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Endodontic treatment of developmental anomalies in posterior teeth: treatment of geminated/fused teeth--report of two cases.

AIM: Gemination or fusion is a rare occurrence in the mandibular posterior teeth. Endodontic treatment of these teeth needs special care and attention to the bizarre anatomy. The aim of this article is to describe the problems encountered and the strategy in treating such cases. CASE REPORT: Two cases of complex endodontic treatment of fused/geminated teeth are presented. The first is an 11-year-old girl with an anomalous 'double' first mandibular molar and premolar diagnosed as having necrotic pulp with chronic apical abscess of endodontic origin; the second is a 16-year-old boy with 'double' second and supernumerary mandibular molars, who was diagnosed with irreversible pulpitis. Both cases were treated successfully in multiple appointments. The common features and treatment modalities are discussed. KEY LEARNING POINTS: Failure to diagnose fused/geminated teeth leads to misdiagnosis and a treatment plan that could cause permanent damage and tooth loss. Generally, there is communication between root canal systems of fused/geminated teeth which should be treated as one entity. Use of magnification is an important aid during treatment.

Adolescent↗

Radix mesiolingualis and radix distolingualis in a collection of permanent maxillary molars.

Two lingual root structures are occasionally found on human permanent maxillary molars. One of these is the normal lingual root, which is always present, the other is a supernumerary structure which can be located either mesiolingually (radix mesiolingualis (RML)) or distolingually (radix distolingualis (RDL)). The available literature refers only to the existence and location of RML and RDL Very small materials have, quite simply, hitherto precluded a more detailed description of these roots. The large collection of extracted teeth at the School of Dentistry in Copenhagen now includes a non-random subcollection of 145 permanent maxillary molars, the root complex of which contains 2 lingual root structures. Based on this material it was possible to undertake a modern, systematic analysis of the macromorphological variation of RMLs and RDLs. In this study, which was mainly non-metric, criteria for the identification of RML and RDL were established. The analysis also showed that the lingual supernumerary roots were only rarely found on the first molar, but with increasing frequency on the second and third molars. Both separate and non-separate RML and RDL were observed. In the material, degrees of separation greater than 0.9 were registered, degrees of divergence up to approximately 45 degrees, an apical bend of approximately 90 degrees, and extreme apical slenderness. Even though the supernumerary roots described here do not occur very often, knowing about them is nevertheless clinically relevant in for example endodontic and surgical contexts.

Humans↗

Prevalence of selected dental anomalies in Saudi children from Gizan region.

The present report gives prevalence values for a selected group of developmental dental anomalies in 2393 Saudi children aged 4-12 yr from Gizan region, Saudi Arabia. The anomalies selected in this study were those involving the number and shape of the dentition. The following anomalies were identified: congenitally missing teeth (2.2%), supernumerary teeth (0.50%), gemination (0.08%), and peg-shaped lateral incisors (0.37%).

Anodontia↗

Supernumerary impactions of the mandibular cuspids and bicuspids. Case report.

A case involving the presence of supernumerary cuspids and bicuspids is described. The condition was probably an inherited one because of the family history and the bilateral incidence. The supernumerary teeth erupted because of alveolar resorption in which inflammatory factors probably played a role. Radiographic follow-up of the site of supernumerary impacted teeth and alveolar resorption should be undertaken.

Aged↗

Evaluation of primary dentition in cleft lip and palate children with and without natal/neonatal teeth.

OBJECTIVE: Natal/neonatal teeth are very common in children with complete unilateral and bilateral cleft lip and palate. The extraction of these teeth is the usual treatment in the Hospital for Rehabilitation of Craniofacial Anomalies. The objective of this study was to verify whether these teeth could be of the normal complement or whether they were supernumerary. DESIGN: The primary dentition of children with cleft lip and palate with and without natal/neonatal teeth was compared at the Hospital for Rehabilitation of Craniofacial Anomalies. SUBJECTS: The sample consisted of 55 children with complete unilateral and bilateral cleft lip and palate with natal/neonatal teeth and 54 without. RESULTS: No positive association between these groups and missing lateral incisor or supernumerary or complete dentition was found. CONCLUSION: The extraction of the natal/neonatal teeth did not alter the final complement of primary teeth, and these teeth could be the lateral incisor or supernumerary.

Anodontia↗

Supernumerary teeth with eumorphism in the lower incisor region: a report of five cases and a review of the literature.

Five cases of supernumerary teeth with eumorphism in the lower incisor region of the permanent dentition are reported. The patients were two males and three females. One (a 31-year-old woman) of them had bilateral supernumerary teeth. The review of the English language literature yielded only one such bilateral supernumerary teeth in the lower incisor region of the permanent dentition was reported.

Adolescent↗

Supernumerary teeth--an overview of classification, diagnosis and management.

Most supernumerary teeth are located in the anterior maxillary region. They are classified according to their form and location. Their presence may give rise to a variety of clinical problems. Detection of supernumerary teeth is best achieved by thorough clinical and radiographic examination. Their management should form part of a comprehensive treatment plan. This article presents an overview of the clinical problems associated with supernumerary teeth and includes a discussion of the classification, diagnosis and management of this difficult clinical entity.

Humans↗

[Supernumerary teeth and orthodontic treatment].

According to the orthodontist supernumerary teeth on dental arches necessitate a special analysis of the occlusion to decide which to keep and which ones to pull out. Then he must solve the problem of the new occlusion to have. Thus in this study the authors, from their personal experiences of treatment of cases about supernumerary teeth go through the matter.

Animals↗

An unusual distribution of supplemental teeth in the primary dentition.

Supernumerary teeth are more common in the permanent than the primary dentition. In the latter, the majority occur in the maxillary lateral incisor region or as a mesiodens. Indeed, in one study conducted in the USA, all 26 cases of primary supernumerary teeth examined were found to be lateral incisors. This report describes a case presenting with three erupted supernumerary (supplemental) teeth in the primary dentition, including, somewhat unusually, bilateral duplication of maxillary canines.

Cuspid↗

Facial and dental anomalies in cleidocranial dysplasia: a study of 17 cases.

Seventeen cases of cleidocranial dysplasia were analysed. On average, there was mandibular prognathism due to increased mandibular length, and a short cranial base. The maxilla was short vertically but not antero-posteriorly. In 13 young subjects followed for an average period of 6 years, more than half of the total number of teeth of each type had not erupted at the normal age, with the exception of mandibular incisors. Twice as many maxillary incisors were delayed compared with those in the lower jaw. Only six of 25 mandibular central incisors were delayed. There was a total of 63 supernumerary teeth in the 13 subjects, mostly occurring in the mandibular premolar and maxillary incisor regions. Many more occurred in the maxillary than in the mandibular incisor region. In the molar regions only six supernumerary teeth were found, five in the upper jaw and one in the lower. Two patients had no supernumerary teeth. One patient showed congenital absence of one mandibular incisor and three premolars.

Adolescent↗

Prevalence of numeric anomalies in the permanent dentition of patients with Down syndrome.

The purpose of this study was to evaluate the prevalence of numeric anomalies in the permanent dentition of patients with Down syndrome by means of panoramic radiographs. The sample consisted of panoramic radiographs from 70 subjects. We examined the radiographs to detect hypodontia as well as supernumerary teeth. Our results confirm the high prevalence of hypodontia among patients with Down syndrome (60%), mostly with mild expression. The teeth most often missing were the upper lateral incisors, usually bilaterally, followed by the lower second premolars and upper second premolars. Supernumerary teeth were seen in 6% of the subjects, and the concomitant occurrence of hypodontia and supernumerary teeth occurred in one patient.

Adolescent↗

Supplemental mandibular permanent incisor teeth: report of two cases.

Two cases of supplemental mandibular permanent incisors are presented. These supernumerary teeth often erupt into the dental arches causing crowding and aesthetic problems. Management may range from simple extraction of the supernumerary teeth to comprehensive orthodontic treatment. Early diagnosis may provide better opportunity for optimal treatment outcome.

Child↗

Isolated soft tissue cleft lip: the influence on the nasal cavity and supernumerary laterals.

OBJECTIVE: The purpose of this investigation was to estimate the vertical deviation of the nasal floor and to register dental disturbances (i.e., hypo- and hyperdontia) in patients with an isolated soft tissue cleft lip. DESIGN: Thirty patients with isolated cleft lips were randomly selected from the files of the Department of Maxillo-Facial Surgery and Jaw Orthopedics. As a matched control group, 30 patients were selected from the files of the Department of Orthodontics. Panoramic radiographs were analyzed and the lowest point of the floor of the left and right nasal cavity was measured to the nearest 0.5 mm. The presence of supernumerary (deciduous or permanent) or missing lateral incisors was recorded from the patient's journals. RESULTS: The vertical position of the nasal floor differed significantly between the cleft and the non-cleft side (p < 0.001). Supernumerary, deciduous, and permanent laterals were recorded in 73% of the subjects in the cleft lip group (22 patients). In the control group, no differences were found between the position of the nasal floor on the left and right side and no supernumerary laterals were recorded. Missing laterals were not noted in any of the individuals investigated. CONCLUSIONS: Isolated cleft lips were in most cases associated with: (1) lowering of the nasal floor on the cleft side and (2) supernumerary primary or permanent lateral incisors on the cleft side. Panoramic radiographs can be used to detect differences in the vertical position of the floor of the nasal cavity in patients with isolated cleft lips and to diagnose supernumerary laterals.

Adolescent↗

Radiographic diagnosis of supernumerary teeth: report of six unusual cases.

The purpose of this report was to describe the radiographic findings of 6 uncommon situations of supernumerary teeth in a Brazilian pediatric dentistry and orthodontic clinic. Six cases of supernumerary teeth were diagnosed in association with other dental anomalies such as number, position, and form. The supernumeraries were asymptomatic and were detected through routine radiographic examination. The importance of routine radiographic examination is emphasized for the correct diagnosis of supernumerary teeth, and avoidance of associated complications.

Anodontia↗

Radiographic diagnosis of supernumerary premolars: case reviews.

The literature reported prevalence of supernumerary teeth within the mandible and maxilla varies from 0.2-0.9%. This study reviews the formation and diverse clinical appearances of supernumerary premolars. We present case reports where supernumerary teeth were recognized as incidental findings during routine radiographic examination in patients with an age range of five to thirty-nine years. Cases are presented to illustrate that the initiation and development of supernumerary premolars are often delayed by a magnitude of years. Periodic examination is recommended for occurrence and clinical behavior. In the presented cases, displacement and resorption of the adjacent teeth was not evidenced. None of the supernumerary teeth demonstrated cystic transformation. The importance of differential radiographic diagnosis is discussed.

Adolescent↗

Clinical management of multiple maxillary anterior supernumerary teeth: report of case.

Supernumerary teeth in the maxillary midline can present both esthetic and pathologic concerns that can be difficult to solve. The frequency with which supernumerary teeth occur justifies an oral radiographic survey for preschool children as early detection is most important, if such complications are to be avoided or minimized. The case presented in this report required both surgical and innovative orthodontic therapy to bring an unerupted, impacted maxillary central incisor into proper alignment. The tooth was moved into the dental arch and injury to the root structure and surrounding oral tissues was avoided by using a combination of conservative surgical and orthodontic therapy.

Child↗

[Ectopic teeth in the area of the paranasal sinuses].

In contrast to dentogenious affections of the sinus maxillaris ectopic or supernumerary teeth in the paranasal sinuses are seldom. Ectopic teeth located at the ostium of the sinus maxillaris are rare, intranasal teeth are very rare and ectopic/supernumerary teeth in the sinus etmoidalis are a curiosity. We report about two patients with such ectopic teeth. A 55 year old woman had a rootless tooth in her right sinus ethmoidalis which had caused a "pseudopolyposis" with consecutive nasal airway obstruction and severe headache. A 59 year old man had ectopic teeth in both sinus maxillaris which obstructed the left ostium, causing dumbness of the left cheek and severe headache. Both patients have been cured by operation. However the presented patients demonstrate that even elaborated radiological efforts could not prove diagnosis. The etiology, diagnostical steps and treatment of these teeth are discussed. The surrounding soft tissue should be examined histologically after resection of such a tooth to prevent the development of a residual cyst and to notice the extremely rare development of malignancies deriving from the highly potential tissue of the dental follicle.

Diagnosis, Differential↗

Cranial and dental anomalies in three species of platyrrhine monkeys from Nicaragua.

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.

Alouatta↗