Pathologic tooth migration (PTM) is a common complication following moderate to severe chronic periodontitis, which lead to the undesirable consequences such as traumatic occlusion and impaired aesthetic appearance. Multidisciplinary approach had been successfully used in overcoming the problem. However, since periodontal tissue support is reduced in PTM, further migration of teeth may occur as they were always subjected to the external forces such as occlusion and soft tissue pressure during function. This case report described a 41 year-old male with a further migration of his upper right central incisor after periodontal therapy. After multidisciplinary approach was carried out to overcome the problem and the tooth was on stable condition, permanent splinting was placed to secure the tooth.

The in vitro cytotoxic potential of locally produced dental porcelain was evaluated in this study. The cellular response of human osteoblast and fibroblast cell lines were assessed using MTT assay by incubating with the fluid extract of dental porcelain powder and dental porcelain discs (direct test). Aging process was carried out by submerging the discs into 3% bovine serum albumin (BSA) solution. Tests on extracts showed that dental porcelain was significantly different from the control at a concentration of 250 mg/ml. Direct test showed that dental porcelain after aging was not significantly different from the control with a mean (SD) of 89.2 (13.4)%, whereas, it was significantly different from the control before conditioning of BSA with a mean (SD) of 88.5 (12.1)%. However, the dental porcelain caused mild suppression of succinate dehydrogenase activity (<25%), which is considered to be accepted clinically and hence can be ranked as being non-cytotoxic.

Marfan syndrome (MFS) is an autosomal dominant and multisystemic disorder affecting the connective tissues. Patients with MFS may exhibit characteristic oral features including maxillary protrusion, high palate, crowded teeth, and fragility of the temporomandibular joint. Periodontal manifestations may include a higher prevalence of gingivitis and/or periodontitis owing to the high concentration of elastic fibres in the periodontal ligament. This case report describes the management of gingival enlargement associated with MFS. The patient was successfully managed with non-surgical and surgical periodontal therapy. In patients with oral manifestations of systemic disorders, patient motivation and effective treatment planning are able to achieve the optimum periodontal and oral health outcomes.

A perfect smile always relates to well-aligned teeth. Factors such as fracture, malocclusion, and tooth migration challenge a clinician to restore a patient’s appearance and functionality. This case report presented a 32-year-old Malay male patient concerns on his appearance because of a fractured maxillary canine due to motor vehicle accident. There has been no restoration on the tooth since three years ago. After obtaining the patient’s agreement, a full ceramic crown was constructed despite being complicated by Class III malocclusion. It is challenging to improve aesthetics and longevity for this patient with a midline shift and diastema of the lower arch, anterior cross bite of tooth 12, and an open bite between teeth 14 and 44. After discussion, the patient agreed and decided on a full ceramic crown of tooth 23 despite being challenged to achieve an ideal occlusion. The patient was satisfied with the crown’s quality and aesthetic.