Histological Evaluation and Management of Rare Case of Supernumerary "Ghost" Teeth.

Supernumerary teeth are teeth that exceed the normal dental formula. Their prevalence in the permanent dentition is 1-14% and they occur more frequently in maxilla with a sex ratio of 2 : 1 in favor of males. They are often associated with syndromes but there are examples of nonsyndromic multiple supernumerary teeth reported in the literature. CBCT is usually the best exam for radiographic diagnosis and treatment planning, because it provides 3D information about location and morphology of supernumerary teeth. This paper reports a rare case of four supernumerary teeth in a nonsyndromic 9-year-old boy. The peculiarity of this case is that two more exceeding teeth were found during surgical procedure. After extraction, all the teeth underwent a histological undecalcified processing for light microscopical examination. The two "ghost" supernumerary teeth seemed to be primordial dental germs, possibly resulting from an altered odontogenic process. After supernumerary teeth extraction, X-rays and exfoliation monitoring are recommended, since permanent retained teeth often erupt naturally or, at least, improve their condition. Radiographic follow-up is also useful in order to assess the formation of further teeth due to the hyperactivity of the dental lamina.

Possible causal relationships between competitive swimming in growing age and three-dimensional dentoalveolar development.

BACKGROUND: The aim of this study was to investigate possible links between competitive swimming during the growth phase and the development of the dentoalveolar arches. METHODS: The study sample included 100 swimmers and a control group of 100 age-matched non-swimmers who had never practised swimming or related sports. Subjects who had had previous orthodontic treatment were excluded. Overjet, overbite, sagittal and transverse parameters, arch dimension, crowding and oral habits were recorded. RESULTS: In the swimmers, there was a significantly higher frequency of molar symmetry (P=0.04), together with a greater number of Class I subjects. The overjet in the swimmers was mainly normal, but the arch dimensions were significantly wider (+10% in the upper arch; P<0.001). Similarly, the swimmers showed significantly less severe crowding (P<0.001) and significantly reduced oral habits (P<0.001). CONCLUSIONS: Our data and analysis demonstrate that competitive swimming during the growth phase has a favourable effect on dental arch development in the sagittal, vertical and transverse planes.

Age estimation in children by measurement of open apices in tooth roots: Study of a Mexican sample.

The aim of this cross-sectional study was to test the accuracy of Cameriere's European formula for age assessment in a large sample of Mexican children. The accuracy of dental age estimation was defined as how closely real age, measured as the difference between chronological age (CA) and dental age (DA), could be predicted. Digitalized orthopantomographs of 502 Mexican children (254 girls and 248 boys), aged between 5 and 15 years, were analyzed. The seven left permanent mandibular teeth were evaluated using Cameriere's method. Intra- and inter-observer variability for this technique was tested on a small random sample. Dental age was estimated for each individual and compared with known chronological age. Accuracy was measured as the difference between known chronological age and dental age and tested for significance with the mean prediction error (ME). The standard deviation and 95% confidence interval of the mean difference were also calculated. ME was 0.63 years for girls and 0.52 years for boys. ME was found to be slightly overestimated by 0.10 years for girls, but was correctly estimated for boys with an accuracy of 0.00. In conclusion, this method is very useful and may be recommended for practical application both in clinical dentistry and forensic procedures on the Mexican population.

Adapting Häävikko's dental age for the assessment of Italian children: use of LMS and other models based on smoothing splines.

The expression 'dental age' (DA) denotes the mean age at which a given stage of dental development is achieved in a population chosen as calibrator. The rhythm at which the maturation occurs is a characteristic of a given population in a given period. When DA is determined on subjects of a population different from the calibrator, the shape of the relationship of DA to chronological age (CA) must be empirically determined to trace reference charts for DA that properly apply to this population. The aim of this study is to show how the DA determined in a calibration set (Häävikko's DA) can be adapted to apply to another population (Italian children), by means of CA-dependent smooth functions of the location, scale and shape of DA distribution. A set of 492 good quality panoramic films taken on healthy Italian children aged 5.5-14.5 years was analysed. The techniques under comparison produced quite similar curves: a parsimonious (4 e.d.f.) and rather satisfactory smoothing spline was found for median, but not for scale and shape indices: so the meaning of SDS values derived from these adjusted reference charts may result doubtful. Among the software products considered here, LMS program was found to be particularly user friendly, since allows the user to visually control the effect of changing the number of e.d.f. on the pattern of DA reference charts.

Traditional plaster casts and dental digital models: intra-examiner reliability of measurements.

UNLABELLED: The aim of this study was to compare the intra-examiner reliability of measurements made on plaster cast and dental digital models. MATERIAL AND METHODS: Five young patients with different occlusal patterns were selected and their dental casts and corresponding digital models were obtained. Twenty expert orthodontists were asked to measure two times both the traditional and digital models. The measurements taken included: lower inter-canine distance, lower inter-molar distance, lower right first molar mesio-distal length, lower right lateral incisor mesiodistal length and overbite. The absolute differences between the two sets of repeated measurements were computed for each of the five couples of parameters and compared with Student's paired T tests. RESULTS: Four parameters showed no statistical difference when the error of measurement of the traditional models was compared to the error of measurement of the digital models. They where the lower inter-canine distance (p = 0.11), the lower inter-molar distance (p = 0.24), the lower right first molar mesio-distal length (p = 0.4), the lower right lateral incisor mesio-distal length (p = 0.39). On the contrary, the error of measurement for the overbite was lower (P < 0.001) for digital models (Mean = 0.24, SD = 0.21) compared to traditional models (Mean = 0.69, SD = 0.53). CONCLUSIONS: Digital and traditional casts offer the same intra-examiner reliability in most cases, but for some measurements, when digital cross sections could help, digital models seem to produce a smaller error.

Häävikko's method to assess dental age in Italian children.

The aim of this study was to determine if Häävikko's maturation standards are applicable to Italian children. The sample included 500 healthy Caucasian children 3.9-15.4 years of age: 267 girls [mean age 9.6 years, standard deviation (SD) 2.1] and 233 boys (mean age 9.9 years, SD 2.1), living in Italy. All dental ages were assessed from panoramic films by one examiner using Häävikko's method. A second examiner independently scored 48 panoramic films to evaluate the reproducibility of the dental age measurements. A good correlation (0.95) was found, as shown by Cohen's kappa. To evaluate the relationship between dental age estimated by Häävikko's standards and the chronological age of the Italian sample, Bland and Altman's graphical method was employed. Moreover, centiles of dental age were constructed both for girls and boys using the LMS (L=skewness, M=median, S=coefficient of variation) method of Cole and Green. It was found that Häävikko's standards tended to underestimate chronological age in this Italian sample. Dental maturation standards as described by Häävikko do not appear suitable for Italian children; instead, centile curves constructed for girls and boys using the LMS method could be used for the estimation of dental age in the Italian population.