Observation of a child with multiple submerged primary teeth

The authors presented a case report of a seven-year-old male with eight submerged primary molars and a primary lateral incisor. Two major treatment modalities, tooth extraction and observation, were reported. In this case we applied the two alternative modalities and observed the patient for five years. The permanent successors were in the process of almost normal eruption after the extraction of the submerged primary teeth; no eruption and more severe submerging were observed, however, in the permanent successors of the submerged primary teeth that were not extracted. These results suggest that submerged or impacted primary teeth should be extracted immediately when they are moderately or severely submerged.     

Sexual transmission of GB virus C/hepatitis G virus

Tooth transposition is a positional interchange of two adjacent teeth. The most commonly transposed tooth is the permanent canine with either the first premolar or lateral incisor. The records of 54 subjects with transposed canines, both maxillary and mandibular, were collected. Pretreatment study models of these subjects were matched with a similar number of models from unaffected individuals. Bucco-lingual and mesio-distal tooth widths, arch depth and arch width were measured on each model. Thirty-four subjects (63 per cent) were female. Thirty-seven (68.5 per cent) of the cases involved the maxillary arch and thirty-three (89.2 per cent) of these upper arch transpositions were of the canine and first premolar. In cases involving the lower arch the canine was invariably transposed with the lateral incisor. Peg-shaped lateral incisors, supernumerary and/or congenitally absent teeth occurred in 19 subjects. There were some small, but significant differences in the dimensions of some teeth, however there were no statistically significant differences in arch depths, arch widths and most tooth dimensions in subjects with and without transposed canines. These factors do not appear to be related to the development of canine transposition.     

The impacted maxillary canine. Further observations on aetiology, radiographic localization, prevention/interception of impaction, and when to suspect impaction

Adjacent anomalous or missing maxillary lateral incisors have been implicated in the aetiology of palatally displaced canines by not providing proper guidance to the canine during its eruption. However, a recent review of the literature suggests that the aetiology of palatally displaced canines is genetic in origin. The aetiology of labially impacted canines differs, being due to inadequate arch space. Vertex occlusal radiographs have been recommended for localization but have limitations, and a case is illustrated where this radiograph is deceptive. The prevention/interception of a palatally displaced canine by the extraction of the deciduous canine is best carried out as early as the displacement is detected, mostly soon after 10 years of age. Usually, prevention/interception will avoid the surgical and orthodontic treatment needed to align a palatally impacted canine and may help prevent resorption of the adjacent incisor root. Suspicions that an impaction could occur or has occurred arise a) before the age of 10 years if there is a familial history and/or the maxillary lateral incisors are anomalous or missing; b) after the age of 10 years if there is asymmetry in palpation or a pronounced difference in eruption of canines between the left and right side; or the canines cannot be palpated and occlusal development is advanced; or, the lateral incisor is proclined and tipped distally; and, on a panoramic radiograph of the late mixed dentition if the incisal up of the canine overlaps the root of the lateral incisor.     

Secondary alveolar bone grafting--five-year periodontal and radiographic evaluation in 100 consecutive cases

A prospective study of secondary alveolar bone grafting based on the Norwegian (Oslo) team approach has been conducted by the CLP Unit at the Princess Margaret Hospital for Children in Perth, Australia, since 1982. The 5-year results of 100 consecutive cases of uni- and bilateral cases are presented according to periodontal and radiographic parameters of tooth support. The vast majority of cases grafted (98%) resulted in the eventual eruption of the cleft side cuspid/lateral incisor within acceptable parameters of tooth support. The results confirm the predictability of this safe procedure when utilized within a strict clinical protocol involving the whole CLP team.     

Hypodontia of primary and permanent teeth in a sample of Saudi children

Hypodontia, congenitally missing teeth is more common in permanent than primary dentition. The present investigation reports the prevalence and pattern of hypodontia in the primary and permanent dentitions, excluding third molars in a sample of Saudi children. The sample consists of 1,300 children, aged 5 to 10 years of age. Clinical and radiographic examinations were performed. The prevalence of children with hypodontia was found to be 2.6 percent. The mandibular second premolar was the tooth most frequently absent and account for 45 percent of the total missing teeth. In primary dentition, the maxillary lateral incisor was the tooth most frequently absent (9%). A peg-shaped permanent maxillary lateral incisor was present in 0.7 percent of the sample. Congenitally missing teeth were almost equally distributed between maxillary (52%) and mandibular (48%) arches.     

Maturation alters the contractile role of calcium in ovine basilar arteries

OBJECTIVE: To investigate the distribution patterns of primary and permanent teeth in the cleft area and the numerical variation in teeth in unilateral complete cleft lip and palate (UCLP) patients. DESIGN: A survey of the dentition in UCLP patients. SETTING: Craniofacial Center, Chang Gung Memorial Hospital, Taipei, Taiwan. PATIENTS: 137 UCLP patients who met the following criteria: (1) have had at least one panoramic film taken, (2) the first panoramic film illustrates either primary or early mixed dentition. Evaluation of both permanent and primary dentition was available in 91 cases. MAIN OUTCOME MEASURES: Two evaluators performed independent evaluations of number and distribution of teeth in UCLP patients. The hypothesis that there are two odontogenic origins for maxillary lateral incisors was proposed to explain the occurrence of distribution patterns of dentition in the cleft area and to explain differences between primary and permanent dentition in UCLP patients. RESULTS: Four distribution patterns in the cleft area were identified in both the primary and the permanent dentition. In the primary dentition, placement of the lateral incisor distal to the alveolar cleft was the predominant pattern (pattern y, 82.4%), followed by absence of the cleft side maxillary lateral incisor (pattern ab, 9.9%), presence of one tooth on each side of the alveolar cleft (pattern xy, 5.5%), and placement of the lateral incisor mesial to the alveolar cleft (pattern x, 2.2%). In the permanent dentition, the most common pattern was the absence of the maxillary lateral incisor on the cleft side (pattern AB, 51.8%), followed by lateral incisor placement distal to the alveolar cleft (pattern Y, 46%), lateral incisor placement mesial to the alveolar cleft (pattern X, 1.5%) and the presence of one tooth on each side of the alveolar cleft (pattern XY, 0.7%). The discrepancy between the distribution patterns of primary dentition and permanent dentition successors is 57.1%. Variations in tooth number in both primary and permanent dentition of UCLP patients occurred most often in the cleft area. Abnormalities in the number of teeth (hypodontia or hyperdontia) outside the cleft area were more common in the permanent dentition than in the primary dentition (24.1% versus 4.4%). CONCLUSIONS: Four distribution patterns in the cleft area were identified in both sets of dentition. Our findings of distribution patterns in UCLP patients support the hypothesis that there may be two odontogenic origins for maxillary lateral incisors. Clinicians involved in managing the dentition of UCLP patients should consider the high frequency of numerical variation both in and outside the cleft area before starting dental treatment.     

Long-term assessment of early alveolar bone grafts using three-dimensional computer-assisted tomography: a pilot study

Fifteen patients with complete unilateral cleft lip and palate who had primary alveolar bone grafting were studied with computer-assisted tomography at a mean age of 12 years. Keeping the maxillary alveolar crest parallel to the plane of the scan, 1.5-mm cuts of the maxilla were made from the infraorbital rim to the gingival third of the crowns of the teeth. A single operator reformatted the data into three-dimensional images using the Maxiview 3200 computer workstation. This allowed examination of the position, size, and spatial relationship of the grafted area and quantification of the amount of bone coverage of root surface and bone height of the alveolus in or adjacent to the graft site. Ten patients showed a lateral incisor in the line of the cleft. The average bony coverage of these tooth roots was 76.5 percent. In the five patients in whom there was lateral incisor agenesis, the canine root had average bony coverage of 82.6 percent. The average height of bone at the lateral incisor was 8.7 mm; at the canine, 14.1 mm. In two patients in whom there was only 42 percent tooth root coverage, the teeth were still viable, stable, and without mobility. Computed tomographic (CT) scans of the 15 patients demonstrated good graft survival with adequate volume. The functional and aesthetic status of the dentition in the area of the cleft also was demonstrated.     

Removal of deciduous canine tooth buds in Kenyan rural Maasai

The removal of deciduous canine tooth buds in early childhood is a practice that has been documented in Kenya and in neighboring countries. This paper describes the occurrence, rationale and method of this practice amongst rural Kenyan Maasai. In a group of 95 children aged between six months and two years, who were examined in 1991/92, 87% were found to have undergone the removal of one or more deciduous canine tooth buds. In an older age group (3-7 years of age), 72% of the 111 children examined exhibited missing mandibular or maxillary deciduous canines. It was found that the actual removal of a deciduous tooth bud is often performed by middle-aged Maasai women who enucleate the developing tooth using a pointed pen-knife. There exists a strong belief among the Maasai that diarrhoea, vomiting and other febrile illnesses of early childhood are caused by the gingival swelling over the canine region, and which is thought to contain 'worms' or 'nylon' teeth. The immediate and long-term hazards of this practice include profuse bleeding, infection and damage to the developing permanent canines. A multi-disciplinary approach involving social anthropologists in addition to dental and medical personnel, is recommend in order to discourage this harmful operation that appears to be on the increase.     

Abnormalities of the maxillary incisors in children with cleft lip and palate

Dental anomalies of the maxillary anterior teeth were studied in seventy-seven children affected by unilateral and bilateral clefts of the lip and alveolar process, with or without involvement of the palate. As for the permanent lateral incisor in the cleft area, our results show that its congenital absence is the most frequent abnormality followed by anomalies in size and shape and supernumerary teeth. Enamel hypoplasia was found to affect the permanent central incisor on the cleft side more frequently. Early recognition of tooth abnormalities during the primary dentition phase for an interceptive treatment of potentially severe problems was emphasized.     

Successful treatment of brain metastases from ovarian cancer using gamma-knife radiosurgery

We report two cases of fully intruded tooth after facial fracture in adults. In the first case, the lateral incisor was intruded into the nasal cavity and slipped into the pyriform sinus during operation. The second case involved full intrusion of a molar into the maxillary sinus, resulting in infection. The importance of a thorough intraoral examination for patients with facial trauma is emphasized. All missing teeth should be accounted for to ensure that they have not dislodged inside the body. When full intrusion of a tooth is suspected, facial computed tomography scan may provide assistance with definite diagnosis. If an incisor is completely intruded into the nasal cavity, removal through the floor of the nostril should be considered.     

Surgical treatment of unilateral alveolar cleft

In this study, 16 cases of unilateral alveolar cleft with cleft lip and palate were repaired with autografts of cancellous bone (13 cases) or hydroxyapatite (3 cases). The grafts were covered by reflected mucoperiosteal flaps and a mucosal flap from the upper lip. Twelve of the thirteen cases were followed up for 1-5 years. Nine of whom using cancellous bone had bony continuity of the maxilla and 7 cases erupted permanent maxillary canines within the area of autografts. None of the 3 cases using hydroxyapatite erupted a canine tooth. The results showed that autograft was better than hydroxyapatite in terms of maxillary canine eruption.     

Glial tumor cell proliferation and immune response in the brain

Absence of the maxillary lateral incisor creates an aesthetic problem which can be managed in various ways. The condition requires careful treatment planning and a consideration of the options and outcomes following either space closure or prosthetic replacement. Recent developments in restorative dentistry have warranted a re-evaluation of the approach to this clinical situation. Factors relating both to the patient and to the teeth, including the presenting malocclusion and the effect on the occlusion, are considered. This review considers the possible options: no treatment; orthodontic space closure with canine modification; space maintenance and replacement of the missing tooth with denture, bridge (adhesive and conventional), or implant.     

Concomitant hypohyperdontia: simultaneous occurrence of a mesiodens and agenesis of a maxillary lateral incisor

A 13-year-old boy appeared for evaluation with a missing maxillary left lateral incisor. He also had an abnormally shaped tooth in the midline between his maxillary central incisors. This mesiodens had an incompletely developed root. The unusual association of these 2 anomalies is discussed as a possible transposition of the lateral incisor to the mesiodens position.     

Risk factors associated with incisor injury in elementary school children

This study examined risk factors associated with incisor injury in 3396 third and fourth grade school children in Alachua County, Florida. One of six orthodontists completed a standardized examination form for each child to assess severity of incisor injury, gender, age, race, skeletal relationships, morphologic malocclusion, incisor exposure, interlabial gap, TMJ sounds, chin trauma, and history of lower facial trauma. One in five (19.2%) exhibited some degree of incisor injury. This was limited to a single tooth in 73.1% of those with injury, while enamel injury predominated (89.4%). The majority of the injuries (75.4%) were localized in the maxillary arch, with central incisors the most frequently traumatized. Chi-square tests of association indicated that gender, race, school, orthodontist, history of lower facial trauma, chin trauma, profile, and maxillary and mandibular horizontal positions were associated with incisor injury (P < 0.05). Wilcoxon rank sum tests identified differences in age, overjet, time of screening, and interlabial gap between those with and without injury (P < 0.05). Results of logistic regression analyses indicated risk of incisor injury was greater for children who had a prognathic maxilla, a history of trauma, were older, were male, and had greater overjet and mandibular anterior spacing.     

Helicobacter pylori infection in congestive gastropathy

This report describes a family who demonstrated anomalies of tooth form and eruption of the lower second premolar. Observation of the second premolars remaining in the mother's and father's dentitions included ectopic eruption with impaction and substantial spacing between the first and second premolars. Four siblings were also examined--three boys aged 15, 14 and 12 years, and one girl aged 11 years. Anomalies of the second premolar recorded in the males and female include: congenital absence, ectopic eruption with impaction, delayed eruption and spacing. Associated anomalies included: congenital absence of other permanent teeth and spacing. It appears that the defect in tooth form and eruption is of a genetic origin, affecting both males and females. The condition(s) did not appear to be associated with a syndrome and the human papilloma virus lesions noted in all family members were not considered to be related to the dental defects. This family demonstrated two anomalies of the lower second premolar: congenital absence and disturbance in tooth eruption. The question raised by this case report is whether these two anomalies are inherited as separate traits or whether failure of tooth eruption is a variation in expression of the same genetic factor that results in oligodontia.     

Monitoring of WT-1 gene expression in peripheral blood of patients with acute leukemia by semiquantitative RT-PCR; possible marker for detection of minimal residual leukemia

The effect of implanting autogenous and xenogenous (Bio-Oss) bone transplants into metabolically active sites within beagle dog mandibles during permanent premolar tooth eruption was examined. Ten 14-week-old beagles were used. Before commencing the radiographic experiments, metal bone markers were placed in the caudal margin of the mandible at the age of 10 weeks. The deciduous first and third molar teeth were extracted and their sockets over the permanent second and fourth premolars were implanted with autogenous particulate enchondral iliac crest bone, autogenous particulate membraneous mandibular body bone, xenogenous bovine anorganic bone mineral spongiosa granules (1-2mm3) (Bio-Oss, Geistlich Pharma, Switzerland) of left empty. The third premolar served as control site. Standardized oblique lateral radiographs were taken once a week. A number of coordinates of defined points and structures were determined by means of a coordinate digitizing system. Animals were killed 4, 10 and 16 weeks after bone transplantation for histological examination of the transplantation sites. All premolars showed no delay in eruption or disruption of crown and root development. On histology, the Bio-Oss particles were not resorbed or integrated in the alveolar bone but were pushed forward into the gingiva. We have demonstrated that there is on difference in the eruption curve of the permanent premolars in the four groups (ANOVA P > 0.5) and that bone transplantation has no inhibitory effect on eruption (ANOVA P > 0.3) and crown development of the underlying permanent premolar but that Bio-Oss does not have the same resorbable or integrating capability as autogenous bone grafts.     

Clinical and microbiological aspects of the Sargon immediate load implant

A maxillary lateral incisor with severe periodontal destruction was extracted after forced eruption and was replaced with a Sargon Immediate Load Implant. The clinical and microbiological results of the case are reported. The Sargon Immediate Load Implant is an apically expandable, quintapodal, root-form dental implant, designed to be loaded immediately with a provisional fixed restoration in normal occlusion.     

Bone grafting at the stage of mixed and permanent dentition in patients with clefts of the lip and primary palate

Secondary bone grafting of a residual alveolar cleft has become a well established procedure. However, little attention has been paid to the benefits of these bone grafts in patients with clefts of the lip and alveolus only. This retrospective and comparative study includes 21 patients who had received a secondary or a late secondary bone grafting procedure from tibia and whose mean clinical and radiographic follow-up after the bone graft was 5.5 years. Eighteen patients treated without bone grafting served as controls. Length and width of cleft, presence or absence of permanent lateral incisor, size of nasal floor bony defect, and interdental alveolar bony height in the cleft area were investigated. The results showed that bone grafting was indicated particularly in wide clefts with missing lateral incisors. Eruption of a tooth close to the cleft was facilitated and the bony support for teeth neighboring the cleft was improved. In some cases, additional support of the alar base of the nose was achieved and closure of an oronasal fistula facilitated. A further advantage of bone grafting of clefts of the primary palate was that it might make it possible to insert a titanium implant carrying an artificial tooth in the cleft area.     

Cortical bone resorption secondary to endodontic-implant pathology. A case report

A single implant was inserted to replace the mandibular right lateral incisor in a 50-year-old Caucasian woman. After one month, an endodontic lesion formed on the adjacent canine, which went on to engulf the fixture. Even though endodontic therapy was instituted expeditiously on the canine, the implant exfoliated spontaneously the following month. There was a large radiolucency afterwards, suggesting resorption of both the labial and lingual cortical plates. A follow-up radiograph four months later revealed a residual detect along with delayed wound repair.     

Childhood cancer etiology: recent reports

Sinus cysts are epithelium-lined, fluid-filled cavities that can occur in the paranasal sinuses of horses. Extensive damage to the permanent tooth buds was a significant feature in this case. The sequellae of these abnormalities, although not apparent at the time of presentation, remain an important consideration for prognosis.