FOCAL ORAL PIGMENTATION ON THE GINGIVA OF MANDIBLE – a case report

Benign pigmented lesions on the oral mucosa are occasional findings that are physiologically or pathologically determined. Such lesions can occur in healthy individuals or as a manifestation of systemic disease. The pigmented lesions are presented as melanoplakia, melanocytic macule, melanocytic nevus or melanoacanthoma. Without appropriate treatment, they could transform into malignant melanoma. The purpose of the presentation at hand is to exhibit a case of focal oral pigmentation on the gingiva of the mandible of 17-years old patient without other comorbidities. The lesion subsequently is excised and pathohystologically examined in order to determine the diagnosis. Patient’s recovery was uneventful, no complications are registered during the 6-months follow-up period

PYOGENIC GRANULOMAS IN THE ORAL CAVITY: A SERIES OF CASES

Introduction: Pyogenic granulomas represent tumour-like lesions affecting the skin and the oral cavity. This classic definition can be somewhat misleading because such lesion is not associated with infection and lacks any clinical evidence of pus or histological evidence of actual granulation tissue. Scientific literature sources estimate its prevalence to 1:25000 per capita, affecting females twice as often. Pyogenic granuloma in the oral cavity affects the interdental papilla in 70% of the cases. Purpose: The authors present a case series of pyogenic granulomas in the oral cavity with varying localization and therapeutic approach. Materials and methods: This article presents six clinical cases of PG. Diagnosis is challenging due to similarities with a number of tumorous and non-tumorous neoplasms (formations) in the oral cavity. Two histological types of pyogenic granuloma can be identified: lobular and non-lobular capillary hemangioma. Surgical excision is the treatment method of choice, followed by deep curettage of the lesion toward the underlying bone. Such precautions are necessary because 15,8% of the lesions tend to recur over time. Results: Alternative therapeutic approaches for removal of PG are explored, which are aimed at reducing the recurrences after surgical treatment. Such an opportunity is provided by utilization of Er:Yag laser because its effect can reach the underlying bone. Conclusion: Pyogenic granuloma represents a diagnostic challenge, specifically in cases of atypical localization. The effective surgical approach requires complete removal of the pathological process from the surrounding healthy structures in order to prevent recurrences

TREATMENT OF ORAL MUCOSAL LESIONS BY SCALPEL EXCISION AND PLATELET-RICH FIBRINMEMBRANE GRAFTING: A case report

Purpose: The treatment of oral mucosal lesions and mucosal hypertrophy in particular, is most often achieved by an excision with or without covering the surface of the wound. The platelet rich fibrin membrane (PRFm) is an autogenous product containing platelets and leukocytes and their secreted growth factors and cytokines. The purpose of the presented clinical case is to describe a new, recent technique used for the covering of mucosal wounds left after the removal of pathological lesions. Material and Methods: On a single patient mucosal hypertrophy was removed by an excision with scalpel and the resulting surgical wound was covered with an autogenous PRF membrane. Postoperatively the healing process was followed on the 7th, 14th and 30th day. Results: The healing period went smoothly with minimal postoperative discomfort and no complications. Conclusion: The results of the presented clinical case demonstrate that the PRF membrane can successfully be used to cover postoperative mucosal defects

REHABILITATION OF SEVERELY ATROPHIED UPPER JAW WITH INTRAOSSAL DENTAL IMPLANTS - clinical case

Objective: The purpose of this presentation is to show the difficulty in prosthetization of a clinical case with a pronounced atrophy of the upper jaw and the various types and nature of restrictions imposed by the requirements of the patient. Methods: The clinical analysis, surgical protocol and prosthetic solution are presented in the treatment of 72 year-old woman with a pronounced atrophy of the upper jaw. OPG, standard CT of the upper jaw was used in the planning and a special surgical template was fabricated, helping us to find intraoperatively the exact locations of implants. The preliminary analysis of the number, height and diameter of intraossal implants helped us to find the exact prosthetic solution in this clinical case. The preparation of the implant bed was done by conical osteotomy in order to expand and condense the existing bone, which allowed us to use endoossal implants with a possible maximum size in a very limited maxillary volume and the reluctance of the patient to use other methods and surgical techniques. Conical threaded and self-tapping intraossal implants were used, placed according to a classic two-stage methodology with a flap and a long-term functional loading after a period of four months.Results and Conclusion: The applied surgical and prosthetic solution allowed us to achieve a good functional and aesthetic rehabilitation in this case of severe atrophy of the upper jaw, following a number of restrictions imposed on us by the reluctance of the patient to use other surgical solutions. This shows that in the case of severe atrophy of the upper jaw, a good clinical result can be achieved. For this reason, the use of CT,a well-planned surgical template, sufficient preparation ,the maximum use of available bone volume and the choice of a good prosthetic solution is very important

SURGICAL TREATMENT IN PATIENTS WITH WILSON’S DISEASE

Background: Wilson’s disease is an autosomal recessive disorder due to mutation in ATB 7B gene, which is a membrane-bound copper-transporting ATPase. The impaired excretion of copper results in an increase in serum levels and accumulation of copper in the body. Various signs can be observed in liver, nervous system, kidneys, eyes, heart. There are also changes in blood chemistry. Objective: A forty-six-year-old female patient presents with Wilson’s disease in the treatment rooms at the Faculty of Dentistry in Plovdiv. She needs complete dental care. She has also had an ischaemic stroke. Methods and results: As the treatment plan started with extraction, of teeth under local anesthesia, a complete blood count and INR test were performed. Oral mucosa and bone were obtained by biopsy for evidence of pigments in these tissues. The biopsy results showed accumulation of copper in them as well. Conclusion: It’s a rare disorder, approximately 1 in 40 000, severely affecting the liver and nervous system. It requires in-depth analysis and discussion over the clinical and paraclinical approach with a view to avoid possible complications and achieve the desired results

A CASE OF COMPOUND MAXILLARY ODONTOMA AND MANDIBULAR HYPODONTIA

Odontomas are formations which are still classified as benign tumors by the World Health Organization. They are lesions on any odontogenic tissue – enamel, cement and dentin, which are affected in different proportions and degree. We present a case of compound odontoma on upper jaw, on a 15 year-old girl, causing retention of a permanent canine tooth. After the extirpation 16 tooth-like structures were uncovered. The mandible was diagnosed with hypodontia of both 2nd premolars. Patient’s history showed that there was a trauma in the area of the upper jaw at younger age. In this article we will present the clinical and radiographic examination, the stages of the complex surgical-orthodontic treatment and a discussion of the etiology of the diagnosis, complications and the treatment itself

INTERDISCIPLINARY APPROACH IN COMPEX TREATMENT OF ORAL LICHEN RUBER PLANUS /Review and a Case report/

Lichen planus(LP)is a common chronic muco­cuta­neous disease of unknown etiology. Usually, it presents with lesions on the flexor surfaces of the upper extremities, genitalia and mucous membranes. Oral lesions can be the initial as well as the only manifestations of this condition. Patients with LP can present first to the general dental practitioner so sufficient knowledge on this condition is important for the proper diagnosis, treatment and prevention of further complications. The clinical management of LRP requires liaison between dental and medical specialists.This article provides a review of the current literature on LP and a case report of a 55 years old female suffering with this condition. A multidisciplinary approach in the diagnosis and management of this case is described

Application of Platelet-Rich Fibrin and Injectable Platelet-Rich Fibrin in Combination of Bone Substitute Material for Alveolar Ridge Augmentation - a Case Report

Background: Different barrier membranes and augmentation techniques are used in oral surgery to recover lost bone structures with varied success. Recently, a combination between bone graft materials and Platelet-Rich-Fibrin (PRF) is implemented in the periodontology and implantology