RESUMO
INTRODUCTION: Maxillary anterior teeth that have not erupted may substantially alter the appearance of the teeth and face. Orthodontists often encounter a clinical challenge while dealing with an impacted maxillary incisor, which creates space problems in the anterior region. The purpose of this paper is to describe the well-synchronized orthodontic and surgical treatment of a horizontally impacted maxillary central incisors. CASE PRESENTATION: A male patient, aged 27, presented with a complaint of unerupted two maxillary front teeth. This resulted in the displacement of adjacent teeth into the vacant region. An intraoral examination revealed a Class II molars on both sides, a deep curve of the space with a 2.3 mm overjet, and an edge-to-edge bite of 0.1 mm. The 3D cone beam computed tomography (CBCT) imaging unveiled a labial impacted and a rotation of approximately 90 degrees (horizontal impacted) on both central maxillary incisors. DISCUSSION: The self-ligating bracket was installed and orthodontic traction aligned the affected tooth in the dental arch. To reach the labial surface of the impacted incisor, open surgical exposure by window excision of soft tissues with a laser was preferable due to the large bulge in the sulcus. Because self-ligating bracket systems employed modest pressures to position the maxillary right central incisor in the arch, the window surgical technique did not produce gingival scarring or increased clinical crown length. CONCLUSION: The impacted upper central incisor was successfully treated using a collaborative interdisciplinary (surgical-orthodontic) approach, which resulted in a favorable aesthetic and functional outcome.
RESUMO
INTRODUCTION AND IMPORTANCE: Schwannoma, a benign tumor originating from Schwann cells, is a rare case found intraorally. The tongue, palate and buccal mucosa are the most common sites of intraoral Schwannoma while it is very rarely found on the lips. Previous studies reported only twelve cases of Schwannoma on the upper lip. The etiology of Schwannoma is unknown, but in some literature, Schwannoma occurs due to a defect in the NF2 gene. Management of Schwannoma is excision of the capsule. The prognosis is good, and the recurrency is low. This article reports a rare case of upper lip Schwannoma in adolescent and its management with its histological, immunohistochemical and pathogenesis aspects. CASE PRESENTATION: A 16-years old female presented a painless, semi-solid, mobile lump on the upper lip measuring of approximately 1.5 × 3 cm that had similar color with the surrounding tissue. The lump appeared 7 years ago. CLINICAL DISCUSSION: Excision of the capsule and margins of the tumor. Histopathological examination showed a unique feature of Schwannoma, the Verocay bodies. Subsequent immunohistochemical examination of S100 protein showed a classic type of Schwannoma. CONCLUSION: Upper lip schwannoma is a very rare tumor, and this type of tumor cannot be distinguished from other benign soft tissue tumors based on clinical findings. Immunohistochemical results are in accordance with the Histopathological results for the final diagnosis of Schwannoma. Schwannoma can be used as a differential diagnosis in cases of lumps on the lips with sessile, similar color like surrounding tissue, painless, and movable features.
