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A case of multiple bilateral dens invaginatus in the maxillary incisor teeth and an impacted cuspid has been presented. The impacted cuspid was removed surgically.
The topographic relationship of the apices of the primary teeth to the permanent tooth germs explains the potential for possible developmental disturbances of the permanent teeth after injuries to their predecessors. The anatomical, histologic and clinical aspects of permanent tooth malformation following trauma to the primary teeth are described. One hundred and fourteen children with originally 255 traumatized primary teeth have been re-examined (with an average period of 5.1 years after the trauma) to assess any developmental disturbances of the corresponding permanent teeth. Twenty-three per cent of partially or completely erupted permanent teeth showed developmental disturbances. The most frequent malformation was enamel hypoplasia including enamel discoloration and/or enamel defects. The highest prevalence of developmental disturbances of permanent teeth was found after intrusive injuries of primary teeth.
Over the past 20 years, the prevalence of dental disease in Western Australian children has diminished. The causes of this significant improvement in health are associated with better care models, water fluoridation and changes in lifestyle. In this study, the authors examine the reasons for hospitalization for oral health conditions in Western Australia for the calendar year 1995 using the Health Department of WA database. A total of 3,754 episodes of care (4,395 bed days) was recorded for dental conditions. Dental caries resulted in the fifth and sixth highest number of episodes of hospitalization in preschool (1-4 years) and primary-school age (5-12 years) children respectively. Abnormal tooth eruption resulted in the highest number of episodes of hospitalization in high-school age (13-17 years) children. From the age-stratified rates of hospitalization (per 1000), non-Aboriginal children were more than twice as likely to enter hospital for dental related conditions. The primary cause of this is the 15 times higher rate of hospitalization for high-school age non-Aboriginal children which clearly reflects the greater use of services for impacted third molars by the metropolitan non-Aboriginal community. Examination of the distribution by health service region revealed the hospitalization rate was significantly less than the state average for the Kimberley, Pilbara, Northern Goldfields and Wanneroo regions. These data reflect the paucity of oral health care available to residents of these regions, particularly the northwest, and does not reflect a diminished burden of disease. Similarly, the rate of hospitalization for Aboriginal children reflects population and service delivery differences particularly in regional and remote WA. These data highlight the need to develop new strategies in oral health care to target 'at risk' groups in the community, particularly new parents of young children. The preventive measures associated with good oral health in children are clearly aligned with those for good general health and can be integrated into existing health messages.
A survey of twelve-year-old Nepalese children was undertaken in 1994 according to the WHO pathfinder methodology and examination criteria. The study sample was drawn from randomly selected schools within the capital city, and two randomly selected urban settings, together with children drawn from schools in four randomly selected villages within rural Nepal. Three hundred and sixty children were examined. Drinking water samples were obtained from all sources at each examination site and subsequently analysed for fluoride content. The overall caries experience in the country was found to be very low or low. Analysis of drinking water samples revealed that with the exception of one town in the south of the country, all sites had low fluoride levels.
OBJECTIVES: To test the hypothesis that palatal displacement of the maxillary canine is completely under genetic influence. DESIGN: A randomized controlled design studied cases affected by a severe expression of lateral incisor anomaly on one side and by milder expression of the same anomaly on the other. Comparison of frequency of occurrence of unilateral palatally displaced canine measured in each. Each side acted as control for the other within the same individual. SETTING AND SAMPLE POPULATION: The Departments of Orthodontics of the Universities of Jerusalem and Tel Aviv and in private practice. From approximately 12,000 consecutively treated patients, all those exhibiting an anterior maxilla with a missing lateral incisor on one side, a peg-shaped or reduced lateral incisor on the other, and a palatally displaced canine (n = 19). OUTCOME MEASURE: Missing lateral incisors, peg-shaped, and reduced lateral incisors (all genetically determined characters) have been shown to be associated with palatal displacement of the canine. The canine displacement is presumed by some authorities to be similarly genetically determined. If this is so, then the impacted canine should occur with equal frequency on either side in the patient with a missing lateral incisor on one side and a peg-shaped or reduced lateral incisor on the other. RESULTS: The canine aberration occurred far more frequently on the side of the diminutive lateral incisor. CONCLUSION: There is an environmental factor involved in the palatal displacement of maxillary canines.
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BACKGROUND: Incontinentia pigmenti (IP; Bloch-Sulzberger syndrome) is an inherited disorder of skin pigmentation that is associated with skin (100%), dental (90%), skeletal (40%), central nervous (40%) and ocular (35%) abnormalities. The pathogenesis is not yet known. The disease is usually seen in females, as it is an X-linked dominantly inherited disease which is lethal in males. PATIENT PRESENTATION: We present a 9-year-old girl with the classical general and ocular signs of IP. She presented in early childhood with inflammatory vesicular skin changes which changed into pigmented skin alterations especially on the trunk. Ocular findings were microphthalmia and retrolental mass formation in one eye and retinal pigmentary changes in the other. In our patient, the spontaneous mutation may have been caused by the family's close neighbourhood to Semipalatinsk, Kasachstan, where regular nuclear tests took place very shortly before the pregnancy with our patient began. DISCUSSION: Ocular involvement is described in about a third of persons affected with IP. A nearly consistent and pathognomonic finding is a pigment retinopathy (mottled diffuse hypopigmentations). A further consistent finding are abnormalities of peripheral retinal vessels with areas of non-perfusion in the outer retina. The retinal pigment epitheliopathy and the abnormalities of retinal vessels are thought to be the underlying pathognomonic findings, with all other ocular signs being secondary (cataract, leucocoria, optic atrophy, strabismus, nystagmus and microphthalmus). Exudative retinal detachment occurs only in a minority, usually in very early childhood, when the skin lesions are exudative as well. IP patients should, however, be clinically observed regularly because of their retinal pigmentary changes.
Junctional epidermolysis bullosa (JEB) is a clinically and genetically heterogeneous recessively inherited blistering disease of the skin and mucous membranes due to impaired epithelial adhesion. In particular, defective expression of the 180-kD bullous pemphigoid antigen (BP180) has been correlated to a non-lethal (non-Herlitz) form of JEB, generalized atrophic benign epidermolysis bullosa (GABEB), characterized by widespread skin blistering healing with atrophy and by atrophic alopecia with onset in childhood. We report the case of a 33-year-old man suffering from a generalized blistering skin disorder since birth. He also presented nail dystrophy and tooth abnormalities. Mucosal involvement was limited to gingival erosion. Alopecia was absent and body, axillary and pubic hair were normal. Immunofluorescence analysis showed a markedly reduced expression of BP180, electron microscopy studies evidenced hypoplastic hemidesmosomes and Northern blot analysis confirmed a striking decrease in the amount of BP180 mRNA. The clinical features of our patient confirm that BP180 deficiency usually results in a non-Herlitz JEB form. However, the degree of skin, mucous membranes and hair involvement appears more variable and less typical than originally described for GABEB.
OBJECTIVE AND IMPORTANCE: To report a case of the bilateral transposition of the maxillary canines with the premolars in a 17-year-old female with Down syndrome. CLINICAL PRESENTATION AND INTERVENTION: A 17-year-old female presented with moderate mental retardation; she was short and of small stature, and she had a round cherubic face and a broad forehead. Clinical intraoral examination revealed bilateral malpositions of the maxillary canines and premolars as transposition. She had an open mouth, macroglossia and a protruding tongue. The case required the combined orthodontic and prosthetic treatment to achieve an acceptable morphologic and esthetic occlusion. However, the parents refused to accept the proposed treatment. Extractions of the roots and caries treatment were done as these were considered priority for the patient. CONCLUSION: This rare and severe positional anomaly represents an orthodontic challenge and its correction involves treatment risk and requires a great deal of control and carefully applied mechanics.
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This paper presents information on the cranial and dental anomalies observed in the crania of three species of platyrrhine monkeys collected in Nicaragua. Cranial anomalies that are discussed include plagiocephaly, bregmatic fontanelle bones, Wormian bones, cranial trauma, and heterotopic bones. Among the dental anomalies that were studied were the following: crazing caries, periodontal and pulpal disorders, alveolar thinning, mechanical loss, excessive attrition, shear bite, impacted molars, supernumerary teeth, congenital agencies, congenital crown aberration, and irregular placement.
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There are at least six variants of junctional epidermolysis bullosa (JEB). About 20 cases of the generalized atrophic benign variant of JEB (GABEB) have been previously reported. We present an additional case of GABEB, occurring in a 14-year-old girl. Generalized cutaneous blisters occurred since birth and healed without severe scarring or milia, but with slight atrophy. In addition, mucous membrane involvement and hair, nail and tooth abnormalities were found. Electron microscopic examination showed a cleavage within the lamina lucida and the presence of numerically and structurally abnormal hemidesmosomes.
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