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The purpose of the present study is to see whether we follow global guidelines for operative procedures and diagnoses for impacted and retained teeth, and to compare these results with older results in Croatia. Operative protocols from Department of Oral Surgery, School of Dental Medicine, Zagreb in the period from 1997 till 1999 were used in the present study. 4756 patients were operated (total of 4857 diagnosis were set). Of all diagnoses, 24.89% (N=1209) belongs to dens impactus, 5.13% (N=249) to dens semiimpactus, 6.05% (N=294) to dens retentus and 0.64% (N=31) to dentitio difficilis. These four diagnoses make 36.71% of all 4857 set diagnoses. Most commonly impacted teeth are: 8- (38.64%), -8 (35.88%), 8+ (10.9%) and +8 (9.29%). Most commonly retained teeth are: 3+ (19.1%) and +3 (18.8%), while in the remaining two diagnoses -8 and 8- are most commonly diagnosed and operated teeth. Impacted teeth are in 97.90% of the cases operated by alveolotomy procedure. With semiimpacted teeth alveolotomy was conducted in 94.12% cases, and 5.10% of such teeth were extracted. With retained teeth alveolotomy was conducted in 65.21%, corticotomy in 23.01% and extraction in 8.77% of the cases. With dentitio difficilis alveolotomy was applied in 46.88%, extraction in 37.50%, circumcision in 9.38% and corticotomy in 6.25% of the cases. Intra muscular corticosteroids (Dexamethason) were used in 2.80% of the cases, most commonly with dens impactus and dens retentus diagnosis. PHD was done in 4.21% cases. Although its use is on the increase, Dexamethason is still rarely used in everyday practice, despite global guidelines for the postoperative use of corticosteroids. PHD analysis is used most commonly with retained teeth since they usually come with follicular cysts. Anesthesia without epinephrine was used in only 1.80% of the operating procedures, because the epinephrine solution used at Oral Surgery Department is 1:160000.

Numb chin syndrome is a sensory neuropathy in the distribution of the mental or inferior alveolar nerve. It may occur in benign disease, both systemic and dental in origin. It is also an under appreciated sign of malignancy. We present six cases from our experience highlighting the varied presentation and briefly review the aetiology, pathogenesis and management of numb chin syndrome and stress its importance with regards to the association with malignant disease.

In Western European countries, dentists use standardized procedures, rather than individualized risk assessment, for routine oral examinations. The predictive hypothesis was that guideline implementation strategies based on multifaceted interventions would be more effective in patient care than the dissemination of guidelines only. A cluster-randomized trial was conducted, with groups of general dental practitioners (GDPs) as the unit of randomization. Patients were clustered within practices and prospectively enrolled in the trial. Patient data were collected from registration forms. The primary outcome measure was guideline-adherent recall assignment, and a secondary outcome measure was guideline-adherent bitewing frequency. The interventions consisted of online training, guideline dissemination, and educational sessions. For low-risk patients, guideline-adherent recall increased in the intervention group (+8%), which differed from the control group (-6.1%) (p = 0.01). Guideline-adherent bitewings showed mixed results. We conclude that multifaceted intervention had a moderate but relevant effect on the performance of GDPs, which is consistent with other findings in primary care.

Background: The authors conducted a literature review regarding the clinical and radiographic diagnoses of impacted maxillary canines, as well as the interceptive treatment (including surgical and orthodontic management) used to prevent or properly treat impacted canines., Types of Studies Reviewed: The authors reviewed clinical and radiographic studies, literature reviews and case reports. They selected only studies that pertained to the prevalence, etiology and diagnosis of impacted maxillary canines, as well as the most recent studies regarding surgical and orthodontic techniques for the proper management of impacted maxillary canines., Results: Impacted canines can be detected at an early age, and clinicians might be able to prevent them by means of proper clinical diagnosis, radiographic evaluation and timely interceptive treatment. Surgical techniques that can be used to manage impacted canines vary depending on whether the impactions are labial or palatal, and orthodontic techniques vary according to clinical judgment and experience., Clinical Implications: Canine impaction is a common occurrence, and clinicians must be prepared to manage it. With early detection, timely interception, and well-managed surgical and orthodontic treatment, impacted maxillary canines can be erupted and guided to an appropriate location in the dental arch.

Objective: The aim of this study was to evaluate and establish any similarity between the associated symptoms, pathologies, positions, and angulation types of bilateral occurring mandibular third molars among a group of young adult patients., Study Design: A total of 342 patients (167 females, 175 males), aged between 20 and 25 years (mean: 22.2, SD: 1.8) participated in the study. Clinical and radiographic examinations were performed. Eruption status, mucosal and bony coverage type, presence of pain, pericoronitis, suppuration, ulceration, caries in third molar, distal caries in second molar, bone loss, root resorption, or cyst or tumor formation was investigated in addition to the position and the angulation of each tooth. Patients having at least one completely or partially erupted mandibular third molar were classified as group 1 and patients having bilateral impacted mandibular third molars were classified as group 2., Results: No significant difference was found between the symptoms and pathologies related with the mandibular right third molar (RM) and the left third molar (LM) among both groups and genders (P > .05). In the total sample, no significant difference was found between the RM and the LM in terms of mucosal coverage type, bony coverage type, and position both in group 1 and group 2 (P > .05); but gender had an influence on the bony coverage type and ramus distance of the RM and the LM in group 2 (P < .05). In the total the sample, symmetry was present for horizontal or distoangular and vertical or distoangular angulations in group 1 and group 2, respectively. Gender was found to also have an impact on angulation symmetry., Conclusion: In most cases, a similarity was present between the symptoms and pathologies related with the bilateral mandibular third molars; but symmetry in position and angulation differed according to eruption status, angulation type, and gender.

The aim of this study was to assess the severity of any underlying malocclusion in subjects presenting for treatment of a palatally impacted canine (PIC) using a modification of the Dental Health Component (DHC) of the Index of Treatment Need (MIOTN), which does not factor in the impacted canine. The pre-treatment study models of 54 subjects who had previously undergone surgical exposure of a PIC, followed by fixed appliance orthodontic alignment, were scored independently by two examiners on two occasions using the MIOTN system. Unweighted kappa statistics revealed good intraoperator agreement for the two examiners and a moderate level of interexaminer agreement. Forty-six and 41 per cent of the sample still scored either an MIOTN grade 4 or 5 (i.e. a great or very great need of orthodontic treatment). However, 20 and 25 per cent of the subjects were graded with a MIOTN score of 1 or 2, indicating little or no need for treatment when the PIC was not taken into consideration. This finding emphasizes the importance of early diagnosis of an impacted canine and the need to institute interceptive measures where necessary, as up to 25 per cent of patients might otherwise require no other orthodontic treatment.

Dentoalveolar ankylosis is a local etiologic factor of malocclusion that can have deleterious effects on normal dental development. Therefore, it is of paramount importance to diagnose the problem as early as possible so that interception can be performed at the correct time. This case report demonstrates the consequences of late diagnosis of dentoalveolar ankylosis and discusses its effects on development of the occlusion and how it can increase orthodontic biomechanical complexity and treatment time.

Objective: To evaluate treatment outcome in patients with second molar impaction and retention., Materials and Methods: A total of 135 second molars, 65 in the maxilla and 70 in the mandible were collected from 87 patients (45 girls and 42 boys) with a mean age of 15 years (range: 11- 19 years). Available patient records, x-rays, study casts, and photos were studied. The mean follow-up period was 22 months (range: 4-106 months)., Results: A total of 166 second molars were diagnosed as impacted, 24 as primary and 5 as secondarily retained; 80% of the second molars were orthodontically or surgically treated. In more than half of the treated patients the second molars failed to erupt into a proper position. Surgical exposure of the retained or impacted second molar was the treatment found most successful (71%). The least successful treatment (11%) used the third molar to replace the second molar after the second molar was extracted. No clear difference in treatment outcome could be detected between the impacted and the primary or secondary retained teeth. However, a clear difference was found between the impacted and the primary retained second molars regarding treatment strategy: 9% of the impacted and 67% of the primary retained teeth were left untreated. Dental crowding was found in 70% of the patients., Conclusion: In more than half of the treated patients the second molars failed to erupt into a proper position. The most common treatment given (extraction of the second molar) was the least successful.

Objective: The purpose of this study was to report on the clinical, radiographic, and histological dental findings and the resulting treatment load in a five-generation family with amelogenesis imperfecta (AI)., Material and Methods: Thirteen affected and 15 unaffected individuals were examined clinically and radiographically. In addition, four exfoliated deciduous teeth were examined by scanning electron microscopy and microradiography., Results: The mode of inheritance of AI was autosomal-dominant. At eruption, most of the tooth enamel was yellow, lacking translucency, and prone to gradual loss in subjects with AI. Post-eruptive breakdown of enamel was extensive in accordance with the histological observations of hypomineralized and porous enamel. Extensive enamel loss and discoloration were observed in older affected individuals. The treatment need had been extensive: 76.2% of the total number of teeth present in affected individuals had been treated with partial or full coverage compared to 1.7% of the teeth in unaffected relatives. Unaffected individuals had more endodontically treated teeth than AI-affected relatives. Adjunctive findings, e.g. tooth agenesis, tooth impaction, pulp stones, enlarged follicular space, and taurodontism, were rare in both groups., Conclusions: Affected family members had the hypocalcified type of AI, which is characterized by severe hypomineralization, extensive post-eruptive loss, and discoloration of the enamel. Adjunctive findings were rare. Individuals with the hypocalcified type of AI have an extensive restorative treatment load compared to unaffected relatives.

Unlabelled: Supernumerary teeth can present in various forms and in any region of the mandible or maxilla, but have a predisposition for the anterior maxilla. They can cause a variety of complications in the developing dentition. This article reviews the epidemiology, clinical features, diagnosis and options for the management of supernumerary teeth., Clinical Relevance: Early diagnosis and appropriate management can minimize the potential complications caused by supernumerary teeth. Dental practitioners should be aware of their clinical signs and the treatment options.

Aim: The aim of this report is to present a clinical case of impaction of a maxillary left central incisor in a mixed dentition caused by the presence of an odontoma as well as a review of the pertinent dental literature., Background: Knowledge of the normal tooth eruption patterns is essential for the identification and appropriate treatment of deviations in eruption that may endanger physiologic development. A delay in time between the exfoliation of a deciduous tooth and the eruption of its permanent successor may be related to a disorder known as dental retention. This occurs when tooth eruption does not occur within a normal time frame, the tooth is not present in the dental arch, and there is no potential for eruption due to the presence of a completely formed root or when the homologous tooth has been erupted for at least six months with complete root formation., Report: A 10-year-old boy in the mixed dentition stage presented with an impacted maxillary left central incisor due to the presence of an odontoma. Treatment included the surgical removal of the lesion and the follow up of the spontaneous eruption while a partial fixed appliance was used to recover the space of the missing tooth. Since spontaneous eruption failed to occur within the expected time frame, surgical exposition of the crown and bonding of an orthodontic appliance for traction was done to facilitate eruption., Summary: The incisor was integrated to the dental arch without any root or periodontal sequelae. The treatment was considered a success, since both health and aesthetics of the smile were recovered. The importance of the clinical and radiographic diagnosis of the retention of a permanent tooth associated with a pathological entity should be emphasized. The participation of a multidisciplinary team to accomplish the appropriate treatment of such patients is extremely relevant because of the esthetic and functional ramifications of a missing anterior tooth as well as the psychological well-being of the individual.

Eruption failures in the maxillary frontal region occur during the mixed dentition period. Dislocation and impaction of central incisors are diagnosed during or at the end of the early mixed dentition stage. These failures can be caused by crowding, premature loss of deciduous teeth, trauma or supernumerary teeth. Occasionally, a preventive orthodontic treatment is desirable to release the obstructed eruption path of a canine. Sometimes, a surgical intervention may be indicated to expose an obstructed central incisor and to remove supernumerary teeth. Retention and impaction of canines are generally discovered late in or after the late mixed dentition stage. In the agenesis of the lateral incisors or peg-shaped teeth, there is frequently impaction of the canines. General dental practitioners must be alert for possible deviations in the pattern of change in dentition right from the early mixed dentition period. Conventional two-dimensional radiographs can sometimes unjustifiably suggest a bad prognosis of an impacted tooth. Cone-beam CT scanning, which gives a three-dimensional image, can provide important additional diagnostic information.

Disturbances during morphodifferentiation of tooth germs are rare in the permanent dentition. Reasons for abnormalities are: trauma (fighting, falling, any sport activity) occurring during the eruption; mechanical blockage of the path of eruption by neoplasms; cysts; supernumerary teeth; therapeutic irradiation of the area; and orthodontic treatment. Abnormalities are classified as dilaceration, extra root formation, double root formation, concrescence, rizomegali and hypercementozis. In this article, three different root abnormalities are presented.

Cleidocranial dysplasias is an autosomal dominant disorder that presents with skeletal dysplasia. The dental manifestations are mainly delayed exfoliation of primary teeth and delayed eruption of permanent teeth, with multiple impacted supernumeraries. This report addresses the complex nature of the treatment modalities. In our patient, surgical exposure of unerupted teeth was done with orthodontic traction. Post-surgical follow-up was uneventful.

Concrescence is an uncommon developmental anomaly that may influence exodontia as well as periodontal, endodontic, orthodontic and even prosthodontic diagnosis and treatment planning. Unexpected complications arising from this condition may lead to legal complications. To minimize risk and adverse outcome of treatment, consideration should be given to recognizing this condition and, possibly, modifying treatment planning. This article presents an unsuspected case of concrescence with a review of the literature.

Supernumerary teeth are a relatively frequent disorder of odontogenesis characterized by an excess number of teeth. Mesiodens is the most common type of supernumerary tooth found in the premaxilla between the two central incisors. They can be supplemental (resembling natural teeth), conical, tuberculate or molariform. We present the case of a 19 year-old girl who presented with a mesiodens of an unusual morphology and multiple impacted supernumerary teeth not associated with any syndrome.

Concrescence of teeth is a condition showing a union of adjacent teeth by only cementum. In all the previously reported cases, the union has been observed between the roots of the affected teeth. Here, we describe the first case that showed a concrescence of the crown of an impacted tooth and the roots of the erupted tooth. In addition, we discuss how this condition, especially the deposition of acellular cementum on the crown, occurred.

Aim: Surgical extraction of impacted Mandibular third molar is one of the commonest dentoalveolar surgeries. This study aims to investigate the pattern of presentation of impacted Mandibular third molars, the indications for extraction and the post operative complications after this procedure at the Lagos University Teaching Hospital., Patients and Methods: A prospective study of patients who required surgical extraction of impacted Mandibular third molars between October 2003 and May 2006 at the Lagos University Teaching Hospital (LUTH) was carried out. Data collected included Patients' age, sex, indication for extraction, tooth/teeth extracted. Also collected were the types of impactions and surgical morbidity (postoperative complications). The data collected were evaluated using the SPSS for windows (version 11.0: SPSS Inc, Chicago, IL) descriptive analysis was used as appropriate., Results: Three hundred and thirty one (331) Mandibular third molars were extracted from 329 patients. The ages ranged from 17 to 55 years with a mean of 26.63 (+/- 7.39). There were 153 males and 176 females; with male to female ratio was 1:1.15. Recurrent Pericoronitis was the most common indication for extraction (209 extractions; 63.1%), while the mesioangular impaction was the most common angulation (117 impactions; 53.4%). 47 (14.2%) of the extractions had postoperative complications and dry socket which occurred in 25 (53.2%) cases was most common., Conclusion: The pattern of presentation of impacted Mandibular third molars is similar to earlier reports. The morbidity is however higher than the average value in the literature, it however does not seem to increase with increasing age.

Meniere's disease has been ascribed to a disturbance of the vestibular apparatus or its connections within the Central Nervous System. Several hypotheses have been advanced regarding its aetiopathogenesis, but treatments based on these hypotheses have often not produced the desired results. Two cases are described where common intraosseous pathology within the lower half of the functional face, i.e. within the mandible and maxillae, was shown to be the cause of Meniere's disease. Together, these cases contributed to the chance discovery of the comparative compression sign which, when able to be elicited, may be considered pathognomonic for a dental origin of the condition. It is suggested that, in addition to other hypothesized causes involving the vestibular apparatus and the CNS, Meniere's disease and vertigo may also be caused by common, readily-identifiable intraosseous dental pathology. These unexpected findings open up a new field for future research.

Background: Patients who suffered from impacted teeth increase in number every year They have a wide range of ages and also have symptomatic or asymtomatic impacted molar teeth. The most common symptoms were pain, dental carious problem, gingivitis and oral infection. This was different in each patient., Objectives: 1) to study the relation of age and common symptoms among patients with an impacted molar tooth. 2) to study the type of impacted molar tooth, Setting: Department of Dentistry, King Chulalongkorn Memorial Hospital, Research Design: Descriptive study, Material and Method: Six hundred and eighty patients who had an impacted tooth were treated at the Department of Dentistry, King Chulalongkorn Memorial Hospital from June 2002 to December 2005. They were categorized in 5 age groups, namely: < or = 20 years, 21-30 years, 31-40 years, 41-50 years, and > 50 years. Data was collected from history taking, oral and radiographic examinations. The details of the patient's data and tooth's data were recorded, i.e., gender, age, location and type of the impacted tooth including the details of symptoms including pain, dental caries, gingivitis, oral and throat infections., Results: Four common symptoms including pain, dental caries, gingivitis and oral infection were recorded in each age group. The Pearson Chi - square test showed that in the statistical difference of variation of ages, p-values were 0.001, 0.037, < 0.001, 0.036 for the symptoms of pain, dental carious problem, gingivitis, and infection, respectively. One hundred and seventy eight maxillary third molar impacted teeth and 502 mandibular third molar impacted teeth were found. The impacted molar teeth were classified into five types. There was a mesioangular (402 cases), horizontal (125 cases), vertical (116 cases), distoangular (30 cases) and linguoversion or buccoversion impacted tooth (7 cases). There was a significant difference of type of impacted tooth, p-values were 0.013, 0.002 for the symptom ofpain and oral infection, respectively, but non significant difference for the dental carious problem and gingivitis, p-values were 0.702, 0.367 respectively., Conclusion: The most frequent age group of patients with an impacted molar tooth was 21-30 years. Patient under 30 years had dental carious problems more than other symptoms, while gingivitis was more common in the older group. There was a statistical significant difference of variation of age and symptom. The most common type of impacted molar tooth was mesioangular type.

We report a case of osseous dysplasia (OD) showing extremely rare clinical features. A 37-year-old Japanese woman was referred to our clinic complaining of a left alveolar bony swelling at an impacted canine. Radiographic examinations revealed a mixed radiopaque lesion involving the impacted left canine and also revealed an impacted left wisdom tooth with a cystic change and a clear radiopaque lesion suspected to be odontoma. All the extracted upper teeth and odontoma showed hypercementosis and the canine was fully involved in it. Histopathologically, they showed the same features and were diagnosed as OD. The findings of multiple OD from incompletely erupted teeth and odontoma in our case may well show that OD can arise from any tooth with periodontal ligaments and that focal OD can show expansive growth like the ossifying fibroma.

Treating an impacted maxillary canine requires identifying its exact position; this can pose a challenge to both orthodontists and oral surgeons. The purpose of this article is to present a new method for diagnosis and treatment planning of maxillary canine impaction by using computed tomography combined with rapid prototyping. Computed tomography image files of a patient with tooth 13 impaction were edited to produce, by means of rapid prototyping, an anatomic model of the maxillary teeth and a single attachment model that was later used to fabricate a metal attachment to be bonded to the impacted tooth. The dental model was used in the diagnosis and orthodontic treatment planning, and to communicate with the patient and his parents. The model showed the exact anatomical relationship between the impacted tooth and the other teeth; it was the main aid in intraoperative navigation during surgery to expose the tooth. The metal attachment built from the prototype was bonded to tooth 13 during surgery. Prototyping could become a new tool for fabricating brackets and other precision accessories for specific needs. Dental models made with rapid prototyping could become the diagnostic procedure of choice for evaluating impacted maxillary canines.

Impaction of first permanent molars is an uncommon condition and few cases are reported in the literature. Two cases of a mandibular and a maxillary impacted first permanent molar are presented, their aetiology and treatment alternatives are discussed.

Binkley and Johnson first reported this syndrome in 1951. But it was in 1960, Gorlin-Goltz established the association of basal cell epithelioma, jaw cyst and bifid ribs, a combination which is now frequently known as Gorlin-Goltz syndrome as well as Nevoid Basal Cell Carcinoma Syndrome (NBCCS). NBCCS is inherited as an autosomal dominant trait with high penetrance and variable expressivity. NBCCS is characterized by variety of cutaneous, dental, osseous, opthalmic, neurologic and sexual abnormalities. One such case of Gorlin-Goltz syndrome is reported here with good illustrations.

Early diagnoses and prevention of maxillary cuspid impactions can save much time when treating patients orthodontically. Effective recognition and interception requires initial diagnosis at the dental age of about eight years. When a cuspid bulge is absent, diagnosis with oriented lateral and frontal radiographs is advocated and has been shown to aid in the positive recognition of lingually positioned unerupted maxillary cuspids at risk for impaction. Recommended treatment is early removal of maxillary deciduous cuspids and perhaps deciduous first premolars. Lateral and frontal radiographs should be taken at six-month intervals to follow the intra-bony eruptive movement of the permanent cuspids until they have entered the oral cavity. Failure to diagnose and intercept the potentially impacted cuspid often leads to serious malpositions that require extensive mechanical therapy for proper alignment and good function.

The aim of this study was to identify a model of cephalometric variables for early diagnosis of the displacement of upper permanent canine and early prognosis of upper canine impaction. Postero-anterior (PA) cephalograms of 43 subjects (22 males and 21 females) with different types of malocclusions in the mixed dentition were analyzed at the time of first observation (mean age 8 years and 5 +/- 9 months). All subjects were reevaluated at the mean age of 14.3 years. At this time the sample was divided into 2 groups according to the presence of canine impaction: nonimpacted canine group (31 subjects) and impacted canine group (12 subjects). Stepwise variable selection on the measurements at the time of first observation identified 2 predictive variables on PA cephalograms, ie, the distance between the center of the canine crown and the midsagittal plane (A3cc to Cg Vertical) and the distance between the jugal process and the midsagittal plane (J to Cg Vertical). The closer the canine crowns to the midsagittal plane and the larger the posterior portion of the hemimaxilla, the higher the probability of canine impaction. Discriminant analysis assigned a classification power of 95.3% to the predictive model. On the basis of the equation generated by the multivariate statistical method, impaction of the maxillary canine for each new case at the age of 8 years can be predicted. The importance of PA cephalograms in the diagnosis and prediction of canine eruption disturbances is emphasized.

Adenomatoid odontogenic tumor (AOT) is an uncommon tumor of odontogenic origin, characterized histologically by the formation of ductlike structures with amyloid-like deposits. Histogenesis of AOT is still uncertain and it is often considered as a hamartomatous lesion rather than a true neoplasm. AOT has a benign behavior and conservative surgical enucleation or curettage is sufficient. We report a case of AOT in a 15-year-old female who presented with left-sided jaw swelling with tooth resorption. Histopathology revealed intraosseus follicular variant of AOT. A brief review of literature is also discussed.

A case of eruption cyst in the right maxilla of a 40-year-old female is reported.

Aim: Significant delay in tooth eruption may be observed in many orthodontic patients. This delay may lead to complications, such as devitalization, ankylosis, external root resorption, injury to the adjacent teeth, and mucogingival problems. These complications may result in prolonged treatment time, esthetic deformities, damage to the periodontal tissues, and tooth loss. This report investigates the special considerations needed in treating such cases., Methods: Combined orthodontic and surgical treatment can be used in managing teeth exhibiting significant delay in eruption., Results: A high rate of success can be achieved in terms of esthetics, occlusion, and periodontal health., Conclusion: Nontraumatic surgery, adequate control of gingival inflammation, and use of minimal orthodontic forces may ensure a higher percentage of success and prevention of problems associated with teeth exhibiting significant delay in eruption.

Though the management of impacted canine is considered a multi-disciplinary entity requiring the expertise of a number of specialists, the general practitioner needs to coordinate care and must know about the diagnosis and management of canine impaction. The management of canine impactions can be simplified by following a logical and systematic approach. The schematic treatment plan for impacted canines and the factors influencing and determining the plan are discussed in this article.

This section deals with the important issue of impacted teeth. Impacted canines in Class I uncrowded cases can be improved by removal of the deciduous canines. There is some evidence that this is true for both buccal and palatal impactions. Treatment of impacted canines is lengthy and potentially hazardous. Interceptive measures are effective and preferred to active treatment. Supernumerary teeth may also cause impaction of permanent incisors, their early diagnosis and appropriate treatment is essential to optimise final outcomes. If there are any doubts about impacted teeth it is better to refer too early than too late, this latter option may unnecessarily extend the length of treatment as well as the treatment required.

Maxillary canine impaction has an incidence of 1 in 100 in the general population and has been reported as much higher in an individual orthodontic practice. Because patients with canine impactions generally have longer treatment times, depending on the location of the impacted tooth, early identification of impaction is of critical interest to the orthodontist. Sector location and angulation of the unerupted tooth have been analyzed previously as predictors of canine eruption after deciduous extraction. Additionally, sector location has been studied as an indicator of eventual impaction, resulting in good predictive success. In this study, angulation of the unerupted tooth was measured from panoramic radiographs and added to sector location to see whether the combination of these factors could predict impaction more accurately than sector alone. Results verified earlier findings for sector: canines that become impacted will overlap the adjacent lateral incisor in 82% of cases. Logistic regression analysis also determined that once the canine overlaps the midline of the lateral incisor, there is a greater than 0.87 chance of impaction. Sector was found to be the better predictor of impaction, with angulation adding little supplementary predictive value.

Herein we present five cases of submasseteric abscess that most commonly occurred in patients with a history dental disease. CT has been the main imaging method for diagnosing lesions in the masticator space and adjacent to the mandible; however, we found that, in some of our cases, CT defined the lesion poorly or not at all. In some cases, MR imaging defined the lesion better. Radiologic manifestations of this condition and pathologic correlations are discussed.

In numerous cases of head and facial pain, the underlying causes are found to be ENT problems. The most common cause of pain affecting the forehead and mid-facial region is acute sinusitis, in which the sphenoidal sinus is more commonly affected than previously assumed. Pain in the oral-facial region is largely due to disorders of the masticatory apparatus, but inflammatory diseases of the oral mucosa, abscesses or the so-called Eagle syndrome may also be involved. An accurate history and a clinical examination often points the physician in the right direction. To establish an accurate diagnosis, endoscopy of the upper airways and digestive system, together with ultrasonography, are usually required, followed, where necessary, by a radiological and NMR work-up, and puncture or biopsy. Provided that an accurate diagnosis has been established and multidisciplinary cooperation is available, the therapeutic options are usually effective.

Dentigerous cysts are benign odontogenic cysts that are associated with the crowns of permanent teeth. They are usually single in occurrence and located in the mandible. Multiple cysts are reported in patients with conditions such as mucopolysaccharidosis and basal cell nevus syndrome. We present the radiologic findings of bilateral impacted maxillary cuspids with dentigerous cysts displacing the maxillary sinuses in a nonsyndromic patient, a condition that, to our knowledge, has not been previously reported.

In orthodontic practice occurred problems associated with labio-palatal localization of impacted permanent maxillary canines. Not always is possible to determinate labio-palatal location of these teeth on the basis of palpation, therefore clinical examination aided by radiographic investigation. Orthopantomogram is the most widely used radiograph in orthodontics. The purpose of present study-test diagnostic value of palpation and orthopantomography in cases of maxillary canines impaction on the basis of evaluation of migration and inclination of impacted teeth. Thirty nine patients of Clinic of Orthodontics, Kaunas University of Medicine, orthopantomograms were available for analysis. Forty two impacted canines were investigated. Only 64% of canines could be palpated. It depended on the vertical position of the tooth. Distribution of the values of canine inclination to the middle of upper jaw was too big for more precise statistical analysis. Canines, which were medial to the 3th horizontal sector (these canines overlapped longitudinal axis of the lateral incisor), were located palatally.

A three-year-old Labrador retriever was referred for decreased appetite, a painful swelling in the region of the maxillary right fourth premolar, and a heart murmur indicative of patent ductus arteriosus (PDA) diagnosed 1.5-weeks prior to presentation. Oral examination and intraoral dental radiographs showed impaction of the maxillary right fourth premolar surrounded by reactive alveolar bone. Necrotic bone, remnants of the deciduous maxillary right fourth premolar, and the impacted permanent maxillary right fourth premolar were removed following surgical exploration of the area. The PDA was repaired without complication 2-weeks following oral surgery. The extraction site was healing appropriately, and the dog's inappetence and painful facial swelling had resolved.

Impacted permanent canines in a child, particularly in the maxilla, pose a functional as well as an esthetic concern for the patient and parents alike. Informing the parties involved that all the permanent canines are impacted is, needless to say, a distressful dilemma for the parents and a unique challenge for the orthodontist. The response to the treatment in this case was quite acceptable. All 4 canines were properly aligned with the aid of orthodontic traction and surgical assistance, and now the patient possesses confidence to smile and has enhanced self-esteem. There is no additional cost or burden of prosthesis for the parents, since all 4 impacted canines were successfully positioned, and all are natural and beautiful teeth. The root resorption that occurred may have been the result of the long treatment time or the result of root movement during incisor uprighting, both of which have been associated with this phenomenon. As in many of these cases, proper gingival contours of one of the orthodontically erupted mandibular canines was a problem and may require the service of a periodontist.

As impacted permanent maxillary cuspids occur in 1-2% of the population, the general dentist should know the signs and symptoms of this condition and the interceptive treatment. Features of buccal or palatal cuspid impaction include lack of canine bulges in the buccal sulcus indicating a lingual eruption path and possible impaction; lack of symmetry between the exfoliation and eruption of cuspids that may indicate palatal or lingual impaction; and abnormal mesiodistal location and angulation of the developing maxillary permanent cuspids on radiographs. Diagnosis of impacted cuspid teeth at age 8-10 years can significantly reduce serious ramifications, including surgical exposure and orthodontic alignment as well as root resorption of the lateral incisors. In specific cases, extraction of the primary maxillary cuspids can prevent impaction of the permanent maxillary cuspids and additional sequelae.

Background: A compilation of treatment options for impacted teeth is presented to assist dentists in discussing the sequelae of impacted teeth as well as the complications of treatment with their patients., Overview: A differential diagnosis for an impacted tooth is not possible without clinical assessment. However, an ankylosed tooth or a tooth with failure of its eruption mechanism may be mistaken for an impacted tooth. This review of national and international dental texts, journals and publications concerning impacted teeth spans more than 50 years., Practice Implications: Treatment options for the management of impacted teeth are separated into four categories: observation, intervention, relocation and extraction. The indications, contraindications and complications of each option are presented. This information will help the clinician identify developmental conditions associated with an increased probability of tooth impaction and assess available treatment options.

Gardner syndrome is a type of hereditary gastrointestinal polyposis. Dental professionals should be aware that this syndrome can present as multiple impacted teeth and sometimes as large osteomas in the head and neck area. Following a brief review of literature, we present two cases of Gardner syndrome. One of these cases was diagnosed after a dental examination. The high incidence of malignant transformation of polyps into colorectal cancer indicates the importance of early diagnosis and follow-up.

Two cases of retained teeth in maxilla, very rare disease seen in otolaryngological practice, are described. The authors present causes of this pathology, symptomatology, diagnostics and treatment. Diagnosis of retained teeth is made mainly by radiologic investigation i.e. CT and pantomography. A review of literature was made.

Impaction of the maxillary canine is not a rare affection. A correct treatment can be appointed only after a serious evaluation of the case. In this work, the Authors describe clinical and radiographic methods which give the possibility to make a correct diagnostic evaluation of the maxillary canine impaction. A correct radiographic analysis could allow to three-dimensionally locate the impacted teeth and to show resorptions or ankylosis. Literature reports a great number of radiographic analysis; conventional methods can be used in simple cases, but, in difficult cases, some Authors suggest to use five different projections. New technologies in digital radiology allow to have high quality images, using which it is possible to make a diagnosis of great accuracy, also in difficult cases. Bidimensional images can show little particulars; three-dimensional images give the possibility to understand immediately the problems of the case also to not expert operators. The rate of radiation absorbed by the patient is similar to a panoramic radiograph. These characteristics make CT the method of election in difficult cases of maxillary canine impaction.

Reasons for localizing impacted maxillary canines are outlined and methods of localization described. The favored method of radiographic localization is the parallax method (image/tube shift method). Tube shifts can be carried out in both the horizontal and the vertical planes. For a horizontal tube shift, two occlusal radiographs are recommended; for a vertical tube shift, a rotational panoramic radiograph and an occlusal radiograph are recommended. This latter combination is usually the combination of choice because the panoramic radiograph, which provides information about all the teeth in both arches, the two jaws, and the surrounding structures, is often taken as an initial radiograph and this combination only requires one additional exposure, the occlusal radiograph. To facilitate the interpretation of a vertical tube shift, the angle of the tube in the occlusal radiograph should be increased from the customary 60 degrees to 65 degrees to 70 degrees to 75 degrees. Less accurate methods of radiographic localization are to use (1) image magnification of the impacted maxillary canines and (2) image superimposition of the impacted maxillary canines on the central or lateral incisor. Reasons why periapical radiographs are not recommended to be used for a horizontal tube shift or for a vertical tube shift in combination with a panoramic radiograph are explained. Indications to suspect palatal impaction may occur in the future if the patient is less than 10 years of age, and indications to suspect impaction may have occurred if the patient is more than 10 years of age are discussed. Patient questionnaires are advocated to aid the clinician in anticipating palatal impaction, the most frequent impaction.