Supernumerary primary tooth with facial and palatal talon cusps: a case report

Talon cusp is a tooth anomaly originating from the tooth's lingual surface in most cases. To date, very rare cases have been reported documenting talon cusps both on the facial and palatal surface of an affected tooth in the dental literature. The purpose of this case report was to describe the facial and palatal talon cusps on an ectopic supernumerary primary maxillary tooth. A micro-CT investigation indicated no pulpal extensions within facial and palatal talon cusps.

Management of supplemental permanent maxillary lateral incisors in association with talon cusp on the primary predecessors: a report of 3 cases

Most of the cases of talon cusp in the primary dentition affected the maxillary central incisors, but have no effect on the permanent successors. Among the 5 cases of a talon cusp in primary maxillary lateral incisors reported in the dental literature, however, one was associated with a supernumerary tooth and 3 with supplemental permanent successors. The purpose of this report was to describe 3 cases of a talon cusp on the primary maxillary lateral incisors of Chinese children, all of which were associated with talon teeth or the permanent successors. A conservative approach was used to manage these supplemental permanent lateral incisors, and the advantages of such an approach are discussed.

Enamel, dentine and pulp in talon primary maxillary central incisors: a histomorphometric study

AIM

To examine whether a talon incisor has an abnormal shape due to excess of dental hard tissues or pulp.

METHODS

Two bilateral primary maxillary central incisors with talon cusp and a supernumerary mesiodens were removed from a 6-year-old boy. Histologically, 7 undecalcified cross sections (70 microm) were harvested from each talon tooth and from two regular primary central incisors of another child. Microradiographs of the sections were prepared and examined for enamel width, dentin width, pulp tissue area, and crown size (mesio-distal, labio-palatal) using Image Analysis.

RESULTS

No association to other developmental disorders was observed. The mean width of the enamel and dentin was similar in the talon and the regular incisors (difference 7.5% and 2.4%, respectively). The pulp area was greater in the talon teeth (37.4%). The latter had an effect on the increase in the mesio-distal and labio-palatal dimensions of the talon teeth (17.6% and 23.9%, respectively).

CONCLUSIONS

The fact that the talon cusp has normal enamel and dentin layers with a substantial enlarged pulp tissue suggests that similar developmental anomalies occur during tooth morphodifferentiation as in taurodontism and dens evagintus of premolars.

Supernumerary tooth in the primary molar region: a case report

Supernumerary teeth are among the most common dental anomalies affecting the primary and permanent dentition. They are usually found in the anterior maxilla and occur infrequently in the primary dentition. The purpose of this paper was to report a case diagnosed with primary supernumerary tooth in the primary second molar region. The crown and root shape of the primary supernumerary tooth resembled that of the primary first molar. On radiographic examination, the primary supernumerary tooth was followed by a permanent supernumerary successor with an unusually big crown. The primary supernumerary molar was immediately extracted to avoid interference with the development of the second premolar's tooth bud. This dental anomaly is rarely observed, as only primary supernumerary teeth in the anterior region have been reported in the dental literature.

The relationship between a primary maxillary incisor with a talon cusp and the permanent successor: a study of 57 cases

BACKGROUND

Most reported cases of talon cusps in the primary dentition have been on the maxillary central incisors and the permanent successors have remained unaffected. Four of the five reported cases on a maxillary lateral incisor, however, have been associated with a supernumerary permanent successor.

AIM

This paper describes the relationship between the presence of talon cusps on a primary maxillary incisor, and the morphology and number of the permanent successors in a population of Chinese children.

DESIGN

The dental records of children diagnosed with a talon cusp on a primary incisor were retrieved for review. The diagnoses took place in a regional school dental clinic in Hong Kong between April 2002 and August 2005.

RESULTS

Fifty-eight primary maxillary incisors with talon cusps were found. When the central incisors were involved, 32 of the 35 (91.4%) underlying permanent successors were not found to be associated with any odontogenic abnormalities. When the lateral incisors were involved, however, 18 of the 23 cases (78.3%) showed odontogenic abnormalities, 14 of which were associated with supernumerary teeth.

CONCLUSIONS

The present study shows that, when there is a talon cusp on a primary maxillary lateral incisor, a high proportion of the underlying permanent successors can be expected to exhibit odontogenic abnormalities.

Primary Double Tooth: Report of a Rare Correlation with the Permanent Dentition

Double tooth is a developmental anomaly that is seen more frequently in the primary than the permanent dentition. Double tooth involving primary canines and lateral incisors is found only in the mandible. The succeeding permanent lateral incisor is often found missing congenitally in the same region. This article reports a rare case of a double tooth involving a mandibular primary canine and lateral incisor. Instead of agenesis, the double tooth has been succeeded by a permanent supernumerary tooth in the same region.

Enamel defects and its relation to life course events in primary dentition of Brazilian children: a longitudinal study

OBJECTIVE

To evaluate the cumulative incidence of enamel defects (ED) and its correlation with life course events such as malnutrition and pre- and postnatal infections, in a cohort of children of low socioeconomic status.

METHODS

The children were registered at birth and examined from 12 to 36 months of age. At the baseline, 246 were examined and in the follow-up, 228. The teeth were examined under natural light and dried with gauze. ED was determined by the DDE index.

RESULTS

Results show that gender was not significant. The cumulative incidence of ED at the last recall examination was 78.9%. The most prevalent type of defect was diffuse opacity, present on the gingival half of the buccal surface (p < 0.001). For logistic regression analysis maternal infections, intrauterine growth retardation (IUGR), malnutrition and postnatal infections were selected as predictor variables for the occurrence of enamel defects.

CONCLUSIONS

The results indicate that life course events such as undernutrition and childhood infections during teeth development may be associated with enamel defects in socioeconomically underprivileged communities and may compromise the oral health-related quality of life.

Buccal and palatal talon cusps with pulp extensions on a supernumerary primary tooth

This paper reports an unusual occurrence of talon cusp on a supernumerary primary incisor, presenting on both labial and palatal sides. The tooth was scheduled for extraction due to its interference with the occlusion. Morphometric analysis of the taloned cusps was performed on digitized replicas of the tooth crown using open-source image analysis toolkit (ImageJ). Further non-destructive investigation of the taloned crown under cone-beam X-ray computed tomography revealed pulpal extensions in both talon cusps.

Occulocerebrocutaneous syndrome: a case report

Occulocerebrocutaneous syndrome is a rare condition characterized by orbital cysts and skin tags. The presence of supernumerary teeth has not previously been associated with this syndrome. A primary supernumerary tooth with a permanent supernumerary successor was found in this case. This highlights the importance of very careful examination when assessing children with syndromes.

Is amelogenesis imperfecta an indication for renal examination?

BACKGROUND

The term 'amelogenesis imperfecta' (AI) describes a diverse group of hereditary conditions primarily affecting the quality and/or quantity of dental enamel.

CASE REPORT

This paper describes a case in which hypoplastic AI with delayed/failure of eruption of the permanent teeth was shown to be associated with renal calcification.

CONCLUSION

Given the importance of the renal involvement, the authors suggest that paediatric dentists consider referring all children with this dental phenotype for renal ultrasound examination.

Dental management of a talon cusp on a primary incisor

There are many treatment options for the pediatric patient with a talon cusp (TC). The purpose of this paper was to report the case of a TC involving a primary maxillary right central incisor in a 14-month-old male causing displacement of the affected tooth. The etiology of a TC is thought to be a disturbance during the morphodifferentiation stage of tooth development. Clinical problems include: (1) occlusal interferences; (2) esthetic disturbances; (3) accidental cusp fracture; (4) tongue irritation; (5) nursing difficulty; (6) caries; and (7) displacement of the affected tooth. The TC affecting the central incisor was reduced over a period of 4 visits, followed by immediate placement of a 5% sodium fluoride varnish at the conclusion of each reduction visit. Restoration of esthetics and function was evident within 1 month following complete cusp reduction. There were no clinical signs of any problems related to the reduction, and the prognosis was considered to be guarded. The pediatric patient was placed on a 6-month oral hygiene maintenance follow-up.

Double-rooted primary canines: A report of three cases

This article reports three rare cases of birooted primary canines. In one of the three cases reported, the double-rooted primary canine was unilateral, which is a unique condition in the dental literature. One of the birooted primary canines was extracted for examination. Root canal morphology was examined using the clearing technique and three root canals were detected. The detection of birooted teeth requires a fastidious radiographic evaluation. Moreover, it should be kept in mind during endodontic therapy that the number of root canals might exceed the number of roots for these teeth.

Congenitally missing maxillary primary canines: report of three cases

BACKGROUND

Hypodontia is uncommon in the primary dentition and lateral incisors are the most commonly missing primary teeth in the patients affected. Studies have found that hypodontia in the primary dentition involving only maxillary canine is rare.

CASE REPORTS

Three cases of hypodontia in the primary dentition involving only maxillary canine are presented. Two of them were affected by hypodontia and hyperdontia in the permanent dentitions respectively, yet all the permanent canines developed normally in these three cases.

CONCLUSION

In children with congenitally missing maxillary canines, the permanent dentitions may show diverse anomalies in tooth numbers, ranging from hypodontia to hyperdontia.

Talon cusp in the primary dentition: literature review and report of three rare cases

This paper reviews the nomenclature, prevalence, definition, etiology, association with other dental/anomalies, diagnosis and treatment planning of talon cusp in the primary anterior teeth. Most of the reported cases have involved the primary maxillary central incisors. However, talon cusps on the primary maxillary lateral incisors are associated with high percentages of anomalies in the permanent successors. This paper reported three such rare cases and dentists should be aware of such additional anomalies.

Management of a case with bilateral talon cusp in primary dentition

The talon cusp is a relatively rare dental developmental anomaly characterized by the presence of an accessory cusp-like structure projecting from the cingulum area or cementoenamel junction. The alteration can cause clinical problems such as caries or occlusal interference. Management of the talon cusp varies according to the circumstances of the individual case and should be as conservative as possible. The purpose of this report was to present the case of bilateral talon cusp in primary maxillary central incisors that was successfully managed with conservative therapy.

Presence of developmental defects of enamel in cystic fibrosis patients

PURPOSES

Cystic fibrosis (CF) is an autosomal recessive hereditary disease and is the frequently common lethal genetic pathology. The purposes of this study were to: (1) determine the presence of 3 different types of enamel defects: (a) demarcated opacities; (b) diffuse opacities; and (c) hypoplasia in the deciduous and permanent dentition of CF patients; and (2) compare with a control group.

METHODS

The case group was defined as 13 patients who were diagnosed with CF and enrolled in a multiprofessional project of the Catholic University of Brasília (CUB), Brasilia, Brazil. All CF subjects were compared with control subjects selected from patients at the CUB. Each CF subject was individually paired with a control subject of similar sex and age. A full-mouth examination was carried out for the developmental defects of enamel (DDE) index.

RESULTS

The most prevalent enamel defect in deciduous teeth was demarcated opacities present in 16% of the case group and in 7% of the control group. Although the defects were more prevalent in the case group, the difference was not statistically significant (P=0.57). The frequency of demarcated opacities was more prevalent in permanent teeth of the case group: 39% compared to 11% in the control group. For the control group, diffuse opacities were the more prevalent defects: 17% compared to 15% in the case group. The case group had more enamel defects in permanent teeth compared to the control (P=0.0003).

CONCLUSIONS

In this study, enamel defects were frequently found in the permanent teeth of CF patients. Therefore, professionals who treat children should be alerted to promoting oral health among these patients.

Kabuki syndrome: oral and general features seen in a 2-year-old Chinese boy

This report describes the case of a young Chinese boy with Kabuki syndrome (KS). KS is a congenital condition characterized by multiple anomalies, especially of the face, and is usually associated with mild to moderate mental retardation. The patient presented with the characteristic facial features of KS and some skeletal and neurological anomalies including a butterfly vertebrae with scoliosis, cerebral atrophy, and irregular dentition. Dental examination revealed screwdriver-shaped incisors and a high arched maxilla, features typical of patients with KS, as well as very poor oral hygiene and early childhood caries. This report includes discussion of the aetiology of KS as well as discussion of the long-term prognosis for this particular patient, and patients with KS in general, with consideration of associated dental and medical issues.

Breast-feeding and other mother-child factors associated with developmental enamel defects in the primary teeth of Brazilian children

PURPOSE

The purpose of this study was to examine the association between developmental defects in the enamel (DDE) of the primary teeth and low birth weight or prematurity.

METHODS

A case-control study was carried out in Itajaí, Southern Brazil, involving 3- to 5-year-old children. The case group was composed of 102 children presenting at least 1 dental surface with DDE. The control group comprised 113 children without DDE matched by sex and age and enrolled in the same day care centers. All teeth were clinically examined using the Modified Index of Developmental Defects of Enamel. The outcome variable of the study was DDE in at least 1 dental surface, and the independent variables were: (1) birth weight; (2) gestational age; and (3) breast-feeding. Maternal schooling and health problems of the mother during pregnancy and of the child during the first year of life were collected as potential confounding factors. Simple and conditional multiple logistic regression analyses were performed, providing crude and adjusted odds ratio and 95% confidence intervals.

RESULTS

Prematurity (OR=2.6; 95% CI=1.0-6.4) and children who did not breast-feed (OR=3.2; 95% CI=1.2-8.4) were associated with defects in tooth enamel after adjusting for possible confounding variables.

CONCLUSIONS

In this study, premature children and those who did not breast-feed could be considered at risk for developing defects in tooth enamel.

Facial talon cusp in primary maxillary lateral incisor: a report of two unusual cases

Talon cusp is an uncommon dental anomaly in which an accessory cusp-like structure projects from the cingulum area or cemento-enamel junction of the maxillary or mandibular anterior teeth. This anomalous cusp resembles an eagle's talon. It occurs in both the primary and the permanent dentition. A comprehensive literature review shows that only 37?cases of talon cusps have been reported in the primary dentition, of which only 4?cases report this anomaly on the primary maxillary lateral incisor. Though labial/facial talon cusps have been reported in the permanent dentition, no case of a labial talon has been reported in the primary dentition. We report two females with cleft lip and palate with facial talon cusps on the primary lateral incisor and believe that these are the first cases to be reported. Clinical considerations and debate on the etiology of this anomaly are discussed.

Taurodontism of deciduous and permanent molars: report of two cases

Taurodontism is an aberration of teeth that lacks the constriction at the level of the CEJ characterized by elongated pulp chambers and apical displacement of bifurcation or trifurcation of the roots, giving it a rectangular shape. Its occurrence in permanent teeth is common and is quite rare in deciduous dentition. Presented in this article are two cases with taurodontism involving deciduous and permanent molars.

Dental findings of a child with Wolf-Hirschhorn syndrome

The case presented is that of a 5-year-old female with Wolf-Hirschhorn syndrome. Dental findings were severe hypodontia, late dental development, taurodontism of the primary molars, microdontia, and spacing. Hypodontia has previously been reported and therefore this case adds to the evidence that hypodontia may be a common feature of this syndrome. It also suggests that other dental anomalies could occur in children with Wolf-Hirschhorn syndrome.

Restorative therapy of primary teeth severely affected by amelogenesis imperfecta

OBJECTIVE

Primary teeth severely affected by amelogenesis imperfecta (AI) often show an extensive loss of enamel. Such defects are difficult to restore with resin composites, since neither the correct anatomic form nor the marginal fit can be guaranteed.

METHODS AND MATERIALS

After clinical and scanning electron microscopic examinations were performed on replica models of 5 patients with primary teeth affected by AI, impressions were made without previous preparation by rotary instruments. Composite crowns and veneers were manufactured and luted adhesively using the total bonding technique and low-viscosity resin composite.

RESULTS

The pre-restorative scanning electron microscopic analysis showed that the dentinal tubules were exposed and that the border of the residual enamel was in the process of splitting. The preoperative oral examination had revealed tooth discoloration, masticatory disturbances, hypersensitivity, and speech problems. After placement of the restorations, patients reported improvements in tooth sensitivity, articulation, and mastication.

CONCLUSIONS

A new protocol for restoration of primary teeth with an extensive loss of enamel is offered. It is quick and easy to perform, highly esthetic, and can be applied in children younger than 4 years old.

Kabuki make-up (Niikawa-Kuroki) syndrome: dental and craniofacial findings in a Brazilian child

This article reports the case of a Brazilian child diagnosed with Kabuki make-up syndrome (KMS), addressing the clinical features observed, with emphasis on the disease-specific oral and craniofacial manifestations. The patient had the distinctive KMS craniofacial appearance, mild delayed mental development, fingers with prominent fingertip pads and visual deficit. The dental findings included fusion of the left mandibular incisors (central and lateral), gemination of the right mandibular central incisor and congenital agenesis of the right mandibular lateral incisor, in the primary dentition, as well as absence of both permanent mandibular lateral incisors. Fusion and gemination have not been previously referred to as typical dental features in KMS. The detection of unique dental findings, such as missing teeth and dental anomalies of form in the primary dentition by means of clinical and radiographic examinations, might consist of a helpful diagnosis parameter in identifying children who may have milder forms of Kabuki syndrome.

Prevalence of enamel hypoplasia in deciduous canines of patients with complete cleft lip and palate

OBJECTIVE

To evaluate the prevalence and type of enamel hypoplasia in deciduous canines of patients with complete unilateral and bilateral cleft lip and palate, as well as its distribution according to gender, dental arch, and side of cleft.

DESIGN

Cross sectional.

SETTING

Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, São Paulo, Brazil.

MATERIAL AND METHODS

Three-hundred twelve Caucasian children (193 boys, 119 girls), aged 3 to 10 years, presenting complete unilateral and bilateral cleft lip and palate were included in this study. A single examiner carried out clinical examination under natural light with a dental probe and dental mirror and, after drying of the tooth, by means of a simplified hypoplasia index.

RESULTS

A prevalence of 43.8% was observed for unilateral and 39% for bilateral clefts. Both groups revealed similar distributions regarding the maxillary and mandibular dental arches and gender. Similar distribution was also observed on the cleft and noncleft sides for the unilateral cleft group. The most frequent type and severity was obvious hypoplasia, followed by minimal hypoplasia, both roughly round.

CONCLUSION

The results suggest that the cleft does not influence the occurrence of hypoplasia in deciduous canines.

Erupted maxillary conical mesiodens in deciduous dentition in a Bengali girl--a case report

Mesiodens is a midline supernumerary tooth commonly seen in the maxillary arch. It is the most significant dental anomaly affecting permanent dentition mainly and primary dentition rarely. It may occur as an isolated dental anomalous condition or may be associated with a syndrome. Many theories have been promulgated to explain its etiology. But an exact etiology is still obscure. Incidence of mesiodens in children varies from 0.15 to 3.8%. Boys are affected more (2:1) than girls. Morphologically, mesiodens may be of three types: the most commonly seen is conical, while tuberculate and supplementary types.

Witkop tooth and nail syndrome: a case report

Witkop tooth and nail syndrome is an autosomal dominant ectodermal dysplasia characterized by hypodontia and nail dysplasia. Mutations in MSX-1 have been identified as being involved in the syndrome. Mandibular incisors, secondary molars and maxillary canines are the most frequently missing teeth. Tooth shape may vary, and conical and narrow crowns are common. Nail dysplasia affects finger- and toenails, and is often more severe in childhood. Nails may be spoon-shaped, rigid, slow-growing and easily broken. The clinical and radiographic features of a mother and child presenting with this rare condition are described.

Enamel hypoplasia of the primary dentition in a 4-year-old with intestinal lymphangiectasia

Intestinal lymphangiectasia (IL) is a rare disorder, and its incidence and prevalence is unknown for either Australia or world-wide. It is characterized by diarrhoea, mild steatorrhoea, oedema, enteric loss of protein (protein-losing enteropathy) and abnormal dilated lymphatic channels in the small intestine. Whilst oedema and diarrhoea are the predominant clinical features, other observed features include hypoalbuminemia, hypogammaglobulinemia, trace metal deficiency, hypocalcemia and chylous pleural effusions. While medical presentation of the condition has been reported widely, few descriptions of oral findings have been published. A search of Medline found two reports of dental findings in the permanent dentition in patients with IL. To date, there have been no reports on dental findings in the primary dentition. The primary dentition of a 4-year-old boy with IL had teeth with enamel defects which reflected the timing of enamel development and the period in which the disease was active. The present report highlights the need for early involvement of the dental team in the dental management of children with IL.

Labial and lingual talon cusps of a primary lateral incisor: a case report

Talon cusp occurs as a result of disturbances during the morpho-differentiation stage of tooth development. It is more common on the palatal surface of the permanent maxillary incisors. It can be unilateral/bilateral, but can also occur on the same tooth. Only 2 published reports exist documenting talons on both labial and lingual surfaces of the same tooth in permanent incisors. The purpose of this case report was to present a rare case of a facial and palatal talon cusp on the primary maxillary right lateral incisor in a 5-year-old girl with bilateral cleft lip. In this case, the morphology of the primary incisor was "+" shaped on occlusal view.

'Double' teeth-a diagnostic conundrum

A 'double' tooth is an uncommon dental developmental anomaly that can occur in the deciduous and/or permanent dentition. It is not always possible to differentiate clinically between fusion and gemination. Clinical and radiographic examination, as well as a histological assessment, can help to differentiate between fusion and gemination. A case of fusion in the deciduous dentition is presented to demonstrate the diagnostic differences but also, more importantly, to draw attention to the potential impact of 'double' teeth on the developing secondary dentition and its future management.

Morphological and functional rehabilitation of severely infra-occluded primary molars in the presence of aplasia of the permanent premolar: A clinical report

This clinical report describes the fixed prosthodontic rehabilitation of an infra-occluded primary molar. Diagnostic considerations included the patient's age, occlusal status, condition of the infra-occluded tooth including the degree of infra-occlusion and root resorption, as well as adjacent alveolar bone levels. Due to the patient's young age, an invasive prosthetic approach was delayed in favor of an onlay restoration, which represented a more rapid and conservative therapeutic choice. The treatment involved the design and fabrication of a composite onlay on the deciduous molar using a ceramic optimized polymer on a fiber-reinforced composite framework. Three years later, intraoral radiography showed satisfactory marginal adaptation. No change was observed in periodontal tissues.

Talon cusp in a primary lateral incisor from a medieval child

This paper describes talon cusp in an ancient skeleton and is a rare report of its occurrence in a primary lateral incisor. As well as talon cusp, the affected incisor also shows abnormal widening, probably representing a double tooth. There is also a supernumerary permanent incisor. The report shows that talon cusp existed in British populations more than 600 years before the first written description. A brief review of the literature on the occurrence of talon cusp in the primary dentition is presented.

Missing C, supplemental D and supplemental premolar all in one quadrant: a case report

This case report describes a non-syndromic Caucasian patient who presented with a missing upper right primary canine and a supplemental upper right primary first molar. Later, a supplemental premolar developed in the upper right quadrant. The report highlights the importance of early diagnosis of dental anomalies and a multidisciplinary approach to treatment planning. A regular review and radiographic examination are essential.

Mesiodens in primary, mixed and permanent dentitions: a clinical and radiographic study

The term mesiodens refers to a supernumerary tooth located between the maxillary central incisors. The aim of the study was to investigate the characteristics of mesiodens among children in Turkey. The study population involved 24 children who attended the Department of Pediatric Dentistry, Ege University for dental problems. The characteristics of mesiodens were obtained from clinical and radiographic examinations. Results showed that twenty-four patients had thirty-four mesiodens for an average of 1.42 mesiodens per person. Males were affected approximately 3 times more frequently in comparison with females. Forty-two percent of the patients had bilateral mesiodens. All of the mesiodens were conical in shape and 91% were in the downward position. The age and sex distribution, location, direction, eruption of mesiodens and effects on permanent maxillary incisors were also presented in this study. It could be concluded that, delayed, ectopic or asymmetric eruption of the central incisors should alert the clinician to the possibility of a mesiodens.

Triple teeth: case report of an unusual fusion of three teeth

An unusual case of fusion between primary central incisors, lateral incisors, and a supernumerary tooth is reported. The fusion was at the enamel and cementum only, and the tooth was extracted.

Regional odontodysplasia: a review of the literature and report of a case

We present a rare case of a developmental anomaly called regional odontodysplasia or 'ghost teeth' in an 8.5-year-old Jordanian girl. The anomaly affected both the mandibular primary and permanent incisors, and the canines bilaterally. The maxillary teeth were unaffected. This is the first case of the anomaly to be reported in Jordan. The clinical, radiographic and histological features are reviewed. The management of affected patients is discussed.

Dental characteristics of the Wolf-Hirschhorn Syndrome: a case report

Little attention in the dental literature has been given to the dental characteristics of patients with the Wolf-Hirschhorn Syndrome (WHS). The syndrome is caused by deletions of the terminal portion of the short arm of chromosome 4. This case report provides information on dental anomalies noted in a child with WHS. The dental findings include agenesis of multiple permanent teeth, particularly premolars and molars, taurodontism, and over-retained primary teeth. This syndrome exhibits variable clinical expressivity, possibly due to the extent and the specific locus of the chromosomal deletion. Further studies are required to obtain a clearer view of the clinical oral/dental manifestations of this syndrome.

Nager syndrome (preaxial acrofacial dysostosis): a case report

The Nager syndrome is a rare condition associated with craniofacial malformations such as micrognathia, zygomatic hypoplasia, cleft palate, and preaxial limb deformities. This report features a case of the Nager syndrome occurring in a 4-year-old boy showing microdontia, thumb duplication and radioulnar synostosis, and ventricular septum defect, characteristics not usually encountered in the published cases.

Histopathology of the teeth in segmental odontomaxillary dysplasia: new findings

Histological examination of the deciduous teeth in two cases of segmental odontomaxillary dysplasia (SOMD) showed fibrous enlargement of the pulps, an irregular pulp/dentine interface displaying many pseudoinclusions and pulp stones. There were tubular defects in the coronal dentine from pulp horn to cusp tip, an irregular tubular structure to the circumpulpal dentine of the apical half, a focally deficient odontoblast layer and widespread external resorption. Together with the clinical features of unilateral maxillary enlargement, upper alveolar expansion in the distal segment, increased spacing and delayed eruption of the deciduous molars and absence of premolar teeth, these histological appearances allow distinction of this condition from fibrous dysplasia (FD), segmental hemifacial hypertrophy (SHH) and regional odontodysplasia (ROD).

Aberrant root formation: review of root genesis and three case reports

The mechanism of root formation and tooth eruption is a complex process which is not fully understood. Prior to a tooth emerging into the oral cavity, root genesis is initiated by derivatives of the enamel organ. The dental follicle mediates an eruption pathway allowing for movement of the developing tooth in a coronal direction. As the tooth moves towards the oral cavity, root formation occurs passively in the resulting space. Failure of the enamel organ and dental follicle to properly coordinate may result in complications in the eruption process. This clinical report presents 3 cases of isolated, unerupted teeth with dysmorphology of the roots. The process of root development and tooth eruption is also briefly reviewed.

Dental implications of Tooth-Nail dysplasia (Witkop syndrome): a report of an affected family and an approach to dental management

Tooth-Nail dysplasia is a rare genetic disorder, which is classified as an ectodermal dysplasia. Diagnostic differentiation from other conditions in this category is necessary for effective dental management and genetic counseling. The oro-dental and clinical manifestations of Tooth-Nail dysplasia in an affected male infant and his father are documented. Other family members have the condition and pedigree data are in keeping with autosomal dominant inheritance. A comprehensive approach to the dental management of an affected child is proposed.

A premaxilla with a supernumerary tooth indicating a developmental region with a variety of dental abnormalities: a report of nine cases

The aim of this study was to elucidate whether a premaxilla with a supernumerary tooth has additional dental abnormalities. The study does not include premaxillas with a mesiodens, only premaxillas with parasagittally located supernumerary teeth. Radiographs from eight children, followed from 1 year and 5 months to 11 years and 5 months in the municipal dental health service in Denmark, were analyzed. One patient was seen only once. Dental abnormalities recorded included: invaginations on permanent incisors, resorption of roots of incisors, curved roots of incisors, delayed eruption, and delayed formation of roots. The study shows that there are dental abnormalities within the premaxillary region where the supernumerary tooth is located. This indicates that, apart from the supernumerary tooth, a more widespread deviation from normal conditions including tooth malformation, arrested eruption, and root resorption occur within the premaxillary region. The most important outcome of this study is that in the region with a supernumerary tooth the adjacent incisor shows delayed eruption after surgical removal of the supernumerary tooth. The deviations in root morphology, including root resorption, are not limited to patients who have had orthodontic treatment, but patients who did not receive orthodontic treatment also revealed deviations in root morphology. Therefore the treatment outcome can be different from the expected outcome.

Variations in expression of oral-facial-digital syndrome (type I): report of two cases

Two case reports are presented, both clearly demonstrating the diagnosis of oral-facial-digital syndrome, type I, but widely different in the expression of the condition. The first patient showed only mild expression of the syndrome. On examination at the age of 4 years there were no obvious extra oral signs, intraoral findings included the presence of supernumeraries in the primary dentition, spacing in two areas and the presence of an extra frenum. The second can be considered as a more severe case. This patient had many of the typical manifestations, including frontal bossing, a degree of zygomatic hypoplasia and clinodactyly. Orally, the most striking finding was a bilateral cleft palate which had not been diagnosed prior to examination at the age of 6 years. Other findings included multiple frena and a bifid tongue.

Congenital defect of maxillary primary central incisor associated with exposed pulp and gingival [fibrosis]: case report

This report describes a rare case of hypoplastic primary incisor in which the pulp was exposed at the crown portion and covered by the gingiva in a 1-year-11-month-old boy. The patient was referred to us due to swelling of his labial cervical gingiva of the maxillary right primary central incisor, and on examination, extended to the hypoplastic labial surface. Radiographically, there was a round radiolucent area on the crown including the edge. Surgical removal of the swollen gingiva revealed a large defect of the labial aspect of the incisor, showing pulpal tissue inside. The tooth was treated by vital pulpotomy. Histopathologically, the removed gingival tissue contained many pieces of dysplastic tooth elements in the lamina propria portion which should have been connected to the exposed pulp. The findings suggested that pulp exposure resulted from focal dental hypoplasia not from resorption of the tooth.

[An epidemiological survey on fusion of deciduous teeth of 4286 kindergarten children in Shenyang city]

OBJECTIVE

To clarify the occurrence and distribution of the fusion of deciduous teeth in Shenyang.

METHODS

By using cross-sectional study, 4286 children were examined, who aged from 2 to 6 years in 37 kindergartens.

RESULTS

Of 4286 children investigated, fusion of the deciduous teeth were detected in 65 children (1.52 percent) without sex predilection. The fused teeth typically occurred unilaterally (68.75 percent), and mainly located in the anterior region, more frequently in the mandibular (91.25 percent) than that in the maxillary arch. 12 cases were bilaterally symmetrical (18.46 percent). Two rare cases were found with fused teeth, one occurred in central incisor, lateral incisor and canine, the other occurred between two molars with two incisors fused in the same side. Fused teeth in two cases had caries.

CONCLUSION

The occurrence of the fused teeth may cause some complications. Pediatric dentists should pay attention to the fused teeth occurred in preschool children.

Reshaping a mesiodens

A mesiodens is a supernumerary tooth that is found in the midline of the maxilla. Fifteen percent erupt usually between the ages of 3 and 7. The standard treatment is extraction of the supernumerary to allow the permanent incisors to erupt properly. This case report describes an instance where the primary incisor was prematurely exfoliated due to the eruption of the mesiodens. Because of the favorable position of the mesiodens in the dental arch, it was decided to reshape the supernumerary to resemble a primary incisor. This was accomplished successfully, and the mesiodens is being monitored to assess any need to trim or add to the bonding material as the child grows.

Increased primary tooth size in a 47,XXY male: a first case report

Increased tooth size has previously been reported in association with Klinefelter syndrome. However, until now, this observation has been restricted to the permanent dentition. In this paper, we report increased mesio-distal width in the primary incisor and molar teeth of a 47,XXY male.

Hypohidrotic ectodermal dysplasia: a review and case report

A case involving a 5-year-old girl with hypohidrotic ectodermal dysplasia is presented. A review of the disease and the treatment options for patients is discussed.

Pulp therapy in a maxillary fused primary central incisor--report of a case

This paper describes a case in which pulp therapy was provided in a fused maxillary primary central incisor in a 4-year-old patient with a history of fistula on the gingival mucosa. The tooth involved was larger than expected, suggesting fusion. The diagnosis of fusion was confirmed on radiographical examination. The clinical management of the case is described and the diagnosis and treatment discussed.

[Replacement of deciduous incisors in children: psychological aspects]

The absence of the temporary incisors could be to a genetic illness or to some multiple premature extractions. These extractions are the aftermaths of the carious lesions or some traumatisms underwent by the temporary incisors. Beyond measure the loss of the space, the premature loss some temporary incisors very often assign the relational development of the child and disturb its psychological development and the aesthetic function. Across some cases clinics, the authors show that the replacement of the temporary incisors is the therapeutic ideal solution. Indeed, the child prosthesis, replacing the temporary absent incisors, solves the psychological, aesthetic and relational problems of the child.