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Thirty-four children with lower premolar crowding were treated by extraction of second molars. Thirteen cases had mechanical lower arch treatment started not less than 6 months after extractions. The remainder had no treatment in the lower arch. The change in premolar crowding was measured, and the reasons why spontaneous alignment occurred in some cases and not in others were examined.
The hypothesis that palatally-displaced canines are associated with smaller than average lateral incisors or with congenital absence of adjacent lateral incisors was tested on a West of Scotland population. A retrospective study of the records of orthodontic patients attending Glasgow Dental Hospital was carried out. One-hundred-and-eighty-two subjects with palatally displaced canines were identified. The tooth length of lateral and central incisors was measured on radiographs and the crown widths of lateral incisors were measured on study casts. One-hundred-and-six extracted maxillary lateral incisors were examined to allow more accurate measurement of crown width and root length than was possible from radiographs. An association was sought between the size of the lateral incisor or its absence, the position of the adjacent maxillary canine, and between crown size and root length of the lateral incisor. The conclusions supported the hypothesis that there is a weak association between palatally displaced maxillary canines and lateral incisors of smaller than average crown width. There was weak support for the association between palatal canines and absence of the adjacent lateral incisor. There was no correlation between lateral incisor crown width and root length.
A mathematically determined technique which seemed to be valid for the calculation of crowding and spacing in arches with acceptable alignment, was tested on a series of arches with varying degrees of crowding and irregularity. Upper and lower study casts of 30 individuals with sufficient malalignment and crowding to warrant orthodontic treatment with fixed appliances were examined. Models were measured by three operators, using a reflex microscope interfaced to an IBM compatible PC and a customized calculation program. The degree of crowding was compared with a "clinical' assessment of each arch, in which the irregularity was measured directly using a steel ruler. Both the computer calculated and clinical values varied between observers, but the agreement between observers was better using the reflex microscope. Correlation coefficients ranged from 0.92 to 0.96 for the reflex microscope, and between 0.86 and 0.91 for the clinical assessment. Inter-observer agreement for the three operators was high: 0.93 for the reflex microscope and 0.87 where a ruler was used. This suggests that the computer program used to calculate the crowding was valid for the crowded arches under consideration.
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OBJECTIVE: To assess the pattern of distribution and age changes in odontomas in a Chinese population. METHODS: Forty cases of odontomas found in Chinese patients for which the clinical notes, radiographs and histopathology reports were available were classified as either compound or complex odontomas on the basis of their radiological appearance. Thirty-nine were wholly within the alveolus and one in the maxillary antrum. The overall size of the 39 alveolar odontomas and the size of their central opacities were measured digitally from periapical radiographs. RESULTS: Twenty-one of the 39 alveolar odontomas were complex (M/F = 8/13) and 18 compound (M/F = 10/8). The majority of cases presented in the second and third decades with an overall mean of 23 years. Thirty-eight per cent were found in the anterior maxilla. Complex odontomas had a predilection for the anterior maxilla and mandibular molar areas. The odontomas increased in size with increase in age. CONCLUSIONS: The pattern of presentation of this Chinese series is broadly in agreement with other series. Odontomas tend to increase in size with the age of the patient, suggesting continuing growth.
OBJECTIVES: To examine radiographically the relationship between the deciduous tooth and dentigerous cyst of the permanent successor during the transitional dentition. METHODS: From a retrospective review of all patients who visited our institution from April 1988 to August 2001, 70 patients under 16 years of age who had histologically confirmed dentigerous cysts that had developed from the central incisor to the second premolar were identified. These 70 patients were investigated using panoramic and periapical radiographs. RESULTS: In most cases (54 cases; 77.1%) the cyst was in the premolar region. Of the 54 premolars with dentigerous cysts, the overlying deciduous tooth had already been lost in 7 cases. Of the 47 remaining premolars with associated deciduous tooth, 35 (74.5%) had bone resorption of the periapical or bifurcation region, or irregular resorption of the associated deciduous tooth. Of the remaining 12 deciduous teeth with no periapical lesions, 9 had been treated with root canal therapy. Thus, 44 of these 47 cases (93.6%) had the possibility of inflammation at the deciduous tooth associated with the dentigerous cyst. Evidence from one case in the present study suggesting the process by which cyst development occurs is also given. CONCLUSION: Inflammatory change at the apex of the deciduous tooth may bring on a dentigerous cyst of the permanent successor.
OBJECTIVES: The diagnostic advantages of digital volume tomography (DVT) over conventional imaging and computed tomography are demonstrated in terms of the respective radiation exposure. The potential role for three-dimensional imaging in cleft lip and palate patients is illustrated on the basis of clinical examples. METHODS: The radiation exposure resulting from scans using a cone beam DVT (NEW TOM QR-DVT 9000, Marburg, Germany) was measured with an Alderson-Rando-Phantom (The Phantom Laboratory, New York, NY) and compared with that resulting from other standard imaging modalities. The patient sample consisted of young children with cleft lip and palate on whom orthodontic and surgical treatment was planned on an interdisciplinary basis at the University-Hospital of Heidelberg. RESULTS: Digital volume tomography allows high-quality three-dimensional imaging of the premaxilla region, with an effective equivalent investigation dose of (110 kV, 5.4 mA) 0.342 mSv based on ICRP recommendations. While the effective equivalent investigation dose for DVT is higher than that for standard imaging techniques (for example digital panoramic radiograph Orthophos Plus DS Ceph (66 kV, 8 mA) 0.016 mSv), it is much lower than that for a normal CT scan (e.g. Picker International Inc., Highland Heights, OH) adjusted at (spiral 130 kV, 125 mA, and 30 mA, 1.5 s) 2.27 mSv. Digital volume tomography provides extensive data important in clinical decision making. CONCLUSIONS: The clinical examples show the good applicability of DVT with a reduced radiation dose.
Pyle's disease (PD) or metaphyseal dysplasia is an extremely rare genetic disorder, transmitted as an autosomal recessive trait. The peculiarity of the disease is that the striking radiographic manifestations contrast with the relatively normal clinical features. The oral findings and radiographic features of the disease are not well documented. The present paper describes the radiographic features of Pyle's disease in a 17-year-old girl and draws attention to the findings in the jaw bones.
OBJECTIVES: To examine mesiodens with regard to their status, their influence on adjacent teeth and their alteration during the follow-up period. METHODS: From retrospective reviews of all patients who visited our institution from 1990-2001, we identified 200 patients (256 mesiodentes) who were shown to have mesiodentes on the basis of a periapical radiograph, a panoramic radiograph or an axial radiograph. RESULTS: The number of supernumerary teeth was one in 146 cases (73%), two in 52 cases (26%) and three in 2 cases (1%). Of 256 mesiodentes, the direction of the crown of the mesiodens was inverted in 172 (67%), in a normal direction in 69 (27%) and in a horizontal direction with regard to the tooth axis in 15 (6%). Of the 147 mesiodentes for which axial radiography was performed, 131 (89%) were located at a palatal site against the dental arch, 16 (11%) overlapped the dental arch and none were at a labial site. Of our 200 cases, a delay of eruption of the permanent central incisor was seen in 12 (6%), malposition or rotation of the central incisor in 5 (2.5%) and dentigerous cyst formation arising from mesiodens in 22 (11%). Marked movement of the mesiodens was seen in 10 cases during the follow-up period of 5-7 years. Some complication arising from mesiodens was seen in 19.5% of all cases in our research. CONCLUSION: Although mesiodentes are not caused by malocclusion, they may cause it. A long period of impaction of mesiodentes may bring about dentigerous cyst formation or movement of the mesiodentes.
A case of intracoronal resorption in a recently erupted mandibular canine in an 11-year-old girl is presented. Possible aetiology and approaches to treatment of such lesions are discussed.
A case is presented of a young boy with cleidocranial dysplasia, whose multiple supernumerary teeth prevented the eruption of most of his permanent teeth. His maxillary incisor teeth failed to erupt following removal of anterior supernumerary elements and orthodontic traction. Lack of abutment teeth and a difficult maxillary base made prosthetic treatment almost impossible. A horseshoe acrylic denture retained by milled crowns bonded to the deciduous canines and a maxillary first molar proved a very successful restoration. The problems of treating this group of patients are discussed.
The management of submerged deciduous teeth can present a dilemma for general practitioner and specialist alike. These teeth are often extracted to avoid potential problems. The recent literature, mainly publications in specialist journals of paediatric dentistry and orthodontics, suggests that a conservative approach is often preferable, particularly when the permanent successor is present. The purpose of this article is to review the aetiology, diagnosis and potential consequences of submerging deciduous molars; a second paper will discuss the treatment options available.
The previous article in this series dealt with the aetiology, diagnosis and potential consequences of submerging deciduous teeth. This paper will discuss the appropriate treatment options. The management is highly dependent on whether the permanent successor is present or absent. The degree of submergence and the age of the patient are also important factors for consideration.
A case is presented of a 25-year-old man with a submerged lower second deciduous molar and an impacted lower second premolar. Treatment was complicated by the relationship of the teeth to the inferior dental nerve, which necessitated extensive bone removal and mental nerve transposition to remove the submerged and impacted teeth. Early recognition and treatment of the submerging tooth might have prevented the need for such extensive surgery and morbidity at a later date.