11/45. A new bacterial species associated with failed endodontic treatment: identification and description of actinomyces radicidentis. OBJECTIVE: This report describes 2 endodontic patients who had persistent signs and symptoms after conventional root canal treatment. The aim of this study was to determine what microorganisms were present in the root canals of the teeth with failed endodontic therapy. STUDY DESIGN: After removal of the root fillings, the canals were sampled by advanced microbiological techniques and the isolates were characterized by various tests. RESULTS: bacteria, which grew in pure cultures, were isolated in each case. The bacteria were similar to each other and were classified as actinomyces on the basis of phylogenic and phenotypic evidence. The bacteria were different from others within the genus, thus warranting designation as a new species, actinomyces radicidentis. CONCLUSIONS: The 2 cases of endodontic failure were infected with A radicidentis, a new actinomyces species. This bacterium joins a restricted group of other microorganisms that have been associated with failure of root canal treatment. ( info) |
12/45. Tuberculous osteomyelitis of the mandible: a case report. osteomyelitis of jaws caused by infection with mycobacterium tuberculosis is uncommon, especially in children. We present a case of tuberculous osteomyelitis in a young child. Its clinical presentation, with features similar to a dento-alveolar abscess, underline the importance of considering it in the differential diagnosis of jaw lesions. We discuss of the diagnostic techniques, management and preventive measures, and stress the importance of history taking during clinical examination. ( info) |
13/45. Pyogenic granuloma in a renal transplant patient: case report. This case report describes a 14-year-old female referred to pediatric dentistry for evaluation and treatment of cyclosporine-induced gingival hyperplasia. Examination of the anterior maxillary area showed a red, vascular, exophytic, soft-tissue mass which had been excised a few months earlier without a histopathologic examination being done. The mass did not appear consistent with gingival overgrowth induced by long-term use of medication, and thus an excisional biopsy was performed, which diagnosed the lesion as a pyogenic granuloma. A review of the literature and management recommendations are discussed. ( info) |
14/45. Exarticulation and reimplantation utilizing guided tissue regeneration: a case report. The extraction and reimplantation of teeth is a technique that has been practiced for many years, resulting in successful retention of teeth for up to 30 years. Although evidence confirming the advantages of this technique is limited, clinical observations and histologic examinations have revealed some important factors that are prerequisites for success: limitation of the time the tooth is exposed to the extraoral environment and preservation of vital periodontal tissue attachments on root surfaces. The latter goal can be achieved by gentle, atraumatic removal of the tooth from its socket, and hence the term exarticulation and reimplantation is more representative of the technique. In the present case report, a maxillary lateral incisor with a developmental defect was treated by exarticulation and reimplantation and application of calcium sulfate. Exarticulation and reimplantation seems to be a useful clinical procedure, but controlled studies are required to confirm its efficacy. ( info) |
15/45. The horizontally impacted maxillary canine situated in a labial position. Surgical management of unerupted teeth depends upon a thorough understanding of anatomic, physiologic and pathologic factors. attention has been given to problems of eruption in the maxillary anterior region. It is a region where a variety of anomalies occur. Since the maxillary anterior region influences appearance so greatly, early detection of difficulties and careful planning and treatment can be extremely beneficial to patients. The purpose of this case report is to present a case of maxillary permanent canine impaction in a horizontal displacement that developed after loss of the deciduous canine to chronic apical periodontitis, and incomplete root resorption of the deciduous canine. ( info) |
16/45. Where is it coming from? A case report is presented of an unusual situation where standard routine diagnostic methods failed to reveal the true origin of an endodontic infection. ( info) |
17/45. Clinical presentation and differential diagnosis of nasolabial cyst. Nasolabial cyst is a rare non-odontogenic, soft-tissue, developmental cyst occurring inferior to the nasal alar region. The patient usually presents with a slowly enlarging asymptomatic swelling, typically without radiographic abnormalities. This paper documents the presentation and management of a 46-year-old woman with a nasolabial cyst. The histopathologic features, differential diagnosis, treatment and prognosis are discussed. ( info) |
18/45. Focal cemento-osseous dysplasia involving a mandibular lateral incisor. AIM: To report a case of focal cemento-osseous dysplasia (FCOD) affecting a single tooth misdiagnosed as an inflammatory periapical lesion.SUMMARY: The patient, a black 47-year-old woman complained of pain affecting the right side of the mandible. Routine X-ray examination discovered a periapical radiolucency on the mandibular left lateral incisor (tooth 32), which was otherwise normal and not carious. As the response of this tooth to a vitality test was doubtful, the lesion was diagnosed as a periapical granuloma or cyst secondary to pulpal necrosis. Endodontic treatment and curettage of the periapical lesion were performed, and histological examination of the curettage material revealed a localized osseous dysplasia. KEY learning POINTS: FCOD may rarely affect only one tooth, resembling a periapical granuloma or cyst. Careful diagnosis is of paramount importance in cases of questionable periapical lesions affecting normal-looking teeth, before beginning treatment. FCOD generally requires no treatment. biopsy is warranted in case of doubt. ( info) |
19/45. Periapical radiolucency mimicking an odontogenic cyst. AIM: To present a clinical case of a giant cell lesion located in an unusual site, initially misdiagnosed and treated as an odontogenic cyst. SUMMARY: Periapical radiolucencies often suggest the presence of odontogenic pathosis, usually inflammatory granulomas or cysts. The high frequency of such lesions tends to lead clinicians to arrive at a diagnosis without completing a comprehensive assessment of the patient or carrying out the full range of available diagnostic tests. A case report of a giant cell lesion, which was misdiagnosed and treated initially as an odontogenic lesion because of its unusual location, is presented. KEY learning POINTS: Clinical signs and radiographic appearance are usually sufficient to reach a diagnosis of periapical pathosis. When traditional treatment does not lead to success, a biopsy should be considered to ascertain the diagnosis and allow the correct treatment to be provided. Histological examination of soft tissue removed during endodontic surgery is essential. ( info) |
20/45. Odontogenic sinus tract to the neck skin: a case report. We describe a 22-year-old woman with neck skin sinus tract that developed as a consequence of dental infection. The patient was treated twice in an inappropriate way with recurrence of the sinus tract. We opted for an extraction of the tooth. This case illustrates the need for cooperative diagnostic referrals between physicians and dentists. ( info) |