Marcus Gunn syndrome, or mandibulopalpebral synkinesis, is a congenital movement of the upper eyelid when the mouth is opened. The cause is a paradoxical ipsilateral innervation between the eyelid retractor and the lateral pterygoid muscle. Clinically, there is ptosis of the affected eyelid, which disappears when the mouth is opened. The inverse Marcus-Gunn phenomenon describes an ipsilateral closure of the eyelid when the lateral pterygoid muscle contracts. The combination of both phenomena is also known as ‘See-Saw’ Marcus Gunn syndrome. This is a congenital condition that leads to lifting of the upper eyelid on one side and lowering of the upper eyelid on the opposite side when the mouth is opened. This condition is considered an extreme rarity. In this case report, we show a twenty-year-old woman who has had the condition from birth. At rest, there is incomplete ptosis of the right eye. When the mouth is opened, the right eyelid lifts involuntarily and the left upper eyelid lowers almost completely. In addition, she shows a bilateral involuntary pupil movement to the left caudal side. A causal therapy is not yet known, genetic counselling is recommended. Therapeutic approaches relate to independent conscious training of the dysinervated eyelid in front of the mirror; in severe cases, surgical correction may be considered. Keywords: MGS, rare phenomenon, mandibulopalpebral synkinesis

The cutaneous horn is a clinical finding rooted in a variety of different benign and malignant causes. Sampling with subsequent histologic examination is the diagnostic gold standard. Depending on the causing pathology, different therapies are necessary. We report a case in which a patient presented to our outpatient clinic with two cutaneous horns of the lower lip. A biopsy had already been performed in another clinic five years ago, in which a not fully excised, well-differentiated squamous cell carcinoma (G1), was found. The patient refused further surgical treatment recommendations at the time. Due to the size-progressive and functionally limiting findings, the patient presented to our clinic. After removal of the lesions, a histological examination was performed. Apart from verrucous hyperplastic squamous epithelium, no evidence of malignancy was histologically found. As there were no histologically visible signs of malignancy, the patient was discharged in an aesthetically and functionally acceptable state into a follow-up program with clinical check-ups every six months in order to detect and remove any recurrences at an early stage. Keywords: cornu cutaneum, cateneous horn, squamous cell carcinoma, lower lip

Primary failure of eruption is a genetic partial eruption disorder that leads to an open posterior bite. The clinical severity and manifestation of primary failure of eruption are variable. The correct diagnosis of this eruptive anomaly plays an essential role in treatment planning, which can be prosthetic, orthodontic, surgical or multidisciplinary. The aim of this study was to determine the extent to which adequate treatment can be derived from the radiologic presentation of the PFE in the orthopantomogram. Preoperative panthomogram images were evaluated in 42 patients with confirmed PFE. The basis for treatment decisions was defined as follows: Evaluation of the affected teeth, evaluation of the bone, occlusal lines in the posterior region. Treatment can be standardised on the basis of orthopantomogram images in patients with PFE. We were able to derive the following treatment options from the orthopantomogram images: If the teeth are slightly below the occlusal plane, prosthetic treatment is indicated; in the case of a negative occlusal line in the mandible and also in the maxilla, extraction / augmentation / implantation / prosthetics should be selected as a treatment option; if the occlusal plane is displaced caudally in the mandible and cranially in the maxilla, a bimaxillary repositioning osteotomy would be indicated; if the occlusal plane is displaced caudally in the mandible and cranially in the maxilla, distraction or a segmental osteotomy with fixation would be indicated. The evaluation of orthopantomogram images of confirmed primary failure of eruption patients has shown that criteria can be defined that lead to standardisation and simplification of treatment. Keywords: orthopantomogram, primary failure of eruption, PFE, treatment decisions, treatment standardised

Acute myeloid leukaemia (AML) is an acute disease in which B-symptoms such as weakness, fever, and night sweats usually appear early in the case history. However, subtypes of AML can present with specific symptoms, for example in the form of gingival hyperplasia. Sampling (PE) with histological examination is considered the gold standard of diagnosis. We report a case in which a patient with gingival hyperplasia in region 17-13 presented in September 2023. The PE performed revealed the presence of a chloroma (syn. myeloblastoma or granulocytic sarcoma), which is the extramedullary manifestation of AML or an AML-related syndrome. The patient was then referred to the oncology day clinic. After further diagnostics, AML with an NPM1 mutation was detected and the patient was transferred to oncology treatment. A complete inspection and palpation of the oral cavity is essential for the early detection of (malignant) changes. In addition, systemic diseases often show oral manifestations as an initial or accompanying symptom. Here, the dentist can play a decisive role in quickly establishing the diagnosis. If lesions show no tendency to heal within two weeks despite adequate treatment, the previously made (suspected) diagnosis and the cytological or histological findings must be questioned and repeated if necessary. Keywords: acute myeloid leukaemia, AML, oral manifestation

In the case of vascular malformations of the face and neck, such as venous malformations, a purely mucosa-supported prosthesis can often not be tolerated. Implant-supported restorations are therefore the only way to provide these patients with a functionally and aesthetically satisfactory restoration. The present case describes a patient with an extensive venous low-flow malformation in the area of the right cheek and the right maxilla. It was possible to fix a bar-supported prosthesis on three implants, which hardly stresses the mucosa. Keywords: vascular malformation, implant, prosthetics

The dental treatment of patients with epidermolysis bullosa is complex and challenging. In general, a fixed restoration should be aimed for, as this puts only minimal strain on the fragile mucosa. Implants can significantly improve the quality of life of these often young patients. This case report describes the treatment of a 19-year-old female patient with epidermolysis bullosa. All of her impacted teeth were first removed and auxiliary implants were inserted. Bone was then augmented so that eight implants could subsequently be inserted. Finally, the patient received a fixed prosthetic restoration. Keywords: epidermolysis bullosa, implant, oral diseases

In autoimmune diseases, such as oral lichen ruber planus, a sufficient prosthetic restoration without dental implants is often not possible. Due to the extreme vulnerability of the oral mucosa, the indication for an implant restoration should be considered, especially for tegument relief. Interdisciplinary planning between prosthodontist and surgeon is necessary to realize an individual, mucosa-relieving treatment for the patient. Implants in patients with immunodeficiencies are therefore justified when strictly indicated and can lead to a rehabilitation of the physiological masticatory function, an increased quality of life, and a positive influence on the general state of health. Keywords: Oral lichen planus, implant, oral mucosal diseases

In autoimmune diseases such as oral lichen planus or mucosal pemphigoid, a sufficient prosthetic restoration without dental implants is often not feasible. Interdisciplinary planning between the prosthodontist and surgeon is necessary to realize an individual, mucosa-relieving treatment for the patient. Implants in patients with immunodeficiencies are therefore justified when strictly indicated and can lead to a rehabilitation of the physiological masticatory function, an increased quality of life, and a positive influence on the general state of health. Keywords: Dental implant, oral diseases, oral lichen planus, mucous membrane pemphigoid

In order to achieve a functional and, from an aesthetic point of view, optimal treatment result, various things have to be taken into account in cleft patients: comprehensive interdisciplinary cooperation, favourable tooth positions and intermaxillary relationships, and appropriate peri-implant soft tissue management. Nevertheless, difficult conditions, e.g., narrow interdental gaps, often persist despite extensive pretreatment over many years from a preimplantological point of view. The present case report shows a patient with a left-sided cleft. At the age of 21, the patient could be treated implantologically with a single-tooth implant in region 22. The success prognosis of implants in the cleft jaw region is comparable to implants placed after trauma. Sufficient bone supply is absolutely essential for this. Keywords: cleft, implant

Simpson-Golabi-Behmel syndrome is an x-linked recessive overgrowth disorder characterized by macrosomia, mental deficits, a large head, prominent cranial sutures, midface deficits, hypertelorism, a broad nose, a wide mouth, macroglossia, dental malocclusions, a strongly arched palate, and musculoskeletal and limb abnormalities. The male sex is more commonly affected, with only about 200 cases being described. The presented case of a 2-year-old patient showed a flat facial profile, macroglossia, a deep tongue position with forced mouth closure, a large upper and lower jaw, and enamel formation disturbances at the primary molars. Preventive, interdisciplinary care of the patient regarding his oral health as well as dentition and speech development are recommended. Keywords: Simpson-Golabi-Behmel syndrome, rare diseases associated with oral symptoms