Tooth transposition: a multidisciplinary approach

ABSTRACT Tooth transposition is one of the most difficult dental anomalies to treat in the dental clinic. Several factors must be taken into account with a view of making the best decision. The aim of this study was to discuss treatment modalities for tooth transposition, their advantages and disadvantages. Additionally, it aims at presenting a clinical case of transposition between canine and lateral incisor in the upper quadrant on the right side. The treatment of choice was extraction of one transposed tooth. A multidisciplinary approach involving Orthodontics, Cosmetic Dentistry, and Periodontology was necessary to allow proper esthetic and functional outcomes to be achieved.

RESUMO A transposição é considerada uma das anomalias dentárias mais difíceis de se administrar clinicamente. Vários fatores devem ser considerados para que a melhor decisão seja tomada. Neste artigo, o objetivo foi discutir as modalidades de tratamento da transposição dentária, suas vantagens e desvantagens, e apresentar um caso clínico de transposição entre canino e incisivo lateral na hemiarcada superior direita. A opção terapêutica de escolha foi a extração de um dos dentes transpostos, tendo-se a necessidade de uma abordagem multidisciplinar com a participação da Ortodontia, Dentística e Periodontia, a fim de que adequados resultados estéticos e funcionais fossem alcançados.

Tercer molar ectópico en seno maxilar: reporte de un caso / Ectopic third molar in maxillary sinus: report of a case

Los dientes ectópicos son órganos dentarios que se encuentran enuna región diferente a la habitual, existen publicaciones que reportanórganos dentarios ectópicos en la región maxilofacial siendo sitioscomunes el paladar, región paraorbitaria, cavidad nasal, seno maxilar, mentón, apófisis corónides y cóndilo. También se han publicado casos de zonas más alejadas como ovario o región anterior del mediastino,que por lo general están relacionados con un teratoma. En su mayoría son hallazgos radiográficos, por lo que en general son asintomáticos. Al encontrarse dentro del seno maxilar su terapéutica puede ser conservadora,bajo vigilancia clínica-radiográfi ca o quirúrgica mediante endoscopia, abordaje transnasal, Caldwell-Luc o abordaje cuadrangular. La extracción de estos órganos dentarios es necesaria por la tendencia que presentan a formar quistes, desarrollar tumores odontogénicos y desencadenar alteraciones neuropáticas. Se reporta el caso de una paciente de 32 años de edad con diagnóstico de tercer molar ectópico en región de antro maxilar.

Ectopic tooth are dental organs found in a uncomon regions. There arepublication that report ectopic tooth in the maxillofacial region beingcommon sites palate, paraorbitaria region, nasal cavity, maxillarysinus, chin, coronides process and condyle. Cases have also beenreported in non-dental areas such as ovary, anterior mediastinum regionusually related to a teratoma. Ectopic tooth are often radiographicfi ndings because they are generally asymptomatic. Its therapeuticwhen found in the maxillary sinus could be conservative under periodicclinical-radiographic vigilance. Removal of these dental organs isnecessary for their tendency to form cysts, develop odontogenic tumorsand trigger neuropathic disorders. Surgical options are endoscopic,transnasal, Caldwell Luc or quadrangular approach. We present acase of a female of 32 years old with a diagnosis of ectopic third molarin maxillary antrum.

Risk of developing palatally displaced canines in patients with early detectable dental anomalies: a retrospective cohort study

ABSTRACT The early recognition of risk factors for the occurrence of palatally displaced canines (PDC) can increase the possibility of impaction prevention. Objective To estimate the risk of PDC occurrence in children with dental anomalies identified early during mixed dentition. Material and Methods The sample comprised 730 longitudinal orthodontic records from children (448 females and 282 males) with an initial mean age of 8.3 years (SD=1.36). The dental anomaly group (DA) included 263 records of patients with at least one dental anomaly identified in the initial or middle mixed dentition. The non-dental anomaly group (NDA) was composed of 467 records of patients with no dental anomalies. The occurrence of PDC in both groups was diagnosed using panoramic and periapical radiographs taken in the late mixed dentition or early permanent dentition. The prevalence of PDC in patients with and without early diagnosed dental anomalies was compared using the chi-square test (p<0.01), relative risk assessments (RR), and positive and negative predictive values (PPV and NPV). Results PDC frequency was 16.35% and 6.2% in DA and NDA groups, respectively. A statistically significant difference was observed between groups (p<0.01), with greater risk of PDC development in the DA group (RR=2.63). The PPV and NPV was 16% and 93%, respectively. Small maxillary lateral incisors, deciduous molar infraocclusion, and mandibular second premolar distoangulation were associated with PDC. Conclusion Children with dental anomalies diagnosed during early mixed dentition have an approximately two and a half fold increased risk of developing PDC during late mixed dentition compared with children without dental anomalies.

Localization of impacted permanent maxillary canine using single panoramic radiograph.

Background and Objectives : The objective in localization is selection of a suitable technique which has minimal radiation dose, cost and maximum details. Panoramic radiograph, being a screening radiograph, can satisfy the above needs. Taking this into consideration, the present study was done to evaluate the reliability of panoramic radiograph in localization of impacted permanent maxillary canines by applying the criteria suggested by Chaushu et al. and by comparing it with Clark's rule. Materials and Methods : The study comprised of 114 subjects in the age group of 13-30 years of both the genders with 150 impacted canines visiting Department of Oral Medicine and Radiology during the study period. The study subjects were examined for clinically missing canine, and then confirmed with intra-oral peri-apical radiograph (IOPAR). Panoramic radiographs (for application of Chaushu et al. criteria) and IOPAR's (for application of Clark's rule) of the subjects were made and interpreted for parameters pertaining to the impacted canines. The data obtained was tabulated and subjected to statistical analysis using the statistical package for social sciences (SPSS) software. Results : Determination of the bucco-palatal position from panoramic radiographs, by applying Chaushu, et al. criteria, showed that localization in bucco-palatal position was possible for 96 of the 102 impacted canines placed in the middle and coronal zones. The remaining six impacted canines, three each in the middle and coronal zones, could not be localized as they showed overlapping in their range. By excluding them, the overall agreement worked out to be 94.11%. Localization was not possible for 48 impacted canines that lied in the apical zone. Conclusion : A single panoramic radiograph can serve as a reliable indicator for determining the bucco-palatal position of the impacted canines when they lie in the middle and coronal zones. When they lie in the apical zone it is recommended to explore their presence with other conventional or advanced imaging modalities.

Transmigrated mandibular permanent canine: a case report.

A case of transmigration of mandibular canine is presented. The importance of anesthetizing the transmigrated tooth from the side of origin is highlighted.