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Cases have been reported in the literature in which a coronal defect has been noted in unerupted permanent teeth. This paper reports on two cases which were treated by professional intervention. Knowledge of the existence of this condition, early recognition of its radiographic characteristics, and appropriate treatment is a major factor in achieving a successful outcome.
A 9-year-old boy suffering from cleidocranial dysplasia presented with multiple unerupted permanent teeth and five unerupted supernumerary teeth. During a 4-year observation and treatment period he developed nine more supernumerary teeth at a time when normally new teeth would no longer be forming. By the age of 13 years and 5 months a total of fourteen supernumerary teeth had been produced and it is possible that more teeth may develop in the future.
Fourth molar do not occur very frequently. They tend to be unerupted or if they erupt may cause malalignment of the dentition or aesthetic problems. The preferred location is in the maxilla, and they may be normal or rudimentary and located either directly distal or distolingually to the maxillary third molar. Supernumerary molars should probably be extracted only when their presence is responsible for the failure of eruption or malalignment of permanent teeth.
This case report describes the treatment of a patient with three unerupted mandibular right molars and a lateral open bite in a Class II subdivision malocclusion with mandibular arch asymmetry. Sequential uprighting and traction of the three mandibular unerupted teeth with a compressed open-coil spring, reverse sliding jig, and light force system was used in the treatment and are described in detail. The results remained stable during the 8-year 6-month posttreatment and 4-year postretention periods.
Unerupted primary teeth are a rare event and in most cases involve the second primary molars. The impaction may be primary, meaning that the teeth never have been erupted (also called primary failure of eruption), or it may be secondary, meaning that the teeth after eruption are reimpacted. The present report describes five cases (three boys and two girls) with primary failure of eruption of totally fourteen second primary molars. None of these teeth ever erupted and were removed surgically at an age of 10-11 yrs. Additionally, in all five cases the eruption of the entire permanent dentition was severely retarded. Consequences of the nonerupting primary molars put a more functional strain, with severe attrition, on the remaining teeth. The unerupted primary molars also seemed to prevent the development of the corresponding premolars. In addition the impacted primary molars were in some cases a threat to the eruption of first permanent molars. The etiology of the present primary failure of eruption seems to be inheritance, and the mode of transmission is judged to be autosomal dominant.
A new case of squamous odontogenic tumor (SOT) is presented. This is the seventeenth case of SOT to be reported and the first reported case related to a lower unerupted canine. A review of the literature reveals the extreme variability of the clinical and radiologic features of this tumor. Conversely, the microscopic characteristics of SOT are clearly defined: numerous islands of benign squamous epithelium scattered in an apparently mature connective tissue, absence of peripheral columnar cells with palisading nuclei, and absence of stellate reticulum. Keratin pearl formation, intraepithelial microcyst formation, and calcification are present to a variable extent. A circular arrangement of fibroblasts and fibrous condensation and/or hyalinization are observed around some epithelial islands, suggesting a reaction of the connective tissue to the epithelial proliferation. The observation of small epithelial islands near the apical surface of the retained tooth supports the theory that the tumor originates from Malassez's rests. The treatment of choice seems to be conservative, with thorough enucleation, but it should be borne in mind that multifocal cases have been described.
The occurrence of supernumerary teeth is not uncommon. The preferred location of the supernumerary teeth is in the maxilla, mostly incisors, followed by the molars. Supernumerary molars are divided into two types, depending on their location: distomolars and paramolars. Distomolars are supernumerary teeth that are distal to the third molars, while paramolars are supernumerary teeth on the side of the molars. The paper describes an unusual case of four distomolars. The two maxillary distomolars were unerupted, in a vertical position distal to the third molars. Their morphology was normal but they were smaller than the regular molars. The two mandibular distomolars were unerupted, in a horizontal position distal to the third molars. Their morphology was normal but they were smaller than the regular molars. Cases of four distomolars with normal morphology are extremely rare and have seldom been reported in the dental literature. The phenomenon is interesting especially considering the fact that in modern man, missing third molars are becoming a common finding.
Pyknodysostosis is an autosomal-recessive disorder of osteoclast dysfunction causing osteosclerosis, with associated maxillofacial anomalies. Multidetector CT with multiplanar and 3D reconstruction illustrated the pathologic findings in this case. Abnormalities included multiple retained deciduous teeth, unerupted teeth with associated follicles, an irregularly expanded alveolus and body of the mandible, and an obtuse mandibular angle. Volume-rendered imaging better delineated the irregular dentition, with crowding and retention of deciduous teeth.
This report describes a complex case with unerupted upper anterior teeth and other dental anomalies requiring the two-stage incisor transplantation technique in conjunction with two phases of orthodontic treatment. The case illustrates the benefits of careful planning and of limiting treatment goals to the needs and perceptions of the patient. The final result also emphasizes the aesthetic dental improvements now possible with a multidisciplinary approach.
The effects of varying acid concentration, etch time and agitation, on the etch properties of enamel from unerupted and erupted human teeth, were examined using the scanning electron microscope. Results showed that whilst there are differences in behaviour between erupted and unerupted enamel when conditions are varied, under most circumstances unerupted enamel will behave in a similar manner to erupted enamel. With low acid concentration both the duration of etch and agitation seem to be important factors in producing a roughened surface. It is suggested that the manufacturers' recommendations be more precise for a new low acid concentration orthodontic bonding package.
Failure of permanent teeth to erupt without any known cause is a rare incident. We report a case of multiple unerupted permanent teeth and make an effort to predict all possible causes of non-eruption of permanent teeth clinically and radiographically. It is essential to diagnose and treat eruption disturbances as early as possible because treatment at a later stage is usually more complicated due to the tendency of malocclusion to increase with time and reduced ability of remaining dentition to adjust.
Maroteaux-Lamy syndrome is one of the genetic disorders involving disturbances in mucopolysaccharide metabolism resulting in increased storage of acid mucopolysaccharide in various tissues. The basic defect in Maroteaux-Lamy syndrome is a deficiency of arylsulfatase B, which leads to accumulation of dermatan sulfate in tissues and their urinary excretion. The deposition of mucopolysaccharides leads to a progressive disorder involving multiple organs that often results in death in the second decade of life. This disease, which has several oral and dental manifestations, is first diagnosed on the basis of clinical findings. A large head, short neck, corneal opacity, open mouth associated with an enlarged tongue, enlargement of skull, and a long antero-posterior dimension are the main characteristic features. Dental complications can be severe and include unerupted dentition, dentigerous cystlike follicles, malocclusions, condylar defects, and gingival hyperplasia. An 11-year-old boy with Maroteaux-Lamy syndrome (mucopolysaccharidosis type VI) is described in this article, with special emphasis on the oral manifestations.
The high prevalence of anomalies of number or form of teeth supports the principle that the developing dentition should be screened radiographically at least once. However, there is considerable controversy, as to when and how to screen, and increasing concern about risks from unnecessary radiation. This study presents a case of late discovery of supplemental premolars in a 14-year-old boy. Screening would have detected the supplementary teeth earlier; however, management of the patient would not have been significantly affected.
Two cases are presented, each with both unerupted maxillary canines so badly positioned that eruption seemed unlikely. However, over a period of approximately three years, three out of the four initially displaced canines did erupt; the improvements in position being unrelated to whether or not the associated primary canine was extracted. Three out of four primary canines were removed. These cases highlight the difficulties in predicting canine eruption for individual patients.
AIMS AND OBJECTIVES: Documentation of dental and orthodontic implications of osteoglophonic dysplasia (OGD). SETTINGS AND PARTICIPANTS: Case report describing oral and dental manifestations of a female with OGD, aged 39 years, who was first documented three decades ago. RESULTS: This rare genetic disorder manifests with gross stunting of stature, associated with severe craniofacial malformation and multiple unerupted teeth. Radiographically, multiple lucent lesions were present in the tubular bones and mandible as well as several impacted teeth. CONCLUSION: We concluded that prosthetic dental replacement in this patient would be difficult because of the distorted jaw relationship and large alveolar ridges. Equally, craniofacial reconstruction might be compromised by obstruction of the nasal airways, difficulty in intubation and postoperative respiratory problems.
OBJECTIVES: We sought to measure the diagnostic yield of relevance to treatment on routine panoramic radiographs taken of new adult (ie, 18 years and over) patients in general dental practice. STUDY DESIGN: Routine panoramic radiographs (n = 1817) obtained from general dental practice were assessed and radiologic yield recorded using consensus viewing by 2 dental radiologists. A modified diagnostic yield of relevance to treatment for each radiograph was calculated by omission of findings that would have been identified on bilateral posterior bitewing radiographs and of radiologic findings of no relevance to treatment. Stepwise logistic regression analysis was used in attempt to identify clinical indicators of a high diagnostic yield of relevance to treatment. RESULTS: The diagnostic yield of relevance to treatment was zero for the majority (56%) of patients. This figure rose to 71% when the symptom-free patients were considered. Five clinical indicators for panoramic radiography were identified, as follows: clinical suspicion of teeth with periapical pathologic conditions, presence of partially erupted teeth, clinically evident caries lesions, swelling, and clinically suspected unerupted teeth. CONCLUSION: Routine panoramic radiography of adult dental patients is not supported by the results of this study. The use of clinical indicators to select patients may help to improve diagnostic yield.
A case of an unerupted mandibular left permanent first molar, a partially erupted permanent second molar, and a congenitally absent third molar in a 12-year-old girl is described. The permanent first molar, being dilacerated and impacted, required surgical exposure of the crowns of the first and second molars and distalization of the second molar, with the help of a space regainer, to bring the molars into occlusion.
A method is described by means of which organic content in fissure areas of 12 unerupted 3rd mandibular molars can be prepared for studies in the light microscope (LM) and in the transmission electron microscope (TEM). Thus, LM and TEM examinations revealed that the organic content throughout the fissure in bone-covered and in mucosa-covered 3rd molars with uncompleted root formation consists of cells belonging to the enamel organ in late or in postmaturative stages. In mucosa-covered teeth with completed root formation it was only possible to identify enamel organ cells at the entrance of the fissure. Deeper parts were occupied by degenerative cells, polymorphonuclear cells and unidentified material. The results indicate that ameloblasts in fissures do not transform to stratified squamous epithelium but gradually degenerate towards terminal stages and remain as such, as the tooth emerges into the oral cavity.