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Case report BC: extraction decisions based on treatment responses.

We have all been into treatment and lost sight of the "plan" we were so familiar with at the treatment planning stage. Eighteen to 21 months into treatment, we are faced with extraction decisions or surgical planning that should have been addressed at 9 or 12 months. This case report illustrates a treatment plan with several variables that were dependent upon treatment responses. It also illustrates planning a gingival graft to increase the crown length of a first premolar after the canine was substituted as the lateral incisor.

Adolescent↗

Primary double teeth. A retrospective clinical study of their morphological characteristics and associated anomalies.

AIM: To investigate the relationship between morphology and position of double teeth, and the occurrence of other dental anomalies in the same subjects and in their siblings. SAMPLE OF CHILDREN AND METHODS: Fifty-three double teeth in a group of 50 Spanish children were included in the study. All of these children were examined clinically and had radiographs and photographs taken at the time of examination. Twenty-two of the children had a total of 30 siblings who were also examined for the presence of anomalies. RESULTS: Of the 50 subjects, 47 had one and three subjects had two double teeth. Statistically there were no significant differences in occurrence between boys and girls, left and right sides or between maxilla and mandible. Four morphological types were identified: type I, bifid crown-single root; type II, large crown-large root; type III, two fused crowns-single root; type IV, two fused crowns-two fused roots. Type I was seen only in the maxilla and types II and III only in the mandible. Type IV was seen mostly in the maxilla. More than half of the cases showed associated anomalies in the permanent dentition and anomalies of number or shape were also present in six of the siblings. CONCLUSION: It is suggested that both double teeth and other anomalies in the same children or in their siblings may be manifestations of a primary abnormality in the distribution of dental material.

Child↗

Multiple dental anomalies in a young patient: a case report.

This case illustrates the management of multiple dental anomalies in a young patient, which included anomalies of number and morphology. Although individually these anomalies are not uncommon, the combination is unusual and highlights the importance of careful clinical and radiographic examination of patients with dental anomalies.

Child↗

Dental morphologic characteristics of normal versus delayed developing dentitions with palatally displaced canines.

An earlier study reported on the delayed dental age in about 50% of patients with palatally displaced canines (PDC), suggesting the possible existence of 2 different PDC phenotypes. The present study aimed to determine whether the PDC subgroup with late dental age displays different dental features from the PDC subgroup with normal dental age, supporting the above assumption. The 3 dental parameters examined were mesiodistal and buccolingual tooth sizes, the presence of anomalous maxillary lateral incisors, and other congenitally missing teeth. Fifty-eight subjects with PDC, 37 girls and 21 boys, were divided according to dental age and compared with age- and sex-matched controls. The results revealed marked sexual dimorphism. Delayed dental development was twice as prevalent among the PDC males. The existence of 2 distinct PDC subgroups was supported for males only. One subgroup was characterized by delayed dental development, smaller-than-average teeth, and a marked increase in the prevalence of anomalous lateral incisors. The second subgroup more closely resembled the controls, presenting a timely developed dentition, a moderate and nonsignificant increase of anomalous lateral incisors, and a reduction in the dimensions of only the central incisors and the first molars. In females, although the prevalence of anomalous lateral incisors was slightly increased in the late dental age subgroup, tooth sizes were remarkably similar, negating the existence of 2 distinct subpopulations. Studying the overall PDC group as a single entity produced confusing results because important differences were obscured when the 2 sexes and the 2 dental age subgroups (in males) were combined.

Adolescent↗

Early craniofacial signs of cleidocranial dysplasia.

OBJECTIVES: Early diagnosis of CCD is essential for a timely introduction of the appropriate treatment approach. Since certain symptoms first fully manifest only during the pubertal growth spurt, their indicatory signs are often overlooked. The aim of this study is to describe the initial craniofacial findings in patients with CCD in order to categorise their reliability for early detection. METHOD: 14 patients with CCD between the ages of 6 and 11 years who were referred to the University of Regensburg over a 4-year period were included in this study. The patients were examined clinically and radiologically and their dental status was determined. Typical signs of CCD were analysed according to such classic criteria as the 'quatermoon'-physiognomy described in the literature. The clinical findings were compared to medical data and case history. RESULTS: Early signs were registered for each patient. While some signs could be found in all patients, others were variably expressed. The typical extraoral symptoms were only rarely exhibited in our patient population. CONCLUSION: As various indicators of CCD are age related, their expression should be taken into account for early diagnosis. Apparent signs only manifest during the growth spurt when the ideal timeframe for beginning treatment has already past. The symptoms described should serve as early markers to aid the general and paediatric dentist in planning appropriate treatment or referring patients to specialised centres.

Age Factors↗

Missing C, supplemental D and supplemental premolar all in one quadrant: a case report.

This case report describes a non-syndromic Caucasian patient who presented with a missing upper right primary canine and a supplemental upper right primary first molar. Later, a supplemental premolar developed in the upper right quadrant. The report highlights the importance of early diagnosis of dental anomalies and a multidisciplinary approach to treatment planning. A regular review and radiographic examination are essential.

Anodontia↗

Congenitally missing maxillary primary canines: report of three cases.

BACKGROUND: Hypodontia is uncommon in the primary dentition and lateral incisors are the most commonly missing primary teeth in the patients affected. Studies have found that hypodontia in the primary dentition involving only maxillary canine is rare. CASE REPORTS: Three cases of hypodontia in the primary dentition involving only maxillary canine are presented. Two of them were affected by hypodontia and hyperdontia in the permanent dentitions respectively, yet all the permanent canines developed normally in these three cases. CONCLUSION: In children with congenitally missing maxillary canines, the permanent dentitions may show diverse anomalies in tooth numbers, ranging from hypodontia to hyperdontia.

Anodontia↗

Atypically located paramolar. Report of a rare case.

A paramolar mesial to the mandibular second molar would be predicted from the atavistic theory on phylogenetic evolution of the human dentition. The actual finding of this feature, however, appears to have been reported only once. A 4 mm long tooth was found mesial to the right mandibular second molar in a 54-yr-old Japanese female. The tooth had a ball-shaped crown, a relatively normal crown/root length ratio, and a tapering root located entirely in the gingival soft tissue.

Female↗