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This case report describes the presence of 14 supernumerary teeth. Unique factors include symmetrical involvement in the canine and premolar regions of all four quadrants. The appropriate plan of treatment is left up to the reader.
The purpose of this study was to determine the relationship between the inclinations of second and third molars during a two- to 2.5-year period in patients treated orthodontically both with and without premolar extractions. Records of 37 first premolar extraction patients and 33 nonextraction patients were examined. The pretreatment and posttreatment panoramic radiographs were analyzed. The angles were measured between the long axis of the third molar and the occlusal plane and between the long axis of the third molar and the long axis of the second molar. Changes in third molar angulations from pretreatment to posttreatment for two groups were compared by Mann-Whitney U-test. Statistical analysis revealed that mandibular third molars showed an improvement in angulation relative to the occlusal plane in the first premolar extraction group.
Severe vertical growth pattern and open bites are frequent problems the orthodontist must resolve but require a proper diagnosis, treatment plan, timing, and mechanotherapy to be properly treated. A case report with these problems is presented.
Ehlers-Danlos syndrome (EDS) type VI is an autosomal recessive disorder of the connective tissue characterized by joint hypermobility, muscle hypotonia, scoliosis, and ocular fragility. In this case report, an EDS type VI patient with a skeletal and dental Class III malocclusion is presented and the clinical approach to his orthodontic problem is emphasized. A 17-year-old male patient presenting some major and minor symptoms of the syndrome was referred to our orthodontic department for diagnosis and treatment. The typical clinical signs confirmed the diagnosis of EDS type VI. He was a skeletal and dental Class III malocclusion patient (both mandibular protrusion and maxillary retrusion) with a noncontributory family history. He had severe crowding in the lower and upper dental arches with retruded incisors. His first treatment plan included orthognathic surgery, but because of the risks of bleeding and poor healing, we elected to treat the patient without surgery.
AIM: The purpose of this study was to determine the prevalence of dilaceration in a sample of Jordanian dental patients. METHODOLOGY: The data were collected from examination of radiographs from a random sample of periapical films. In all, 4655 teeth from 814 dental records at the Faculty of Dentistry, Irbid, Jordan were evaluated. The films were viewed using a magnifying lens and an X-ray viewer. A tooth was recorded as having a dilaceration towards the mesial or distal direction if there was a 90 angle or greater along its long axis using a small ruler aligned along the pulp of the tooth. Dilacerated roots towards the buccal or lingual directions were determined by evaluating the appearance of a round opaque area with a dark shadow in its central region, cast by the apical foramen in which the root canal gave a 'bulls-eye' appearance. RESULTS: Dilacerations were recorded in 3.78% of the teeth examined. Mandibular third molar teeth were the most commonly affected (19.2%) followed by mandibular first molars (5.6%). The maxillary anterior teeth and mandibular incisors were least affected exhibiting dilaceration in approximately 1% of teeth. Two-thirds of the dilacerations were in the mandible and approximately 5% were in anterior teeth. CONCLUSION: Dilaceration is not common, but it is an important dental anomaly that affects all teeth. Recognizing the condition will facilitate endodontic, orthodontic and surgical treatment.
AIM: To simultaneously analyse the expression of type I collagen, osteonectin and bone sialoprotein (BSP) in human dental pulp of different ages. METHODOLOGY: Cultured dental pulp fibroblasts (FP1 cell line), pulps from dental germs with incomplete root formation (n = 4) and pulps of erupted teeth with total root formation (n = 4) were used. Bone proteins were searched by immunohistochemistry and immunofluorescence using polyclonal antibodies and compared among the three groups assessed. RESULTS: Immunohistochemistry detected the three proteins in dental pulp tissue, as it labelled extracellular matrix, predentine and odontoblasts. The BSP label was weaker, when compared to both type I collagen and osteonectin. The presence of type I collagen was more evident in pulps from erupted teeth, when compared to germ dental pulps. On the other hand, a strong expression of osteonectin in germ dental pulps was observed. CONCLUSIONS: Regardless of the degree of maturation, dental pulps present type I collagen, osteonectin and BSP in the extracellular matrix (ECM) and in the odontoblastic layer. Thus, the results suggest that these proteins are related to the production and mineralization of dentine.
Primary failure of eruption is a condition where there is eruption failure in the permanent dentition with no obvious mechanical cause. It has previously been reported in the literature as a cause of posterior openbite, with a varying degree of familial inheritance. This case report describes two sisters that experienced eruption failure in the permanent dentition, most notably of the first and second molars, with greater severity in the younger sister. Teeth were exposed in both patients and orthodontic traction was applied with little or no success. The report provides further evidence of the genetic contribution to the aetiology of this condition and also highlights the problems in attempting treatment, including exposing to the oral environment teeth that are infra-occluded and difficult to clean effectively.
The aetiology of submerged primary molars is not known and optimal treatment has still not been established. If submerged primary teeth are left untreated, the occlusal consequences are space-loss due to tipping of adjacent teeth and/or overeruption of the opposing teeth. Normally, treatment consists of extraction of the deciduous teeth or observation for normal exfoliation. Here we report a case where the submerged primary molar was extracted surgically after space-loss had been regained.
A 2-year-and-6-month-old Japanese girl with delayed eruption of a maxillary right primary canine and disturbance in the development of maxillary right primary molars was examined. The crown of the maxillary right first primary molar was severely decayed and hypoplastic. The periodontal tissues on the maxillary right posterior region were swollen and slight erythrogenic change was observed. Radiographic examination revealed a disturbance in the development of the permanent successor and the primary teeth in the maxillary right quadrant. According to the history, the maxillary right first primary molar had erupted on day seven after birth. It is suggested that the disturbance in development of the permanent successor and the primary teeth was secondary to osteitis caused by infection of the neonatal tooth. Appropriate dental treatment had not been administered for more than two years because the neonatal molar had not been diagnosed.
This report describes the case of an 8-year-old girl with focal dermal hypoplasia. As well as deformities affecting her hands and feet she had marked facial asymmetry, one diminutive eye and coloboma affecting the other. Intraorally, the patient had papillomas at the base of the tongue and tonsils. Her teeth showed irregular spacing, hypodontia, enamel hypoplasia, anomalous tooth form and delayed development. Radiographically, several teeth showed abnormal form. The patient's previous surgical experiences had adversely affected her behaviour and treatment has been limited to patient motivation and oral hygiene instructions, acclimatization, and simple restorative care.
Carbamide peroxide bleaching agents have raised important questions on their potential adverse effects on the structure of enamel. The purpose of this study was to examine the effects of three carbamide peroxide bleaching agents in different concentrations (10, 16 and 35%) on the structure of enamel. Forty enamel slabs prepared from human third molars were divided equally among four groups. The specimens in the first and second group were subjected to 10% or 16% carbamide peroxide for 8 h per day for 6 weeks. Thirty-five percent carbamide peroxide was applied to the third group for 30 min a day for a 4 day period according to the manufacturers recommendation. The fourth group served as the control and was kept in artificial saliva during the test period. At the completion of the treatment, all the specimens were examined by infrared absorbtion spectroscopy and X-ray diffraction analysis. The results revealed that 10% or 16% carbamide peroxide did not seem to effect the structure of enamel, whereas 35% carbamide did affect the structure. The use of lower concentrations of carbamide peroxide (10-16%) is recommended over higher concentrations (35%) to avoid changes to the enamel.
PURPOSE: We report the prevalence of periodontal probing depth (PD) as a clinical measure of the extent of periodontitis associated with asymptomatic third molars at the initial examination in a cohort of patients enrolled in an institutional review board-approved longitudinal clinical trial. PATIENTS AND METHODS: Three hundred twenty-nine healthy patients were enrolled during a 30-month period. Full mouth periodontal probing that included third molars was conducted to determine periodontal status. Panoramic radiographs were taken to assess the degree of eruption of the third molars and the angulation of third molars compared with the adjacent second molar. Vertical bitewing radiographs were analyzed to detect alveolar bone levels relative to the cementoenamel junction on the distal of second molars. RESULTS: Twenty-five percent (82 of 329) of all enrolled patients, and 34% (14 of 41) of black patients, had at least one PD equal to or greater than 5 mm on the distal of a second molar or around a third molar. PD equal to or greater than 5 mm was associated with periodontal attachment loss of at least 1 mm in every patient; PD equal to or greater than 5 mm was associated with attachment loss equal to or greater than 2 mm in 80 of 82 patients. A higher proportion of patients 25 years old or older had a PD equal to or greater than 5 mm on the distal of second molars or around third molars compared with patients younger than 25 years (33% vs 17%, P =.002). The distals of second molars and third molars in the mandible were affected more often than in the maxilla (25% vs 5%, P =.0001). CONCLUSIONS: Our data indicating that 25% of patients with retained asymptomatic third molars have considerable periodontal pathology in the third molar region were unexpected. National epidemiologic surveys indicate a much lower rate of periodontitis in the population younger than 35 years.
We present a case in which the patient had both bilateral shortening of the roots, and hemifacial atrophy. As far as we know, this combination has not been described before.
A case is presented of simultaneous adjacent odontogenic keratocyst and dentigerous cyst occurring in the same quadrant. Their in vivo behaviour, influence and effect on each other, surrounding tissues and on tooth development over a period of 4 years are described. This unique case may further advance the understanding of the behaviour of the odontogenic keratocyst in vivo.
BACKGROUND: Odontogenic tumors are a heterogenic group of neoplasias of the oral cavity, whose biological behaviour reaches from true hamartomas to highly malignant tumors. PATIENT: We describe the case of a 4 year old caucasian girl presenting with eruption disturbance of a primary tooth and corresponding maxillary tumor. After surgical removal of the mass, histological examination classified the tumor as ameloblastic fibroodontoma. This very rare neoplasm is of odontogenic origin. DISCUSSION: Following our case report, the variety of odontogenic tumors regarding tumor biology, clinical symptoms and therapeutic options in childhood are discussed. CONCLUSION: In case of complaints or clinical symptoms paediatricians should take the possibility of such neoplasias into consideration.
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25 patients with 35 retained upper canines were examined by high resolution CT; only 5 patients did not show evidence of damage to the remaining teeth. 8 patients showed resorption related to medial and lateral incisors. 19 teeth were in contact with the crowns of the displaced canines and were therefore liable to damage. The average extent of the resorption was 4.5 mm. Contact between teeth was demonstrable by means of two consecutive CT cuts.
The occurrence of tooth anomalies in association with failure of the first and second molars to erupt was assessed in a sample of 1520 nonsyndromic subjects with uncrowded dental arches (mean age, 14 years 4 months) and compared with the prevalence rate calculated in a matched control group of 1000 subjects. The tooth anomalies examined included infraocclusion of deciduous molars, palatal displacement of maxillary canines, rotation of maxillary lateral incisors, aplasia of second premolars, and small size of maxillary lateral incisors. Associations among arrested eruption of first and second permanent molars and anomalies in tooth eruption and position (infraoccluded deciduous molars, palatally displaced canines, rotated maxillary lateral incisors) were highly significant (P <. 001). No significant association was found among the occurrence of molar eruption disturbances, aplasia of premolars, and small-sized laterals. These findings point to a common biologic cause for the appearance of failure of eruption of molar teeth and other disturbances in tooth eruption and position, most likely under genetic influence.