case_images: PMC11300055_01
case_images: (a) Frontal view of the initial clinical aspect showing the self-inflicted gingival recession with an ulcerated margin on the buccal gingiva of the maxillary incisors, caused by fingernail scratching of the gingiva. (b) Maxillary occlusal view showing no evidence of clinical alterations in the palatal gingiva of the maxillary incisors.
case_images: CRID2024-2278083.001.jpg
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case_images: fig1
case_images: The intraoral examination revealed a complete primary dentition, minimal plaque deposits, and gingival recession on the buccal surfaces of the four upper primary incisors (Figure 1), extending 2 to 5 mm apical to the cementoenamel junction without papilla loss (Figure 2).
case_images: Measuring gingival recession height on the four maxillary incisors.
case_images: CRID2024-2278083.002.jpg
case_images: PMC11300055_01_CRID2024-2278083.002.jpg
case_images: fig2
case_images: The intraoral examination revealed a complete primary dentition, minimal plaque deposits, and gingival recession on the buccal surfaces of the four upper primary incisors (Figure 1), extending 2 to 5 mm apical to the cementoenamel junction without papilla loss (Figure 2).
case_images: (a) Intraoral periapical and (b) panoramic radiographs showing interproximal bone loss in the incisors and normal alveolar bone in the molars of the primary teeth.
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case_images: fig3
case_images: A periapical radiograph showed interproximal bone loss in the incisors, with no abnormalities detected in the molars (Figure 3).
case_images: Patient demonstrating her fingernail-scratching habit on the gingiva.
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case_images: fig4
case_images: The diagnosis was confirmed by observing the finger placement in the specific area after inquiring about the patient's technique (Figure 4).
case_images: Clinical view after 2 weeks: initial healing of the ulcers.
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case_images: fig5
case_images: At the 15-day follow-up (Figure 5), initial healing of the ulcers was observed.
case_images: Follow-up of the patient after 6 months: (a) clinical view showing no progression of the gingival recession and (b) periapical radiograph showing physiological root resorption of central incisors.
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case_images: fig6
case_images: Notably, the patient exhibited complete cessation of her habit by the 6-month follow-up period (Figure 6).
case_images: Follow-up after 8 months: physiological shedding of the left maxillary central incisor.
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case_images: fig7
case_images: Throughout the following 16 months, during which her primary incisors were replaced by permanent teeth, the child showed no recurrence of the gingival scratching habit or any similar behavior (Figures 7 and 8).
case_images: Clinical view after 16 months showing healthy gingival tissue surrounding the erupted permanent incisors, with no recurrence of the fingernail-scratching habit of the gingiva.
case_images: CRID2024-2278083.008.jpg
case_images: PMC11300055_01_CRID2024-2278083.008.jpg
case_images: fig8
case_images: Throughout the following 16 months, during which her primary incisors were replaced by permanent teeth, the child showed no recurrence of the gingival scratching habit or any similar behavior (Figures 7 and 8).