Publications by authors named "Justin W Kleinman"

6 Publications

  • Page 1 of 1

Gingival squamous cell carcinoma: an unexpected clincal presentation.

Quintessence Int 2019 ;50(1):50-57

Squamous cell carcinoma (SCC) is an aggressive tumor and represents the most common oral malignancy found by dental health care providers. Timely detection is paramount to reduce patient comorbidities of regional and distant metastases and improve survival rates. To augment recognition of early stage of gingival SCC (GSCC), this article features the somewhat innocuous clinical findings in a 60-year-old female.
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http://dx.doi.org/10.3290/j.qi.a41334DOI Listing
September 2019

Emergent gingival cyst of the adult.

Gen Dent 2017 May-Jun;65(3):42-44

The gingival cyst of the adult is a relatively rare, benign odontogenic cyst that maintains an insidious growth rate. This article describes a case of a diminutive fibrotic overgrowth arising on the labial interproximal gingiva between the mandibular right canine and first premolar in a 68-year-old woman. Within 1 year, the lesion had increased in size and appeared vesicular. The morphologic changes warranted surgical excision and histopathologic review. The lesion was diagnosed as a gingival cyst. At a 4.5-month recall appointment, there was no evidence of recurrence. Early lesional detection can potentially mitigate mucogingival defects and improve clinical outcomes.
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May 2018

Resolution of psoriatic lesions on the gingiva and hard palate following administration of adalimumab for cutaneous psoriasis.

Cutis 2017 Feb;99(2):139-142

Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, USA.

We report the case of a 51-year-old man who presented with an atypical inflammatory response of the gingiva and hard palate that was concomitant with widespread cutaneous psoriasis. The patient had discontinued taking adalimumab 6 months prior to presentation, having achieved satisfactory management of his cutaneous lesions; however, he resumed 2 days prior to presentation due to recurrent disease. A gingival biopsy was consistent with oral psoriasis. At a 2-month follow-up, dramatic resolution of oral involvement was evident and the cutaneous psoriatic plaques were greatly reduced in size. The administration of adalimumab for cutaneous psoriasis may concurrently modulate oral dissemination.
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February 2017

Electronic cigarette explosion associated with extensive intraoral injuries.

Dent Traumatol 2017 Apr 10;33(2):149-152. Epub 2016 Jul 10.

Department of Periodontology, University of Maryland School of Dentistry, Baltimore, Maryland, USA.

With the rise in popularity of usage of various electronic smoking devices, there have been increasing reports of explosions, often resulting in complex injuries to the head and neck. To promote the awareness of this new phenomenon, a case report is provided regarding an 18-year-old male who had an electronic cigarette explode in his mouth. He presented with severe damage to the anterior dentition (fractured teeth, avulsions, luxation), had fractured the premaxilla and anterior nasal spine, and sustained lacerations to the upper lip, labial mucosa, gingivae, tongue, hard palate, and facial skin.
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http://dx.doi.org/10.1111/edt.12293DOI Listing
April 2017

Alendronate-Associated Osteonecrosis of the Hard Palate After Harvesting of a Connective Tissue Graft: A Case Report.

Clin Adv Periodontics 2015 Aug;5(3):171-177

Department of Periodontics, University of Maryland School of Dentistry.

Introduction: Much attention has been given to the development of osteonecrosis of the jaws, concomitant with a history of bisphosphonate usage, particularly regarding inciting dental procedures. This report describes a case of bisphosphonate-related osteonecrosis of the hard palate after the harvesting of a subepithelial connective tissue (CT) graft for treatment of gingival recession (GR) in the mandible.

Case Presentation: A 60-year-old female sought periodontal therapy for GR. Her medical history revealed the use of alendronate for osteopenia, hypothyroidism, sulfa allergy, and >18 regimens of steroid formulations (oral, inhaled, and topical) for various upper respiratory and dermatologic disorders. The hard palate was selected as the donor site for the subepithelial CT graft. At a 4-month postoperative evaluation, osteonecrosis was evident in the palatal site. Successful clinical outcome was achieved after conservative debridement, antibiotics, and use of chlorhexidine gluconate.

Conclusions: It is advised that a patient's medical history include current and past intake of bisphosphonates and comorbidities that could predispose to the development of osteonecrosis of the jaws. Attempts should be instituted to achieve primary wound closure of the donor site in patients who have taken bisphosphonates. Postoperative follow-up of the donor site of CT grafts should continue for at least 6 months for surveillance of bisphosphonate-related osteonecrosis.
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http://dx.doi.org/10.1902/cap.2014.130104DOI Listing
August 2015

Retrieval of extensive gutta-percha extruded into the maxillary sinus: use of 3-dimensional cone-beam computed tomography.

J Endod 2013 Sep 22;39(9):1189-93. Epub 2013 May 22.

Department of Oncology and Diagnostic Sciences, University of Maryland Dental School, Baltimore, Maryland 21201-1586, USA.

Introduction: Close proximity of the maxillary sinus to the roots of maxillary teeth can predispose to the inadvertent deposition of endodontic products into the maxillary sinus. One such material is thermoplasticized injectable gutta-percha, which has gained popularity of late. As a consequence of overfilling, some patients warrant surgical retrieval.

Methods: A case report of extreme overextension of gutta-percha within the maxillary sinus after endodontic retreatment on tooth #14 was provided. The distobuccal and palatal canals had been obturated with gutta-percha master cones and backfilled with thermoplasticized injectable warm gutta-percha. The mesiobuccal canal had only been filled with thermoplasticized injectable warm gutta-percha, the origin of the extrusion. Imagery with 3-dimensional cone-beam computed tomography was performed for localization of the gutta-percha.

Results: The patient underwent a Caldwell-Luc approach for removal of the extruded material. The gutta-percha was successfully removed intact, and the patient had an unremarkable postoperative course. However, the patient continues to have mild tenderness in the sinus region.

Conclusions: The featured case exemplified the consequence of overinstrumentation and ensuing inadequate apical stop. In these situations, the obturation of a maxillary tooth with thermoplasticized injectable gutta-percha, without master cones, can potentially result in overfilling and deposition into the antrum. Use of 3-dimensional cone-beam computed tomography could enhance endodontic diagnosis, serve as an aid for visualization of foreign materials within the sinus and contiguous soft tissue structures, and improve clinical outcome.
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http://dx.doi.org/10.1016/j.joen.2013.04.006DOI Listing
September 2013
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