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The lesion of microhypoplasia of an unerupted tooth was composed of small, irregularly distributed crystals, similar to those of immature and hypomineralized enamel. The lesion appeared to be a defect of crystal growth and maturation, probably involving a partial and momentary failure of the operating cycle of an ameloblast.
Radiographic, gross, and histologic evidence is provided to demonstrate the development of caries and periodontal disease over a 5-year period in an unerupted tooth. The authors speculate on the pathogenesis of these disease processes.
A total of 351 odontomas were retrieved and analyzed from 53,824 submitted specimens. The majority (53.6%) were diagnosed in the second decade of life; the most common location was the anterior portion of the maxilla (33.9%), but there was no overall predilection for the maxilla. An associated unerupted tooth was present in at least 47.6% of the cases. Dentigerous cysts were diagnosed in conjunction with 27.6% of the odontomas, and a calcifying and keratinizing odontogenic cyst was seen in 0.9% of the cases.
The aim of this study is to investigate the proliferative potential of rests of odontogenic epithelium found in follicles of unerupted teeth, epithelium of oral mucosa and epithelial linings of various odontogenic cysts. MIB-1 expression was studied in the rests of odontogenic epithelium (n=10), healthy oral mucosa (n=10), odontogenic keratocysts (n=10) and other odontogenic cysts (n=10) using an avidin-biotin peroxidase technique on paraffin sections. The number of positively stained cells was counted on 10 representative areas of epithelium using a x40 objective. The average number of MIB-1 positive cells in each group was calculated. No MIB-1 positive cells were seen in the rests of odontogenic epithelium. The mean numbers of MIB-1 positive cells detected within the epithelium of oral mucosa, and of radicular and dentigerous cysts were similar. The number of MIB-1 positive cells was found to be increased in the presence of marked inflammatory cell infiltration. The highest number of MIB-1 positive cells was seen in the keratocysts. These findings suggest that removal of an unerupted tooth to prevent the possibility of neoplastic transformation of rests of odontogenic epithelium is not a justifiable rationale.
Because of a predilection for occurrence in the anterior jaw in association with an unerupted tooth, the odontogenic adenomatoid tumor (OAT) will sometimes be discovered in the context of an orthodontic procedure to promote and guide eruption of the tooth. Two cases illustrate this situation. Some other lesions that might have a clinical presentation similar to the OAT are named.
The parallax method and the use of 2 radiographs taken at right angles to each other are the 2 methods generally used to accurately localize teeth. For the parallax method, the combination of a rotational panoramic radiograph with an occlusal radiograph is recommended. This combination involves a vertical x-ray tube shift. Three case reports are presented that illustrate: (1) how this combination can accurately localize unerupted mandibular anterior teeth, (2) how a deceptive appearance of the labiolingual position of the unerupted tooth can be produced in an occlusal radiograph, (3) how increasing the vertical angle of the tube for the occlusal radiograph makes the tube shift easier to discern, (4) why occlusal radiographs are preferable to periapical radiographs for tube shifts, and (5) how localization can also be carried out with 2 radiographs at right angles to each other, one of which is an occlusal radiograph taken with the x-ray tube directed along the long axis of the reference tooth.
In this paper we have described the case of a 7-yr-old Moroccan osteopetrotic boy, who had received a bone marrow transplant (BMT). He was transplanted from his older brother and, despite immunosuppressive therapy, developed chronic graft-versus-host disease and was placed on corticotherapy. Seven months after the bone marrow transplant, graft versus host disease (GVHD) was stabilized, but corticotherapy had inhibited growth. There was evidence of normalizing bone, his hearing was better but he had not recovered vision. Dental findings before the bone marrow transplant revealed some missing teeth, failure of teeth to erupt and decayed teeth but no enamel hypoplasia. The patient had developed one carious lesion on one unerupted tooth: bacteria seem to have found a way through the gubernaculum dentale. The scanning electronmicrographs showed decayed tooth and tissues fitted into each other. Since the bone marrow transplant, no tooth has erupted. We think that, in this case, failure of tooth eruption would be the sign of osteopetrosis.
The discovery of a radiolucency within an unerupted tooth is a rare occurrence. One cause is external resorption. The clinical features, the histology, and the management of three cases are described.
Adenomatoid odontogenic tumours (AOT) are benign, hamartomatous odontogenic lesions that not uncommonly mimic a dentigerous cyst radiographically. Such a case as found involving an unerupted left maxillary canine in a 19-year-old Chinese female is described. The differential diagnosis of some common odontogenic cysts and neoplasms occurring in Malaysians, that may present in a dentigerous relationship to an unerupted tooth is discussed. A brief review of the radiographic literature on AOT is also included.
Pre-eruptive intracoronal resorption is a lesion often located within the dentin, adjacent to the dentin-enamel junction, in the occlusal aspect of the crown. As the lesions resemble caries, they are often referred as "pre-eruptive caries." The purpose of this case report was to describe the diagnosis and treatment of a permanent molar with pre-eruptive intracoronal resorption and to elaborate on possible associated clinical problems. After surgical exposure of the unerupted tooth, the tooth structure in the resorbed area was removed and the tooth was restored with glass-ionomer material. Three months after the treatment, partial pulpotomy had been performed and the restoration was replaced by amalgam. Elaboration on possible associated clinical problems is provided.
The problem of impaction of the maxillary anterior teeth can be solved under cooperation of the oral and maxillofacial surgeon and the orthodontist. In that way unerupted teeth which in the past were scheduled to be extracted, nowadays can be saved and take their place in the dental arch. There are various surgical techniques of exposure of unerupted anterior maxillary teeth, for orthodontic management. Decision of the most suitable for each individual case can be taken after careful analysis of the diagnostic data from the surgeon and the orthodontist taking under consideration the location of the unerupted tooth, the periodontal status and the patients' cooperation. In this paper reference is being made in different techniques of surgical exposure for orthodontic traction with regard to the maintaining of a good tooth-gingiva relationship. Same clinical cases are also presented.
A case is presented in which a maxillary left central incisor was delayed in its eruption. At initial examination, there was no known etiological factor; two years later, however, an intraoral radiograph revealed a substantial odontome. Treatment consisted of surgical removal of the odontome and application of orthodontic traction to the unerupted tooth. Histological examination confirmed a diagnosis of complex odontome.
Physical trauma to the developing first molar after initial dentin formation (5-day-old rat) and apposition stage (10-day-old rat) caused disturbance in amelogenesis, dentinogenesis, root formation which lead to aberrant odontogenesis. On the other hand, a combination of trauma and injection of carcinogenic substance (NMU) produced a more pronounced disturbance in odontogenesis and higher incidence of unerupted tooth. The transformation of the retained reduced enamel epithelium to squamous type cells was an interesting finding and has not been reported elsewhere. The presence of large proliferating type of odontogenic cell rests was observed.
Children with trauma visit frequently the department of oral and maxillofacial surgery. The treatment for injured permanent teeth is different from that for injured deciduous teeth. We have experienced a case of a 9-year-old boy with an injured unerupted immature permanent tooth with tooth crown fracture. When the tooth erupted gradually, fractured pieces were removed three times, and indirect pulp capping was performed. Three years after the injury eruption was almost completed and pulp was alive, even though the dental roentgenograph showed obliteration of the crown pulp cavity.
A user- and patient-friendly method of treating unerupted teeth is described. A neodymium iron boron magnet is attached to the unerupted tooth, and a second, larger magnet is incorporated in a removable appliance. The resulting forces provide a friction-free system, requiring little or no adjustment, which rapidly encourages the unerupted tooth into a position in which it may be bonded and thereby aligned by more conventional methods.
Adenomatoid odontogenic tumor (AOT) is a slow-growing, asymptomatic and uncommon lesion that arises from odontogenic epithelium with inductive effects on connective tissue. The more common variant is the follicular type, which involves an unerupted tooth and is often mistaken for a dentigerous cyst. Histopathologic examination demonstrates cuboidal or spindle-shaped epithelial cells forming aggregates or rosette-like structures with minimal connective tissue, and cuboidal or low columnar cells forming glandular duct-like structures. Treatment is complete enucleation, and recurrences are rare. We presented a case of AOT in a 14-year-old male presenting as a cystic mass around an unerupted tooth.
Maxillary canine impaction has an incidence of 1 in 100 in the general population and has been reported as much higher in an individual orthodontic practice. Because patients with canine impactions generally have longer treatment times, depending on the location of the impacted tooth, early identification of impaction is of critical interest to the orthodontist. Sector location and angulation of the unerupted tooth have been analyzed previously as predictors of canine eruption after deciduous extraction. Additionally, sector location has been studied as an indicator of eventual impaction, resulting in good predictive success. In this study, angulation of the unerupted tooth was measured from panoramic radiographs and added to sector location to see whether the combination of these factors could predict impaction more accurately than sector alone. Results verified earlier findings for sector: canines that become impacted will overlap the adjacent lateral incisor in 82% of cases. Logistic regression analysis also determined that once the canine overlaps the midline of the lateral incisor, there is a greater than 0.87 chance of impaction. Sector was found to be the better predictor of impaction, with angulation adding little supplementary predictive value.
Fifty consecutive cases presenting with unerupted maxillary incisors at orthodontic clinics were recorded and progress of the unerupted tooth followed up over a 4-year period following the exposure of the unerupted tooth (including removal of supernumerary tooth, etc., if present). The occlusal level, rotation, tilting, and general appearance were assessed at the conclusion of the investigation and the results are presented in this report. The earlier the removal of the causative factor preventing eruption of the incisor the better is the prognosis, and it is suggested that all teeth that have not erupted 6 months after the normal eruption date should be subject to radiological examination to ascertain any possible cause for the delayed eruption.