Regional early development and eruption of permanent teeth: case report.

BACKGROUND: Early development and eruption of permanent teeth are rarely reported in scientific literature. Early eruption of permanent teeth has been reported to occur due to local factors such as trauma or dental abscesses in primary teeth, and in systemic conditions. Congenital diffuse infiltrating facial lipomatosis (CDIFL) is a rare condition that belongs to a group of lipomatosis tumours. In this disorder, the mature adipocytes invade adjacent soft and hard tissues in the facial region. Accelerated tooth eruption is one of the dental anomalies associated with CDIFL. CASE REPORT: A 3-year-old boy presented with a swelling of the lower lip localised early development and eruption of permanent teeth and dental caries involving many primary teeth. TREATMENT: The planned treatment included biopsy of the swollen lower lip to confirm the diagnosis, surgical reduction and reconstruction of lip aesthetics. The management of the carious primary teeth included preventative and comprehensive dental care and extractions. These procedures were completed under general anaesthesia due to the child's young age and poor cooperation. The lip biopsy showed features of CDIFL such as the presence of infiltrating adipose tissue, prominent number of nerve bundles and thickened vessels. FOLLOW-UP: The high recurrence rate of CDIFL mandates long-term monitoring during the facial growth period of the child. Follow-up care by the paediatric dentist and maxillofacial surgeon has been required to manage all aspects of this congenital malformation. CONCLUSION: This rare disorder has many implications affecting child's facial aesthetics, psychological well being, developing occlusion and risk of dental caries. A multi-disciplinary approach is needed for management of this condition.

Regional Odontodysplasia with Generalised Enamel Defect.

Regional odontodysplasia (ROD) is uncommon developmental anomaly, which tends to be localised and involves the ectodermal and mesodermal tooth components. A five-year-old female was referred to Department of Child Dental Health at the Leeds Dental Institute regarding malformed primary teeth. On examination 64, 74, and 72 had localised hypomineralized enamel defect. The crown of 55 was broken down with only the root remaining below the gingival level. 54 has a yellowish brown discolouration with rough irregular surface. The upper anterior teeth show mild enamel opacity. Radiographically, 55 and 54 had thin radioopaque contour, showing poor distinction between the enamel and dentine and the classic feature of a wide pulp chamber. 15, 16, and 17 were developmentally delayed and were displaying the characteristic "ghost appearance." Comprehensive dental care was done under local anaesthesia and it included extraction of the primary molars affected by ROD, stainless steel crown on 64, and caries prevention program. Fifteen months following the initial assessment the patient's oral condition remains stable and she is under regular follow-up at the department. Paediatric dentists should be aware of this anomaly as it involves both dentitions and usually requires multidisciplinary care.