case_images: PMC10810142_01
case_images: Intraoral clinical photos before treatment. a) Intraoral clinical photo frontal view. b) Intraoral clinical photo of the maxillary arch. c) Intraoral clinical photo of the mandibular arch. Red arrows: demineralized enamel lesions and cavitated dental caries. Black arrows: remaining roots. Blue arrows: deep palatal pits
case_images: cureus-0016-00000052923-i01.jpg
case_images: PMC10810142_01_cureus-0016-00000052923-i01.jpg
case_images: FIG1
case_images: Existing restorations included defective resin-based fissure sealants on the first permanent molars and large occlusal composite resin restoration on tooth #85 (Figure 1).
case_images: OPG and bitewing radiographs before treatment. a) OPG radiograph. b) Right-side bitewing radiograph. c) Left-side bitewing radiograph. Yellow arrows: recurrent dental caries under existing restorations/fissure sealants. OPG: orthopantomogram
case_images: cureus-0016-00000052923-i02.jpg
case_images: PMC10810142_01_cureus-0016-00000052923-i02.jpg
case_images: FIG2
case_images: Ultrasonography of normal and missing right and left parotid and submandibular salivary glands. a) Ultrasonography of normal parotid gland. b) Ultrasonography of missing right parotid gland. c) Ultrasonography of missing left parotid gland. d) Ultrasonography of normal submandibular gland. e) Ultrasonography of missing right submandibular gland. f) Ultrasonography of missing left submandibular gland. White arrows: location of salivary glands with distinction between normal images (a and d) and images with missing salivary glands (b, c, e, and f)
case_images: cureus-0016-00000052923-i03.jpg
case_images: PMC10810142_01_cureus-0016-00000052923-i03.jpg
case_images: FIG3
case_images: Special imaging for salivary glands was performed including ultrasonography, which revealed bilateral absence of all major salivary glands (parotid and submandibular) (Figure 3).
case_images: Nuclear medicine scan of major salivary glands showing no uptake. a) Anterior view showing no uptake by major salivary glands. b) Left view showing no uptake by major salivary glands. c) Right view showing no uptake by major salivary glands. Red arrows: position of parotid salivary glands. Blue arrows: position of submandibular salivary glands
case_images: cureus-0016-00000052923-i04.jpg
case_images: PMC10810142_01_cureus-0016-00000052923-i04.jpg
case_images: FIG4
case_images: The results confirmed a bilateral absence of secretion and uptake of parotid and submandibular salivary glands (Figures 4, 5).
case_images: Major salivary glands: function (secretion and uptake) graph. a) Salivary gland function graph of the parotid gland. b) Salivary gland function graph of the submandibular gland. c) Salivary gland function graph of the whole mouth
case_images: cureus-0016-00000052923-i05.jpg
case_images: PMC10810142_01_cureus-0016-00000052923-i05.jpg
case_images: FIG5
case_images: The results confirmed a bilateral absence of secretion and uptake of parotid and submandibular salivary glands (Figures 4, 5).
case_images: Intraoral clinical photos after treatment. a) Intraoral clinical photo frontal view. b) Intraoral clinical photo of the maxillary arch. c) Intraoral clinical photo of the mandibular arch. Black arrows: amalgam restorations. Blue arrows: sealants on palatal fissures. Red arrows: non-cavitated demineralized enamel lesions
case_images: cureus-0016-00000052923-i06.jpg
case_images: PMC10810142_01_cureus-0016-00000052923-i06.jpg
case_images: FIG6
case_images: The follow-up was conducted for three consecutive years during which no new carious lesions developed, and oral hygiene was stabilized (Figures 6, 7).
case_images: OPG and bitewing radiographs after treatment. a) OPG radiograph. b) Right-side bitewing radiograph. c) Left-side bitewing radiograph. Yellow arrows: amalgam restorations. Red arrows: demineralized non-cavitated enamel lesions
case_images: cureus-0016-00000052923-i07.jpg
case_images: PMC10810142_01_cureus-0016-00000052923-i07.jpg
case_images: FIG7
case_images: The follow-up was conducted for three consecutive years during which no new carious lesions developed, and oral hygiene was stabilized (Figures 6, 7).