Nonsurgical treatment for a severe anterior and lateral open bite and multiple congenitally missing teeth: a case report with 4-year follow-up

ABSTRACT This case report describes the treatment of a severe anterior and lateral open bite combined with multiple congenitally missing teeth. A 10-year-old girl presented with an open gonial angle, absence of lip sealing, and soft tissue pogonion retrusion. She had an open bite of 8.5 mm, agenesis of the upper right and left lateral incisors and the upper left first premolar, and transverse maxillary deficiency. Nonsurgical treatment was planned aiming at controlling the vertical pattern, establishing the correct overbite, and closing the spaces on the upper arch, to provide satisfactory occlusion and facial and dental esthetics.

RESUMO O presente caso clínico descreve o tratamento de uma mordida aberta anterior e lateral associada à ausência congênita de dentes permanentes. Paciente com 10 anos de idade, apresentava ângulo goníaco aberto, ausência de selamento labial passivo e retrusão do pogônio mole. Além disso, foi diagnosticada uma mordida aberta de 8,5 mm, agenesia de incisivos laterais superiores direito e esquerdo e de primeiro pré-molar superior esquerdo, além de deficiência transversa da maxila. O planejamento do caso envolveu um tratamento não cirúrgico, com controle vertical do crescimento, obtenção de correta sobremordida e fechamento dos espaços superiores. O caso foi finalizado com uma boa intercuspidação, contemplando a estética facial e dentária.

Prevalence of dental anomalies of number in different subphenotypes of isolated cleft palate

OBJECTIVE: This study aimed at carrying out a radiographic analysis on the prevalence of dental anomalies of number (agenesis and supernumerary teeth) in permanent dentition, in different subphenotypes of isolated cleft palate pre-adolescent patients. METHODS: Panoramic radiographs of 300 patients aged between 9 and 12 years, with cleft palate and enrolled in a single treatment center, were retrospectively analyzed. The sample was divided into two groups according to the extension/severity of the cleft palate: complete and incomplete . The chi-square test was used for intergroup comparison regarding the prevalence of the investigated dental anomalies (P < 0.05). RESULTS: Agenesis was found in 34.14% of patients with complete cleft palate and in 30.27% of patients with incomplete cleft palate. Supernumerary teeth were found in 2.43% of patients with complete cleft palate and in 0.91% of patients with incomplete cleft palate. No statistically significant difference was found between groups with regard to the prevalence of agenesis and supernumerary teeth. There was no difference in cleft prevalence between genders within each study group. CONCLUSION: The prevalence of dental anomalies of number in pre-adolescents with cleft palate was higher than that reported for the general population. The severity of cleft palate did not seem to be associated with the prevalence of dental anomalies of number. .

OBJETIVO: o propósito deste estudo foi avaliar radiograficamente a prevalência das anomalias dentárias de número (agenesias e supranumerários), na dentição permanente, em diferentes subfenótipos da fissura isolada de palato, em pacientes pré-adolescentes. MÉTODOS: foram investigadas, de forma retrospectiva, 300 radiografias panorâmicas de pacientes com fissura palatina (pós-forame), de 9 a 12 anos de idade, matriculados em um mesmo centro. A amostra foi dividida em dois grupos de acordo com a extensão/gravidade da fissura palatina: completa e incompleta. O teste qui-quadrado foi utilizado para comparação intergrupos das prevalências de anomalias avaliadas (p < 0,05). RESULTADOS: a agenesia dentária foi encontrada em 34,14% dos pacientes com fissura pós-forame completa e em 30,27% com fissura pós-forame incompleta. A prevalência de dentes supranumerários correspondeu a 2,43% nos pacientes com fissura palatina completa e a 0,91% no grupo com fissura palatina incompleta. Não houve diferença estatística significativa entre os grupos quanto à prevalência de agenesias dentárias e supranumerários. Não se observou diferença sexual quanto à prevalência de fissura dentro de cada grupo de estudo. CONCLUSÃO: os pacientes pré-adolescentes com fissura palatina apresentam maior prevalência de anomalias dentárias em relação à população em geral. A gravidade da fissura palatina parece não se associar com a prevalência de anomalias dentárias de número. .

Orthodontic movement of teeth with short root anomaly: should it be avoided, faced or ignored?

INTRODUCTION: Short Root Anomaly (SRA) is an uncommon disease and a challenge for orthodontic treatment as it tends to increase the risk of root resorption. OBJECTIVE: Assess the current status of the diagnosis, etiology and orthodontic management of teeth with SRA, and present case reports. METHOD: A literature review was carried out in PubMed, SciELO, LILACS, Scopus and Web of Science databases. RESULTS: A differential diagnosis of SRA should be conducted for teeth with incomplete root formation, external apical root resorption, dentin dysplasia type I and post dental trauma root hypoplasia. SRA is genetically determined and orthodontic movement requires changes in clinical and radiographic management in order to restrict damage. CONCLUSION: Orthodontic movement of teeth with SRA is contraindicated in extreme cases, only. Caution at all stages could minimize attachment loss and lead to long-term stability.

INTRODUÇÃO: a anomalia de raiz curta (ARC) é uma patologia incomum e constitui um desafio para o tratamento ortodôntico, pois tende a elevar o risco de reabsorção radicular. OBJETIVO: revisar a literatura sobre o diagnóstico, a etiologia e a conduta ortodôntica recomendada para esses casos, ilustrando esse tema com relatos de caso. MÉTODOS: devido ao baixo nível de evidência sobre o tema, realizou-se a revisão narrativa da literatura com estratégia de busca nas bases de dados PubMed, SciELO, Lilacs, Scopus e Web of Science. RESULTADOS: o diagnóstico diferencial da ARC deverá ser realizado entre dentes com rizogênese incompleta, reabsorção radicular externa apical, displasia dentinária tipo I e hipoplasia radicular pós-traumatismo dentário. A ARC apresenta determinantes genéticos para o encurtamento, e a movimentação ortodôntica exige que medidas de controle clínico e radiográfico sejam adotadas, ensejando a restrição de danos. CONCLUSÃO: a movimentação ortodôntica de dentes com ARC somente é contraindicada em casos extremos. A conduta cautelosa em todas as suas etapas poderá minimizar a perda de inserção e lograr em estabilidade em longo prazo.

Multidisciplinary Therapy of Extensive Oligodontia: A Case Report

Oligodontia is a rare congenital disorder consisting in the absence of six or more teeth. This case report describes a multidisciplinary treatment approach for a 12-year-old male with absence of 11 permanent teeth. Prior to any procedure, all primary teeth were scheduled for extraction due to poor crown-to-root ratio. The treatment plan comprised two phases: 1. orthodontic and speech therapy aimed at overbite and anterior open bite adjustment, as well as tongue position improvement; and 2. prosthetic treatment by insertion of removable temporary partial dentures. The multidisciplinary treatment involving orthodontics, speech and prosthetic therapies have reestablished the masticatory function and aesthetics, allowing the patient to achieve greater self-esteem and better social acceptance.

Resumo A oligodontia é uma doença rara, congênita, caracterizada pela ausência de seis ou mais dentes. Este relato de caso descreve uma abordagem terapêutica multidisciplinar de um adolescente de 12 anos de idade com ausência de 11 dentes permanentes. Antes de qualquer procedimento, todos os dentes decíduos foram extraídos devido à pobre relação coroa-raiz. O plano de tratamento foi constituído por duas fases: 1. terapia ortodôntica e fonoaudiológica com o objetivo de ajuste de sobre-mordida e mordida aberta anterior, bem como melhoria da posição da língua, e 2. tratamento reabilitador protético através da instalação de próteses parciais removíveis provisórias. A abordagem multidisciplinar envolvendo os tratamentos ortodônticos, fonoaudiológico e protético reestabeleceram a função mastigatória e a estética, melhorando a autoestima e aceitação social do paciente. .

Lingual radicular rift valley in a mandibular right first premolar root: report of a rare case and review of the literature / Surco radicular lingual en la raíces del primer premolar mandibular derecho: reporte de un raro caso y revisión de la literatura

Irregular root configurations which often challenge the requirements of successful root canal treatments are always misleading doctors to incorrect clinical judgments and treatment planning. In this article we describe a rare case of CBCT C-shaped mandibular premolar with a huge area of invagination measuring 6 mm ´ 3 mm, which we termed a "radicular rift valley" from a 76-year-old man. Considering the complex process of differential diagnosis, the overall status of disease condition and the will of the patient we proposed five treatment plans and finally conservatively chose plan B composed of both RCT and periapical scaling. A related literature review is also added into this article to describe the whole situation of root invagination, to stress the importance of the vigilance of diagnosis and to provide reference views for future similar diseases.

Las configuraciones radiculares irregulares que a menudo desafían las exigencias de un tratamiento de canal radicular exitoso, son siempre engañosas llevando al especialista a juicios clínicos y planificación de tratamientos erróneos. En este artículo se describe, en un hombre de 76 años de edad, un raro caso de un premolar mandibular que mediante CBCT se observa la forma de C con un área enorme de invaginación midiendo 6 mm x 3 mm, lo que hemos denominado un "Rift valley radicular ". Teniendo en cuenta el complejo proceso de diagnóstico diferencial, el estado general de enfermedad y la voluntad del paciente, se propusieron cinco planes de tratamiento y, finalmente, se eligió el plan B conservador compuesto por el tratamiento del canal radicular y tratamiento periapical. Una revisión de la literatura relacionada se añade en este artículo para describir las situación de invaginación radicular, haciendo hincapié en la importancia del diagnóstico y para proporcionar referencias para enfermedades similares futuras.

Double root anatomical variations in a single patient: endodontic treatment and rehabilitation of a three-rooted first premolar: case report / Variaciones anatómicas de raíces dobles en un solo paciente: tratamiento endodóntico y rehabilitación de un primer premolar trirradicular: reporte de caso

Abnormal interaction between oral epithelium and underlying mesenchematic tissue during odontogenesis could result in teeth with an anatomical variation. First maxilar premolar has such variable root canal morphology. However, (0.2-6% of cases) a three-rooted premolar is particularly uncommon. First mandibular premolar frequently has one root and one single canal (75% of cases), however, a tooth with two canals and two separate roots could be found (19.5-22.5%). Execution of an accurate diagnosis of root canal system is essential to perform a successful endodontic treatment and tooth rehabilitation. This article describes diagnosis, endodontic treatment and rehabilitation (means single crown) of a maxillary three-rooted and three-canal first premolar, and a non-endodontically treated mandibular first premolar with two canals and two independent roots in a single patient.

La interacción anormal entre el epitelio oral y el tejido mesenquimático subyacente durante la odontogénesis puede resultar en la formación de un diente con una variación anatómica. El primer premolar maxilar posee una anatomía relativamente variable, sin embargo, es especialmente poco frecuente (0,2% a 6% de los casos) la presencia de este diente con tres raíces y tres canales radiculares. El primer premolar mandibular posee frecuentemente una raíz y un canal radicular (75% de los casos) y es bastante más infrecuente encontrar este diente con dos raíces y dos canales radiculares (19.5 a 22.5%). Un diagnóstico acabado y preciso de es fundamental para lograr un exitoso tratamiento de endodoncia y posterior rehabilitación. Este artículo describe el diagnóstico, tratamiento de endodoncia y rehabilitación (mediante prótesis fija singular) de un primer premolar maxilar con tres raíces y tres canales radiculares, además el reporte de un caso de un primer premolar mandibular biradicular con dos canales radiculares. Ambos se presentan en un mismo paciente.

Surgical removal of trans-alveolar mandibular 2[nd] premolar impactions by lingual approach

There is an abundance of literature on impacted teeth but only a few papers have addressed impacted premolars. A case of a young female with bilaterally impacted mandibular 2[nd] premolars in trans-alveolar position with their crowns facing lingually and roots buccally is reported. The patient was under orthodontic treatment for correction of malocclusion with an orthodontic plan for surgical removal of impacted mandibular 2[nd] premolars. Due to lingual position of crowns of these impacted teeth, it was decided to adopt lingual surgical approach rather than conventional buccal approach for their removal. The surgical approach with discussion on the various management options for management of impacted premolars is described here

Associação de fatores oclusais e gengivais com lesão cervical não cariosa: estudo controlado e pareado / Association of a gingival and occlusal factors with noncarious cervical lesion: controlled and paired study

A lesão cervical não cariosa (LCNC) caracteriza-se por perda da estrutura dentária na junção esmalte-cemento (JCE). Foi sugerido que cargas oclusais que incidem latrealmente causam flexão das cúspides e uma grande concentração de tensão na região cervical do dente. Além disso, a recessão gengival pode estar associada com a origem da LCNH funcionando como um fator coadjuvante. A proposta deste estudo foi investigar a associação de fatores oclusais e gengivais com LCNC. Trata-se de um estudo observacional em humanos, com delineamento transversal controlado e pareado, considerando como unidade de análise um par de dentes pré-molares selecionado no mesmo indivíduo...

Primeiro pré-molar superior com três raízes: caso clínico / Maxillary frst premolar with three roots: Case report

Introdução: o primeiro pré-molar superior pode, raramente, apresentar-se com três raízes — uma palatina e duas vestibulares — , exigindo mais atenção do profissional durante a intervenção endodôntica. Objetivo:o presente trabalho relata o caso clínico de um pré-molar superior com três raízes e três canais radiculares, salientando as dificuldades e os cuidados especiais durante o tratamento endodôntico. Métodos: após radiografia inicial e abertura coronária, foi detectada a presença de três raízes e três canais radiculares. A exploração dos canais foi realizada com lima tipo K #10, e a odontometria foi realizada pela técnica radiográfica, por meio da qual foi possível confirmar a variação anatômica e aferir que os canais vestibulares apresentavam-se independentes. A instrumentação foi mista, com limas manuais tipo K até a lima memória #35, e automatizada com o sistema ProTaper (Dentsply). A obturação dos canais foi realizada com a técnica da compactação lateral com o cimento obturador Sealer 26. Conclusão: os profissionais sempre devem analisar cuidadosamente a radiografia de diagnóstico e realizar todos os passos do tratamento endodôntico convenientemente, para que possíveis alterações sejam detectadas e não comprometam o sucesso do tratamento.

In vitro macroscopic and endoscopic analysis of three-rooted maxillary premolars and two-rooted mandibular premolars in the same individual: a case report / Análisis macroscópico y endoscópico in vitro de premolares maxilares trirradiculares y mandibulares birradiculares en un mismo individuo: un reporte de caso

The recent addition of endoscopy in dental practice has enabled clinicians to have an excellent view of the operative field, yielding highly successful visualization of anatomical structures that are difficult to access, both in oral surgery and endodontics. The purpose of this report is to provide an in vitro macroscopic, radiographic, and endoscopic description of the anatomic variation of the roots of maxillary and mandibular first premolars in the same patient. A 22-year-old patient was referred by an orthodontist for the extraction of all the first premolars. Once extracted, the premolars were examined macroscopically and then analyzed radiographically after trepanation and filled root canal systems. Subsequently, a diaphanization process was carried out and the samples were sectioned at the middle and apical third for observation by endoscope. It was found that both the maxillary first premolars had three roots, and mandibular first premolars had two roots, all with complete root formation. Apical deltas or accessory canals were not identified in the radiographic images; however, through endoscope at the middle third, it was possible to observe an accessory canal to the first maxillary and mandibular right premolars. Thus, it can be concluded that the view through the endoscope allows better identification of accessory canals than X-rays.

La reciente incorporación del endoscopio a la práctica odontológica ha permitido al clínico, contar con una excelente visualización del campo operatorio, consiguiendo resultados altamente exitosos en la visualización de estructuras anatómicas de difícil acceso, tanto en cirugía oral como en endodoncia. El propósito de este reporte de caso es realizar una descripción in vitro macroscópica, radiográfica y endoscópica de las variables anatómicas de las raíces de los primeros premolares maxilares y mandibulares en un mismo paciente. Una paciente de 22 años es derivada por un ortodoncista para exodoncia de los primeros premolares. Una vez extraídos, los premolares fueron analizados en un principio macroscópicamente, para luego ser analizados radiográficamente una vez trepanados y obturados los sistemas de conductos radiculares. Posterior a esto, se sometieron a un proceso de diafanización y se les realizaron cortes a nivel del tercio apical y medio para ser observados mediante endoscopio. Se detectó que ambos primeros premolares superiores presentaban 3 raíces, y los inferiores 2 raíces, todos con formación radicular completa. No se identificaron deltas apicales ni conductos accesorios en las imágenes radiográficas; sin embargo, fue posible mediante el endoscopio a nivel del tercio medio, un conducto accesorio para los primeros premolares derechos inferiores y superiores situación que no se pudo identificar radiográficamente. Finalmente, la visualización a través del endoscopio permite una mejor identificación de conductos accesorios que las radiografías.

Distribuição de tensões em um modelo tridimensional do primeiro pré-molar superior com esmalte anisotrópico ou isotrópico: análise comparativa pelo método de elementos finitos / Stress distribution in a premolar 3D model with anisotropic and isotropic enamel: finite element method analysis

A distribuição das tensões ao longo da estrutura dentária é determinada pela direção, o tipo e a magnitude das cargas que incidem na superfície oclusal e pelas características das estruturas de suporte. Este estudo teve como objetivo analisar, através do Método de Elementos Finitos, a distribuição de tensões na estrutura dentária, em um modelo tridimensional (3D) do primeiro pré-molar superior submetido a diferentes tipos de carregamentos, considerando o esmalte anisotrópico ou isotrópico...

Microscope-aided endodontic treatment of maxillary first premolars with three roots: A case series.

Maxillary premolars have a highly variable root canal morphology. However, the presence of three roots is a rare occurrence. This clinical article describes the unusual anatomy detected in maxillary premolars during routine endodontic treatment using microscope. The diagnosis and clinical management of maxillary first premolars with three roots and canals using radiographic interpretation, access cavity modification and visual enhancement with operative microscopes is discussed in the article.

Prevalence of hypodontia in nine- to fourteen-year-old children who attended the Mashhad School of Dentistry.

Context: Hypodontia is defined as the congenital absence of one or a few teeth, and is also the most common anomaly in dental development. This condition occurs either individually or as part of the symptoms of a syndrome, and it is more common in permanent teeth than in deciduous teeth, reporting a prevalence of between 1.6 and 9.6%. Aims: The objective of this study is to investigate the prevalence of hypodontia for permanent teeth in nine- to 14-year-old children who attended the Mashhad School of Dentistry in 2007. Setting and Design: We conducted this descriptive, analytical, cross-sectional study, to determine the mentioned aims. Materials and Methods: In this descriptive, cross-sectional study, panoramic radiographs belonging to 600 children (351 girls and 249 boys), aged nine to 14 years, were available for examination. All related findings were recorded in the respective forms. Statistical Analysis Used: The data were processed using Exact and Chi-square tests. Results: The prevalence of hypodontia in the girls was 9.2%, in the boys 8.8%, and in both sexes combined 9%. The most and the least frequent cases of absent teeth were the mandibular second premolars and the maxillary central incisor (only one child), respectively. The most commonly absent teeth were the mandibular second premolars, the maxillary lateral incisors, the mandibular central incisor, and the maxillary second premolars, in that order. Conclusions: This study showed a high frequency of hypodontia among the understudied population. Thus, due to the complicated treatment, accurate examination of children for on-time diagnosis of this developmental anomaly is crucial.

Valoración de la ecuación de Tanaka-Johnston en estudiantes cubanos con oclusión normal / Assessment of Tanaka-Johnston equation in Cuban students presenting normal occlusion

El análisis de Tanaka-Johnston, mundialmente empleado para la predicción del espacio de caninos y premolares no brotados, ha sido muy cuestionado por la variabilidad en el tamaño dentario entre las diferentes poblaciones, y por haber sido realizado en un grupo étnico no aplicable a todos. Se realizó un estudio descriptivo transversal, con el objetivo de determinar el ancho mesiodistal de incisivos, caninos y premolares mandibulares, así como de caninos y premolares maxilares, y comparar la suma real de estos dientes con los estimados por Tanaka-Johnston, según el sexo y la arcada. El universo de esta investigación estuvo constituido por 50 estudiantes de la Facultad de Estomatología de La Habana, 25 del sexo femenino y 25 del sexo masculino, con oclusión normal, sin antecedentes de tratamiento ortodóncico; todos descendientes de cubanos. En los resultados se observó que los anchos mesiodistales de los incisivos, caninos y primeros premolares inferiores y de caninos y segundo premolar izquierdo superiores fueron significativamente mayores en el sexo masculino que en el femenino. La suma real de caninos y premolares superiores e inferiores fue mayor en el sexo masculino que en el femenino. Cuando se comparó la suma real de caninos y premolares, con lo estimado según la ecuación de Tanaka-Johnston, se halló que la esta sobrestimó los valores de caninos y premolares, ya que los resultados fueron significativamente menores(AU)

The Tanaka-Johnston analysis used at worldwide to predict the space of non-erupted canines and premolars has been questioned due to the variability in the teeth size among different populations and also to be carried out in non-applicable whole ethnic group. A cross-sectional and descriptive study was conducted to determine the mesiodistal width of mandibular incisives, canines and premolars, as well as of danines and premolar-maxillary and to compare the real sum of these theeth with the estimates by Tanaka-Johnston, according to sex and the arcade. Universe of this research included 50 students of Stomatology Faculty of havana (25 males and 25 females) presenting with normal occlusion, without a history of Orthodontics treatment all of them descendants of Cubans. In results it was noted that the mesiodistal widths of incisives, canines and first lower premolars and of canines and second left premolars upper are greater in male sex than in the female one. The real sum of upper and lower canines and premolars was greter in male sex than in the female one. Comparing the real sum of canines and premolars with that estimated according Tanaka-Johnston, it was noted that it overestimated the values of canines and premolar since the results were significantly lower(AU)

Dens evaginatus in hemophilic patient: a case report / Dens evaginatus en un paciente hemofílico: reporte de un caso

Tooth development occurs through the interaction between oral tissues during embryogenesis. Alteration through odontogenesis may cause tooth morphological alterations, one of these could be Dens evaginatus. This anatomical variation could be originated from an abnormal proliferation and folding of a portion of the inner enamel epithelium and subjacent ectomesenchymal cells of the dental papilla into the stellate reticulum of the enamel organ during the bell stage of tooth formation. Dens evaginatus is defined as a tubercle, or supplemental solid elevation on some portion of the crown surface. Inadequate clinical management of these teeth may result in a pulpal exposure and possible loss of vitality of the tooth. The research wants to report a case of Dens evaginatusin a permanent mandibular premolar requiring endodontic treatment.A 13-year old male patient attended the Dental Service of a local Hospital, reporting pain the lower left side of the jaw. He reported to be in medical treatment for hemophilia. During an intra oral examination, the left side in the mandible exhibited a multitubercular appearance of left premolars which suggest. Patient shows a sinus tract related to tooth 3, 4, which was sore to palpation and percussion. In radiographic analysis a radio-opacity appeared in the tubercle area of the tooth. Due to low incidence of this anomaly among the young population, it is important that Dentistry related professionals know the characteristics of this anatomical variation in order to perform an adequate clinical management of Dens evaginatus.

El desarrollo dentario se produce por la interacción de tejidos orales durante la embriogénesis. Alteraciones en la odontogénesis pueden causar alteraciones morfológicas, una de ellas es Dens evaginatus. Esta variación anatómica se puede originar de la proliferación anormal de la porción interna del epitelio del órgano del esmalte y las células ectomesenquimáticas del retículo estrellado durante el estado de campana de la odontogénesis. La resultante puede ser una estructura definida como una elevación sólida suplementaria de la corona dentaria. Un manejo clínico inadecuado de dientes con esta alteración puede resultar en una exposición pulpar y posible pérdida de la vitalidad del diente. La investigación reporta el caso clínico de un paciente hemofílico con un Dens evaginatus que requiere tratamiento de endodoncia. Un paciente de 13 años de edad de sexo masculino consultó en el servicio dental del Hospital local en la zona izquierda de la mandíbula. Al examen intraoral presentó premolares mandibulares izquierdos con apariencia multitubercular compatibles con Dens evaginatus. Se observó una fístula en relación al diente 3.4, el que se encontraba sensible a la percusión y palpación. El análisis radiográfico reportó una zona radiopaca en relación a la zona tubercular del diente. En consideración a la baja incidencia de esta variación anatómica, es importante para los profesionales del área de la Odontología conocer las características del Dens evaginatus, con el ánimo de lograr un adecuado abordaje clínico al momento de tratar dientes con esta alteración morfológica.

Three root canals in the maxillary second premolar.

In this study, we report an endodontic treatment of the maxillary second premolar with three root canals and distinct foramens. The possibility of three root canals in this tooth is quite small; however, it must be taken into account in clinical and radiographic evaluation during endodontic treatment. Many times, their presence is noticed only after canal treatment due to continuing post-operative discomfort.

Bilateral dens invaginatus in the mandibular premolar region.

Dens invaginatus (dens in dente, DI) is a rare developmental anomaly resulting from invagination of a portion of the crown rare. It is an important dental anomaly due to the possible pulpal involvement. DI can be detected clinically in a tooth presenting unusual crown morphology or having deep foramen coaceum. Also, clinically, non-suspected affected teeth are commonly diagnosed as an incidental radiographic finding. Presence of DI in the mandibular premolar teeth is unusual. Aims is to introduce a case of bilateral occurrence of DI in mandibular first premolar teeth. A 33- year-old man was referred to our clinic with a chief complaint of severe pain in his lower third molar tooth. Radiographic examination revealed bilateral DI (single at the left, double at the right) in mandibular first premolar teeth. The teeth were restored with fissure sealant. Although bilateral appearance of DI is a frequent situation, mandibular occurrence is very rare. Our review of the literature reveals just nine cases of DI, and only one of them is in a premolar tooth.

Prevalencia de agenesia dentaria en pacientes que intresaron al Servicio de Ortopedia del Hospital Juan U. Carrea, Olivos, Buenos Aires, Argentina / Prevalence of dental agenesis in patients entering the Orthopedics Service of Dr. Juan U. Carrea Hospital, Olivos, Buenos Aires, Argentina

Objetivo: Determinar la prevalencia de agenesia dentaria en pacientes que ingresaron al servicio de ortopedia del Hospital Dr. Juan U. Carrea entre abril 2007 y marzo 2008. Materiales y Métodos: Análisis clínico-radiográfico. Registro de casos en una hoja de cálculo, con las siguientes variables: sexo, pieza dentaria afectada, maxilar y lado afectado. Resultados: De 1.315 pacientes, 3,95 por ciento presentó agenesia, de los cuales: 51,9 por ciento pertenecía al sexo femenino; 50 por ciento presentó ausencia de una pieza; la más frecuentemente ausente fue el segundo premolar inferior izquierdo con 30,12 por ciento; sólo 9,61 por ciento tenía conocimiento de antecedentes hereditarios y 7,69 por ciento presentó alguna anomalía dentaria asociada. Conclusión: No se observaron diferencias entre ambos sexos. La pieza más afectada fue el segundo premolar inferior izquierdo. La mayoría de los pacientes presentó agenesia de una pieza. Un bajo porcentaje, relató antecedentes hereditarios. Se observó asociación entre agenesia y anomalía dentaria en escasa cantidad de pacientes.

[Comparison of different reinforcement methods of weakened buccal walls in premolar teeth]

In order to improve the aesthetics and functional quality of restorations, the combined amalgam-composite restorations have been introduced. The aim of this study was to compare different reinforcement methods, in weakened buccal walls of premolar teeth. In this in vitro study, 70 similar and intact premolar teeth were used. The specimens were divided into seven groups of ten. In six groups, the three reinforcing materials composite [A], Compoglass F [B] and glass ionomer [C] with two methods: I: buccal and distal wall reinforcement. II: buccal, distal and pulpal floor reinforcement was used. In the seventh group [D], the Scotchbond M.P.P adhesive as a control group was applied. Then specimens were restored conventionally with amalgam and submitted to 500 thermal cycles [5°C-55°C]. The specimens were loaded through Instron testing machine at a crosshead speed of 1 mm/min with angle of 45 degree. Statistical analyzes of ANOVA, Duncan and chi- square tests were used to analyse fracture strength, location and type of fracture. The highest strength was detected in group with composite reinforcement on buccal and distal walls and pulpal floor. The highest failure mode was adhesion type and observed in composite reinforcement and control group. The highest cohesive and mixed failure mode was respectively observed in Compoglass and glass ionomer groups. This study showed that composite resin was the best material for reinforcement of weakened walls with favourable aesthetic property

Mesiodens with an unusual morphology and multiple impacted supernumerary teeth in a non-syndromic patient.

Supernumerary teeth are a relatively frequent disorder of odontogenesis characterized by an excess number of teeth. Mesiodens is the most common type of supernumerary tooth found in the premaxilla between the two central incisors. They can be supplemental (resembling natural teeth), conical, tuberculate or molariform. We present the case of a 19 year-old girl who presented with a mesiodens of an unusual morphology and multiple impacted supernumerary teeth not associated with any syndrome.