Mesiodens en dentición temporal y mixta: informe de casos / Mesiodens in primary and mixed dentition: case reports

Objetivo: Presentar una serie de casos clínicos de me- siodens en niños con dentición temporal y mixta, su trata- miento y seguimiento. Casos clínicos: Se muestra el manejo clínico de tres casos de mesiodens en dentición temporal y un caso en den- tición mixta, los cuales fueron diagnosticados en un examen radiográfico de rutina (AU)

Aim: To present a series of clinical cases of mesiodens in children with primary and mixed dentition, their treatment and follow-up. Clinical cases: This paper describes the clinical man- agement of three cases of mesiodens in primary dentition and one case in mixed dentition which were diagnosed in routine radiographic examinations (AU)

Tratamento cirúrgico de mesiodentes sob sedação consciente com óxido nitroso: relato de caso clínico / Surgical treatment of mesiodens under conscious sedation with nitrous oxide: clinical case report

Dentes supranumerários são caracterizados como um excesso no número de dentes da série normal. Os mesiodentes, definidos pela sua localização mediana aos incisivos centrais superiores, referem-se ao tipo de dente supranumerário mais comumente encontrado na cavidade oral, normalmente intraósseo e assintomático. A presença desses dentes pode ocasionar alterações na dentição permanente, mas a abordagem cirúrgica na fase da dentição mista mostra resultados satisfatórios no alinhamento dental espontâneo. Em pacientes pediátricos, a sedação consciente com óxido nitroso tem demonstrado ser uma alternativa segura e eficaz no controle do medo e da ansiedade. Objetivo: relatar um procedimento cirúrgico de remoção de dois mesiodentes em paciente pediátrico sob anestesia local associada à sedação com óxido nitroso. Relato de caso: paciente do sexo feminino, 11 anos de idade, necessitava de remoção cirúrgica de dois dentes supranumerários localizados em região anterior de maxila. Com a avaliação da tomografia computadorizada, pôde-se observar a posição em que ambos se encontravam. Realizou-se também a exodontia do elemento dentário 14, como solicitado pela ortodontista, para posterior continuidade do tratamento ortodôntico. Devido à complexidade cirúrgica e ao tempo operatório, considerando a idade da paciente e o possível aumento nos níveis de ansiedade, optou-se pela realização de sedação consciente com óxido nitroso. Conclusão: clinicamente, dentes supranumerários podem causar danos locais. O tratamento cirúrgico associado à sedação consciente mostrou-se bastante seguro e efetivo no controle comportamental, além de poder ser implementado na rotina ambulatorial.(AU)

Supernumerary teeth are defined as those in addition to the normal series. The mesiodens, is the most common supernumerary tooth and it is present in the midline between the two central incisors. It is usually intraosseous and asymptomatic. The presence of these teeth may cause changes in permanent dentition and the surgical approach in the mixed dentition phase shows satisfactory results in spontaneous dental alignment. In pediatric patients, conscious sedation with nitrous oxide has been shown to be a safe and effective alternative in controlling fear and anxiety. Objective. To report a surgical procedure for the removal of two mesiodens in a pediatric patient under local anesthesia associated with nitrous oxide sedation. Case report. 11-year-old female patient required surgical removal of two upper mesiodens. The computed tomography images assisted to indicate their exact position. The extraction of the upper right premolar (tooth #14) was also performed as requested by the orthodontist. Considering the patient's age and the possible increase in anxiety levels, along with surgical complexity and operative time, the conscious sedation with nitrous oxide was selected. Conclusion. Clinically, supernumerary teeth cause local damage and surgical treatment associated with conscious sedation has proved to be quite safe and effective in the behavioral control besides being able to be implemented in the outpatient routine.(AU)

Fusión del tercer molar inferior con un cuarto molar: reporte de tres casos / Fusion of the lower third molar with a fourth molar: report of three cases

Los dientes supernumerarios y la fusión dental son anomalías del desarrollo dental cuyas causas aún no se han dilucidado con certeza. El cuarto molar inferior, también denominado distomolar, es uno de los dientes supernumerarios con menor frecuencia de aparición clínica y su fusión con el tercer molar es una condición todavía menos común. A continuación, se reportan los casos clínicos de tres pacientes masculinos que presentaron fusión del tercer molar inferior derecho con un distomolar tratados mediante odontectomía (AU)

Supernumerary teeth and dental fusion are abnormalities of dental development whose causes have not yet been elucidated with certainty. The lower fourth molar, also called distomolar, is one of the supernumerary teeth with the least frequency of clinical appearance and its fusion with the third molar is an even less common condition. Next, the clinical cases of three male patients who presented fusion of the right lower third molar with a distomolar treated by odontectomy are reported (AU)

Supernumerary teeth in patients with cleft lip and palate: the tooth germs do not separate

ABSTRACT Introduction: Supernumerary teeth in cases of cleft lip and palate do not result from the division of normal germs before the formation of hard tissue. Deciduous and permanent teeth odontogenesis begins after the face has formed, either with or without the cleft. Discussion: The most acceptable hypothesis to enable understanding of the presence of supernumerary teeth on one or both sides of the cleft palate is hyperactivity of the dental lamina in its walls. This hyperactivity, with the formation of more tooth germs, must be attributed to mediators and genes related to tooth formation, under strong influence of local epigenetic factors, whose developmental environment was affected by the presence of the cleft. Conclusion: The current concepts of embryology no longer support the fusion of embryonic processes for the formation of the face, but rather the leveling of the grooves between them. All human teeth have a dual embryonic origin, as they are composed of ectoderm and mesenchyme/ectomesenchyme, but this does not make it easy for them to be duplicated to form supernumerary teeth.

RESUMO Introdução: Os dentes extranumerários nas fissuras labiopalatinas não são resultado da divisão dos germes normais antes da formação do tecido duro. A odontogênese dos decíduos e permanentes inicia-se depois de formada a face, com ou sem fissuras. Discussão: A hipótese mais plausível para compreender a presença dos dentes extranumerários em um ou nos dois lados da fissura labiopalatina é a hiperatividade da lâmina dentária em suas paredes. Essa hiperatividade, com formação de mais germes dentários, deve ser atribuída aos mediadores e genes relacionados à formação dos dentes, sob forte influência de fatores epigenéticos locais, cujo ambiente de desenvolvimento foi afetado pela presença da fissura. Conclusão: Os conceitos atuais da embriologia não fundamentam mais a fusão de processos embrionários para a formação da face, e sim o nivelamento dos sulcos entre eles. Todos os dentes humanos têm uma dupla origem embrionária, pois se compõem de ectoderma e mesênquima/ectomesênquima, mas isso não facilita sua duplicação para formar dentes extranumerários.

Prevalence of dental anomalies and bone alterations in childrens panoramic radiographies / Prevalência das anomalias dentárias e alterações ósseas em radiografias panorâmicas de crianças

ABSTRACT Objective To verify the prevalence of dental anomalies in terms of number, position and shape, and the presence of bone alterations, through analysis of panoramic radiographs. Methods This study evaluated dental anomalies and bone alterations in children aged 6 to 12 years-old, detected on panoramic radiographies recorded in the radiographic database of the Federal University of Espírito Santo between 2012 and 2016. Clinical and demographic information were registered. Dental records were retrieved to obtain the medical history involving syndromes or other diseases that may interfere with the anomalies and alterations. Chi-square and exact Fischer's statistical tests were performed. Results There were alterations in 83 out of 301 panoramic radiographs analyzed. There were 169 anomalies or alterations (mean of 2,04±1,38 anomalies/patient), involving 201 teeth. The most prevalent anomaly was tooth impaction (26.63%), which affected the canines more frequently, followed by hypodontia (24.26%), more often found in the second premolar, and both affected mostly females. Hyperdontia and radiolucent lesions showed the same prevalence (18.93%), the most affected teeth were those of the anterosuperior region and the first mandibular molars, respectively. The least prevalent anomalies were dilaceration (7.69%), taurodontism (2.37%) and radiopaque lesions (1.18%). Bone alterations were significantly more found in mandible and in the posterior region, which confirms the prevalence in the lower molars. Conclusion Although there was no statistically significant difference regarding sex, there was a high prevalence of anomalies and alterations in our study population, which indicates the importance of its diagnosis by means of a panoramic x-ray examination.

RESUMO Objetivo Verificar a prevalência das anomalias dentárias de número, posição e forma, além da presença de alterações ósseas, por meio de radiografias panorâmicas. Métodos Levantamento das anomalias dentárias e alterações ósseas em crianças de 6 a 12 anos, com radiografia panorâmica registrada no Banco de Imagens Radiográficas da Universidade Federal do Espírito Santo nos anos de 2012 a 2016. Foram registradas informações clínico-demográficas referentes aos pacientes atendidos. As fichas clínicas foram recuperadas para obtenção da história médica de síndromes ou outras doenças que interfiram nas anomalias e alterações. Foram realizados os testes estatísticos qui-quadrado ou exato de Fischer. Resultados Foram encontradas 83 radiografias panorâmicas que mostravam algum tipo de alteração em 301 analisadas. Foram descritas 169 anomalias ou alterações (média de 2,04±1,38 anomalias/paciente), envolvendo 201 dentes. A anomalia mais prevalente foi a impactação (26,63%) que afetou mais os caninos, seguida da hipodontia (24,26%) que ocorreu mais em segundos pré-molares, em ambas o sexo feminino foi mais acometido. A hiperdontia e as lesões radiolúcidas tiveram a mesma prevalência (18,93%), os dentes mais acometidos foram da região ântero-superior e os primeiros molares inferiores, respectivamente. As menos prevalentes foram dilaceração (7,69%), taurodontia (2,37%) e lesões radiopacas (1,18%). As anomalias ósseas estavam significativamente mais em mandíbula e na região posterior, o que confirma a prevalência em molares inferiores. Conclusão Não houve diferença estatisticamente significativa em relação ao gênero. Mas houve alta prevalência de anomalias e alterações na população estudada, o que denota a importância do diagnóstico por meio desse importante exame complementar.

Prevalence of Dental Anomalies in School Children of Muzaffarpur District (Age 5 to 12 Years)

Introduction: The development of the tooth is highly complexphenomena controlled by various complex mechanisms whichare dependent on the hereditary and environmental factors.Any alteration in these mechanisms leads to developmentaldisturbances or the dental anomalies. Study aimed to knowthe prevalence of developmental anomalies in school childrenbetween age group of 5 to 12 years located in Muzaffarpurcity.Material and methods: The study was based on a clinicalexaminations review of 6182 school children (Male-3364 &Female- 2818) of Muzaffarpur city, aged between 5 years to12 years. Routine instruments like mouth mirror, probe andnatural and/or artificial light was used for the examination.Results: The prevalence of dental anomalies observed in thisstudy is 0.12%. The prevalence of supernumerary teeth in thisstudy is 0.04 %, In our study we found ankyloglossia is foundin male only in this population and the prevalence value is0.01%. In our study we found Microdontia is equal prevalencevalue in both male and female sexes and was 0.03 % of thoseexamined.Conclusion: Epidemiological studies have provideduseful information regarding the prevalence, location, anddistribution of primary tooth anomalies, contributing to theformulation of public health policies adequately informed bythe specificities of each population.

Supernumerary: the Importance of Early Orthodontic Treatment / Supranumerário: a Importância do Tratamento Ortodôntico Precoce

The presence of supernumeraries may lead to irruptive problems, such as impacted teeth, functional and aesthetic disorders. The present study describes two clinical cases, with anterior teeth eruption disorders caused by additional dental elements, treated early. Patients presented with aesthetic involvement, with delay in the emergence of the upper incisors. The clinical and radiographic examinations detected the presence of obstacles to the teeth eruption. Early treatment with 2x4 appliance was realized, followed by final corrective orthodontics. After restoration of the dimension for retained teeth, there was spontaneous eruption in clinical case 1 and need of traction in clinical case 2. When patients reached the complete permanent dentition, a corrective phase was performed with the objective of detailing the dental occlusion and finishing the treatment. The early diagnosis of teeth impacted and supernumerary, provide the achievement of adequate occlusion and positive aesthetic of patients, with good prognosis, avoiding psychological and functional problems caused by absence of anterior teeth. (AU).

A presença de supranumerários pode ocasionar problemas irruptivos, como impacção de dentes, desordens funcionais e estéticas. O presente trabalho descreve dois casos clínicos abordados precocemente, com alterações na irrupção de dentes anteriores devido a presença de supranumerários. Os pacientes apresentavam queixas estéticas, com atraso no aparecimento dos incisivos superiores. Os exames clínico e radiográfico detectaram a presença de barreiras irruptivas. Realizou-se tratamento precoce com auxílio da mecânica 4x2, seguido pela ortodontia corretiva final. Após etapa de restabelecimento da dimensão para os dentes retidos, houve irrompimento espontâneo no caso clínico 1 e necessidade de tracionamento no caso clínico 2. Quando pacientes atingiram a dentição permanente completa, realizou-se uma fase corretiva com o objetivo de detalhamento da oclusão dentária e finalização do tratamento. O diagnóstico precoce de impacção dentária e detecção de supranumerários favoreceu a restituição de oclusão adequada e estética dos pacientes, com prognóstico muito favorável, evitando problemas psicológicos e funcionais provocados pela ausência de dentes anteriores. (AU).

Distomolares en posición ectópica (kissing molars): reporte de un caso / Distomolars in ectopic position (kissing molars): report of a case

Introducción: El término kissing molars se traduce como «dientes besándose¼; superfi cies oclusales de dos molares retenidos están en contacto una con otra en espacio folicular único y raíces en dirección contraria. Literatura científi ca ha reportado 44 casos. Cuartos molares o distomolares, supernumerarios que se forman distalmente a terceros molares; tamaño y forma variable, generalmente retenidos. Caso clínico: Femenino de 32 años con molestias en zona retromolar inferior izquierda, limitación de apertura, trismus, disfagia. En ortopantomografía, se observa cuarto molar retenido junto con tercer molar, superfi cies oclusales de ambos órganos dentarios retenidos en íntimo contacto dentro de un mismo saco folicular, raíces en dirección opuesta. Discusión: Existe controversia acerca de diferencia entre molares retenidos y KM, algunos autores sugieren que la ausencia de contacto entre dos molares retenidos no permite incluirlos en esta condición. Etiología aún incierta, algunos lo consideran como un evento aislado. Existe una teoría en relación con la formación de quiste dentígero; resorción ósea causada por presencia y expansión de éste, resulta en pérdida de hueso en zona mesial de molares retenidos facilitando movilización, inclinación y contacto uno con otro (AU)

Introduction: The term kissing molars is used when the occlusal surfaces of two retained molars are in intimate contact inside the same follicular sack and roots in opposite direction. Literature has reported 44 cases. Fourth molars, also known as distomolars, are a supernumerary tooth that grows distally to third molars; size and shape are variable, generally retained. Case report: Female 32 years old, pain in the left inferior retromolar zone, trismus, dysphagia. Fourth and third retained molars, with occlusal surfaces in contact, inside the same follicular sack, roots in opposite direction are observed in orthopantomography. Discussion: There is controversy about the diff erence between retained molars and KM, some authors suggest that the absence of contact between two retained molars, does not allow to include them in this condition. Etiology still unknown. Dentigerous cyst formation theory is proposed due to the bone resorption in the mesial zone of retained molars in this entity, which facilitates mobilization and contact between molars (AU)

Sedative efficacy of nitrous oxide combined with midazolam in extraction of impacted supernumerary teeth in children / 口腔疾病防治

Objective@#To study the sedative efficacy and safety of nitrous oxide (N2O ) inhalation combined with oral midazolam in children with impacted supernumerary teeth for extraction under sedation and to provide a reference for the selection of anesthetic methods for children undergoing impacted teeth extraction.@*Methods @#Sixty patients aged 5-10 years with maxillary impacted supernumerary teeth were randomly divided into three groups, with 20 in each group, as follows: the N2O group: N2O inhalation sedation before the operation; the midazolam group: oral midazolam sedation before the operation; the combination group: N2O inhalation combined with oral midazolam sedation before the operation. Sedation was performed before extraction under local anesthesia. The Ramsay sedation effect, Houpt behavioral score and incidence of adverse reactions were evaluated after the operation.@*Results@#The Ramsay sedation scale score was significantly higher in the combination group (2.75 ± 0.55) than in the N2O group (2.30 ± 0.47) and the midazolam group (2.40 ± 0.50) (P ＜0.05). Similarly, the Houpt behavioral rating scale score was significantly higher in the combination group (5.25 ± 0.64) than in the N2O group (4.70 ± 0.73) and the midazolam group (4.80 ± 0.69) (P ＜0.05). The adverse reaction rate was lower in the combination group (5%) than in the N2O group (10%) and the midazolam group (10%), but the difference was not significant (χ2=0.436, p=0.804).@*Conclusion@#N2O inhalation combined with oral midazolam sedation in the extraction of impacted supernumerary teeth in children can significantly improve the sedative and therapeutic efficacy and is a safe and effective sedation method.

Application of surgical locating guides on impacted supernumerary teeth extraction / 华西口腔医学杂志

OBJECTIVE@#To study the application of surgical locating guides based on cone beam computed tomography (CBCT) and computer-aided design/computer-aided manufacturing (CAD/CAM) technique on extraction of impacted supernumerary teeth.@*METHODS@#This study included 15 patients with impacted supernumerary teeth in anterior maxillary. Surgical approach was determined by CBCT. Surgical locating guides of labial approach or palatal approach were designed and fabricated by CAD/CAM technique. Impacted supernumerary teeth were extracted under the location of surgical locating guides.@*RESULTS@#Surgical locating guides were well attached in the operation. The impacted supernumerary teeth were located and exposed rapidly, and the adjacent important anatomical structures were avoided.@*CONCLUSIONS@#Surgical locating guides benefit the accurate detection and reduction of trauma in extraction of impacted supernumerary teeth.

Characterization of Human Dental Pulp Cells from Supernumerary Teeth by Using Flow Cytometry Analysis / 대한소아치과학회지

The aim of this study was to analyze cells from human dental pulp tissue of impacted supernumerary teeth as stem cells with flow cytometry. Human dental pulp cells from 15 supernumerary teeth were identified their characteristics as stem cells by expression of mesenchymal stem cell markers through flow cytometry analysis at passage 3 and passage 10. Cluster of differentiation (CD) 73, CD 90, CD 34, CD 45 and STRO-1 cell surface markers were used to figure out characteristics of dental pulp stem cells from supernumerary teeth. At passage 3, the cell population showed positive expression of CD 73, CD90 and STRO-1, lacked expression of CD 34 and CD 45. At passage 10, CD 73, CD 90 and STRO-1 showed positive expression while CD 34 and CD 45 showed negative expression. This study indicated that dental pulp stem cells of supernumerary teeth had the properties of mesenchymal stem cells at both early and late passage. Impacted supernumerary teeth could be considered as a noble source of stem cells because of rapid growth and maintaining characteristics of stem cells until late passage.

An orthopantomographic study of prevalence of hypodontia and hyperdontia in permanent dentition in Vadodara, Gujarat

Developmental anomalies in the number of teeth can result from disturbances in the developing dental lamina of the tooth. The dental lamina may become hyperactive leading to the formation of a supernumerary tooth or may fail to proliferate leading to the congenital absence of a primary or permanent tooth. Aims: The aim of the study was to assess the prevalence and distribution of hypodontia and hyperdontia in permanent dentition, excluding the third molars in children in Vadodara, Gujarat. Setting and Design: A descriptive, analytical, and cross-sectional study was conducted to determine the above-mentioned aims. Materials and Methods: In the study, panoramic radiographs of 1816 children (967 girls and 849 boys), aged 8 to 14 years were recorded and inspected for anomalies in the number of teeth. Statistical Analysis Used: The data was analyzed using SPSS version 10.00 (Statistical Package for the Social Sciences, Chicago, USA). Descriptive statistics and Chi-square-test were used to compare the results. The level of significance was set at 0.05. Results: The prevalence of hypodontia was 11.01%, and the most frequently absent tooth was the maxillary lateral incisor. There was an increased prevalence of hypodontia in females and in the mandibular arch of the permanent dentition. The prevalence of hyperdontia was 2.97% and the most common supernumerary tooth was mesiodens. There was an increased prevalence of hyperdontia in males and in the maxillary arch of the permanent dentition. Conclusions: There was a high prevalence of hypodontia and a low incidence of hyperdontia in the studied population. Prompt diagnosis of these anomalies can help plan treatment modalities at an early age to establish a functional and esthetic dentition.

Terapéutica quirúrgico-ortodóntica en adultos con dientes supernumerarios múltiples. Presentación de caso / Surgical-orthodontic therapy on adults with multiple supernumerary teeth

Se presentó a la consulta estomatológica, una paciente femenina de 39 años de edad, sin antecedentes médicos de interés, por presentar pérdida espontánea de un diente temporal. A través del examen físico intrabucal, se pudo corroborar la ausencia clínica del diente número 13, y en su lugar, la presencia de mucosa, que evidenciaba una exfoliación reciente de un diente, con notable disminución del espacio entre el incisivo lateral y la primera bicúspide superior izquierda. El examen radiográfico periapical mostró la presencia de una imagen radiopaca, ubicada entre el incisivo lateral y la primera bicúspide de la hemiarcada superior izquierda, la cual sugiere la presencia de múltiples órganos dentarios. Dada la afectación funcional, estética y psicológica de la paciente, y la existencia de discrepancia negativa moderada hueso-diente, se decidió realizar la exéresis quirúrgica de los dientes supernumerarios y en una segunda etapa, la corrección ortodóncica. El tratamiento quirúrgico se realizó sin complicaciones, pues la paciente mostró una evolución postquirúrgica positiva. Luego de la recuperación total del área intervenida, comenzaron los movimientos ortodóncicos, que finalmente permitieron obtener un resultado estético y funcional óptimo.

A 39 years old female patient, with no medical records, comes to dentistry consulting because of a temporal tooth loss. During the intraoral physical examination the absence of the 13 tooth was corroborated, and the recently exfoliation of a teeth with a considerable diminish of space between the left upper lateral incisor and the left first upper bicuspid were corroborated. The x-rays showed radiopacity, located between the lateral incisor and the first upper bicuspid of the left hemi-arcade, suggesting several dental organs. Due to functional, aesthetic and psychological influencies on the patient, and the presence of a moderated negative bone-teeth discrepancy, it was decided to practice surgical extraction of supernumerary teeth and the orthodontic correction. Surgical treatment was practiced without complications, and the patient showed a good postsurgical evolution. After a total recovery of the affected area, orthodontic movement began. It allowed an optimum aesthetic and functional outcome.

Supernumerario distomolar en rama mandibular asociado a quiste dentígero. Presentación de un caso / Distomolar Supernumerary in the mandibular ramus associated with a dentigerous cyst. A case presentation

Introducción: Los dientes supernumerarios son anomalías donde hay un aumento de la fórmula dental normal. Ocasionalmente provocan complicaciones, como la formación de un quiste dentígero. Por lo infrecuente del hallazgo, y más aún del reporte de esta asociación, se realizó la presentación del caso. Objetivo: Describir el manejo de un supernumerario distomolar en rama mandibular asociado a un quiste dentígero, enfatizando en la importancia de los estudios imaginológicos preoperatorios y el abordaje quirúrgico endobucal. Presentación del caso: Paciente femenina de 34 años, que se extrajo los terceros molares en la adolescencia, y que 3 meses atrás presentó una celulitis facial por la que se le realizó una ortopantomografía, y se detectó un molar en la rama mandibular. Al examen bucal se encontró ligera expansión de la tabla vestibular de rama mandibular izquierda. Se constató en la ortopantomografía la presencia de una estructura dentaria del grupo molar asociada a área radiolúcida, lo que se corroboró en una tomografía. Se planificó la exéresis de ambos mediante abordaje endobucal bajo anestesia general. No se presentaron complicaciones. La paciente fue egresada a las 24 horas y fue seguida evolutivamente por consulta externa durante 6 meses. El diagnóstico histopatológico indicó la presencia de un quiste. Conclusiones: La detección de un diente supernumerio distomolar en rama mandibular asociado a quiste dentígero es una situación clínica infrecuente que permite explotar los beneficios de estudios imaginológicos digitales y crear un plan de tratamiento que culmine en la exéresis exitosa por vía endobucal, sin complicaciones(AU)

Introduction: Supernumerary teeth are anomalies in which there is an increase of the normal dental formula. They occasionally cause complications, such as the formation of a dentigerous cyst. Because of the unusual finding, and even more because of the report of this association, a case presentation is carried out. Objective: To describe the management of a supernumerary distomolar in the mandibular ramus associated with a dentigerous cyst, making emphasis on the importance of the preoperative imaging studies and the endo-buccal surgery approach. Case presentation: 34 years old female patient from whom the third molars were removed during adolescence, who presented facial cellulitis 3 months before the molars removal, which was a reason to perform an orthopantomography. Then, a molar in the mandibular ramus was detected. During oral examination, a light vestibular table expansion in the left mandibular ramus was found. The presence of a dental structure from the molar group which was associated with a radiolucent area was confirmed by orthopantomography, and was also confirmed by CT-scan. Exeresis of both molars under general anesthesia was planned, with an endo-buccal approach. There were no complications. The patient was discharged 24 hours later, and was treated in the outpatient consulting room for 6 months. Histopathological diagnosis revealed the presence of a cyst(AU) Conclusions: The finding of a supernumerary distomolar tooth in the mandibular ramus associated with a dentigerous cyst is an infrequent clinical situation that allows to make good use of the benefits of digital imaging studies, and implement a treatment plan that ends in a successful exeresis via an endo-buccal route, without any complications(AU)

Endodontic management of central incisor associated with large periapical lesion and fused supernumerary root: a conservative approach

Fusion and gemination are developmental anomalies of teeth that may require endodontic treatment. Fusion may cause various clinical problems related to esthetics, tooth spacing, and other periodontal complications. Additional diagnostic tools are required for the diagnosis and the treatment planning of fused tooth. The present case report describes a case of unilateral fusion of a supernumerary root to an upper permanent central incisor with large periapical lesion in which a conservative approach was used without extraction of supernumerary tooth and obturated with mineral trioxide aggregate to reach a favorable outcome.

Clinical retrospective study of navigation guided impacted maxillary supernumerary tooth extraction / 中华口腔医学杂志

Objective@#To analyze the efficiency and safety of navigation guided extraction of impacted supernumerary tooth.@*Methods@#Twenty-five cases of navigation guided supernumerary tooth extraction and 25 cases of non-navigation guided supernumerary tooth extraction (control group) were included in the study. Each group had 3 cases with one impacted supernumerary tooth and 22 cases with two impacted teeth.@*Results@#Preoperative navigation system designing time was (45.0±8.0) min in average. Navigation system installation time was (15.0±2.8) min. The average operation time was (0.64±0.08) hour in navigation group and (0.91±0.09) hour in control group.@*Conclusions@#Navigation guided extraction of impacted supernumerary tooth takes less time for operation but more time for the preoperative navigation system design.

Characteristics of Supernumerary Tooth-derived Pulp Cells during Long-term Culture / 대한소아치과학회지

This study was conducted to investigate the characteristics of subculture times in the early, middle, and late passages by measuring the time under subculture until it was judged that the supernumerary tooth-derived pulp stem cells (sDPSCS) were no longer proliferating. Three supernumerary teeth from two healthy six-years old boys were extracted and stem cells were obtained from the pulp tissue. This was called SNT1 (supernumerary tooth 1), SNT2, and the supernumerary tooth from another child was named SNT3. SNT1 and 2 were subcultured at the same time and SNT3 was subcultured a little faster. The mean time of complete subculture was 3.6 ± 1.1 days. Total passages were cultured up to 23.3 ± 0.6 and took 83 days. These were divided into three groups based on the passage. The increase rate of time taken in subculture between group I and group II was 11.9%, but the rate between group II and group III was 28.6%, which was 2.4 times increased. The time taken between passages during long-term subculture up to 22 passages shows a regressive pattern y = 0.1169x + 2.25 and y = 0.1169x + 2.0. In conclusion, the passage time of SPSCs increased in late passages, and it shows a similar pattern.

Hallazgos imagenológicos de dens in dente tipo II con formato de odontoma dilatado en un mesiodiente / Imaging findings of a dilated odontoma shaped type II dens in dente in a mesiodens

Introduction: there are three types of dens in dente: Type I, minimal invagination confined to the crown of the tooth which does not extend beyond the amelocemental junction; Type II, invagination extends to the pulp chamber, but remains within the root canal with no communication with the periodontal ligament; and Type III, invagination extends to the root of the affected tooth, beyond the cementoenamel junction. The term dilated odontoma is used to describe the most severe variant of invagination (Type III), which is characterized by crown and/or root dilation of the affected tooth. Objective: describe a rare case of a dilated odontoma shaped dens in dente in a mesiodens and its imaging findings, diagnosed by cone beam computed tomography. Case presentation: a 14-year-old male patient was referred for radiographic examination of the mandible and maxilla to determine the cause of abnormal tooth eruption chronology. Two mesiodens were found on the maxilla. Due to the peculiar morphology of the mesiodens on the right side, cone beam computed tomography was performed. Multiplanar reconstructions revealed an oval structure on the eruption path of the upper right central incisor, in contact with its palatal surface. Coronal and sagittal reconstructions showed that invagination extended beyond the cementoenamel junction, without any additional apical/lateral formation. Conclusions: the final diagnosis was dilated odontoma shaped type II dens invaginatus in a mesiodens(AU)

Introducción: existen tres categorías de dens in dente: Tipo I, invaginación mínima confinada a la corona del diente y que no se extiende más allá de la unión amelo-cementaria; Tipo II, la invaginación se extiende a la cámara de la pulpa, pero permanece dentro del canal de la raíz, sin comunicación con el ligamento periodontal; y Tipo III, la invaginación se extiende a la raíz del diente afectado, más allá de la unión cemento-esmalte. El término odontoma dilatado se utiliza para describir la variante más grave de la invaginación (tipo III), que se caracteriza por la dilatación de la corona y/o laraíz del diente afectado. Objetivo: describir un caso raro de un dens in dente con formato de odontoma dilatado en un mesiodiente y sus hallazgos imagenológicos, diagnosticados mediante tomografía computarizada de haz cónico. Presentación del caso: paciente varón, 14 años de edad, fue enviado a un servicio de Radiología Odontológica con el fin de determinar la causa de anómala cronología de la erupción dental en maxilar superior y mandíbula. Dos mesiodientes fueron identificados en el maxilar superior. El mesiodiente del lado derecho llamó la atención debido a su peculiar morfología, por lo que se realizó la tomografía computarizada de haz cónico. Las reconstrucciones multiplanares revelaron una estructura ovalada ubicada en el trayecto de erupción del incisivo central superior derecho, en contacto con su superficie palatina. Reconstrucciones coronales y sagitales demostraron que era posible identificar la extensión de la invaginación más allá de la unión cemento-esmalte, sin constitución de forma apical/lateral accesoria. Conclusiones: el diagnóstico final fue dens invaginatus tipo II en forma de odontoma dilatado en un mesiodiente(AU)

Mesiodentes na dentição mista: relato de caso / Mesiodens in mixed dentition: case report

Os dentes supranumerários são dentes adicionais à série normal e podem ocorrer em qualquer região da arcada dentária, entretanto, são comumente encontrados em maior número na maxila. O termo mesiodente refere-se ao dente supranumerário localizado na região da pré-maxila, mais precisamente entre os incisivos centrais superiores, e é o tipo mais frequente de supranumerário. Este artigo apresenta o caso clínico de uma criança de 08 anos de idade, gênero masculino, cujos pais procuraram por tratamento com queixa de não esfoliação dos incisivos superiores permanentes. Foram realizados exames clínicos e radiográficos e estes demonstraram a presença de dois dentes mesiodentes impedindo a irrupção dos permanentes. O objetivo do trabalho é enfatizar a importância de um diagnóstico precoce para evitar possíveis complicações e auxiliar no planejamento cirúrgico(AU)

Supernumerary teeth are additional teeth to the normal range and can occur in any region of the teeth, however, they are commonly found in the maxilla. The term mesiodens refers to the supernumerary tooth located in the region pre - jaw, more precisely between the upper central incisors and is the most common type of supernumerary. This article presents a case of a child, 08-years-old, male, whose parents sought treatment for complaining of no exfoliation of the permanent incisors. Clinical and radiographic examinations were performed and these showed the presence of two mesiodens teeth preventing the eruption of the permanent. The aim is to emphasize the importance of an early diagnosis to prevent possible complications and assist in surgical planning(AU)

Mesiodens: a case report / Mesiodens: reporte de caso

ABSTRACT Mesiodens are supernumerary teeth, commonly seen in the maxillary midline. Given their high frequency, dentist should be aware of the signs and symptoms of mesiodens and their appropriate treatment. This case report describes an 8-year-old girl with a radiographic image suggesting two unerupted mesiodens between the central incisors on the palate. The intraoral examination showed swelling in the anterior palatal region with no mucosa alteration. The supernumerary teeth were diagnosed by periapical radiograph and computed tomography. The objective of this study is to present the clinical importance and use of diagnostic images, such as periapical radiograph (Clark technique) or tomography.

RESUMEN. Un mesiodens es un diente supernumerario que comúnmente se presenta en la línea media maxilar. Dada la frecuencia con la que se presenta, el odontólogo general debe estar bien informado acerca de los signos y síntomas del mesiodens y del tratamiento adecuado. Este artículo relata el caso de una paciente de 8 años de edad, en cuyo examen radiográfico se observa una imagen sugestiva de dos mesiodens no erupcionados entre los incisivos centrales superiores. En la valoración intraoral se encontró una inflamación en la región palatina anterior, sin ninguna alteración en la mucosa. Los dientes supernumerarios se diagnostican mediante radiografía y tomografía computarizada. El objetivo de este trabajo es presentar la importancia clínica observada y la utilización de imágenes auxiliares para el diagnóstico, como la radiografía periapical (técnica de Clark) o la tomografía computarizada.