Five cases of hypophosphatasia with dental findings.
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OBJECTIVE: The purpose of this study was to assess the morbidity and outcomes associated with large cysts that developed in conjunction with pulpotomized deciduous molars. STUDY DESIGN: This retrospective study was based on the files of 18 patients who were referred to 2 oral surgery departments during a 10-year period (1986-1996). The inclusion criteria were large cyst lesions (>1 cm in diameter) and complete documentation. Data regarding symptoms at presentation, histologic and radiologic features, treatment modalities, morbidity, and outcomes were analyzed. RESULTS: An equal gender distribution of patients was found, as were a later development in males (12+/-2 years in boys, 9+/-2 years in girls) and a 5:1 ratio favoring the mandible over the maxilla. Treatment included enucleation (12 patients) and marsupialization (6 patients). The morbidity was high and included loss of permanent teeth (3 patients), extensive loss of alveolar bone (3 patients), use of flaps (2 patients), and adjuvant orthodontic treatment (9 patients). CONCLUSION: Failure of early detection and treatment of cysts that develop in conjunction with pulpotomized deciduous molars can cause considerable morbidity. Therefore, periodic clinical and radiologic follow-up until the eruption of succedaneous teeth is recommended.
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A statistical exploration of space changes following early loss of deciduous molars, developing a picture of closure from both directions with district differences between upper and lower arch changes.
This purpose of this research was to examine the stability of normal occlusion during the transition from primary to permanent dentition. The sample consisted of 128 children (83 boys and 45 girls) 4.5 to 5.5 years old with normal occlusion in the primary dentition. The subjects were reexamined at 12.5 to 13.5 years. None had received orthodontic treatment. Although all the subjects had normal occlusion in the primary dentition, 72.7% (73.5% boys and 71.1% girls) had developed anomalies following eruption of the permanent teeth. These anomalies included crowding, Class II Division 1 or Class II Division 2 malocclusion, mesial occlusion complex, lateral crossbite, anterior crossbite, premature tooth loss, openbite or other anomalies.
The purpose of this prospective study was to determine if there is a difference between the amount of cellular and acellular cementum on the roots of 2 teeth extracted from a subject with cleidocranial dysplasia (CCD) compared to 10 teeth extracted from 10 subjects unaffected by CCD. The cementum of 2 permanent teeth, which had been extracted from the CCD subject, was examined and histomorphometrically analyzed for comparison to the cementum of 10 anterior teeth that had been extracted from individuals who were unaffected by CCD. The percentage of the root covered by cellular or acellular cementum was quantified to determine if patients affected by CCD typically lack cellular cementum. In the roots of the 2 permanent teeth of the subject with CCD, a mean of 18.05 +/- 10.67% was covered by cellular cementum and 76.90 +/- 3.53% was covered by acellular cementum. In the 10 permanent teeth from subjects without CCD, a mean of 19.12 +/- 15.60% of the root was covered by cellular cementum and 80.34 +/- 15.71% was covered by acellular cementum. The findings indicate that there is no statistically significant difference between the amount of either cellular or acellular cementum covering the roots of the study subject with CCD and the roots of the 10 control teeth. The presumption that a lack of cellular cementum causes the increased number of unerupted teeth in patients with CCD is not supported by the findings of this study.
The objective of this paper is to clarify the literature's findings and provide guidelines for decision-making during the long-term treatment planning of infraoccluded primary molars. This paper presents a synopsis of findings concerning prevalence, aetiology, diagnostic methods, diagnostic criteria and treatment options. Treatment decisions are mainly guided by the clinical assessment of the presence or absence of succedaneous tooth, evaluation of onset, time of diagnosis, resorption rate, rate of progression of infraocclusion, risk of adverse effects over time, and predictive clinical patterns of infraoccluded primary molars. These models are a result of a comprehensive review of the literature and presents a compilation of findings in a format that is of practical use to the clinician.
AIM: This study evaluated the prevalence of signs of temporomandibular disorders (TMD) in children with and without premature loss of primary teeth. SAMPLE: Fifty-eight children, aged 4-6 years, with missing primary molars, were compared with 58 age- and sex-matched control children with complete primary dentitions. METHOD: All the children underwent an examination that consisted of palpation and assessment of the joints and associated muscles for tenderness and joint sounds. Maximum vertical opening and deviation during jaw opening were also recorded. Children with any single anomalous finding were designated positive for TMD signs. RESULTS: There were no statistically significant differences in the prevalence of single or collective TMD signs between the two groups. CONCLUSION: The results of this study show that premature loss of primary teeth, uncomplicated by other factors, does not appear to be an aetiological factor for TMD development.
OBJECTIVE: The aim of this study was to investigate pulpal tissue of primary teeth in early and late stages of physiological resorption by means of silver-binding nucleolar organizer region (Ag-NOR) staining. STUDY DESIGN: Ten primary teeth in early, ten in the late stage of resorption and five sound premolar teeth pulps as the control group were investigated by means of silver-binding nucleolar organizer region (Ag-NOR) staining. RESULTS: The mean number of Ag-NOR's per nucleus increased with the continuing of the resorption process. The difference in the mean number of Ag-NORs was statistically significant both in the early and late stage of resorption compared with controls (P > 0.001). In the early stage of resorption calcific plates in the apical part of the pulps were observed. Odontoclasts, as well as inflammatory cells, were observed in the late stages of resorption. CONCLUSIONS: The increase in the mean number of Ag-NORs per nucleus with the progression of the resorption process in primary teeth suggests that metabolic cell activity in the early stages of resorption is enhanced and increased with the continuing of the process, thus showing the importance of the pulp tissue in the resorption process.
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A retrospective study of 26 patients with maxillary incisor root resorption relating to the presence of an ectopic canine was undertaken from case records. The group consisted of nine male and 17 female patients with a mean age of 12.5 years. There was a total of 35 resorbed teeth, 26 lateral and nine central incisors, and these were related to 32 ectopic canines. The resorption tended to be extensive, 30 teeth had pulpal involvement. In two-thirds of cases the pattern of resorption involved both apical and middle thirds of the root. Despite the extensive nature of the involvement there were few clinical signs and symptoms reported by patients. 43.8 per cent of canines were lying palatal to the arch, 18.7 per cent were in the line of the arch and 37.5 per cent were buccal. Significantly 15.6 per cent were buccal and erupted. The path of canine eruption was mesio-horizontal in 21 cases. No relationship could be found between resorption and the retention or loss of the deciduous canine. The canine root formation was virtually complete in 31 of the involved canines. The study indicated that the problem is often diagnosed late both in relation to the patient's age and the extent of resorption present. It is suggested that the problem may be underestimated by dental practitioners.