Early diagnostic evaluation of mandibular symmetry using orthopantomogram.

AIMS: The aim of this research was to complete Habets's method on orthopantomogram, in order to measure mandibular symmetry horizontally and diagonally in mixed dentition as the first diagnostic evaluation. SETTINGS AND DESIGN: Mixed dentition subjects were consecutively selected according to skeletal maturity. MATERIALS AND METHODS: Inclusion criteria were: Mixed dentition, cervical vertebral stages 1-2, Class II or Class III malocclusions, with or without unilateral posterior cross-bite. Fourteen subjects with cross-bite (mean age 8 y, 9 m) cross group (CG) and 14 subjects with normal transverse occlusion (mean age 8 y, 6m) non-cross group (NCG) were selected. Nine measurements were determined. An asymmetry index was performed for all linear variables. STATISTICAL ANALYSIS USED: NCG patients' data were compared with CG data using parametric t-tests. Probabilities of <0.05 were accepted as significant. RESULTS: In CG, comparing right and left side, single values showed no significant differences up to 6% (twice if compared to the 3% threshold value). T-tests showed statistically significant differences between the groups for ramus + condyle height (index 2.5% vs 4.5%, P = 0.04), condylar height (index 3.7% vs 6.6%, P = 0.02) and mandibular length (index 1.4% vs 2.3%, P = 0.04). Overall CG group was more asymmetrical than NCG. CONCLUSIONS: In mixed dentition (CS1-2), a first appraisal of mandibular symmetry may be performed on orthopantomogram utilizing this modified Habets's method. This tracing method provides an early evaluation about mandibular symmetry and is able to show slight asymmetries in mixed dentition thereby reducing the number of cone beam computed tomograms performed.

Surgical orthodontic treatment of an impacted canine in the presence of dens invaginatus and follicular cyst.

Introduction. "Dens invaginatus" is a dental anomaly which originates from the invagination of the ameloblastic epithelium into the lingual surface of the dental crown during the odontogenesis. It can cause early pulpal necrosis, abscesses, retention or dislocation of contiguous elements, cysts, and internal resorptions. It normally affects the upper lateral incisors. In the following study the authors will discuss the etiology, the physiopathology, and the surgical-orthodontic management of a rare case of impacted canine associated with dens invaginatus and follicular cyst, with the aim of highlighting the importance of taking any therapeutic decision based on the data available in the literature. Case Report. The present study describes a combined surgical-orthodontic treatment of an impacted canine associated with a lateral incisor (2.2) suffering from type III dens invaginatus with radicular cyst, in a 15-year-old patient. Discussion. When treating a dens invaginatus there are different therapeutic solutions: they depend on the gravity of the anomaly and on the association with the retention of a permanent tooth. The aesthetic and functional restoration becomes extremely important when performing a surgical-orthodontic repositioning.