International Poster Journal of Dentistry and Oral Medicine, 04/2023

A 6-year-old patient with proven cutaneous lichen ruber showed reticular striae on the inner surface of the upper lip and hyperpigmentation of the attached gingiva. Oral lichen planus (OLP) is very rare in children, with a prevalence in adults of 0.5-2% of the general population and < 2-3% of the total being children. Because the patient was asymptomatic, no therapy was given, and regular follow-up was recommended. Although OLP is considered rare in children, clinicians should consider lichen planus as a possible differential diagnosis in the presence of a non-wipeable white lesion. Keywords: oral lichen planus, oral mucosal diseases, children

Hyperparathyroidism leads to the development of a brown tumour in 2-3% of cases, which can manifest anywhere in the skeleton. Increased parathyroid hormone results in increased osteoclast activation and increased calcium and phosphate. Bone resorption outweighs new bone formation. As a result, giant cell-containing tissue forms, replacing physiologic bone structure and forming radiologically detectable osteolysis. In the present case report, a 65-year-old female patient presented with a hard, nondisplaceable, mildly pressure-dolent swelling in region 32-44. CT scan revealed a diffuse osteolytic sclerotic process extending to the mandibular base. The diagnosis was confirmed by bone biopsy. Histologically typical are multinucleated giant cells, spindle cells and haemorrhage foci organized by the release of hemosiderin, hence the name "brown tumours". Differential diagnosis includes other giant cell-containing lesions such as: central giant cell granuloma or aneurysmal bone cyst. Therefore, additional laboratory parameters must be used to establish the diagnosis. The cause of primary hyperparathyroidism, as in the described case report, is a parathyroid adenoma in 80% of cases. The therapy consisted of the removal of the parathyroid gland. This also resulted in regression of the bony lesion, so that it did not require further surgical treatment. Keywords: Brown tumour, hyperparathyroidism

Probiotics are defined as viable microorganisms that confer a health benefit when administered in sufficient doses. A few studies have revealed that probiotic Lactobacillus strains were useful in reducing gingival inflammation and the number of black-pigmented rods, including Porphyromonas gingivalis (Pg), in the saliva and subgingival plaque. The aim of this study was to evaluate the effects of scaling and root planing (SRP) alone or SRP in combination with Lactobacilli casei in patients with chronic periodontitis. The study population comprised 20 patients who were randomly allocated into a control group (scaling and root planning was done) and the test group (scaling and root planing along with probiotic milk drink supplementation (65 ml) containing Lactobacillus casei strain once per day for one month). The clinical examination included a full-mouth periodontal assessment: BOP (bleeding on probing), PI (plaque index) and GI (gingival index) at baseline and after one month. GI & BOP were significantly decreased in Group B as compared to Group A at one month. Non-significant differences were seen in other periodontal parameters between Group A & B. The patients taking probiotic milk drink as an adjunct to scaling and root planing demonstrated a better improvement in gingival inflammation. However, a further long term, multi-centre study with a large sample size is recommended to determine its practical implementation. Keywords: periodontitis, dental scaling, root planing, probiotics

This case report will describe the reduction of visible oral mucosal findings and the post-improvement of patients' oral health-related quality of life using an holistic therapeutic approach and influence on the immune system. Keywords: lichen ruber mucosae, osteopathy, vitamin status, holistic therapeutic approach

CBCT devices offer a scanning protocol mode with a partial rotation arc of 180^o, followed by a 360^o image reconstruction through algorithms. This scan mode is associated with a low number of basis images and subsequent reduced image quality. However, it does not influence the appearance of artefacts, and it offers a reliable alternative for assessing peri-implant bone. Although the appearance of dental implant artefacts is well documented in literature, metal artefacts are usually determined by grey values or contrast-noise-ratio, but fewer studies have reported the influence of artefacts on diagnostic image quality. Keywords: CBCT, partial rotation arc of 180 degrees, followed by a 360 degree, peri-implant bone, artefacts, diagnostic image quality

Maxillectomy is the surgical removal or resection of the maxilla or upper jaw bone. Maxillectomy is performed during surgical treatment for cancer and infections of the oral cavity, nasal cavity and maxillary sinuses. Patients affected by post-COVID mucormycosis require an aggressive surgical resection resulting in partial or complete maxillectomy. The oronasal communication following resection affects mastication, speech, and swallowing and has a profound psychological impact on the patient. Patients affected by post-COVID mucormycosis reported for definitive rehabilitation following partial or total maxillectomy. Partial maxillectomy patients were rehabilitated with a DMLS designed metal framework along with semi-precision attachment and hollow obturator fabricated using lost salt technique, whereas the complete maxillectomy patient was rehabilitated with a magnet-retained two-part prosthesis (Part I: 3D printed Palatal obturator and Part II: conventional complete denture). 3D printing comprises data acquisition through various scanning technologies followed by data processing and designing the model with computer-aided design (CAD) software. Additional manufacturing through 3D printing provided various advantages such as accuracy, detail reproduction, reduced wastage of material, easier reproduction of complex structures as compared to the conventional approach. ln this presentation both conventional and digital approaches were used for the fabrication of prostheses. The ultimate goal is to provide a retentive and stable prosthesis to help patients overcome the social and psychological predicaments. Keywords: COVID-19, digitalization, mucormycosis, partial maxillectomy

Ceramic veneers are well known as a conservative treatment option for anterior teeth presenting wear, fractures, interdental spaces, and facial defects. Bonded ceramic veneers have been proven to show reliable outcomes with positive long-term results. A 20-year-old female patient reported with the complaint of discoloured and fractured anterior teeth and wanted cosmetic rehabilitation for the same. A treatment plan of ceramic veneers for maxillary canine to canine (13-23) was advised and carried out. A 28-year-old male patient reported with the complaint of midline spacing in upper front tooth region. Ceramic veneers for maxillary central incisors (11-21) were planned as he declined the orthodontic corrections. Nowadays, ceramic veneers have reached a very high level of quality: the parameters of tissue economy, aesthetics, and function are no longer antagonistic. Hence, ceramic veneers should be our first option when establishing a treatment plan for aesthetic regions. Keywords: ceramic, diastema, aesthetics, fluorosis, veneers

Ameloblastic carcinoma is a rare odontogenic tumour that is aggressive with extensive local bone destruction. It retains the features of ameloblastic differentiation and also exhibits cytological features of malignancy. The characteristic histologic features and behaviour dictate a more radical surgical approach than does simple ameloblastoma. It occurs primarily in the posterior mandible in a wide range of age groups. It may arise de novo (primary type) or by malignant transformation of ameloblastoma (secondary type) with a distinction between carcinoma ex intraosseous ameloblastoma and carcinoma ex peripheral ameloblastoma. Histologically, it is characterized by areas with features of typical ameloblastoma and areas with anaplastic appearances. The purpose of this report is to present a case of ameloblastic carcinoma of the anterior mandible in a 55-year-old female patient with a clinical course of typical aggressiveness and extensive local destruction. Keywords: ameloblastic carcinoma, odontogenic tumour, diagnostic engima, oral cavity tumour, malignancy

Objectives: The challenge of limited dental infrastructure in the Tanzanian highlands affects the oral health of the population and local health care workers. This present study investigated the oral health status of health care workers at the Ilembula Lutheran Hospital (ILH) in Tanzania. Materials and Methods: As part of a cross-sectional study, 134 of a total of 184 ILH health care workers (62 women, 72 men; age 36.48 ± 0.83 years, range 19-59 years) were examined during the COVID 19 pandemic in February 2022. The examinations were conducted in the dental ward of the ILH. The decayed, missing and filled teeth index (DMF/T), the simplified oral hygiene index and information on edentulism, the Angle classification, dietary habits, and socioeconomic factors were collected. Results: The mean DMF/T index was 3.33±0.29 (range 0-17). No plaque was found in 72 (53.73%) of those examined. 64 (47.76%) participants in the study were found to require increased prosthodontic treatment (Kennedy class III), and 22 (16.42%) participants required treatment for acute malocclusion. Oral hygiene products were used by 130 (97.01%) participants. Discussion and Conclusion: The oral health situation of the ILH health care workers shows an increased need for restorative and prosthetic treatments compared to Western industrialised nations. The necessary therapies can only be carried out inadequately due to the limited dental infrastructure. Education about adequate oral health and the dissemination of oral health products should therefore also be promoted more strongly in health care facilities. Last but not least, health care workers in dentally underserved areas could act as mediators in the field of oral health for their own patients requiring general medical care. Keywords: caries incidence, Tanzania, general oral health, epidemiology, health care workers

Background: Amelogenesis imperfecta (AI) is a group of genomic developmental disorders that can affect the structure and clinical appearance of the enamel of all or almost all teeth. They can affect both the primary and permanent dentition. Not only are patients aesthetically compromised by the altered enamel, but in severe cases the exposed dentin can exacerbate carious lesions. This case report shows an all-ceramic restoration in a young female patient. Case report: At the time of presentation to the Department of Prosthodontics at the University Hospital of Münster, the patient was 28 years old. Since 2010, carious lesions had been repeatedly treated with composite fillings due to the diagnosis of amelogenesis imperfecta (hypoplastic type 1). As the fillings had to be replaced regularly and the patient had already suffered a moderate loss of bite height of approximately 4 mm, a bite augmentation was planned by crowning all teeth with all-ceramic crowns. The new bite height was first tested with long-term PMMA temporaries. After preparation of all teeth, these were placed in 6 blocks and worn for 3.5 months. The patient showed no problems after the wearing period. Therefore, the new bite height was transferred to all-ceramic crowns for the final restoration. Monolithic zirconia crowns were used in the posterior and mandibular anterior regions, and zirconia frameworks were veneered in the maxillary anterior region to improve aesthetics. Discussion: A few cases of restorations in patients with amelogenesis imperfecta have been described in the literature. In less severe forms, composite abutments or veneers can be used to treat the enamel malformation. As enamel may be completely absent in type 1, crowns are the treatment of choice. A full crown prevents future substance loss and provides the best possible protection for the remaining tooth substance. With modern all-ceramic restorations, highly aesthetic results can be achieved even in severe initial conditions. Keywords: amelogenesis imperfecta, all-ceramic crowns, hereditary disease