis congenita and who acquired severe aplastic anemia. The patient developed hyperpigmentation of the face, neck and chest region, arms, shoulders and legs. In addition, he had dry skin, deformed fingernails and toenails, sparse hair and eyebrows and hyperkeratosis of the dorsum of the hands and feet. Laboratory and histological analysis revealed severe pancytopenia and dyserythropoiesis of red blood cells, hypocellularity of white blood cells and decreased megakaryocytes with dysplasia. The intraoral examination identified bleeding gums; petechiae of the palate, tongue and cheek mucosa; and an atrophic, smooth and shining dorsal surface of the tongue. There were deep carious lesions in the deciduous mandibular molars and maxillary anterior teeth; as well as mobility of mandibular left canine, which had bone loss. The treatment for oral lesions included diet changes, improved oral hygiene, and extraction of the deciduous teeth destroyed by caries.     

Successful minimally invasive management of primary maxillary central incisors after lateral luxation: a case report

Lateral luxation in primary maxillary incisors is a traumatic injury that can lead to darkening of the tooth, pulp necrosis, root resorption, and damage to the permanent teeth. Management of this kind of trauma typically includes pulpectomy or extraction in cases of root resorption. However, in young children, removal of the tooth may be psychological stressing, especially for the parents, while increased mobility can make immediate endodontic treatment difficult to perform. This article outlines a severe palatal luxation on the maxillary right central incisor treated with conservative management in a 2-year-old boy. At the one-year follow-up appointment, the surrounding bone was healthy, the roots displayed physiological resorption, the crowns showed color improvement, and there was no radiographically noticeable damage to the permanent teeth.