Case Reports and Reviews: Open Access

Introduction: In daily clinical practice, dental practitioners encounter numerous variations of normal anatomy. Two notable developmental variations are torus mandibularis and supernumerary teeth. Torus mandibularis is a benign bony exostosis arising on the lingual surface of the mandible, whereas supernumerary teeth, or hyperdontia, refer to the formation of additional teeth beyond the normal dental complement. Objective: The aim of this case report is to present a rare coexistence of torus mandibularis and supernumerary teeth. Observation: A patient presenting with mandibular tori and multiple supernumerary teeth was evaluated clinically and radiographically using panoramic imaging and cone-beam computed tomography (CBCT). The case highlights the anatomical characteristics, diagnostic considerations, and potential treatment challenges associated with the coexistence of these developmental anomalies. Conclusion: Although torus mandibularis and supernumerary teeth arise from different developmental processes, their coexistence may influence clinical decision-making. Comprehensive assessment and a multidisciplinary approach are important to ensure appropriate management and optimal patient outcomes.

Positive treatment outcomes with the usage of CBCT were bolstered with certain treatment challenges faced by the general practitioner when faced specifically with RCT of maxillary molar teeth, such as calcified canals, difficulty detecting and/or navigating the second mesiobuccal canal (MB2), detection of vertical fractures, determination of root morphology, assessment of fill density, presence of internal or external root resorption, and presence of any pathology. Conversely, there were also contradictions present with a subset of studies, which showed flaws in the use of CBCTs as a diagnostic tool. Case studies will be presented which highlight the use of CBCT as an adjunct when traditional therapy with use of PAs has failed. Maxillary molars present unique challenges for the general practitioner, and these cases demonstrate the positive impact of selective CBCT when sub-standard results are achieved during or after initial RCT for the benefit of the patient.

Severe mental illness (SMI) can often lead to severe neglect of self-care, including diminished oral hygienic practices. Medically complex patients, particularly adults, face hardship in finding affordable, consistent dental care that caters to their particular needs. If there are any additional barriers to treatment (i.e. financial, transportation, access, dental fear, imbalance of mental health status, etc.), treatment is at an increased risk of being delayed, aborted, or never initiated. All of these issues can lead to situations where caries control becomes the crucial first step in a comprehensive dental treatment plan where time is of the essence. Training healthcare practitioners who can recognize the challenges faced by their patients in maintaining their oral health and gaining knowledge in preventative options when faced with any delay of definitive dental care can improve the oral health options and outlook for their patients. It is also important for dental practitioners to gain practical knowledge of management and comprehensive treatment modalities for a patient with schizophrenia. The complex medical needs of the patient ties in closely with disease progression, further highlighting the need for dentists who engage and treat patients of varied medical complexity. Use of silver diamide fluoride can aid healthcare providers in preserving a patient’s dentition when comprehensive dental care is delayed.

Ankylosis of the temporomandibular joint is a serious pathology; it is a joint disease requiring bone reconstructive treatment. The etiology of ankylosis of the temporomandibular joint includes a trauma, a previous operation of this area, arthritis and a previous infection. It can be congenital, and in some cases idiopathic. In ankylosis of the temporomandibular joint, a child may experience the following problems: impaired airway maintenance, difficulty in feeding, impaired speech development. We present a case of a 6-year-old child with ankylosis of the left temporomandibular joint found in infancy. A 6-year-old male child weighing 16 kg, with a diagnosis of left-sided ankylosis of the temporomandibular joint, was placed in the maxillofacial department at the surgical clinic of the Azerbaijan Medical University to relieve ankylosis. Surgery of ankylosis of the temporomandibular joint belongs to the category of difficult intubation, since direct visualization of the vocal cords is difficult due to the inability to open the mouth. In ankylosis of the temporomandibular joint, blind nasal intubation is usually recommended. But, this technique can fail, and repeated attempts at intubation can damage the corresponding structures, which will lead to complications such as bleeding, edema, laryngospasm, aspiration. And ultimately, any compromise in the airways will be detrimental to the pediatric population. Currently, the use of a fibrooptic laryngoscope can be the treatment of choice for difficult airways. But in some clinics this may not be available. Therefore, in such situations, it is necessary to consider alternative options, one of which is retrograde intubation.