Forum for Clinical and Surgical Oral Pathology

Case BBOPF 17-3

Dr. Steven Berkowitz (Private practice, Aventura, FL. USA) would like your management advise for the following case (the case will be available for comments from September 18 - September 22, 2017).

Clinical History

A 37 year old female complains of a firm, white band along the palatal gingival margin of tooth #9, which sometimes extends to the buccal. She describes it like a "cuticle" which is hard and she tends to pick at it with her fingernail to remove it. It is firmly attached to the gingiva, but can be picked off with a sharp instrument. This has been present off and on for 2-3 months.

She had a resin bonded bridge (Maryland bridge) attached to that tooth for a long time, until recently when tooth #10 was replaced with a dental implant.

I am thinking this may be some residual bonding or composite that is irritating the tissue, also exacerbated by trauma from her fingernail.

I would greatly appreciate the great insight of your forum.

Thank you,
Steven Berkowitz DDS, MS
Private Practice
Aventura, Florida. USA

Images

Case prepared by Dr. Alfredo Aguirre (BBOP Manager) and Daniel Emmer (University at Buffalo School of Dental Medicine).