Biomedical subjects
Publications and source records attributed to W K Duncan.
A 13-year-old black male patient with Sturge-Weber Syndrome is presented. The report describes the classic presentation of the syndrome, emphasizing the oral manifestations. The case presentation includes a discussion of the differential diagnosis of gingival enlargement, and suggestions for subsequent therapy.
The literature is reviewed to determine the radiographic appearance of the reported cases of dentin dysplasia. The sometimes confusing nomenclature is rationalized. Four distinct forms of dentin dysplasia type I and one form of dentin dysplasia type II are identified. There seems to be no need to identify more than two distinct types of this relatively rare inherited defect of human dentin, but a proposed subclassification of type I dentin dysplasia could make identification of the two types easier.
Dentin dysplasia is a rare developmental disturbance of dentin affecting approximately 1:100,000 people. It has been classified as an autosomal dominant disease. Two distinct forms of dentin dysplasia have been described. As more cases of dentin dysplasia were reported these categories seemed inadequate; subclassification of type I dentin dysplasia were proposed based on root length and the presence or not of a pulpal remnant. This paper presents two cases demonstrating the classic features of type I dentin dysplasia in the mixed and permanent dentitions and discusses the suggested subclassifications. The authors suggest that while differences in root length may be useful in determining treatment options, thinking of these variables as separate types of dentin dysplasia is not warranted at this time. Justification of a subcategory of type I dentin dysplasia should be based on a different disease process, different histology, significantly different symptoms, or different etiologies, and until researchers can clearly prove from a genetic or chromosomal standpoint that the subcategories are separate entities, we should accept, as we do for many other genetic disorders, that some patients are more severely affected than others.
A simplified hypoplasia index for deciduous teeth has been developed. The index utilizes a two-digit system to signify the type and severity of the hypoplastic lesion. The types of lesions recorded are primary canine hypoplasia (PCH) and linear enamel hypoplasia (LEH). The severity ranges from minimal to severe and accounts for the presence of dental caries, dental restorations, and recurrent caries. To determine the reliability of the index, two tests were conducted. The first measure was a repeat reliability coefficient (test-retest) to calculate the stability of the instrument. This measure was calculated for two populations by two examiners under the same examination conditions and exams were conducted seven weeks apart. The second measure calculated the interrater reliability (standardization). Test results were analyzed by employing the Pearson product moment correlation. The repeat reliability coefficients were .75 (P less than or equal to .0001) and .74 (P less than or equal to .0001). The interrater reliability coefficient was .87 (P less than or equal to .0001). These data seem to indicate that the index is reliable over time and between examiners.
Primary canine hypoplasia is an incomplete or defective development of the enamel matrix. The lesion is located on the labial surface and is seen more frequently on mandibular teeth. The purpose of this preliminary study was to determine the prevalence of this lesion among Head Start children. During a dental needs assessment of Mississippi Head Start children, 371 children from 11 centers were examined for this lesion. Of the centers, four were located in optimally fluoridated communities, and six were located in fluoride-deficient communities. Ages ranged from three to five years. There were 206 males and 165 females, 334 black and 37 white children. At ten centers all children were black, while all children at one center were white. Results indicated no significant differences in the black population between fluoridated (38.2%) and fluoride-deficient (36.3%) communities (P = .729) or between males (36.8%) and females (37.6%) (P = .877). When data were collapsed on sex and fluoridation status, the racial differences were highly significant (P = .001). The prevalence rate of dental caries associated with primary canine hypoplasia was 26.0 percent. These preliminary data indicate that the presence of primary canine hypoplasia may result in an increased potential for the tooth becoming carious.
Eosinophilic granuloma is said to be the most benign disorder of the triad commonly known as histiocytosis X. There has been, and still is, confusion about the terminology describing this entity. This article reviews the literature on histiocytosis X, with particular emphasis on eosinophilic granuloma and its oral manifestations. The case of a 22-month-old male child with an eosinophilic granuloma of the right mandible is presented. The diagnostic and treatment methods are reviewed and discussed. During the 4 years that the case has been followed there has been progressive healing of the lesion, but other manifestations of the disease process and of the surgical treatment have become evident. The need for close dental as well as medical follow-up in cases involving the dental structures is stressed.
The dental literature concerning the bilateral presentation of fusion and gemination is reviewed and analyzed. Tables are presented to show the prevalence and distribution of these anomalies in both the primary and permanent dentitions. In addition, the first prevalence statistics for the bilateral occurrence of fusion and gemination in the primary and permanent dentitions are determined. The first case of bilateral fusion of mandibular primary incisors to be reported in 13 years is presented. The presence of all four succedaneous incisors and the diagnosis of bilateral fusion are confirmed radiographically. The developmental concerns and possible sequelae of bilateral fusion and gemination are also discussed.
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The purpose of this study was to determine the prevalence of an uncommon lesion of the primary mandibular canines (primary canine hypoplasia), and its association with age, race, gender, dental caries, fluoridation status of the drinking water, breast-feeding, and geographic location. The study population comprised 2686 randomly selected children, black and white, 4 and 8 years old, who were enrolled in accredited private and public preschools and elementary schools in Mississippi. There were 1318 males and 1368 females, 1289 white children and 1397 black children, 1353 4-year-olds and 1333 8-year-olds. Results indicate that an association exists for race (P = 0.0001), gender (P = 0.01), and dental caries (P = 0.0001), but not for age (P = 0.07), geographic location (P = 0.73), fluoridation status of the water supply (P = 0.145), or breast-feeding (P = 0.392). The prevalence rate of primary canine hypoplasia was 33.2% for black children and 17.2% for white children. These data indicate that this lesion is significantly more prevalent in blacks than whites, and that teeth with this lesion have a greater probability of developing dental caries.
During routine examinations of 334 black Head Start children in Mississippi, many presented with areas of hypoplasia on the labial surfaces of the mandibular primary canines. Mean prevalence was 38 percent in fluoridated areas and 36 percent in areas without fluoridation. As it appears that hypoplastic defects have a strong potential to become carious, one should expect that the incidence of 25 percent reported here would continue to increase.
Recommendations on the need for clean or sterile technique have been made based on personal experience. This retrospective analysis of 100 children and adolescents who received dental treatment in the operating room shows no statistical difference in morbidity or postoperative complications between patients treated with the different techniques.
In this case report, Twin A had four teeth ankylosed and Twin B had five teeth involved; there was a nearly identical pattern of distribution and severity of ankylosis.