Authors : Ulfah Hermin Safitri*, Pingky Krisna Arindra**^🖂, Bramasto Purbo Sejati**

The occurrence of a palatal fistula following cleft palate surgery is a common complication, particularly in patients with palatal clefts. The reconstruction of these defects often leads to the formation of palatal fistulas, which may develop due to the ratio of cleft width to the surrounding available palatal tissue for reconstruction. Additionally, palatal fistulas post-palatoplasty can occur from hematoma formation at the surgical site, that can cause a communication between the oral and nasal cavities. This occurs due to poor tissue approximation and potential tissue necrosis caused by trapped blood. Tongue flaps are considered the preferred method for closing anterior palatal fistulas, as they offer the advantages of excellent vascularity, mobility, and versatility in positioning. This study aims to evaluate the effectiveness of the tongue flap technique in repairing anterior palatal fistulas. This case report presents a 29-year-old female patient with large anterior palatal fistulas that had failed to close previously (sequelae). The patient also presented with inadequate local scars, oronasal communication, fluid regurgitation, and hypernasal resonance. To address these issues, a pedicle tongue flap was used to close the oronasal fistula. The procedure involved creating a flap from the tongue, which was sutured to the palatal defect. The healing process was uneventful, and the pedicle flap division was done and closed primarily. There was reported no nasal regurgitation, no wound dehiscence, the patient’s masticatory function was preserved, and good speech intelligibility. Pedicle tongue flaps are an effective for closing palatal fistulas and are the preferred technique for repairing oronasal fistulas after palatoplasty revisions. read more

Authors : Shavira Amanda Muhandri*, Anrizandy Narwidina**

Early interceptive orthodontic treatment plays a crucial role in guiding occlusion development and preventing the need for more extensive future interventions. Clear aligners with digital planning effectively address malocclusions in growing patients, particularly large overjet and proclined incisors. Objectives: This case report aims to evaluate the effectiveness of clear aligners in correcting a large overjet and proclined upper incisors in an early mixed dentition patient using a digital treatment approach. Case Report: An 8-year-old female in early mixed dentition presented with a large overjet (5.5 mm) and proclined upper incisors, causing aesthetic concerns. Treatment with KLAR Kids^® clear aligners was initiated using digital planning and attachments, following a 7-day aligner change protocol. The total treatment duration was 10 months, with an aligner fit issues and patient compliance challenges. Refinements were required to optimize results, and post-treatment retention was maintained with clear retainers. Discussion: Clear aligners in early mixed dentition provide advantages such as improved aesthetics, comfort, and hygiene. Despite challenges, the treatment successfully reduced the overjet and improved incisor inclination. Digital treatment planning enhanced precision, though refinements were necessary to achieve optimal outcomes. Post-treatment retention with clear retainers is essential for maintaining long-term stability. Conclusion: This case demonstrates the effectiveness of clear aligners as an interceptive orthodontic solution for early mixed dentition. While clear aligners offer aesthetic and comfort benefits, treatment success depends on patient compliance and may require refinements. Further research is recommended to assess the long-term stability and comparative efficacy of clear aligners in early orthodontic treatments.
Keywords: Clear Aligners; Digital Treatment Planning; Early Mixed Dentition; Interceptive Orthodontics; Overjet Correction read more

Authors : Fajar Satrio¹*, Margareta Rinastiti**

Cuspal coverage is often recommended for endodontic treated teeth (ETT) to provide structural support and prevent fracture. Post-cure heat treatment non-rententive composite overlay with fiber-reinforced biobase for cuspal coverage restoration can maintain remaining tooth structure and increase fracture resistance. This study aims to evaluate indirect restoration with post-cure heat treatment non-rententive composite overlay with fiber-reinforced biobase in the upper right premolar tooth after root canal treatment at 1 year follow up. Man patient aged 35 years came to RSGM UGM Prof Soedomo to retain his upper right premolar tooth (15). The caries had extended, destroying all the cusps of tooth 15 and leaving only one-third of the structure from the gingival margin. On the radiograph, there was a remaining tooth structure in good condition in the gingival third and apical radiolucency in the mesio apical. From clinical examination obtained pulp necrosis, symptomatic apical periodontitis. Two visit endodontic retreatment was given than followed by fiber-reinforce biobased with non retentive overlay design to maintain tooth structure and minimize polymerization shrinkage stress. Overlay was made with microhybrid composite with post-cure heat treatment (120 C, 10 minute)  to increase microhardness, fracture toughness and degree of conversion. Overlay cementation with pre-heated composite. After one year follow up there wasn’t chipping, crack or debond of the composite overlay and from the radiograph showed no coronal leakage and apical healing. ETT that was restored with post-cure heat treatment non-rententive composite overlay with fiber-reinforced biobase obtained good result at 1 year follow up. read more

Authors : Dini Ika Mawardhani*, Indra Bramanti, Didit Istiadi*

An eruption cyst is a form of benign soft tissue cyst that accompanies
the eruption of primary or permanent teeth and appears shortly before the appearance
of teeth in the oral cavity. Some studies reveal possible causes, but the exact etiology
of eruption cysts is unknown. A Surgical incision under local anesthesia was
performed to remove this cyst and expose the tooth. Objectives. The aim of this case
report is to report the management of eruption cysts. Case reports. This case reports
an eruption cyst in a 9-year-old male patient. The patient presented with gingival
swelling over the crown of tooth 12. Intraoral examination revealed a smooth swelling,
measuring 1 cm x 0.8 cm, with a transparent red color. The cyst resulted in eruption
failure, necessitating a surgical incision of cyst fluid under infiltration anesthesia,
leaving the crown of the tooth exposed. Bleeding was then controlled with tampon
compression for approximately 10 minutes, the work area was evaluated, and
analgesic drugs were prescribed. The patient and parents were given postoperative
education and instructions. Discussion. It is difficult to see on radiographic
examination as the cyst and tooth are directly in the soft tissue of the alveolar crest
with no bone involvement. Histologically, it shows connective tissue covered by a layer read more

Background: Anterior crossbite affects occlusal function, jaw development, and periodontal health, with a prevalence of 4%–26% in children. Catlan’s appliance provides effective crossbite correction, yet a functional and holistic pediatric perspective, prioritizing root-cause intervention, individualized care, and minimally invasive methods, remains an underrecognized and insufficiently explored in treating malocclusion associated with oral seeking behavior. Objectives: This case report aims to present a functional and holistic pediatric dentistry approach combining behavioral intervention and interceptive therapy in managing anterior crossbite associated with oral seeking behavior in a pediatric patient. Case Report: A 9-year-old male presented with anterior crossbite, progressive mobility of the lower right central incisor, and persistent oral seeking behavior, including habitual object biting. Clinical examination revealed localized gingival recession. Treatment combined habit cessation therapy, psychological support and interceptive therapy using Catlan’s appliance. Discussion: At 2 weeks, successful crossbite correction was achieved. At the 6-months follow-up, no relapse was observed and tooth mobility was absent, along with sustained habit cessation. Addressing oral seeking behavior as a modifiable risk factor improved patient compliance and reduced the risk of relapse. This case highlights that functional pediatric dentistry integrates behavioral and mechanical approaches to promote long-term oral health and stable occlusion. Conclusion: A holistic, patient-centered approach that targets oral seeking behavior and uses interceptive therapy optimizes treatment outcomes and long-term stability. Recognizing behavioral patterns as contributing factors is essential for sustainable crossbite management in children. read more

Authors : Permata Dydha Putri^*, Auliya Rahma*, Ainu Zuhad Sukaton**, Indra Bramanti***, Didit Istadi****

Background: Pyogenic Granuloma is a non-neoplastic vascular tumor growth in the tissues of the mouth. Pyogenic Granuloma in sublingual area is rarely encountered and commonly seen in young children. Several journals have proposed possible etiological factors for pyogenic granuloma, however the exact etiology remains unknown. The treatment which performed is surgical excisional biopsy. Objective: This case report aims to view a case and treatment of pyogenic granuloma in sublingual area in 10-month-old pediatric male. Case Report: The 10-month-old male patient visited the Pediatric Dentistry, Universitas Gadjah Mada, Prof. Soedomo, with a chief complaint of a swelling in the sublingual area with a lesion size 0,7 x 0,6 x 0,5 cm, similar in color to the surrounding tissue, bleeds easily, no pain, and causes difficulty for the infant to breastfeed. Methods: The excisional surgical biopsy treatment with general anesthesia plan was carried out and was sent to the Anatomical Pathology laboratory for further examination. The patient was instructed to follow up one week after the surgical procedure. Results: The patient underwent surgical excision of the lesion located in sublingual was excised with clear margins to ensure complete removal. The wound was then sutured using absorbable sutures. Postoperative care included the prescription of analgesic and instructions to avoid trauma to the surgical site. The histopathological examination revealed subepithelial tissue exhibited granulation tissue with proliferating blood vessels, confirmed the diagnosis of pyogenic granuloma, with no evidence of malignancy. Conclusion: The surgical excisional biopsy and post surgery instructions are essential to prevent recurrence. read more

Authors : Dhella Rizki Ramadhani^*, Faisal Rizki*, Shavira Amanda Muhandri*, Indah Titien S**,  Indra Bramanti**

Background: Dental impression procedures in pediatric patients with special needs such as Autism Spectrum Disorder (ASD), are the biggest challenge for pediatric dentistry. This challenge is mainly related to behavioral management, difficulty opening the mouth, high gag reflex and difficulty to communicate. The use of intraoral scanners in pediatric dentistry has advantages, such as easier procedures and increased patient comfort. Objective: This case report aims to describe the management of dental impression using an intraoral scanner in a patient with ASD. Case Report: The 14-year-old male patient with ASD visited the Pediatric Dentistry, Universitas Gadjah Mada, Prof. Soedomo, with a chief complaint of frequent biting of the inner cheek causing recurrent traumatic ulcers. To reduce this habit, a mouth guard was required as a therapeutic intervention. Methods: Dental impression are performed using the intraoral scanner brand Shining 3D Aoralscan 3. The scanning process involves molding the upper and lower jaw while the patient is in a supine position for increased patient comfort. The intraoral scanner also featured music, which helped to calm the patient during the procedure.  Results: The results of the dental impression with the 3D shining intraoral scanner are visualized in 3D digital form on a computer screen. The data is then transmitted to 3D print machine to produce a physical tooth mold.  Conclusion: The use of an intraoral scanner in pediatric dentistry can be an effective solution for patiens such as ASD, who have difficulty going through the dental impression process for making an appliance.  read more

Authors : Garry Beta*, Didit Istadi**🖂, Bramasto Purbo Sejati**

An ectopic mandibular third molar is a rare condition in which a tooth is impacted in an unusual position or has been displaced from its normal anatomic site. The etiology of an ectopic tooth is still unclear. However, ectopic eruption may originate from developmental abnormalities, iatrogenic activities, or pathogenic conditions. The malpositioned tooth of a pathological condition is associated with a dentigerous cyst. The aim of this study is surgical management with the retromandibular approach to avoid morbidity caused by infection, temporomandibular joint malfunction, and fracture risk in a bone-thin area. A 58-year-old female patient with a chief complaint of pain, slight swelling, and an inability to fully open her mouth on the left cheek, which occurred in the last year. The panoramic and CT scan radiographs showed a radiolucent area of an ectopic third molar in the mandibular neck condylar. The excision biopsy of lesions and removal of ectopic third molars were performed surgically under general anesthesia with an extraoral approach due to an extreme malposition. The lesion was a dentigerous cyst, confirmed by histopathologic examination. The most commonly used extraoral surgical approach is the retromandibular transparotid. This approach is very helpful to expose the entire ramus region from behind the posterior border, especially the neck condylar area. The management of ectopic third molars with unusual lesions is to avoid the risk of postoperative mandibular fractures, which are associated with the weakening of the mandibular due to the size of the lesion and the location of the tooth. read more

Ectopic teeth in the maxillary sinus are a rare occurrence. It can cause various symptoms depending on their position, some of which may be nonexistent. Removal of an ectopic tooth in the maxillary sinus is too difficult to perform due to limited access and visibility therefore it must be done carefully. This report aims to describe the successful removal of an ectopic tooth in the maxillary sinus with assisted visualization and extraction access using nasal endoscopy and Caldwell Luc technique. A 13-year-old male complained of pain and swelling on the left side of his face. The patient had a history of surgery at a hospital in Central Java with a diagnosis of a dentigerous cyst due to an ectopic sinistra upper third molar tooth in the sinistra maxillary sinus. However, extraction of the ectopic sinistra upper third molar was unsuccessful. An ectopic tooth within the maxillary sinus has been confirmed by orthopantomography and computed tomography. It is necessary to employ a nasal endoscopic-assisted Caldwell-Luc technique to better observe the ectopic tooth because of its location in the superolateral sinus. This instrument helps the operator identify the ectopic tooth without compromising a large portion of the sinus wall. Nasal endoscopy can be used in cases related to the maxillary sinus area. It can assist the operator in viewing the sinus cavity and identifying the location of lesions, teeth, or foreign bodies within the sinus, reducing morbidity and accelerating patient recovery. read more

Complicated crown-vertical root fractures are an uncommon type of dental trauma but often result in significant aesthetic and functional challenges for affected individuals. A severely fractured crown extending subgingivally with an inadequate ferrule effect can compromise the predictability of restorative treatment. This report presents the case of a 23-year-old female who suffered a traumatic injury in the aesthetic region, posing a significant treatment challenge. The injury resulted in a crown fracture extending subgingivally, accompanied by a vertical root fracture of the maxillary left permanent central incisor, leading to the loss of the ferrule effect. This clinical case report aims to describe a multidisciplinary treatment approach combining non-surgical endodontic therapy, orthodontic extrusion, and digital restorative rehabilitation to restore the function and aesthetic of the traumatized maxillary left lateral incisor. In this case, orthodontic repositioning combined with endodontic therapy successfully re-established a ferrule effect with adequate biological width, enabling a predictable and excellent final restoration. Furthermore, digital restorative therapy enhanced preparation precision, ensuring optimal fit and marginal adaptation, which resulted in a highly aesthetic and functionally superior outcome. read more