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Case Conference

What’s your diagnosis of this case?

This case is presented by:  Dr. Eric T. Stoopler, D.M.D., FDS RCSEd, FDS RCSEng Dr. Juan M. Bugueno, D.D.S. Dr. Kevin Sweeney, D.D.S. Dr. David C. Stanton, D.M.D., M.D., F.A.C.S  Click here to view the BRONJ Case Diagnosis and Treatment Case Presentation A 64-year-old Caucasian female presented for evaluation of symptomatic exposed bone of a two-year duration post extraction of maxillary teeth with immediate placement of four dental implants. Medical history: Is at stage IV breast adenocarcinoma treated with surgery and trastuzumab. Received intravenous zoledronic acid (ZA) 4 mg monthly for approximately two years for metastatic bone disease. Underwent dental surgery ...

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Your Opinion: How would you treat this case?

This case was submitted by Dr. Matt Gilchrist An 11 year-old presented to my office in December 2013 for a routine recall examination. The right bitewing revealed what appeared to be gross decay on the 1-4 occlusal. Upon further review of the bitewing from last year, it was noted that this exact same lesion had been present since the tooth first erupted into the child’s mouth (sorry, no picture, as we were not digital at that time). The tooth has been symptomatic, and a PA was taken which was within normal limits. Clinically there was no evidence of gross decay, ...

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Your Opinion: How would you treat this case?

This case is presented by Dr. Neel Joshi I have a 17-year old female patient who has had viral gastroparesis for the past 4 years.  It’s a chronic condition that causes her to vomit and/or have stomach acids reflux in her mouth multiple times throughout the day. I don’t believe there is an associated eating disorder – she was diagnosed at Sick Kids Hospital. Her teeth have slowly eroded over time – not yet into the pulp or shortened, but I wish there was something I could suggest.  I have made custom Fluoride trays with neutral Fluoride and also have her ...

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Your Opinion: How would you treat this case?

This case is presented by Dr. Donna Bereznicki A 57 year-old new patient presented with what I think is external resorption on the distal cervical of  tooth 35. This particular tooth is asymptomatic, but requires a replacement restoration due to fracture of the existing amalgam. I am waiting for x-rays from the previous DDS which may or may not be available. How would you treat this tooth? Thank you.                    

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Updated post with full-text article: How would you manage this case: crown fracture with complicated chisel-type fracture?

This case was presented in the Dental Traumatology journal (December 2013). We are asking for your feedback on how you would treat this case. The full-text article is now available. Full-text article (PDF) The Clinical Case A 24-year-old male patient came to The Department of Restorative Dentistry and Endodontics at the Dental Clinic in Vojvodina with dental injury of the maxillary left central incisor. The patient reported a sport injury that had occurred the night before during a football match. Clinical and radiographic examination revealed a complicated oblique crown fracture that extended subgingivally on the mesiopalatal area with a single ...

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Your Opinion: How would you manage this case?

This case is presented by Dr. Emad Girgis I have a 66-year old patient, male Caucasian. Although on medications, these are not contributing to any health complications. The patient had a bridge, done on combined mini implants and teeth, tooth #42had been extracted prior to this X ray due to root fracture . #34 was extracted from under the bridge due to fracture as well. The bridge has been there for about 3 years and the gingiva seems to be healthy around the implants; so, I am assuming there is good integration. #33 has a large periapical radiolucency due to poor RCT ...

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How would you manage this case: crown fracture with complicated chisel-type fracture?

This case was presented in the Dental Traumatology journal (December 2013). We are asking for your feedback on how you would treat this case. The full-text article will be added to the case on November 22nd, 2013. The Clinical Case A 24-year-old male patient came to The Department of Restorative Dentistry and Endodontics at the Dental Clinic in Vojvodina with dental injury of the maxillary left central incisor. The patient reported a sport injury that had occurred the night before during a football match. Clinical and radiographic examination revealed a complicated oblique crown fracture that extended subgingivally on the mesiopalatal ...

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How do I protect my patient medically, while safely providing the required treatment?

This case was submitted by Dr. Ron Kellen  Case Details Male patient, 55.  Diagnosed with AIDS in 2/2013 – at which time, CD4 count was 50. Now he says his CD4 count is 200. On Methadone (on-off for 10 years now). Ex heroin IV, and oxycontin, Percocet, etc. narcotics. On anti-convulsive for grand mal seizures. No more seizures since started medications. Smokes medical marijuana to increase his appetite. He is very underweight. On effective AIDS cocktail since Feb, 2013  Just finished thrush treatment of Nystatin swish & swallow (from G.P., not AIDS MD).  Still remnants clearly visible He has only ...

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