ABSTRACT
Central odontogenic fibroma (COF) is an extremely rare benign odontogenic tumor, which is associated with an unerupted tooth in one-third of the cases. Hyperplastic dental follicle (HDF) is an odontogenic hamartomatous lesion associated with delayed or tooth eruption failure in young patients. Dentigerous cyst (DC) is an epithelial-lined developmental cyst surrounding the crown of an unerupted or impacted tooth. Here, we present a case of 13-year-old boy with pericoronal radiolucency around impacted right maxillary canine tooth, which detected during routine dental examination on panoramic radiograph. The size of radiolucency was varied between 5 and 10 mm and was asymmetrical. Lesion was underwent biopsy with suspicion to a dentigerous cyst. On microscopic examination, the lesion was composed of a cellular fibrous connective tissue with odontogenic epithelium in the form of strands or nests throughout the lesion and calcifications in the form of basophilic cementum-like material and dentinoid. Due to its nonspecific histological features, we encountered a diagnostic dilemma. In this case report, we discuss the clinical and radiologic features of COF, DC, and HDF. We preferred COF for this lesion. By combining surgical and orthodontic treatments, the impacted tooth was directed to its correct position in the maxilla. This case report highlights the importance of clinicopathological correlation in the diagnosis of pericoronal radiolucencies.
ABSTRACT
Background: Chemical plaque control, an adjunct to mechanical approaches, could improve the maintenance of patients with different types of periodontitis. Chlorhexidine, the gold standard in chemical plaque control, might have some side effects; the most determining one is tooth discoloration. Anti-discoloration systems (ADS) have been added to minimize brownish tooth discoloration. This study aimed to evaluate the staining potential and clinical efficacy of chlorhexidine with and without ADS in patients with chronic periodontitis. Methods: In this randomized controlled trial, 46 patients with chronic periodontitis were randomly allocated to two groups. Each patient used 10 mL of mouthwash A (CHX without ADS) or B (CHX with ADS, including sodium metabisulfite and ascorbic acid) twice a day for two weeks. After a two-week interval, they used the second mouthwash. At the beginning and the end of each two-week cycle, plaque index (PI), bleeding on probing (BoP), and staining index were recorded. Results: There was no significant difference between mouthwash A and B in the reduction of BoP and PI. The staining index was significantly lower after rinsing with mouthwash B compared to mouthwash A. Conclusion: CHX mouthwash containing ADS has similar efficacy in microbial plaque control and reduction of BOP as CHX without ADS, with the advantage of lower stain formation on tooth surfaces in patients with chronic periodontitis.
