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      Case of Frontal Glioma With a Factitious Disorder of Self-Inflicting Dental Injuries Managed by Coronally Advanced Flap With Orthodontic Buttons

      case-report
      1 , , 2 , 3 , 4
      ,
      Cureus
      Cureus
      glioma, orthodontic buttons, coronally advanced flap, gingivitis artefacta, factitious disorder

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          Abstract

          Factitious disorders represent deliberately fabricated dissimulation of physical and psychological signs and symptoms seeking medical attention by the patient. Usually, they are ignorant of conventional treatment and consistently change their version of signs and symptoms. Due to various changes in the version, they do not respond to the treatment. They describe their signs and symptoms as dissimulated, imaginative, and exasperated, involving any part of the body. Gingivitis artefacta is an unusual and dramatic presentation with self-inflicted physical injury to the gingival tissues. We present an extremely rare case of frontal lobe glioma causing abnormal psychology of factitious disorder resulting in self-inflected injury to gingiva in an adult male. This case also highlights the management of the dental condition of multiple recessions with coronally advanced flaps with orthodontic buttons.

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          Most cited references15

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          Development of a classification system for periodontal diseases and conditions.

          Classification systems are necessary in order to provide a framework in which to scientifically study the etiology, pathogenesis, and treatment of diseases in an orderly fashion. In addition, such systems give clinicians a way to organize the health care needs of their patients. The last time scientists and clinicians in the field of periodontology and related areas agreed upon a classification system for periodontal diseases was in 1989 at the World Workshop in Clinical Periodontics. Subsequently, a simpler classification was agreed upon at the 1st European Workshop in Periodontology. These classification systems have been widely used by clinicians and research scientists throughout the world. Unfortunately, the 1989 classification had many shortcomings including: 1) considerable overlap in disease categories, 2) absence of a gingival disease component, 3) inappropriate emphasis on age of onset of disease and rates of progression, and 4) inadequate or unclear classification criteria. The 1993 European classification lacked the detail necessary for adequate characterization of the broad spectrum of periodontal diseases encountered in clinical practice. The need for a revised classification system for periodontal diseases was emphasized during the 1996 World Workshop in Periodontics. In 1997 the American Academy of Periodontology responded to this need and formed a committee to plan and organize an international workshop to revise the classification system for periodontal diseases. The proceedings in this volume are the result of this reclassification effort. The process involved development by the Organizing Committee of an outline for a new classification and identification of individuals to write state-of-the-science reviews for each of the items on the outline. The reviewers were encouraged to depart from the preliminary outline if there were data to support any modifications. On October 30-November 2, 1999, the International Workshop for a Classification of Periodontal Diseases and Conditions was held and a new classification was agreed upon (Fig. 1). This paper summarizes how the new classification for periodontal diseases and conditions presented in this volume differs from the classification system developed at the 1989 World Workshop in Clinical Periodontics. In addition, an analysis of the rationale is provided for each of the modifications and changes.
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            Treatment of class III multiple gingival recessions: a randomized-clinical trial.

            The aim of this controlled randomized split-mouth study was to evaluate whether a modified tunnel/connective tissue graft (CTG) technique - enamel matrix derivative (EMD) combination will improve the treatment of multiple class III recession when compared with the same technique alone. Twenty healthy subjects with a mean age of 31.7 years, were enrolled for the trial in a university periodontal clinic. Patients with at least three adjacent gingival recessions on both sides of the mouth were treated with a modified tunnel/CTG technique. On the test side, an EMD was used in addition. Clinical parameters were measured at baseline, 28 days, 3, 6 and 12 months after the surgery. Results are presented at the subject level. The mean root coverage from baseline to 1 year post-surgery was 82% for the test group and 83% for the control group. Complete root coverage was achieved at 1 year in eight (38%) of the 20 surgeries (experimental and control group). One-year results indicate that the modified tunnel/CTG technique is predictable for the treatment of multiple class III recession-type defects. The addition of EMD does not enhance the mean clinical outcomes.
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              Treatment of multiple gingival recessions using a coronally advanced flap procedure combined with button application.

              The purpose of this randomized controlled clinical trial was to evaluate the effectiveness of a new treatment approach, which consists of coronally advanced flap (CAF) procedure combined with orthodontic button application (CAF+B) for the treatment of multiple recession-type defects in patients with aesthetic demands.

                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                16 August 2023
                August 2023
                : 15
                : 8
                : e43602
                Affiliations
                [1 ] Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, IND
                [2 ] Periodontology, Hi-Tech Dental College and Hospital, Bhubaneswar, IND
                [3 ] Orthodontics and Dentofacial Orthopedics, Hi-Tech Dental College and Hospital, Bhubaneswar, IND
                [4 ] Orthodontics and Dentofacial Orthopedics, Meghna Institute of Dental Sciences, Nizamabad, IND
                Author notes
                Article
                10.7759/cureus.43602
                10504062
                37719526
                c9921c8f-dcba-48f3-9019-e9244ef392d1
                Copyright © 2023, Pattnaik et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 16 August 2023
                Categories
                Neurology
                Neurosurgery
                Dentistry

                glioma,orthodontic buttons,coronally advanced flap,gingivitis artefacta,factitious disorder

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