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A case is described of a severely ectopic maxillary canine, which underwent initial spontaneous improvement, and following extraction of the deciduous canine erupted satisfactorily. It provides a cautionary tale when considering surgical removal of ectopic maxillary canines.
In this case, a clear pathway for eruption was provided for the mandibular left first permanent molar by reducing the distal surface of the primary molar. The occlusal surface was also surgically uncovered to remove any possibility of a mucosal barrier. It was thought that the loss of arch length was not too great a sacrifice if the tooth could be brought into occlusion. The tooth proved not to be ankylosed and was, therefore, able to erupt into occlusion. The patient may have some crowding in the mandible; however, it appears to be within normal limits and no further orthodontic treatment is anticipated. When the relative simplicity of treatment is weighed against the severity of the consequences of untreated cases of ectopic eruption, it is suggested that treatment should be started as soon as the condition is diagnosed, to establish a normal eruption pathway and avoid any detrimental effects on a developing occlusion.
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Supernumerary teeth are relatively common in the maxillary incisor and molar areas. However, bilateral ectopic, fully erupted supernumerary mesiodentes are relatively rare. The present case documents a patient with localized periodontitis of the maxillary first and second molars associated with bilaterally erupted supernumerary teeth located in proximity to the buccal embrasure space between the molars. Combined clinical data suggested that these ectopic mesiodentes predisposed or contributed to the development of localized periodontitis.
Ectopic dental eruption into the nasal cavity is a rare phenomenon with an obscure cause. A case of an early erupted intranasal tooth in a patient with a repaired cleft lip, an unrepaired cleft alveolus, and fusion of lower incisor teeth is reported. Only three similar cases of intranasal teeth in cleft patients have been reported in the literature. The unusual features in the present case are highlighted.
AIM: The aim of this study was to review clinical findings in 14 impacted primary teeth in 13 cases treated at a Paediatric Dental Clinic over a period of 18 years. METHOD: The retrospective study used clinical records, radiographs and oral photographs. Data included age, gender, presenting complaints, location, radiographic findings, aetiological factors, treatment and prognosis of impacted primary teeth and their permanent successors. RESULTS: The patients included five males and eight females aged from one year two months to seven years five months. One case had impacted bilateral, mandibular primary central incisors and the remaining 12 cases each had one impacted tooth. The maxillary second primary molar was the tooth most frequently involved. Permanent successor tooth germs were identified in 12 teeth but not in two. Five cases were impacted because of odontomas, in the case with bilaterally affected mandibular primary central incisors these were malpositioned and were erupting ectopically. In seven cases, aetiology was unknown. Four impacted primary teeth were extracted because eruption was unlikely. In four cases, odontomas were surgically removed and the teeth kept under observation. The remaining six were surgically exposed. Traction was applied in two of the six. Eight of the teeth erupted. In two teeth in which traction was used, one was subsequently extracted, and one erupted. In the cases of seven, permanent successors erupted. These were hypoplastic teeth and were delayed in development and eruption. CONCLUSIONS: Impacted primary teeth may be associated with defects in development and eruption of their permanent successors, long-term observation is therefore necessary until the permanent successors erupt.
The eruption paths of 20 ectopic maxillary canine teeth (10 right, 10 left) were measured in three dimensions on annual lateral and depressed postero-anterior cephalometric radiographs of 15 patients between the ages of 5 and 15 years and compared with the eruption of normal canines. It was found that between the ages of 8 and 12 years ectopic canines on the left side moved more anteriorly than the normally erupting canines and the same was true of the right canines between the ages of 7 and 12 years. While the ectopic canines moved occlusally, their vertical movement was less than normal which accounts for the clinical finding that canines are impacted in the palate at a high level. The average palatally ectopic canine always moves palatally, and never shares in the buccal movement shown by normally erupting canines between the ages of 10 and 12 years. It was interesting to find that the differences between growth of normal and ectopic canines in the lateral plane of space are present as early as 5-6 years.
The term mesiodens refers to a supernumerary tooth located between the maxillary central incisors. The aim of the study was to investigate the characteristics of mesiodens among children in Turkey. The study population involved 24 children who attended the Department of Pediatric Dentistry, Ege University for dental problems. The characteristics of mesiodens were obtained from clinical and radiographic examinations. Results showed that twenty-four patients had thirty-four mesiodens for an average of 1.42 mesiodens per person. Males were affected approximately 3 times more frequently in comparison with females. Forty-two percent of the patients had bilateral mesiodens. All of the mesiodens were conical in shape and 91% were in the downward position. The age and sex distribution, location, direction, eruption of mesiodens and effects on permanent maxillary incisors were also presented in this study. It could be concluded that, delayed, ectopic or asymmetric eruption of the central incisors should alert the clinician to the possibility of a mesiodens.
Retrospective analysis of 28 children suffering from severe infra-occlusion and/or primary failure of eruption of deciduous molars revealed an association with eruptive and developmental disturbances in the permanent dentition, including ectopically placed teeth and aplasia of teeth. Taurodont permanent molars were evident in 19 of the 28 selected cases which suggests a possible developmental relationship between these factors. Problems in relation to treatment of these cases are discussed.
Seven cases of ectopically erupting permanent mandibular lateral incisors are reported and their orthodontic management is described. In severely crowded cases the ectopic lateral incisor was extracted. When complete transposition occurred, the teeth were aligned in their transposed positions. If malposition is detected early, orthodontic correction may prevent development of a transposition. Panoramic survey of the developing dentition at the age of 6 to 8 years is a very useful tool in the early detection of this as well as many other dental developmental anomalies.
Computed tomography of the maxillary alveolar arch was performed in three children with delayed eruption of one or both maxillary cuspids. Computed tomography demonstrated close contact between the ectopically localized and nonerupted canine and the lateral incisor. The lesion was unilateral in two patients and bilateral in one. In two patients resorption of the lateral incisor root was demonstrated. Moreover, CT permitted exact determination of the extent of the lesion by differentiating between superficial cementodentine resorption limited to the cementodentine (superficial resorption) and resorption extending into the pulpal canal (pulpal canal involvement).
From the foregoing debate it will be quite clear that Peck et al. have provided ample evidence that may be used to fuel the arguments of both sides: 1. Their material does not contradict the possibility that environmental factors may give rise to palatal displacement of canines generated by genetic anomaly of the adjacent teeth. 2. The buccally displaced canine finds itself similarly environmentally compromised by the different factor of crowding which leads to its characteristic buccally ectopic guidance pattern. 3. (a) Canines that are transposed with the premolar, (b) others that have erupted ectopically, high in the buccal sulcus and in the absence of crowding, and (c) certain palatal canines whose root apex is located markedly distant from their designated site, may all be labeled as genetically controlled with a fair degree of confidence. 4. In between these clearly defined entities there exists a "gray area" in which it is probable that the etiology of the individual displaced teeth may be linked to a combination of circumstances that obey premise number 1 and premise number 2, to varying degrees. The guidance theory cannot provide the complete answer to the etiology of the palatally displaced canine. Were this so, we would find PDC every time there was an anomalous or missing lateral incisor. Equally, it may not yet be discounted out of hand and certainly not on the basis of the evidence provided in the article in question.
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The purpose of this study was to determine the characteristics and occurrence of the ectopic eruption of the maxillary first permanent molar in a sample of growing Spanish children. A descriptive, observational, retrospective study was done using the radiographs of 509 consecutive patients, who were in the first phase of mixed dentition. A method was designed to evaluate the amount of pathologic resorption of the second maxillary primary molar and the impaction of the first permanent molar measured in millimeters. Statistical analysis of the studied variables was done using chi-square, analysis of variance, and Pearson correlation coefficient. The frequency of occurrence was 4.3% with no differences in both sexes. Of these, 36.4% were unilateral and 63.6% bilateral with a right:left relation of 3:1. Of the 36 ectopic molars, 69.4% self-corrected spontaneously. In such cases, the pathological resorption of the root of the second maxillary primary molar and its adverse clinical implications were persistent. The relation between self-correction and impaction was 2.27:1. The average impaction on the right side was 2.91 mm and 1.6 mm on the left side. Correlation between the magnitude of resorption and grade of impaction was not observed. Although resorption was found on grades I and II, spontaneous self-correction could occur without arch length loss. However, on grade III or more, therapeutic intervention has to be done. The benefit of early diagnosis and treatment of the maxillary first permanent molar is the prevention of the premature loss of second maxillary deciduous molar and the resulting malocclusion.
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A 12-year-old female with severe root resorption in the maxillary left central and lateral incisors (Case 1) and a 27-years-old female with the maxillary left canine erupted in the position of the central incisor (Case 2) were examined and treated. The findings and treatment procedures were as follows: 1. In Case 1, severe root resorption was caused by the ectopic eruption of the canine. On the lingual surface, the resorption had proceeded to a part of enamel. 2. In the Case 1, after the central and lateral incisors were extracted, the canine was carefully guided into the position of the lateral incisor. 3. In Case 2, treatment was not performed, because the chief compliant was carious lesions and the patient did not mind the malposition of the canine. 4. In both Case 1 and 2, the main reason of ectopic eruption of canines was presumably not a discrepancy between the tooth material and the basal arch length but the malposition of the tooth germ and/or abnormal eruption process of the canine.