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Retention of permanent incisors by mesiodens: a family affair.

The term mesiodens refers to a supernumerary tooth that is present in the midline of the maxilla between the two central incisors. One or two mesiodentes may be present. We present a rare case of two sisters, in both of whom a pair of mesiodentes caused the retention of permanent incisors. They were referred to our hospital with asymptomatic delayed eruption of upper incisors. This article is written to point out genetic factors as the possible origin of supernumerary teeth.

Adolescent↗

Hypodontia, ankylosis and infraocclusion: report of a case restored with a fibre-reinforced ceromeric bridge.

Retained primary molars without permanent successors often undergo progressive infra-occlusion, without predictable exfoliation. Early prophylactic removal, after assessment of root resorption and adjacent periodontal support loss as well as age of onset, is often indicated. This article describes the joint orthodontic-restorative care of such a case and describes an alternative method of restoration using a fibre-reinforced ceromeric bridge. As well as a conservative preparation and good aesthetics, an overlay restoration provided a fully functional occlusion.

Anodontia↗

Good occlusal practice in children's dentistry.

The difference between paediatric dentistry and most other branches of dentistry is that in the child the occlusion is changing. Consequently 'Good Occlusal Practice' in children is a matter of making the right clinical decisions for the future occlusion. The clinician needs to be able to predict the influence that different treatment options will have on the occlusion when the child's development is complete.

Anodontia↗

Screening panoramic radiography of new adult patients: diagnostic yield when combined with bitewing radiography and identification of selection criteria.

OBJECTIVES: To measure the radiological diagnostic yield on screening panoramic radiographs taken of new adult patients and to identify selection criteria for panoramic radiography of new adult patients. DESIGN: Survey of 1,817 consecutive panoramic radiographs taken as 'routine' on new patients with statistical analysis of clinical and radiological findings. SETTING: All radiographs were obtained from 41 general dental practitioners (GDPs). The GDPs provided the clinical information about the patient obtained by history and examination. Collection of material occurred in 1998/1999. MATERIALS AND METHODS: Two dental radiologists recorded the radiological findings on each of 1,817 panoramic radiographs by consensus. Those findings that would have been identified from bilateral posterior bitewing radiographs of each patient were then excluded to give modified figures for radiological findings. MAIN OUTCOME MEASURES: Indices of diagnostic yield were devised and calculated for each radiograph from the data on radiological findings. Total diagnostic yield (DY) and modified diagnostic yield (MDY), after exclusion of findings identifiable on bitewing radiographs, were both calculated. Clinical indicators of a high MDY were identified using stepwise multiple regression analysis. RESULTS: MDY was 0 for 17% of the radiographs (all patients) and 23% of the radiographs when the asymptomatic group were considered. The clinical variables for which the significance was high (p < 0.001) were: increasing number of teeth with clinical suspicion of periapical pathology, presence of partially erupted teeth, increasing number of clinically evident carious lesions, partially dentate status and presence of crowns. CONCLUSION: Taking posterior bitewing radiographs of new adult patients would reduce the diagnostic yield identified solely by panoramic radiography. Using clinical factors derived from the history and examination as radiographic selection criteria modestly improves the odds of achieving a high diagnostic yield from panoramic radiography.

Adult↗

Links between anaesthetic modality and nerve damage during lower third molar surgery.

OBJECTIVE: To investigate the relationships between eruption status, gender, social class, grade of operator, anaesthetic modality and nerve damage during third molar surgery. DESIGN: Two centre prospective longitudinal study. SETTING: The department of oral and maxillofacial surgery, University Hospital Birmingham NHS Trust and oral surgery outpatient clinics at Birmingham Dental Hospital. SUBJECTS: A total of 391 patients had surgical removal of lower third molars. Sensory disturbance was recorded at one week post operatively. Patients with altered sensation were followed up at one month, three months and six months following surgery. RESULTS: 614 lower third molars in 391 patients were removed. Forty-six procedures (7.5%) were associated with altered sensation at one week with three procedures (0.49%) showing persistent symptoms at six months. Of these 46 nerve injuries, 26 (4.23%) involved the lingual nerve and 20 (3.25%) the inferior dental nerve (IDN). All three persistent sensations were IDN related. A logistic regression model found that the use ofa lingual retractor chi2 = 11.559, p = 0.003 was more significant than eruption status chi2 = 12.935, p = 0.007. There was no significant relationship between anaesthetic modality, age, social class, sex and seniority of operator. CONCLUSIONS: There was no link between the choices of local or general anaesthesia and nerve damage during lower third molar removal when difficulty of surgery was taken into account.

Adolescent↗

Fissures at risk.

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Bicuspid↗