[CLINICAL OBSERVATIONS OF EXTRAORDINARY PRESERVATION OF ECTOPIC TEETH].
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Hutchinson-Guilford progeria is a rare genetic condition showing the stigmata of accelerated ageing combined with severe growth retardation. Patients with this condition show a classical facies and clinical features with an average age of death of 13, usually due to atherosclerotic changes. Craniofacial and dental manifestations include mandibular and maxillary hypoplasia, both vertically and horizontally. Delayed and abnormal tooth eruption and morphology are commonly present. The long-term medical prognosis and eruption potential of individual teeth is important when considering treatment. In addition to this, surgical planning and surgical technique must be modified by the abnormal facial morphology, dermal inelasticity, potential anaesthetic difficulties, and ongoing deterioration in the medical condition. These factors mandate early and definitive intervention for oral surgical conditions. We report the case of a 13-year-old male treated for pericoronitis and oral pain relating to delayed eruption of first permanent molars.
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Dens in dente (dens invaginatus, tooth within a tooth, dilated composite odontome) is an abnormal tooth form which occurs most frequently in the permanent maxillary lateral incisor region. Dens in dente may occur, however, in any tooth in the dental arch, although these other forms are comparatively rare. It may appear within both the coronal part of the tooth and the root, although coronal forms are more common. In this paper, a case of extreme dens in dente with pulpal involvement at an early stage of eruption is presented.
This paper describes the ultrastructure of the affected enamel and the clinical features in two siblings with the syndrome of nephrocalcinosis and amelogenesis imperfecta. Nephrocalcinosis was diagnosed by intravenous pyelography, and confirmed by ultrasonography and CT scan. Amelogenesis imperfecta AI was diagnosed clinically and histologically. Light microscopy showed that the affected enamel surfaces were rough and the enamel was hypoplastic and mainly positively birefringent. Scanning electron microscopy revealed a rough and extensively cracked enamel surface covered with oval shaped blister-like protrusions. TEM showed porous enamel consisting of loosely packed and randomly oriented thin ribbon-like crystals with little or no prismatic structure. Observations showed that hypoplasia together with hypocalcification and/or hypomaturation defects were present in the same tooth, indicating the possibility of an abnormality in interstitial matrix, leading to dystrophic calcification in the kidney and abnormal tooth enamel formation, or alternatively an involvement of two separate but closely linked genes.
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In this report, a case of a mature tooth with abnormal crown morphology, which created plaque retentive areas was presented. The pulp was necrosed due to the periodontal disease, and the anomaly was thought to be an aberration of a talon cusp. Therapy involved the reshaping and the endodontic treatment of tooth.