Cases reported "Oral Fistula"

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1/3. Clinical significance of the structural integrity of the superior aspect of the mandibular canal.

    BACKGROUND: Sparse data can be found regarding the structural integrity of the superior aspect of the mandibular canal. In many cases, the mandibular canal must be carefully evaluated prior to defining patient treatment. methods: In this case report, a 54-year-old patient presented with a periapical infection involving the mesial root of the mandibular right second molar (#31). Radiographic evaluation revealed that the periapical lesion extended from the apex of the tooth to the superior aspect of the mandibular canal. Upon surgical removal of the tooth, an apical communication between the extraction socket and mandibular nerve was located. A guided bone regeneration procedure was performed to protect the nerve from subsequent damage and to prepare the site for future implant placement. Implants were placed in the area approximately 5 months following the regenerative procedure. RESULTS: After implant placement, the patient experienced normal function and no mandibular symptomatology. Implants have been in function for the past 4 years. CONCLUSIONS: Many factors, both pathologic and developmental, can lead to a discontinuity of the superior aspect of the mandibular canal. Normally, a thin cortical plate of bone protects the nerve. When a lack of structural integrity of the canal roof is discovered, enucleation of a periapical infection or subsequent implant placement can lead to potential disruption of the nerve. Limited information is available regarding the integrity of this protective cover. This case report underscores the importance of proper clinical diagnosis before implant placement in the posterior mandible.
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ranking = 1
keywords = communication
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2/3. Submental cutaneous sinus tract as a result of progressive peri-implantitis: a case report.

    BACKGROUND: The aim of the present case report was to define diagnosis and treatment options of a submental cutaneous sinus tract as a result of a progressive peri-implantitis around mandibular dental implants in a patient with a history of oral squamous cell carcinoma. methods: Before the removal of the submental fistula, a panoramic radiograph and a computed tomography of the head and neck were assessed to identify the implants responsible for the cutaneous sinus tract and to exclude the presence of a tumor recurrence and lymph node metastases. The involved implants were removed, as there was a communication along them between the oral cavity and the cutaneous sinus tract resulting from progressive peri-implantitis. A histological examination of the excised fistula was carried out. RESULTS: The histological examination excluded a recurrence of the oral squamous cell carcinoma. The fistula completely consisted of granulation tissue without epithelialization. After affected implants were removed, the wound healing was uneventful. CONCLUSIONS: A panoramic radiograph is mandatory to identify the involved implants. Computed tomography, and excision of the fistula and a histological examination should be performed only in patients with a history of oral squamous cell carcinoma. Since the cutaneous sinus tract showed no epithelialization, it healed spontaneously after the removal of the responsible implants. Because of the large bony defect caused by progressive peri-implantitis leading to a communication of the oral cavity with the cutaneous sinus tract, more conservative treatment options with preservation of the implants could not be adopted in the present case.
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ranking = 2
keywords = communication
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3/3. Oronasal communication caused by a denture with suction cup: a case report.

    suction cups, which provide high retention, are not being recommended anymore because of the destructive effect of the negative pressure on the palatal tissues. It is known that dentures with suction cups can cause perforations in the palate. In this case report, an oronasal communication caused by a denture with suction cup in a patient who had previously undergone pleomorphic adenoma excision of the palate is presented. Disadvantages of suction cups are emphasized.
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ranking = 5
keywords = communication
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