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PubMed1997

Solitary median maxillary central incisor, short stature, choanal atresia/midnasal stenosis (SMMCI) syndrome.

This article describes a series of 21 consecutive cases, each involving a solitary median maxillary central incisor; the patients were seen in the Department of Dentistry or the Victorian Clinical Genetics Unit, Murdoch Institute, at the Royal Children's Hospital, Melbourne, from 1966 to 1997. The spectrum of anomalies and associated features present in these cases--solitary median maxillary central incisor, choanal atresia, and holoprosencephaly--is described, and the literature related to the features, including genetic studies in these conditions, is reviewed. We relate our findings in these cases to current knowledge of developmental embryology. It is hoped that the findings, together with our interpretation of them, will help to clarify understanding of solitary median maxillary central incisor syndrome. This syndrome was previously considered a simple midline defect of the dental lamina, but it is now recognized as a possible predictor of holoprosencephalies of varying degrees in the proband, in members of the proband's family, and in the family's descendants.

Body Height↗

PubMed1998

Solitary maxillary central incisor in the midline associated with systemic disorders.

A single maxillary central incisor in the midline is a rare developmental anomaly. The appearance of a single incisor in place of two teeth may occur as an isolated dental finding that can be related to fusion of two neighboring teeth or to agenesis of a tooth germ. However, the condition has also been reported to occur in association with autosomal dominant holoprosencephaly, growth retardation, and midline developmental defects. This article reports on other systemic defects that can be found in association with a single maxillary central incisor.

Anodontia↗

PubMed1998

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

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

Adolescent↗

PubMed1985

Characterization of the primary gene product of rat incisor alpha-phosphophoryn.

The nature of the primary gene product for the alpha-phosphophoryn component of rat incisor dentin has been examined by cell-free translation of the total RNA and poly(A+) mRNA from rat maxillary incisors, including pulp cells and odontoblasts. The RNA was extracted by the guanidinium thiocyanate method and translated in a rabbit reticulocyte system. The translated proteins were analyzed by gradient gel electrophoresis, and alpha-phosphophoryn was identified by isolation on an anti-rat alpha-phosphophoryn antibody coupled Sepharose column and dot-blot procedures. The major protein identified as alpha-phosphophoryn had a molecular weight of 153 000 (+/- 5000) and had chromatographic properties similar to those of alpha-phosphophoryn. Since tissue-isolated rat phosphophoryn has a molecular weight of only approximately 90 000 when fully phosphorylated, it appears that the primary gene product is a prepro-alpha-phosphophoryn. Thus, alpha-phosphophoryn in the extracellular space of rat incisor dentin must be the product of one or more posttranslational proteolytic processing steps.

Amino Acids↗

PubMed1999

Single implants in the upper incisor region and their relationship to the adjacent teeth. An 8-year follow-up study.

The aim of the study was to find out if implant-supported crowns in the upper incisor region run the risk of coming into an infraoccluded position later in life. Ten adolescents with 15 implant-supported crowns were included in the study. The age of the patients at the implant surgery ranged between 14 and 19 years. They were followed up during an 8-year period. No implant loss was observed. A good or acceptable aesthetic appearance at the last observation was found in most subjects. In some of them a change in the vertical position of the implant-supported crown, resulting in infraocclusion, could be registered, especially in subjects with no incisor contact. Throughout the follow-up period, only minor loss of marginal bone support was observed at the implants. At the teeth adjacent to the implant, a reduction of the marginal bone level was observed in some patients. Of importance to consider in single implant therapy is that a fixed chronological age is no guidance for implant placement, due to a slight continuous eruption of the adjacent teeth post adolescence. An orthodontic treatment should be performed not only in order to gain space in the implant area, but also to attain good incisor stability to reduce the risk of infraocclusion of the implant-supported crown. Furthermore, 3 cases will exemplify that infraocclusion also may occur in patients who had received single implants at adult ages.

Adolescent↗

PubMed2001

Dipeptidyl-peptidase II and cathepsin B activities in amelogenesis of the rat incisor.

A body of published evidence suggests that a significant portion of enamel matrix protein synthesized by ameloblasts localises in the lysosomal-endosomal organelles of these enamel organ cells. Little is known regarding the lysosomal proteolytic activities during amelogenesis. The aims of this study were to detect and measure the activities of lysosomal peptidases cathepsin B (E.C. 3.4.22.1) and dipeptidyl-peptidase II (E.C. 3.4.14.2) in the enamel organ of the rat incisor and to ascertain whether rat enamel matrix proteins are degraded by these peptidases in vitro. Whole enamel organs were dissected from rat mandibular incisors. Enamel protein was also collected from the rat teeth. Analysis indicated that the rat incisor enamel organs contained specific activities of both dipeptidyl-peptidase II and cathepsin B at levels comparable with those of kidney which is rich in both these lysosomal peptidases. Gel electrophoresis and immunoblotting demonstrated that both cathepsin B and dipeptidyl-peptidase II were able to substantially degrade the rat enamel proteins in vitro. Based on these observations, we propose that lysosomal proteases have roles in amelogenesis in the intracellular degradation of amelogenins.

Amelogenesis↗

PubMed2001

Periodontal response to two intracanal medicaments in replanted monkey incisors.

Intracanal medicaments are recommended for use in replanted teeth to inhibit inflammatory root resorption. This study compared the effect of calcium hydroxide (Pulpdent) and a corticosteroid-antibiotic paste (Ledermix) on periodontal healing and root resorption following replantation. Incisors of eight Macaca fascicularis monkeys were extracted, stored dry for 15 min and replanted. After 11 days, root canals in two adjacent maxillary incisors were treated with one medicament and contralateral incisors with the other medicament, or left as untreated controls. Animals were sacrificed 8 weeks later and the teeth prepared for histomorphometric evaluation of periodontal ligament inflammation and root resorption. Periodontal ligament inflammation and inflammatory root resorption were markedly inhibited by both calcium hydroxide and corticosteroid-antibiotic relative to untreated controls. Replacement resorption was lowest in the corticosteroid-antibiotic group, and significantly (P<0.05) more normal periodontal ligament was present in this group (79.6%) than in calcium hydroxide and control groups (64.6% and 62.7%, respectively). Treatment with the corticosteroid-antibiotic inhibited inflammatory resorption and was slightly more effective than calcium hydroxide in producing a periodontal healing response.

Animals↗

PubMed2003

Periodontal mechano-sensory responses following trauma to permanent incisor teeth in children.

The aim of this study was to investigate mechano-sensory responses of injured and uninjured incisor teeth. Twenty-five children who had experienced dental trauma, together with age- and gender-matched controls, were studied prospectively. Touch thresholds of incisor teeth from both groups were determined using calibrated sets of von Frey hairs (force range 0.5-10.0 g in 0.5 g increments) using a forced choice staircase method. Forces were applied perpendicular to the buccal enamel surfaces along the midline, 2 mm from the incisal edge. Touch threshold was defined as the lowest force detected in three out of the five occasions. Following statistical analysis, P < 0.05 was considered significant. At initial examination, the touch threshold values of 25 traumatised teeth were significantly greater than the untraumatised controls (P < 0.001), and these values approached those of the control teeth over 3-12 months (P > 0.05). Dental trauma was associated with increased touch thresholds in permanent incisor teeth, with recovery toward healthy control values usually occurring between 3-12 months.

Adolescent↗

PubMed2000

Retention of permanent incisors by mesiodens: a family affair.

The term mesiodens refers to a supernumerary tooth that is present in the midline of the maxilla between the two central incisors. One or two mesiodentes may be present. We present a rare case of two sisters, in both of whom a pair of mesiodentes caused the retention of permanent incisors. They were referred to our hospital with asymptomatic delayed eruption of upper incisors. This article is written to point out genetic factors as the possible origin of supernumerary teeth.

Adolescent↗

PubMed1996

Combined orthodontic and restorative management of a case of bilateral ectopic canines and resorbed central incisors.

A case is reported in which two ectopic maxillary permanent canine teeth bypassed the lateral incisors and caused extensive resorption to both maxillary central incisor teeth. Management involved positioning the canine teeth into the central incisor region and placing porcelain veneers on these teeth. The orthodontic and restorative implications of the treatment are discussed.

Child↗

PubMed1984

Isolation and partial characterization of proteoglycans from rat incisors.

Newly synthesized proteoglycans of rat incisors were labelled in vivo for 6h with [35S]-sulphate in order to facilitate their detection during purification and characterization. Proteoglycans were extracted from non-mineralized portions (predentine) of rat incisors with 4M-guanidinium chloride and subsequently from dentine by demineralization with a 0.4M-EDTA solution containing 4M-guanidinium chloride. Both extractions were performed at 4 degrees C in the presence of proteinase inhibitors. Purification of proteoglycans was achieved with a procedure involving gel-filtration chromatography, selective precipitation of phosphoproteins, affinity chromatography and ion-exchange chromatography. Two proteoglycan populations were found in the initial extract (Pd-PG I and Pd-PG II), whereas only one fraction (D-PG) was obtained after demineralization. The minor proteoglycan fraction from the first extract, Pd-PG I, although not totally characterized, differed sharply from the other proteoglycans in that it had a larger molecular size with larger glycosaminoglycan chains composed of chondroitin 4- and 6-sulphate isomers. In contrast, the major proteoglycans Pd-PG II and D-PG had smaller hydrodynamic sizes with smaller glycosaminoglycan chains (but larger than those from bovine nasal cartilage proteoglycans) composed exclusively of chondroitin 4-sulphate. The major proteoglycans were incapable of interacting with hyaluronic acid. In general, the amino acid compositions of the major proteoglycans of rat incisors resembled that of bovine nasal cartilage proteoglycans, but the former had lower proline, valine, isoleucine, leucine, and higher aspartic acid, contents.

Amino Acids↗

PubMed1996

Long-term stability of mandibular incisors following successful treatment of Class II, Division 1, malocclusions.

The purpose of this study was to evaluate the long-term stability of mandibular anterior alignment in a large group of Class II, Division 1, patients who demonstrated successful occlusal results at the end of active treatment. The specific aim was to search for predictors of relapse and associations between relapse and other post-retention changes. The sample of 78 adolescents was limited to successfully treated cases as judged by subjective evaluation of intercuspation and incisor occlusion of posttreatment study models. Neither cephalometric characteristics nor post-retention occlusion were considered in sample selection. Of these patients, study models and cephalograms were available pretreatment, at the end of active treatment, and a mean of 14 years post-retention. The results demonstrated an increase of incisor irregularity and a reduction of intercanine width and arch length post-retention. At post-retention, 9.0% had irregularity index values of 6.5 mm or more and 47.4% had values equal to 3.5 mm or less. Stepwise backward multiple regression analyses revealed that narrow pretreatment intercanine width and high pretreatment incisor irregularity were significant predictors of relapse. Treatment increase of intercanine width and post-retention decrease of intercanine width and arch length were associated with relapse.

Adolescent↗

PubMed2005

Maxillary canine transposition to incisor site: a rare condition.

Tooth transposition is defined as positional interchange of 2 adjacent teeth within the same quadrant. The incidence has been reported as about 0.4%, and the maxillary permanent canine has been reported as the tooth most frequently involved. Several etiologic factors like genetics, interchange in position of the developing tooth buds, trauma, mechanical interferences, and early loss of incisors have been associated with tooth transposition. Articles in the literature report various kinds of transpositions, but there are only a few reported cases of transposition of the maxillary canine to central incisor site. This kind of transposition has been suggested as resulting primarily by opportunistic canine migration into the space left from an early lost central incisor. However, there are only 2 long-term roentgenographic follow-up studies documenting maxillary canine migration and substantiating this hypothesis. This report shows 2 cases of this rare condition, with 1 of them documented with long-term records.

Adult↗

PubMed2005

Upper lip changes correlated to maxillary incisor retraction--a metallic implant study.

The soft tissue changes after the extraction of maxillary first premolars and subsequent anterior tooth retraction were evaluated for 16 Class II, division 1 patients. Pre- and posttreatment lateral head cephalograms were evaluated using superimpositions on Björk-type metallic implants in the maxilla. The patient sample was divided into group I patients, those who did exhibit lip seal at rest in the pretreatment cephalogram and group II patients, those who did not exhibit lip seal at rest in the pretreatment cephalogram. Upper incisor retraction was followed by a similar ratio of upper lip retraction in both the lip seal and nonsealed groups (1:0.75 and 1:0.70 mean ratios, respectively). However, those without lip seal did demonstrate more retraction at stomion (USt). The final upper lip position (Ls) was reasonably correlated with retraction of the cervical maxillary incisor point (cU1) with determination coefficients of 63.6% in the lip sealed and 68.5% in the lip incompetent groups. Although labial and nasolabial angles tended to open after incisor retraction, there was little predictability for this response.

Bicuspid↗

PubMed2006

Labially impacted maxillary canines causing severe root resorption of maxillary central incisors.

This is a case report of a patient with bilateral labial impaction of maxillary canines causing pressure resorption on the lateral aspects of the maxillary central incisors. The orthodontic treatment plan included extraction of the impacted canines, positioned between the central and the lateral incisors. Six years after the orthodontic treatment, the affected central incisors remained asymptomatic.

Child↗

PubMed2001

The quality of root fillings remaining in mandibular incisors after root-end cavity preparation.

AIM: The aim of this study was to determine the quality of root fillings remaining in mandibular incisors after root-end resection and root-end cavity preparation. METHODOLOGY: Roots of 40 mandibular incisors,12 mm in length, were divided into two groups and instrumented using a balanced force technique and obturated by vertically compacted warm gutta-percha. In one group sealer was used when back-filling the root canal with the Obtura System. The other group was also back-filled with the Obtura System but without sealer. The apical 4 mm of each root filling was removed by root-end resection and root-end cavity preparation. Fluid transport along the 7 mm of remaining root filling was measured. After the leakage test, horizontal sections were cut at a level 3 mm from the apical end of the remaining root filling. The cross sectional area of the canal and gutta-percha was measured using an image analysis program. The quality of the remaining root fillings was also evaluated by calculating the percentage of gutta-percha filled canal area. RESULTS: In total, 27 (67%) out of the 40 roots demonstrated leakage. No significant difference was found between the two groups (P = 0.265). In the cross-sections the bucco-lingual canal diameter was up to 2.6 mm long (mean 1.6 mm). The average percentage of gutta-percha filled canal area was 85.6%. Warm gutta-percha could not obturate areas where debris remained after instrumentation. CONCLUSIONS: The quality of the root fillings in mandibular incisors was poor, probably because the unprepared recesses of oval canals were not clean.

Dental Leakage↗

PubMed2003

Endodontic and surgical treatment of a geminated maxillary incisor.

AIM: A geminated maxillary incisor required complex multidisciplinary treatment to preserve health and restore aesthetics. This report describes the coordination of coronal division, root extraction, bone grafting, endodontic treatment and orthodontics in achieving treatment goals. It is the intention of this report to show how a difficult case could be managed by properly coordinated multidisciplinary care. SUMMARY: Pulp testing of the geminated central right maxillary incisor gave a normal response. Radiographic investigation indicated a connection of the pulp chambers. Both the mesial and distal root were filled with gutta-percha. The connection between the two root canals was sealed with a flowable dentine-bonded resin. After dividing the crown with a diamond bur, the mesial part of the tooth was removed and the extraction socket was filled with beta-tricalcium phosphate ceramic (Cerasorb). Radiographs taken immediately after surgery and after 6 months showed no periodontal or periapical lesions. No signs of external resorption were identified. The diastema between the central incisors was closed by orthodontic treatment. KEY LEARNING POINTS: Geminated teeth may present aesthetic and functional problems which require multidisciplinary care. Careful clinical and radiographic examination is essential to decide on the fate of the coronal and root halves involved. A proper coordination between endodontic and surgical treatment may result in maintaining one tooth half, even if a midroot connection between the pulp chambers becomes evident. Orthograde endodontic treatment, hemisection and orthodontics may solve the aesthetic problem of a geminated tooth.

Bone Substitutes↗

PubMed2003

A case of bilateral supplemental maxillary central incisors.

A case of bilateral supplemental maxillary central incisors is presented. Treatment comprised of extraction of one supplemental and two lateral incisors, preservation of one supplemental incisor, finishing with a 'Cyclops' arrangement of the teeth. The handling of supernumerary teeth in general is discussed.

Adolescent↗