Search

We cryopreserved mouse tooth germs with widely open cervical margins of the enamel organ to overcome difficulties in cryoprotectant permeation and tested their efficacy by transplanting them into recipient mice. The upper right first molar germs of 8-day-old donor mice were extracted and categorized into the following four groups according to cryopreservation time: no cryopreservation, 1 week, 1 month, and 3 months. The donor tooth germs were transplanted into the upper right first molar germ sockets of the 8-day-old recipient mice. The upper left first molars of the recipient mice were used as controls. The outcome of the transplantation was assessed at 1, 2, and 3 weeks after transplantation. Stereomicroscopic evaluation revealed that most of the transplanted teeth erupted by 3 weeks after transplantation. Micro-computed tomography analysis revealed root elongation in the transplanted groups as well as in the controls. There was no significant difference between the cryopreserved and non-cryopreserved transplanted teeth, but the roots of the cryopreserved teeth were significantly shorter than those of the control teeth. Histological examination revealed root and periodontal ligament formations in all the transplanted groups. These results suggest that the transplantation of cryopreserved tooth germs facilitates subsequent root elongation and tooth eruption.

Background/aim: Numerical aberrations of permanent dentition and dystopic tooth eruption are part of the phenotype of the tumor predisposition syndrome neurofibromatosis type 1 (NF1). In these cases, surplus tooth germs usually develop in the alveolar processes of the jaw. This report attests to the dystopic development of a dysplastic supernumerary tooth in NF1 arising outside the jaw., Case Report: The 8-year-old male patient developed a microdont outside the bone and above the occlusal plane of the retained maxillary right second molar. The supernumerary tooth was completely embedded in oral soft tissue. Hyperplastic oral soft tissue in the molar region and microdont were excised. Specimen of the mucosa surrounding the teeth was interspersed with diffuse and plexiform neurofibroma. The retained upper right first molar emerged spontaneously within a few months after surgery. The upper right second molar did not change position., Conclusion: Odontogenesis can take place within tumorous oral mucosa in NF1. Surgical removal of the tumorous mucous membrane facilitates tooth eruption in some cases., (Copyright © 2021 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

This study tested the hypothesis that a layperson's social perceptions of a dentofacial deformity (DFD) patient with primary mandibular deficiency (PMD) are more positive after bimaxillary orthognathic surgery.A survey was implemented comparing layperson's social perceptions of emotional expressions and personality traits before and >6 months after orthognathic surgery when viewing standardized facial photographs. The study sample comprised 20 patients selected randomly from a larger primary mandibular deficiency database, treated by 1 surgeon after orthognathic surgery. The outcome variable was change in 6 perceived emotional expressions and 6 personality traits studied. Descriptive and bivariate statistics were computed (P < .05).Five hundred respondents (raters) completed the survey. The respondents were 52% male with 44% aging from 25 to 34. After bimaxillary and chin orthognathic surgery, primary mandibular deficiency patients were perceived to be significantly more dominant, trustworthy, friendly, intelligent, attractive, and less threatening (P < .05). They were also perceived as happier and less angry, surprised, sad, afraid, or disgusted than before surgery (P < .05).Laypeople consistently report improved social traits in primary mandibular deficiency patient's perceived emotional expressions and perceived personality traits after bimaxillary and chin orthognathic surgery.

Cleidocranial dysplasia (CCD) is a rare hereditary disorder characterized by skeletal malformations and dental abnormalities. Mutations of the transcription factor RUNX2 are responsible for the pathogenesis of CCD. We present a case of a 10-year-old boy with CCD, presenting with hypoplastic clavicles, delayed closure of the fontanelles, retarded exfoliation of the deciduous teeth, retarded eruption of the permanent teeth, and multiple impacted supernumerary teeth. Based on the clinical and radiographic examination results showing abnormalities of the bones and teeth, a diagnosis was reached easily, but it was difficult to achieve a complete curative effect. We carried out a highly organized schedule of treatment, including extraction of the deciduous and supernumerary teeth, partial resection of alveolar bone, distraction of impacted teeth, and orthodontic surgery. After 7-year follow-up, the patient has achieved acceptable occlusion and midfacial appearance. The main objectives of this study were to present the diagnosis and treatment of CCD and to emphasize the benefits of combined orthodontic-surgical sequential treatment.

Background: Controlled space closure in cases of isolated lower second premolar aplasia (ILSPA) without maxillary counterbalancing extraction is challenging. Anterior anchorage loss may occur during space closure resulting in compromised occlusal results in terms of an absence of proper canine guidance during laterotrusive mandible movements. In order to evaluate the effectiveness of Herbst telescope anchorage in combination with double-cable, pull mechanics and a completely customized lingual appliance for orthodontic space management in cases of ILSPA, we tested the null hypothesis that there is a significant deterioration in the sagittal canine relationship towards an Angle-Class-II occlusion expressed as a loss of anterior anchorage following space closure with molar mesialization., Methods: Twenty-five consecutively de-bonded subjects (female / male 17 / 8; aged at T0 (start of MB Tx) 12.3 to 20.6 years; mean age 15.0 / SD 1.7 years) were included in this retrospective analysis using the inclusion criteria of least of one lower second premolar aplasia; completed treatment with a totally customized lingual appliance (CCLA) in combination with Herbst telescopes. Exclusion criteria were the absence of counterbalancing maxillary extractions, as well as additional tooth aplasia other than lower second premolars. A total of 33 single, lower premolar aplasia space closures (right / left sided 17 / 16) were assessed using plaster casts and intra-oral photographs scaled to the plaster casts, at bonding (T0), Herbst insertion (T1), following gap closure (T2) and de-bonding (T3). Parallelism of roots was controlled by panoramic x-rays at T3., Results: The mean aplasia space at T0 was 7.5 mm (SD 2.6). Complete space closure was achieved in all 33 situations. The null hypothesis was rejected. There was a significant improvement in the initial canine relationships (mean 3.5 mm distal occlusion at T0) to a mean 0.1 mm at T3. When evaluated against the individual treatment plan, the following amounts of planned improvements were achieved: space closure 100%, canine relationship 97.5%, overjet 93.9%, overbite 96.4%, parallel roots in space closure site 93.9%., Conclusion: Herbst telescope anchorage in combination with double-cable pull mechanics and a CCLA for orthodontic space closure can deliver predictable, high-quality treatment results.

Statement of Problem: Immediate placement and provisionalization of implants in fresh sockets has been previously demonstrated to be a predictable treatment in the restoration of non-recoverable teeth in the anterior regions of the maxilla., Purpose: This article reports a clinical case in which an immediate implant placement protocol was used in combination with two distinct and sequential grafts (bovine bone and connective tissue, respectively) followed by immediate implant provisionalization using the patient's crown of an extracted tooth., Clinical Report: Physical, clinical, and image examinations of the patient (female, 23 years old) revealed a maxillary central incisor (tooth No. 8) with slight mobility due the presence of extensive cervical resorption. The treatment proposed was the atraumatic extraction of the tooth followed by immediate implant placement and provisionalization. Two grafts (bovine bone and connective tissue) were used due to the presence of a very thin maxillary bone plate associated with a thin gingival biotype., Results: The use of the extracted crown as a temporary crown after immediate implant placement resulted in immediate attainment of an esthetically pleasing outcome and long-term favorable results., Conclusion: The treatment protocol proposed can be efficiently used to immediately restore the patient's esthetics and function while maintaining the health, volume, and contours of gingival tissues over a 12-month follow-up period., Clinical Implications: Anterior teeth extractions typically require the execution of single-unit prostheses using dental materials of synthetic origin (such as polymers), which often are incapable of achieving the esthetic and physiological results patients expect. The use of the patient's own crown was demonstrated, which allowed good clinical results to be achieved and the natural shape and function of tissues to be maintained.

We evaluated the accuracy of a new scale of surgical difficulty for the extraction of impacted mandibular third molars, which includes consideration of previously underestimated variables. Two hundred patients with impacted third molars were enrolled, and a preoperative clinical and radiographic assessment of difficulty was made by an oral surgeon using the new index. Five oral surgeons with similar degrees of experience then evaluated the surgical difficulty during operation. The kappa test and weighted kappa were used to evaluate the level of agreement between the preoperative and postoperative evaluations. This was 0.73, which indicated a substantial concordance between the preoperative and postoperative assessments of difficulty indicated by the new scale. The linear weight of kappa was 0.8 and the quadratic weight 0.87. We recommend this new scale of surgical difficulty for the extraction of impacted third molars for use in clinical practice., (Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Objective: The term molar-incisor malformation (MIM) has recently been presented in the scientific literature, where it is described as a condition with localized impaired root development. Here we present 6 recently discovered cases referred to our departments., Study Design: The patients were enrolled in the study after referral and were examined clinically and radiologically. Two extracted teeth were further examined with micro-computed tomography or microscopy., Results: Affected teeth were first permanent molars with hypoplastic roots, narrow pulp chambers, and a hypercalcified dentine layer cervical to the pulp chamber. Two of the cases also had cervical constrictions on the upper incisors. The patients were 8 to 12 years of age and healthy, but had experienced serious medical conditions of the head and neck region in their first year of life. Some of the cases had been referred because of acute infection and pain., Conclusion: In 5 out of 6 patients, severe health problems in the head and neck region early in life may have been associated with root malformation in molars and incisors. Patients with MIM need to be followed closely, and extractions should be planned at the right time to avoid unnecessary infection and pain in addition to orthodontic problems., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Mandibular hypoplasia is a hallmark of Treacher Collins syndrome (TCS), and its severity accounts for significant functional morbidity. The purpose of this study is to develop a mandibular classification scheme., Methods: A classification scheme was designed based on three-dimensional computed tomography (3D-CT) scans to assess 3 characteristic features: degree of condylar hypoplasia, mandibular plane angle (condylion-gonion-menton), and degree of retrognathia (sella-nasion-B point angle). Each category was graded from I to IV and a composite mandible classification was determined by the median value among the 3 component grades., Results: Twenty patients with TCS, aged 1 month to 20 years, with at least one 3D-CT prior to mandibular surgery were studied. Overall, 33 3D-CTs were evaluated and ordered from least to most severe phenotype with 10 (30%) Grade 1 (least severe), 14 (42%) Grade 2, 7 (21%) Grade 3, and 2 (7%) Grade 4 (most severe). Seven patients had at least 2 longitudinal scans encompassing an average 5.7 (range 5-11) years of growth. Despite increasing age, mandibular classification (both components and composite) remained stable in those patients over time (P = 0.2182)., Conclusion: The authors present a classification scheme for the TCS mandible based on degree of condylar hypoplasia, mandibular plane angle (Co-Go-Me angle), and retrognathia (SNB angle). While there is a natural progression of the mandibular morphology with age, patients followed longitudinally demonstrate consistency in their classification. Further work is needed to determine the classification scheme's validity, generalizability, and overall utility.

The eruption of a tooth into the nasal cavity is a rare clinical entity. We report a case of an inverted supernumerary tooth in the nasal cavity. A 2-year-old boy was referred to our institution after examination at a local otorhinolaryngology department for otitis media. Radiological examination revealed a tooth-like structure in the right nasal cavity. The tooth was protruding from the floor of the nasal cavity along with granulation tissue. The diagnosis was an inverted tooth in the right nasal cavity. Forceps extraction was performed under general anesthesia.

Introduction: Inverted tooth impaction is a rare occurrence. Third molar impaction is the most extensively studied, and only eight cases of inverted third molars have been reported in a literature search of 40 years from 1973 to 2013. In a study, 43.4% of the premaxillary supernumeraries were inverted and 21.1% were transversely oriented, while occasional inverted central incisors have been mentioned in the literature. Severe dilaceration makes the management of this case a big challenge. The case of an 8-year-old boy with an inverted, rotated, and impacted upper left central incisor obstructed by an odontome is presented here. Under local anesthesia, the odontome was excised; the inverted tooth was swung and repositioned. The patient experienced uneventful healing, and with 30 months follow-up, progressive tooth eruption has been observed. Vitality test is positive, while radiologically there was no sign of resorption. Swinging replantation is a protocol that has been used for the management of an inverted, rotated, and impacted central incisor. Open root apex is an important factor in the selection of the method. The minimal periodontal damage prevents inflammatory and replacement resorption. With some clear advantages over options like orthodontic and prosthetic replacement, it could be a method to be considered in the management of severely dilacerated central incisors. The clinical significance is that even though management of a severely malpositioned tooth has always been a big challenge in dental practice, requiring extraction and prosthodontic replacement, swinging replantation provides a possible protocol of tooth retention, i.e., less expensive and associated with fewer hospital visits.

Isolated bilateral macrodontia of the mandibular second premolars is a rare condition. We believe that the case reported here is the first in which isolated bilateral macrodontia of the mandibular second premolars presents with numerous dental anomalies affecting other teeth. A 14-year-old boy was referred to the Paediatric Dental Department of King’s College Hospital with a partially erupted mandibular left second premolar. Clinical and radiographic examination subsequently revealed macrodontia of both mandibular second premolar teeth and multiple other dental anomalies. This report discusses the presentation and multidisciplinary management of this case. Clinical relevance: This case report describes an already rare condition made even more extraordinary owing to its presentation with multiple other dental anomalies.

A palatogingival groove is an anatomic malformation that predisposes the involved tooth to a severe periodontal defect. When the condition is complicated by pulpal necrosis, affected teeth often present a dilemma in terms of diagnosis and treatment planning. In this report, we describe the case of a patient with a maxillary lateral incisor with a deep palatogingival groove extending to the root apex and severe periodontal destruction (local pocketing). Suggested treatment modalities included curettage of the affected tissues, elimination of the groove by grinding and/or sealing with a variety of filling materials, and surgical procedures. In this case, a combined treatment approach, involving both endodontic therapy and intentional replantation after restoration with a self-etching flowable composite, resulted in periodontal healing and significant healing of the periradicular radiolucency at 12 months. In short, intentional replantation offers a predictable procedure and should be considered a viable treatment modality for the management of palatogingival grooves, especially for single-rooted teeth., (Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Taurodontism is a developmental tooth disorder characterized by lack of constriction in the cementoenamel junction and consequent vertical stretch of the pulp chamber, accompanied by apical displacement of the pulpal floor. The endodontic treatment of teeth with this type of morpho-anatomical anomaly is challenging. The purpose of this article is to report the successful endodontic treatment of a hypertaurodontic mandibular molar using a reciprocating single-file system.

Objective To determine in individuals with unilateral cleft lip and palate the correlation between initial cleft size and dental anomalies, and the outcome of alveolar bone grafting. Methods A total of 67 consecutive patients with non-syndromic unilateral complete cleft lip and palate (UCLP) were included from the cleft lip and palate-craniofacial center, Uppsala University Hospital, Sweden. All patients were operated by the same surgeon and treated according to the Uppsala protocol entailing: lip plasty at 3 months, soft palate closure at 6 months, closure of the residual cleft in the hard palate at 2 years of age, and secondary alveolar bone grafting (SABG) prior to the eruption of the permanent canine. Cleft size was measured on dental casts obtained at the time of primary lip plasty. Dental anomalies were registered on radiographs and dental casts obtained before bone grafting. Alveolar bone height was evaluated with the Modified Bergland Index (mBI) at 1 and 10-year follow-up. Results Anterior cleft width correlated positively with enamel hypoplasia and rotation of the central incisor adjacent to the cleft. There was, however, no correlation between initial cleft width and alveolar bone height at either 1 or 10 years follow-up. Conclusions Wider clefts did not seem to have an impact on the success of secondary alveolar bone grafting but appeared to be associated with a higher degree of some dental anomalies. This finding may have implications for patient counseling and treatment planning.

Syndactyly occurs in 1 in 2,000 live births and is more common in white children. This article describes a patient with syndactyly and additional abnormalities indicating oculodentodigital dysplasia.

This is a very rare case report of a multiple odontome involving the upper jaws, lower jaws and an extragnathic site. A thirty seven year-old male complained of missing teeth in his left upper and lower jaw since childhood. Radiographic examination revealed multiple calcified teeth like structures in the left side of the patient's maxilla, mandible and mastoid region of skull base. We arrived at the diagnosis of compound odontome. Patient was otherwise systemically normal and with good health. He underwent surgical enucleation of the jaw odontome while the extragnathic odontome was left under observation. This rare case report proves that the embryonic dental cells might migrate to the primordium of the Rathke's pouch and further might be carried towards the site of the developing cranial base region.

The huge progress in diagnostic and therapeutic procedures in developmental medicine allowed not only to save lives of many children and adolescents, but also enforced the necessity of close cooperation between many specialists. Unfortunately dental treatment is still not an integral part of taking care of disabled children and youth with chronic diseases. The situation worsens, when we come across the so-called rare diseases. Lack of access to dental services, when it comes to disabled patients, results from financial situation, healthcare system, as well as parents' ignorance of necessity of more frequent prophylactic and treatment visits. Whereas the reluctance of dentists towards the care of disabled patients is caused by difficulties with enforcing the recommendations and lack of procedures for taking care of patients with rare diseases, which was repeatedly signalled by us. Such situation is ideally pictured by yet another described case of the 17 year old patient with Ehlers-Danlos syndrome. Despite many dental visits, no vital treatment decisions have been made. In our Department, in the procedures of 1-day surgery, tooth 48, being the cause of pain, has been extracted. Basing on all of the above, it can be deduced that preserving the continuation and consequence in spreading the knowledge of rare diseases among patients, as well as physicians and dentists, is a responsibility of everyone who even once came across this problem.

Background: The aesthetic and functional outcomes surrounding Le Fort-based, face-jaw-teeth transplantation have been suboptimal, often leading to posttransplant class II/III skeletal profiles, palatal defects, and "hybrid malocclusion." Therefore, a novel technology-real-time cephalometry-was developed to provide the surgical team instantaneous, intraoperative knowledge of three-dimensional dentoskeletal parameters., Methods: Mock face-jaw-teeth transplantation operations were performed on plastic and cadaveric human donor/recipient pairs (n = 2). Preoperatively, cephalometric landmarks were identified on donor/recipient skeletons using segmented computed tomographic scans. The computer-assisted planning and execution workstation tracked the position of the donor face-jaw-teeth segment in real time during the placement/inset onto recipient, reporting pertinent hybrid cephalometric parameters from any movement of donor tissue. The intraoperative data measured through real-time cephalometry were compared to posttransplant measurements for accuracy assessment. In addition, posttransplant cephalometric relationships were compared to planned outcomes to determine face-jaw-teeth transplantation success., Results: Compared with postoperative data, the real-time cephalometry-calculated intraoperative measurement errors were 1.37 ± 1.11 mm and 0.45 ± 0.28 degrees for the plastic skull and 2.99 ± 2.24 mm and 2.63 ± 1.33 degrees for the human cadaver experiments. These results were comparable to the posttransplant relations to planned outcome (human cadaver experiment, 1.39 ± 1.81 mm and 2.18 ± 1.88 degrees; plastic skull experiment, 1.06 ± 0.63 mm and 0.53 ± 0.39 degrees)., Conclusion: Based on this preliminary testing, real-time cephalometry may be a valuable adjunct for adjusting and measuring "hybrid occlusion" in face-jaw-teeth transplantation and other orthognathic surgical procedures.

Warfarin is a synthetic oral anticoagulant that crosses the placenta and can lead to a number of congenital abnormalities known as fetal warfarin syndrome. Our aim is to report on the follow-up from birth to age 8 years of a patient with fetal warfarin syndrome. He presented significant respiratory dysfunction, as well as dental and speech and language complications. The patient was the second child of a mother who took warfarin during pregnancy due to a metallic heart valve. The patient had respiratory dysfunction at birth. On physical examination, he had a hypoplastic nose, pectus excavatum, and clubbing of the fingers. Nasal fibrobronchoscopy showed upper airway obstruction due to narrowing of the nasal cavities. He underwent surgical correction with Max Pereira graft, zetaplasty, and osteotomies for the piriform aperture. At dental evaluation, he had caries and delayed eruption of the upper incisors. Speech and language assessment revealed high palate, mouth breathing, little nasal patency, and shortened upper lip. Auditory long latency and cognitive-related potential to auditory stimuli demonstrated functional changes in the cortical auditory pathways. We believe that the frequency of certain findings observed in our patient may be higher in fetal warfarin syndrome than is appreciated, since a significant number result in abortions, stillbirths, or children evaluated in the first year of life without a follow-up. Thus, a multidisciplinary approach and long-term monitoring of these patients may be necessary., (© 2015 Wiley Periodicals, Inc.)

Talon cusps in anterior teeth are relatively rare developmental anomalies. They are characterized by the presence of an accessory cusp-like structure projecting from the cingulum area or cementoenamel junction. Facial talons occur very rarely; <10 cases have been described in the literature. This article attempts to describe the variants of this anomaly with 2 case reports involving facial and bilateral palatal manifestation.

Objective: The aim of this study was to investigate whether the growth of soft tissue and bone in children with traumatic tooth loss or agenesis of teeth can be developed reliably, using a new technique of autogenous primary canine transplant., Study Design: A total of 10 patients (age range, 7-13 years) were treated either for trauma or for agenesis (n = 14 primary canine transplants). In addition to the clinical examination, patients were subjected to radiologic examinations with regard to root resorption, bone height, and soft tissue level., Results: With an average survival rate of 87%, the average survival time of the transplants using the Kaplan-Meier estimator was 5.2 years. In all cases, soft tissue and bone growth was effectively developed., Conclusions: Autogenous primary canine transplant is a reliable surgical method for rehabilitating children in the early mixed dentition after traumatic tooth loss, enabling adequate soft tissue and bone growth., (Copyright © 2015 Elsevier Inc. All rights reserved.)

The aim of this study was to investigate the effect of volume and pressure, at which the solution of local anesthetic is injected into the tissue, on the effectiveness of infiltration anesthesia of the periosteum on the upper jaw. We used the technique of tooth pain sensitivity thresholds. According to the rate of development and the duration of the maximum analgesia effect, the optimum volume for different levels of pressure was determined. The influence of the tissue density at the injection site on the effect criteria of analgesia was demonstrated.

Hemimaxillary enlargement, asymmetry of the face, tooth abnormalities, and skin findings (HATS syndrome) is a rare developmental disorder involving the first and second branchial arches. Physical manifestations may present at birth or during early childhood. Characteristic findings include unilateral abnormalities of the face involving the bones, teeth, gums, and skin. Among the characteristic cutaneous manifestations of HATS syndrome, Becker nevus is the most common. A variety of modalities have been utilized in the treatment of HATS syndrome, but no standardized therapy has been established. We report a case of this rare condition in a 14-year-old adolescent boy.

Background: Dilacerations is a tooth deformity characterized by an angulation between crown and root causing non-eruption of the tooth. It generally occurs following trauma to the deciduous dentition apices of which lie close to the permanent tooth buds. According to Neville, maxillary and mandibular incisors contribute only approximately to 1% of the incidence of dilacerated teeth., Case Details: A 15 year old male patient reported with chief complaint of missing anterior teeth in the left side of maxillary arch. Radiographic evaluation showed impacted maxillary left central incisor. The radiograph depicted very unusual extreme curve in the root of the same tooth giving it characteristic U-morphology. The root of this tooth was curving into the nasal cavity. Due to extreme curve, surgical removal was suggested by orthodontist. Surgically removing this highly placed tooth with apex into nasal cavity was a surgical challenge. This was done effectively by removing the tooth under local anesthesia itself., Conclusion: U-shaped morphology in single rooted tooth is observed very rarely. This root curvature predisposes to fracture of root during surgical removal. Proper surgical protocol is to be followed during surgical removal of a tooth with such extreme root curvature to prevent fracture of the root and accidental displacement of the tooth into nasal cavity.

Arthrogryposis is characterized by multiple, nonprogressive joint contractures which may be caused by maternal disorders such as oligohydramnios as well as fetal akinesia resulting from primary disorders of muscle, connective tissue, or neurologic tissue. Its prevalence is about 1 : 3000. Distal arthrogryposis (DA) is a heterogenous group of genetic disorders with a characteristic flexion of the joints of the hands and feet divided into different types with additional features. Sheldon-Hall Syndrome (SHS), also known as distal arthrogryposis type 2A (DA2A), has some nonorthopedic features of specific importance to anesthetic care.

Odontomas are the most common odontogenic tumors, representing 70% of all odontogenic tumors. They may present in two specific forms; compound odontoma forms multiple small tooth-like structures, while complex odontoma forms an amorphous calcified mass. In this report, we present a 27-year-old male patient with multiple compound odontoma occupied regions at his jaws. The odontomas involve both alveolar and basal processes of the maxilla and mandible as well as both maxillary sinuses. Converse to conventional recommended treatment, which is surgical excision of the lesion, the management was removal of the lesion and clinical-radiologic followup. The first year's follow-up findings are presented in this case report.

This paper highlights features of dental rehabilitation of patients with Hamamy syndrome. A 10-year-old boy patient with Hamamy syndrome reported pain in the maxillary left central incisor, and all mandibular incisors. Intraoral clinical and radiographical examination showed enamel hypoplasia, severe dilacerated maxillary left central incisor and mandibular incisors, malocclusion, delayed eruption of teeth, taurodontism, and loss of lamina dura. Root canal treatment, strip crown and composite restorations were performed.

Objectives: The purpose of this clinical study was to describe outcome variables of all-ceramic and metal-ceramic implant-supported, single-tooth restorations., Materials and Methods: A total of 59 patients (mean age: 27.9 years) with tooth agenesis and treated with 98 implant-supported single-tooth restorations were included in this study. Two patients did not attend baseline examination, but all patients were followed for 3 years. The implants supported 52 zirconia, 21 titanium and 25 gold alloy abutments, which retained 64 all-ceramic and 34 metal-ceramic crowns. At baseline and 3-year follow-up examinations, the biological outcome variables such as survival rate of implants, marginal bone level, modified Plaque Index (mPlI), modified Sulcus Bleeding Index (mBI) and biological complications were registered. The technical outcome variables included abutment and crown survival rate, marginal adaptation of crowns, cement excess and technical complications. The aesthetic outcome was assessed by using the Copenhagen Index Score, and the patient-reported outcomes were recorded using the OHIP-49 questionnaire. The statistical analyses were mainly performed by using mixed model of ANOVA for quantitative data and PROC NLMIXED for ordinal categorical data., Results: The 3-year survival rate was 100% for implants and 97% for abutments and crowns. Significantly more marginal bone loss was registered at gold-alloy compared to zirconia abutments (P = 0.040). The mPlI and mBI were not significantly different at three abutment materials. The frequency of biological complications was higher at restorations with all-ceramic restorations than metal-ceramic crowns. Loss of retention, which was only observed at metal-ceramic crowns, was the most frequent technical complication, and the marginal adaptations of all-ceramic crowns were significantly less optimal than metal-ceramic crowns (P = 0.020). The professional-reported aesthetic outcome demonstrated significantly superior colour match of all-ceramic over metal-ceramic crowns (P = 0.015). However, no significant differences in the other aesthetic parameters at various restoration materials were registered. After 3 years, the patient-reported outcome variables at different restoration materials were not significantly different., Conclusion: The biological outcomes at the zirconia and metal abutments were comparable. All-ceramic crowns demonstrated better colour match, but higher frequency of marginal discrepancy compared to metal-ceramic crowns. Generally, the patients noticed no difference in aesthetic outcome of all-ceramic and metal-ceramic restorations., (© 2012 John Wiley & Sons A/S.)

The maxillofacial region develops during 3 to 8 weeks in an embryo. The process involves neural crest cell migration and proliferation as well as facial protrusion jointing and fusion. The maxillofacial region is one of the predilection sites of congenital malformations. We treated a 5-year-old Chinese boy with abnormal development of the left maxillofacial region. We describe in detail the patient's characteristics, diagnosis, and treatment processes and try to explain the possible causes of the disease.

Taurodontism leads to constriction of the cementoenamel junction, which results in vertically elongated pulp chambers, apical displacement of the pulpal floor, and bifurcation or trifurcation of the root. This trait can be seen in permanent and primary teeth, in a single tooth or in several molars in the same quadrant, and can be unilateral or bilateral. We report a rare case of a 26-year-old male patient presening with taurodontism involving all the developed molars of all four quadrants, which was not associated with any other anomalies or syndromes.

Objective: To assess the role of multislice spiral computed tomography in the calculation of upper airway volume and its change in patients with different types of dentomaxillary abnormalities after orthognathic surgery., Material and Methods: Twenty-five patients with dentomaxillary abnormalities (19 and 6 patients with Classes III and II dentomaxillary abnormalities, respectively) were examined. All the patients underwent two-jaw operations. Facial skeleton computed tomography was performed before treatment initiation and 6 months after surgery. The DICOM data were loaded in Dolphin Imaging 11.5 and a special program package was applied to calculate the volume of air space in the upper airway. The hard tissue and soft tissue points used to construct the planes setting the detection limits of air space in the upper airway were determined., Results: After surgery, the patients with Class II dentomaxillary abnormalities display unilateral changes in our measured upper airway values (by increasing or reducing the air space); the majority of cases exhibiting higher values. Half of the patients with Class III had unilateral hanges, the increase or reduction in air space values varying in approximately equal proportions., Conclusion: Computed tomography permits the calculation of upper airway volumes before and after orthognathic treatment in patients with dentomaxillary abnormalities, which is in its turn of significant scientific and practical interest.

Double tooth is a term used to describe connate tooth and includes both dental fusion and gemination. Fusion refers to the union of two tooth germs resulting in a single large tooth. Owing to its irregular morphology, this anomaly can cause unpleasant aesthetic appearance. The diagnosis is based on the clinical findings and radiographic examination. We hereby discuss a case of fusion in a 30-year-old woman.

Taurodontism is a rare dental anomaly in which there is an enlarged pulp chamber at the expense of roots with apical displacement of the pulpal floor, giving it a rectangular shape. It is caused by the failure of Hertwig's epithelial root sheath to invaginate at the proper horizontal level. Taurodontism has been reported as an intraoral feature of several syndromes like Down syndrome, Klinefelter syndrome, Smith-Magenis syndrome, Hurler syndrome, etc. Association of taurodontism with hypodontia in permanent dentition has also been reported. Taurodontism in primary dentition and its association with hypodontia is very rarely reported in the literature. The present case illustrates bilateral taurodontism of primary mandibular molars with hypodontia in maxilla.

Study Design: This is a clinical case report with a review of relevant literature., Objective: To describe a case of Larsen syndrome with C3-C4 spondyloptosis and atlantoaxial dislocation in a middle-aged female patient and to discuss management strategies., Summary of Background Data: Spondyloptosis of the cervical spine is relatively rare and is caused by trauma, destruction of the vertebral bodies by tumors, or tuberculosis. Such gross vertebral displacement is usually associated with significant neurological deficits. Larsen syndrome is characterized by multiple joint displacements and can, very rarely, be associated with nontraumatic spondyloptosis of the cervical vertebra. A single case report of C1-C2 joint laxity causing atlantoaxial dislocation in a patient with Larsen syndrome is available in literature. No reports of any patient (with Larsen syndrome or nonsyndromic) who had both cervical spondyloptosis and atlantoaxial dislocation are available in literature., Methods: A 36-year-old female presented with chronic neck pain, bilateral hand deformity, and mild spasticity involving all 4 limbs. Cervical radiograph, computed tomographic scan, and magnetic resonance image revealed C3-C4 spondyloptosis and atlantoaxial dislocation., Results: A combined ventral decompression of subaxial spine and instrumentation from C2 to C5, followed by posterior C1-C2 distraction arthroplasty and lateral mass stabilization of the subaxial spine up to C6, was done. The cervical deformity was corrected, and the patient remains symptom free., Conclusion: Patients with spondyloptosis of the cervical spine can rarely present with chronic neck pain and minimal neurological deficits. An additional pathology, such as atlantoaxial dislocation, can add to the complexity. Circumferential stabilization and fusion would be required in such cases to achieve a good outcome. Larsen syndrome is a rare cause of nontraumatic cervical displacements.

Background: Tooth development may be hampered following traumatic injuries to maxilla or mandible. The developmental deviations that occur in a tooth bud in the line of a jaw fracture range from agenesis to hamartomatous proliferation. Odontomas are benign odontogenic hard tissue tumors, which are hamartomas characterized by slow growth and non-aggressive behavior. 'Erupted odontoma' is a term used to specifically denote odontomas, which are exposed into the oral cavity. These are rare entities with only 25-30 cases being reported so far in the dental literature., Case Description: This clinical report is pertaining to a rare case of an erupted odontoma in an adolescent patient which was presenting as a hard tissue outgrowth along with an extra-oral sinus in the posterior mandibular region. The surgical excision of the odontoma along with the associated malformed teeth resulted in resolution of pain and sinus discharge associated with this lesion., Conclusions: Erupted odontomas need to be considered in the differential diagnosis of hard tissue projections or outgrowths in the site of past maxillofacial injuries. Surgical excision of these lesions enable resolution of patient symptoms associated with this condition as evidenced in the present case and in other cases cited in the literature. The erupted odontoma attached to malformed molars and presenting with signs and symptoms suggestive of osteomyelitis is a rare combination of developmental aberrations following maxillofacial injury.

This paper presents the diagnosis and management of a rare case of bulbous exophytic malformation of three permanent mandibular incisors. An 8-year-old Caucasian girl presented with concerns on the appearance of these teeth. Medical history was noncontributory, and there was no recall of relevant past trauma. Upon clinical examination, 3 permanent mandibular incisors exhibited hard bulbous protuberances in the crown's middle and cervical areas. Radiographic examination assisted by dental computed tomography revealed that these were continuous with the tooth structure, contained no pulpal tissue, and the teeth displayed normal root development. They were excised and the teeth were restored with a thin composite facing. They remained asymptomatic with acceptable esthetics for 4 years. Scanning electron microscopy and histology of the biopsied hard tissue revealed a nonhomogeneous structure resembling anomalously intertwined enamel with predentin and dentin. The etiology of this disturbance of dental development remains unknown.

Taurodontism is a morpho-anatomical developmental anomaly rarely seen in teeth. It is characterised by lack of constriction at the level of cementoenamel junction with elongated pulp chambers and apical displacement of bifurcation or trifurcation of roots. This gives the tooth a rectangular or cylindrical appearance. This paper reports successful endodontic therapy of cases with hypo-, meso- and hypertaurodontism in healthy individuals with no associated syndrome or anomaly., (© 2011 The Authors. Australian Endodontic Journal © 2011 Australian Society of Endodontology.)

Radicular lingual grooves are morphological defects, which are found most frequently in maxillary anterior teeth and are a predisposing factor for periodontal disease. They are easily overlooked as aetiologic factors, as these grooves are covered by periodontal tissues. This case report presents a successful management of a case of a maxillary lateral incisor with an associated radicular lingual groove and severe periapical osseous destruction in a 30-year-old female patient. A combination of endodontic treatment, radiculoplasty to eliminate the radicular lingual groove, and periapical surgery to eliminate the periapical osseous defect was used. At two-year follow-up, the patient was comfortable and complete resolution of the periapical pathology was evident.