Múltiples Dientes Supernumerarios en Paciente Pediátrico No Sindrómico. Una Revisión de la Literatura y Presentación de Caso Clínico / Multiple Supernumerary Teeth In A Non-Syndromic Pediatric Patient. A Review Of The Literature and Presentation of a Clinical Case

Aquellos casos en que se excede la fórmula dentaria normal primaria de 20 dientes o definitiva de 32 dientes se conocen como dientes supernumerarios o hiperodoncia. Los supernumerarios se pueden presentar de manera única o múltiple y de forma heteromórfica o eumórfica. El supernumerario más prevalente es el mesiodens, se da más en hombres, en dentición permanente y en el maxilar. Su etiología no está confirmada, pero puede deberse a una hiperactividad de la lámina dental. El tratamiento varía de acuerdo a cada paciente según si está afectando a la dentición normal o no y el desarrollo que tengan las estructuras dentarias. El siguiente reporte de caso habla de un paciente de 6 años, no sindrómico, en donde se presentó con un mesiodens erupcionado y se encontraron más supernumerarios gracias a la radiografía complementaria.

Those cases in which the primary normal dental formula of 20 teeth or the final one of 32 teeth is exceeded are known as supernumerary teeth or hyperdontia. The supernumeraries can be presented in a single or multiple way and in a heteromorphic or eumorphic way. The most prevalent supernumerary is the mesiodens, it occurs more in men, in the permanent dentition and in the maxilla. Its etiology is not confirmed, but it may be due to hyperactivity of the dental lamina. The treatment varies according to each patient depending on whether it is affecting the normal dentition or not and the development of the dental structures. The following case report talks about a 6-year-old, non- syndromic patient, who presented with an erupted mesiodens and more supernumeraries were found thanks to the complementary radiography.

Analysis of congenital deciduous teeth absence and its permanent teeth phenotype / 华西口腔医学杂志

OBJECTIVES@#This study aimed to investigate the clinical characteristics of congenital deciduous teeth absence and its permanent teeth performance type by using panoramic radiographs.@*METHODS@#A total of 15 749 panora-mic radiographs of 3-6-year-old children with deciduous dentition were collected from January 2020 to December 2021. The incidence of congenital deciduous teeth absence was observed, and the abnormality of permanent teeth was recor-ded. SPSS 24.0 software was used for statistical analysis.@*RESULTS@#The incidence of congenital deciduous teeth absence was 2.54% (400/15 749), which was found in 217 girls and 183 boys, and the difference between the genders was statistically significant (P=0.003). The absence of one and two deciduous teeth accounted for 99.75% (399/400) of the subjects. In addition, 92.63% (490/529) of mandibular deciduous lateral incisor was congenitally absent, 44.80% (237/529) of deciduous teeth was absent in the left jaw, and less than 55.20% (292/529) was absent in the right; the difference between them was statistically significant (P=0.017). The absence of 96.41% (510/529) deciduous teeth in the mandibular was significantly more than that of 3.59% (19/529) in the maxillary, and the difference between was statistically significant (P=0.000). Furthermore, 68.00% (272/400) and 32.00% (128/400) of deciduous teeth were absent in unilateral and bilateral, respectively, and the difference was statistically significant (P=0.000). Four types of congenital deciduous teeth absence with permanent teeth were observed as follows: 1) 73.91% (391/529) of permanent teeth was absent; 2) 20.60% (109/529) of permanent teeth was not absent; 3) the number of fused permanent teeth accounted for 4.91% (26/529); 4) the number of supernumerary teeth was 0.57% (3/529).@*CONCLUSIONS@#Although the absence of congenital deciduous teeth is less common than that of permanent teeth, it affects deciduous and permanent teeth to some extent. Dentists should pay attention to trace and observe whether abnormalities are present in the permanent teeth and take timely measures to maintain children's oral health.

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)

Clinical characteristics and comprehensive treatment of patients with cleidocranial dysplasia / 中华口腔医学杂志

Objective: To summarize the clinical characteristics of patients with cleidocranial dysplasia (CCD) and analyze their treatment methods. Methods: From January 2000 to December 2020, patients with CCD who completed comprehensive treatment in the Department of Orthodontics and the First Dental Clinic, School and Hospital of Stomatology, China Medical University were retrospectively analyzed. A total of 14 CCD patients [7 males and 7 females, aged (16.1±4.5) years] were collected. There were 153 impacted permanent teeth in this study. In addition to the teeth that needed to be extracted due to special conditions, 147 impacted teeth were pulled into the dentition using closed traction. Patients were divided into adolescent group (≥12 years and<18 years, 10 patients) and adult group (≥18 years, 4 patients). Failure rate of traction was compared between the two groups. Factors affecting the success rate of closed traction such as vertical position of teeth (high, middle and low) and horizontal position of the teeth (palatal, median and buccal) were analyzed. Results: The incidence of maxillary impacted teeth [69.3% (97/140)] was higher than that of mandibular impacted teeth [40% (56/140)]. The difference was statistically significant (χ2=24.22, P<0.001). The supernumerary teeth were mainly located in the premolar area 61.4% (21/44), and most of them were in the palatal region of the permanent teeth 95.5% (42/44). They were generally located at the same height or the occlusal side of the corresponding permanent teeth. The success rate of closed traction was 93.9% (138/147). The success rate in the adolescent group [98.2% (108/110)] was higher than that in the adult group [81.1% (30/37)], and the difference was significant (χ2=14.09, P<0.05). Failure after closed traction of 9 teeth was found totally, including 7 second premolars. The success rate of traction in impacted second premolars at different vertical (χ2=11.44, P<0.05) and horizontal (χ2=9.71, P<0.05) positions in alveolar bone was different significantlly. The success rates of the second premolars were high (15/16), middle (12/13), low (2/7), and lingual palatine (10/17), median (19/19), lip-buccal (0/0), respectively. Conclusions: The closed traction of impacted teeth in patients with CCD was effective, and the age was the main variable affecting the outcome. The success rate of traction in impacted second premolars located in low position vertically or in palatal position was low, which required close observation during treatment.

Pindborg tumor associated with a supernumerary tooth: a case report

The calcifying epithelial odontogenic tumor is a rare benign neoplasm that accounts for approximately 1% of all odontogenic tumors. Most of the cases occur in the posterior mandible, and a few involve the maxilla. Despite their relatively indolent biological behavior, tumors in the maxilla tend to grow fast. We report the case of a 33-year-old female patient exhibiting swelling in the right maxilla. An isodense area associated with an impacted supernumerary tooth was found on imaging examination. The histopathologic diagnosis was a calcifying epithelial odontogenic tumor. The treatment of choice was surgical removal of the lesion and associated dental elements. The patient has been followed up for 11 months and shows no signs of recurrence. Besides describing this case, we reviewed the literature on the association of calcifying epithelial odontogenic tumors with supernumerary teeth and found two case reports addressing this subject.

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)

El uso de un cantiléver para el tratamiento ortodóncico del incisivo impactado en posición horizontal / Use of a cantilever for orthodontic treatment of the impacted incisor in a horizontal position

Introducción: La falta de un incisivo permanente no solo genera un efecto adverso en la estética facial, también altera la función, en especial, la guía incisiva. Los incisivos superiores pueden sufrir bloqueo mecánico o cambio en su erupción por un diente supernumerario, un golpe u otro factor. El tratamiento de elección es el quirúrgico-ortodóncico. El pronóstico dependerá de la edad, situación, posición del diente, morfología, tamaño, maduración radicular y método de tracción. Conocer el uso de una aparatología ortodóncica que sea fácil de manipular y pueda ser usada desde edades tempranas servirá de valioso aporte. Objetivo: Mostrar el uso exitoso de un cantiléver para traccionar ortodóncicamente un incisivo impactado en posición horizontal. Presentación del caso: Paciente de 8 años con maloclusión clase I, pieza 2.1 retenida en posición horizontal, presencia de supernumerario y persistencia de pieza 6.1. Se opta por extracción de supernumerario, liberación de pieza 2.1 y tracción ortodóncica. Se usó un cantiléver por vestibular confeccionado en arco de acero redondo 0.020" con dos círculos en cada extremo para brindar elasticidad y anclaje. La fuerza utilizada fue de 70 g, pasado 6 meses se alcanzó el plano de oclusión. Se cementaron brackets y tubos, se continuó con la secuencia de arcos, hasta llegar al arco acero 0.021"x0.025" durante 11 meses. Se obtiene una posición final óptima que favorece la formación radicular y cierre apical. Conclusiones: El uso del cantiléver para el tratamiento ortodóncico de incisivos permanentes impactados en posición horizontal demostró ser exitoso, fácil de manipular y controlar(AU)

Introduction: The lack of a permanent incisor not only generates an adverse effect on facial aesthetics but also alters its function, especially the incisor guidance. Upper incisors can suffer mechanical blockage or change in their eruption due to a supernumerary tooth, a blow or another factor. The treatment of choice is orthodontic-surgical. The prognosis depends on the age, tooth position, morphology, size, root maturation and traction method. Knowing the use of an orthodontic appliance, which is easy to handle and can be used from an early age, will be of valuable contribution. Objective: To show the successful use of a cantilever to enable orthodontic traction of an impacted incisor in a horizontal position. Case presentation: Eight-year-old patient with class I malocclusion, specimen 2.1 retained in a horizontal position, presence of supernumerary tooth and persistence of specimen 6.1. Extraction of the supernumerary, release of specimen 2.1 and orthodontic traction is chosen. A buccal cantilever made of a 0.020" round steel arch with two circles at each end was used to provide elasticity and anchoring. The force used was 70 g. Six months after, the occlusion plane was reached. Brackets and tubes were cemented and the sequence of arches was continued until the 0.021"x0.025" steel arch was reached in 11 months. An optimal final position is obtained, favoring root formation and apical closure. Conclusions: The use of the cantilever for orthodontic treatment of impacted permanent incisors in a horizontal position proved to be successful as well as easy to manipulate and control(AU)

Levantamento de dados secundários de anomalias dentárias em crianças atendidas na Faculdade de Odontologia de Pernambuco / Survey of secondary data of dental anomalies in children attended at the Pernambuco Dentistry Faculty

Os distúrbios de crescimento e desenvolvimento dos dentes são alterações no número, tamanho ou forma dos dentes com origem multifatorial, sendo o objetivo desse estudo conhecer a frequência de anomalias dentárias. Trata-se de uma pesquisa quantitativa, descritiva e com delineamento transversal de dados secundários, utilizando registros dos prontuários de crianças dos 3 aos 12 anos de idade atendidas na Clínica de Atenção Básica Infantil da FOP/UPE. Foram coletadas informações referentes ao sexo, idade, presença, tipo e localização da anomalia. Realizamos uma análise estatística utilizando o Microsoft Excel e Epi Info v.3.5.3. O estudo teve uma amostra final de 197 prontuários, 52,8% do sexo feminino e 47,2% do sexo masculino. Foram identificadas 4,5% anomalias dentárias, sendo (77,8%) anomalia de número, localizada na região anterior (88,8%). A predominância foi maior no sexo feminino (N=6). As anomalias dentárias presentes foram: anodontia (55,5%), dentes supranumerários (22,3%), giroversão (11,1%) e fusão (11,1%). A frequência de anomalia dentária foi de 4,5%, sendo a anomalia de número mais frequente (77,8%), acometendo mais o sexo feminino e com média de idade de 8,5 anos... (AU)

Tooth growth and development disorders are changes in the number, size or shape of teeth with multifactorial origin, and the aim of this study is to know the frequency of dental anomalies. This is a quantitative, descriptive and cross-sectional study of secondary data, using records from the medical records of children aged 3 to 12 years attended at the Primary Child Care Clinic of FOP/UPE. Information regarding gender, age, presence, type and location of the anomaly was collected. We performed a statistical analysis using Microsoft Excel and Epi Info v.3.5.3. The study had a final sample of 197 medical records, 52.8% female and 47.2% male. 4.5% dental anomalies were identified, (77.8%) number anomaly, located in the anterior region (88.8%). Predominance was higher in females (N=6). The dental anomalies were: anodontics (55.5%), supernumerary teeth (22.3%), gyroversion (11.1%) and fusion (11.1%). The frequency of dental anomaly was 4.5%, being the most frequent number anomaly (77.8%), affecting the female sex more and with a mean age of 8.5 years... (AU)

Tratamento de dentes inclusos em proximidade a cavidade nasal e seio maxilar: relato de caso / Treatment of teeth included with proximity to the nasal cavity and maxillary sinus: case report

Durante a formação dentária, distúrbios de desenvolvimento podem acontecer, causando anomalias de número, forma, tamanho, estrutura e posição, além de apresentarem anormalidade no padrão sequencial de irrupção. Uma boa anamnese, associada a palpação e exames de imagens são indispensáveis para um diagnóstico precoce e favorável destas alterações. Os exames de imagem determinarão a relação espacial destes dentes com as estruturas nobres adjacentes. O objetivo deste trabalho é relatar a presença de supranumerário unilateral e impactação bilateral de caninos permanentes, ambas anomalias com proximidade da cavidade nasal e seio maxilar, ressaltando a importância do diagnóstico preciso através de exames clínico e de imagens, que direcionam o planejamento terapêutico específico para cada caso, bem como a associação multidisciplinar para obtenção de um resultado satisfatório do quadro e melhora da qualidade de vida do paciente(AU)

During dental formation, developmental disorders can occur, causing anomalies of number, shape, size and position, in addition to presenting abnormality in the sequential pattern of irruption. Anamnesis associated with palpation are indispensable for an early diagnosis of these alterations. Imaging exams will determine the spatial relationship between these teeth and the adjacent noble structures. The aim of this study was to report the presence of unilateral supernumerary and bilaterally impacted canines, both anomalies with proximity of nasal cavity and maxillary sinus, emphasizing the importance of accurate diagnosis through clinical and imaging exams, that direct the specific therapeutic planning for each case, as well as the multidisciplinary association to obtain satisfactory results and improve the life quality of patients(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)

Dental and maxillomandibular incidental findings in panoramic radiography among individuals with mucopolysaccharidosis: a cross-sectional study

Abstract Mucopolysaccharidosis (MPS) is a group of rare and inherited metabolic disorders caused by the accumulation of macromolecule glycosaminoglycans inside lysosomes. Affected individuals may have dental and craniofacial tissue alterations, facilitating the development of several oral diseases. Objectives To assess, with panoramic radiographic images, the frequency of dental and maxillomandibular incidental findings among MPS individuals and compare them with non-MPS individuals. Methodology A cross-sectional study evaluating a sample of 14 MPS individuals and 28 non-MPS individuals aged from 5 to 26 years was carried out. They were matched for sex and age on a 2:1 proportion. Panoramic radiographs were assessed for the presence/absence of the following dental and maxillomandibular alterations: dental anomalies of number (hypodontia/dental agenesis, supernumerary teeth); anomalies of form (microdontia, macrodontia, conoid teeth, taurodontism, and root dilaceration); anomalies of position (impacted tooth, inverted tooth, tooth migration, partially bony teeth, complete bony teeth); periapical alterations (furcation lesion, circumscribed bone rarefaction); other alterations (radiolucent bone lesions, radiopaque bone lesions, radiopacity in the maxillary sinus, condylar hypoplasia). Differences between groups were tested by the Fisher's exact test and chi-square test (p<0.05). Results For intrarater agreement, Kappa values were 0.76 to 0.85. The presence of supernumerary teeth (p=0.003); conoid teeth (p=0.009); taurodontism (p<0.001); impacted teeth (p<0.001); partial bony teeth (p=0.040); complete bony teeth (p=0.013); and root dilaceration (p=0.047) were statistically more frequent in MPS individuals compared to non-MPS individuals. Bone rarefaction/furcation lesions (p=0.032), condylar hypoplasia (p<0.001), radiolucent bone lesions (p=0.001), and dentigerous cysts (p=0.002) were also more frequent in MPS individuals. Conclusion The presence of specific oral manifestations is more common in MPS individuals than non-MPS individuals.

Paramolares bilaterales maxilares no erupcionados y su abordaje quirúrgico: reporte de un caso inusua / Paramolares bilaterais superiores não erupcionados e sua abordagem cirúrgica: relato de caso incomun / Non-erupted maxillary bilateral paramolars and their surgical approach: unusual case report

El término dientes supernumerarios se refiere al exceso en el número normal de dientes ya sea en la dentición primaria como en la permanente, pueden presentarse de forma única o múltiple, unilateral o bilateral, tanto en maxilar como en mandíbula. Un paramolar es un molar supernumerario generalmente rudimentario ubicado en posición vestibular o palatino de uno de los molares o en el espacio interproximal al segundo y tercer molar. Su prevalencia es menor al 0,20%, se presentan más en hombres que en mujeres y generalmente se encuentran erupcionados. En el presente artículo se reporta el caso inusual de una paciente femenina con paramolares maxilares bilaterales no erupcionados los cuales fueron removidos quirúrgicamente sin complicaciones

A O termo dentes supranumerário se refere ao excesso no número normal de dentes, seja na dentição decídua ou permanente, podendo ocorrer de forma única ou múltipla, unilateral ou bilateral, tanto na maxila quanto na mandíbula. Um paramolar é um molar supranumerário geralmente rudimentar localizado na posição vestibular ou palatina de um dos molares ou no espaço interproximal do segundo e terceiro molares. Sua prevalência e inferior a 0,20%, ocorrem mais em homens do que em mulheres e geralmente surgem. Neste artigo, relatamos o caso incomum de uma paciente do sexo feminino com paramolares superiores bilaterais não erupcionados, que foram removidos cirurgicamente sem complicações

The term supernumerary teeth refer to the excess in the normal number of teeth, either in the temporary or in the permanent dentition, it can appear in a single or multiple forms, unilateral or bilateral, both in the maxilla and in the mandible. A paramolar is a generally rudimentary supernumerary molar located in the vestibular or palatal position of one of the molars or in the space interproximal to the second and third molars. Prevalence is less than 0,2%, they are more frequent in men than in women and are generally erupted. This article reports the unusual case of a female patient with unerupted bilateral maxillary paramolars which were surgically removed without complications

Impact of mesiodens management on the oral health-related quality of life of a child: a case report

Introduction: Mesiodens is a supernumerary tooth present in the anterior maxilla. Children with teeth alterations that could affect their facial features may experience harassment and teasing, leading to difficulties in social interaction. Objective: To report a clinical case of treatment in a pediatric patient with mesiodens. Additionally, we aimed to correlate the mesiodens to the quality of life and happiness through the Child Perceptions Questionnaire (CPQ8-10) and the Subjective Happiness Scale (SHS). Case report: A 7-year-old patient complaining about a tooth between the upper central incisors and esthetical problems his tooth caused, according to his grandmother. In the initial session, the CPQ8-10 and the SHS were applied. The treatment performed was mesiodent extraction and follow-up. Four months after extraction, teeth 11 and 21 spontaneously repositioned, without the need for orthodontic intervention. The initial results (22 points in CPQ8-10 and mean 2.5 in the ESF) showed a negative impact on quality of life. Six months after the initial session, the questionnaires were reapplied and an improvement in the results was observed (7 points in CPQ8-10 and mean 5.25 in SHS). Conclusion: The correct diagnosis and the best moment for treatment were keys for preventing occlusal problems in a patient with mesiodens. Additionally, mesiodens treatment significantly improved the child's quality of life and perceived happiness.

Introdução: Mesiodente é um dente supranumerário presente na maxila anterior. Crianças com alterações nos dentes que podem afetar suas características faciais podem sofrer bullying e dificuldades de interação social. Objetivo: Relatar um caso clínico de tratamento em um paciente com mesiodente. Adicionalmente, correlacionar o tratamento do mesiodente ao impacto na qualidade de vida e felicidade por meio do Child Perceptions Questionnaire (CPQ8-10) e da Escala Subjetiva de Felicidade (ESF). Relato do caso: Paciente de 7 anos tinha como queixa um dente entre os incisivos centrais superiores e diagnóstico de mesiodente. O paciente relatou sofrer bullying por conta disso. Na consulta inicial foram aplicados o CPQ8-10 e o ESF. O tratamento realizado foi exodontia do mesiodente e acompanhamento. Quatro meses após a exodontia houve aproximação espontânea dos dentes 11 e 21, sem a necessidade de intervenção ortodôntica. Os resultados iniciais (22 pontos no CPQ8-10 e média 2,5 no ESF) mostraram impacto negativo na qualidade de vida. Seis meses após a consulta inicial os questionários foram reaplicados e uma melhora nos resultados foi percebida (7 pontos no CPQ8-10 e média 5,25 no SHS). Conclusão: O diagnóstico correto e o melhor momento para o tratamento foram fundamentais para prevenir problemas oclusais. Além disso, o tratamento melhorou significativamente a qualidade de vida da criança e a felicidade percebida.

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.

Odontoma complejo en posición supernumeraria. Reporte de caso / Complex odontoma in supernumerary position. Case report

RESUMEN Fundamento: Los odontomas son entidades odontogénicas benignas mixtas, compuestas por una mezcla de células odontogénicas epiteliales y mesenquimatosas diferenciadas, las mismas pueden ser compuestas y complejas. Los hallazgos radiográficos de estos tumores en posiciones supernumerarias son raras menores al 1 %. Objetivo: Describir el caso clínico de un odontoma complejo infrecuente. Presentación de caso: Paciente femenina de 18 años con un trauma facial, que durante el diagnóstico imagenológico se le encontró una imagen anterosuperior de aspecto tumoral en posición supernumeraria, por lo que se decidió realizar la exéresis quirúrgica de la lesión después de finalizado el tratamiento del trauma. El diagnóstico clínico histopatológico fue de un odontoma complejo. Conclusiones: Se recomienda realizar las vistas imagenológicas tipo ortopantomografías o panorámicas a cada paciente que vaya a ser operado de cirugía bucal a fin de poder detectar de forma precoz cualquier alteración en la anatomía y de esta manera estudiar tanto el comportamiento de los odontomas como de otras lesiones intraóseas, lo que puede garantizar un tratamiento temprano y con ello un mejor pronóstico para el paciente.

ABSTRACT Background: Odontomas are mixed benign odontogenic entities, composed of a mixture of odontogenic epithelial and differentiated mesenchymal cells, they can be compound and complex. Radiographic findings of these tumors in supernumerary positions are rare, less than 1%. Objective: To describe the clinical case of a non-frequent complex odontoma. Case report: 18-year-old female patient with facial trauma, during the imaging diagnosis it was found an anterosuperior tumor image in supernumerary position, thus decided to perform the surgical excision of the lesion after the trauma treatment. The histopathological clinical diagnosis was a complex odontoma. Conclusions: It is recommended to perform standard panoramic radiograph imaging for each patient to be operated on oral surgery to detect any early anatomy alteration, so this way to study both, the behavior of odontomas as well as other intraosseous lesions, which can guarantee an early treatment and a better prognosis for the patient.

Mapping of supernumerary elements in patients seeking orthodontic treatment

Dimension, number and shape alterations are frequently observed dental anomalies. Objective: The aim of this study was to map the frequency, the preferred location and the most prevalent types of supernumerary teeth, in the studied population. In addition, to assess the interference that supernumerary teeth may cause in the ectopic eruption of the normal dental series teeth. Methods: This is an observational retrospective study. Data collection was performed by evaluation of dental records of patients treated in an orthodontic clinic. Patients' radiographs, photographs and gypsum dental models were analyzed and data recorded in protocol files, by previously trained undergraduate and postgraduate students. Records from 1984 to 2019 were evaluated, and evaluation lasted two months. Data were stored in Microsoft Office Excel (version 2016) for descriptive analysis. Results: From the 920 patients' records analyzed, 2.7% presented at least one supernumerary tooth, with preferred location on the anterior maxillary area and mandibular parapremolar area. The most prevalent type was the supplemental tooth, with normal eruption orientation and normal alveolar location. Conclusion: The supernumerary teeth of the studied population showed little interference in the ectopic eruption of the normal dental series. Most of the supernumerary teeth were impacted, and, approximately one third of the supernumerary teeth showed deviated eruptions.

Introdução: Alterações de dimensão, número e forma são anomalias dentárias comumente observadas. Objetivo: O objetivo foi mapear a frequência de dentes supranumerários na população estudada, sua localização preferida e os tipos mais prevalentes. Além disso, avaliar a interferência que os dentes supranumerários podem causar na erupção ectópica da série dental normal. Métodos: A pesquisa possui desenho retrospectivo observacional. A coleta de dados foi realizada pela avaliação de prontuários odontológicos dos pacientes atendidos em uma clínica ortodôntica. Foram analisados radiografias, fotografias e modelos de gesso dental dos pacientes e as informações foram registradas em arquivos de protocolo do estudo. A coleta de dados foi realizada por uma estudante de graduação e uma da pós-graduação, previamente calibradas. A coleta durou dois meses e foram avaliados registros de 1984 a 2019. Os dados foram tratados no programa Microsoft Office Excel (version 2016) com análise descritiva dos dados. Resultados: Dos 920 prontuários analisados, 2,7% apresentavam pelo menos um dente supranumerário, com localização preferida na área superior anterior e na área parapremolar mandibular. O tipo mais prevalente foi o dente suplementar, com orientação de erupção normal e localização alveolar normal. Conclusão: Os dentes supranumerários da população estudada neste estudo mostraram pouca interferência na erupção ectópica da série dental normal. A maioria dos dentes supranumerários estava em posição de impactação. E, aproximadamente um terço dos dentes supranumerários apresentaram desvios de erupção.

Frequency and Characteristics of Mesiodens in Indian School Children: A Retrospective Radiographic Study

Abstract Objective: To determine the frequency and characteristics of mesiodens in Indian school children. Material and Methods: 1232 radiographs of patients attending the Department of Oral Medicine and Radiology of the age group of 4-15 years studied for the present retrospective study. The intraoral periapical radiographs and occlusal radiographs of the premaxilla were examined to determine the presence of mesiodens. The data regarding the presence of mesiodens, number, position, location on the arch, shape and associated complications were recorded. Results: Eleven patients had 14 mesiodens, with a frequency of 0.8%. The ratio of boys to girls was 1.2:1. Maximum mesiodens observed in the age group of 7-9 years. Most of the mesiodens were conical in shape and found on the palatal side. Fifty percent of the mesiodens were unerupted. The majority of patients (57.1%) had vertically positioned mesiodens. Midline diastema was the most common complication due to mesiodens (66.7%). Conclusion: Routine check-up during the primary dentition and mixed dentition stages helps for early detection of mesiodens and thus preventing complications. Early identification is useful for planning comprehensive management, initiating proper consultation and referral for evaluation and treatment.

Supernumerary Teeth: A Retrospective Cross-Sectional Study from Palestine

Abstract Objective: To investigate the prevalence and characteristics of supernumerary teeth among patients attending the students' dental clinics at the Faculty of Dentistry of the Arab American University, Jenin, Palestine. Material and Methods: This is a descriptive, cross-sectional, retrospective study of 1970 digital panoramic radiographs of patients, age ranging between 12 and 50 years. The radiographs and dental records were reviewed for supernumerary teeth. For each patient with supernumerary teeth, were recorded the demographic variables, number, location, eruption status, type, and morphology, the developmental stages. Descriptive statistics were performed and results were tabulated. Results: Supernumerary teeth were detected in 17 subjects (0.86%), of which 13 were males and 4 were females with a male to female ratio of 3.25:1. Of the 17 patients, 64.7% had one supernumerary tooth while the others had two. The majority (78.3%) of the supernumeraries were located in the maxilla. Around 56.5% of the supernumeraries found in this study were located in the premaxilla. Half of the supernumeraries (52.2%) were erupted, and 47.8% were impacted. Mesiodens was the most frequently seen supernumerary teeth followed by distomolars and premolars. Most of the supernumeraries were fully developed, while 21.7% displayed only crown formation. Conclusion: The prevalence of supernumerary teeth in the study sample was found to be 0.86% and the most frequent type was mesiodens. Supplemental morphology was found to be the most common form of supernumerary teeth.

Application of digital positioning guide plate in extraction of impacted supernumerary teeth / 南方医科大学学报

OBJECTIVE@#To explore the application of digital positioning guide plate in extraction of impacted supernumerary teeth and evaluate its clinical efficacy.@*METHODS@#From March to August, 2019, 30 patients with labial impacted supernumerary teeth treated in the Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Southern Medical University were enrolled in this study. Fifteen of the patients were treated with digital positioning guide plate to remove the impacted supernumerary teeth (test group). According to the CBCT data and the dentition model of the patients, the positioning guide plate was positioned by avoiding the important anatomical structure with the tooth-bone surface as the support to design the soft tissue incision line and bone tissue exposure range. The other 15 patients who were treated without the use of the guide plate for operation served as the control group. The design time, tooth searching time, operation time and complications were compared between the two groups.@*RESULTS@#The positioning guide plate was well attached during the operation and allowed quick location of the supernumerary teeth while helping to expose the supernumerary teeth and avoid the damage of the adjacent important anatomical structures. The pre-operative design time was 50 ± 5 min in the test group and 0 min in the control group. The average time of tooth finding in the test group was 5±2 min, as compared with 10±3 min in the control group (=15.40, < 0.01); the average time of operation was significantly shorter in the test group than in the control group (25±4 min 45±6 min; =35.50, < 0.01). No intraoperative complications occurred in the test group, and slight deviation occurred in one case in the control group.@*CONCLUSIONS@#The application of digital positioning guide plate in extraction of embedded supernumerary teeth can significantly shorten the time of tooth finding, reduce the difficulty of operation, and improve the quality of operation.

Queratoquiste Odontogénico en un Paciente con Displasia Cleidocraneal: reporte de un Caso / Odontogenic Keratocyst in a Patient with Cleidocranial Dysplasia: case Report

RESUMEN: La displasia cleidocraneal (DCC), es un trastorno autosómico dominante poco común, que involucra principalmente a los huesos que se osifican por vía membranosa; afectando el cierre de fontanelas craneales y el desarrollo de las clavículas, además de anomalías dentales y vertebrales. El objetivo de este manuscrito fue reportar el caso de una paciente con DCC que presentó un queratoquiste odontogénico (QQO) intrasinusal. Presentamos el caso de una paciente de 81 años, diagnosticada en su niñez con DDC, que consultó por un desajuste protésico y molestias en relación a la zona del seno maxilar derecho. Clínicamente se observó desajuste de la prótesis y aumento de volumen de márgenes poco definidos en la zona maxilar derecha, color rosa coral; que se extendía por todo el margen hemimaxilar derecho hasta el fondo de vestíbulo; doloroso a la palpación, con un mes de evolución. Se solicitó CBCT, con el que se pudo verificar la presencia de un desarrollo tumoral de contenido similar a dentículos, ubicado en la totalidad del seno maxilar derecho; extendiéndose hasta el piso de la cavidad nasal y orbitaria. Se estableció la hipótesis diagnóstica de "odontoma compuesto". Se le intervino quirúrgicamente, bajo anestesia general, realizándose una excisión de la lesión; la que era de márgenes definidos, con cambios de coloración en tonos oscuros, con la inclusión de tres piezas dentarias; de aspecto maligno. Se logró enucleación completa, dejando remanente óseo limpio. La pieza fue enviada a estudio histopatológico. En informe histopatológico, describió la presencia de una lesion quistica con pared compatible con queratoquiste.

ABSTRACT: Cleidocranial dysplasia (CCD) is an uncommon autosomal dominant disorder that mainly involves bones that ossify via the membrane, affecting the closure of cranial fontanels and the development of the clavicles, as well as presenting dental and vertebral anomalies. The aim of this manuscritpt was to report a case of a patient with CCD who presented an intrasinusal odontogenic keratocyst.We present an 81-year-old female patient, diagnosed with this syndrome in childhood, who comes to our service for a prosthetic misalignment and discomfort of the right maxillary sinus area. Clinically, there was a mismatch of the prosthesis and an increase in the volume of undefined margins under it, coral pink color, which extended all over the right hemimaxillary margin to the bottom of the vestibule, painful on palpation, with a one month evolution. A CBCT was requested, which revealed the presence of a tumor development with content similar to denticles, located in the entire right maxillary sinus, extending to the floor of the nasal and orbital cavity. The diagnostic hypothesis of "compound odontoma" was established. The patient was operated on in the central ward, under general anesthesia performing the excisional biopsy of the lesion, which showed changes in coloration in dark tones, with defined edges, with the inclusion of three teeth showing malignancy aspects. Complete enucleation was achieved, leaving tumor-free clean bone remnant. In a histopathological report, the presence of a keratocyst wall was described, which is not very compatible given the appearance of the lesion, the presence of the dental pieces included in it, and the behavior of the lesion.