Atypical hard tissue formation around multiple teeth

Hypercementosis in Late Pleistocene Homo sapiens fossils from Klasies River Main Site, South Africa

OBJECTIVE

To examine early Homo sapiens fossils from the Late Pleistocene site of Klasies River Main Site, South Africa for evidence of hypercementosis. The specimens represent seven adult individuals dated to between 119,000 and 58,000 years ago. These observations are contextualized in relation to the incidences of hypercementosis among recent human populations and fossil human samples and the potential etiologies of hypercementosis.

DESIGN

The fossils were investigated utilizing micro-CT and nano-CT scanning to visualize and measure cementum apposition on permanent incisor, premolar and molar roots. Cementum thickness was measured at mid-root level, and the volume of the cementum sleeve was calculated for the two fossil specimens that display marked hypercementosis.

RESULTS

Two of the fossils display no evidence of cementum hypertrophy. Three exhibit moderate cementum thickening, barely attaining the quantitative threshold for hypercementosis. Two evince marked hypercementosis. One of the Klasies specimens with marked hypercementosis is judged to be an older individual with periapical abscessing. The second specimen is a younger adult, and seemingly similar in age to other Klasies fossils that exhibit only minimal cementum apposition. However, this second specimen exhibits dento-alveolar ankylosis of the premolar and molars.

CONCLUSIONS

These two fossils from Klasies River Main Site provide the earliest manifestation of hypercementosis in Homo sapiens.

Concrescence of maxillary second molar and impacted third molar: A case report

BACKGROUND

Morphological anomalies of teeth, including talon cusp, dens evaginatus, gemination, fusion, concrescence, root dilaceration, and taurodontism, always involve changes in the enamel, cementum and dentin. Diagnosing concrescent teeth through routine clinical examination alone is difficult, and most cases of concrescence are found accidentally during extraction. A definite preoperative diagnosis of concrescence would contribute to a better treatment plan and fewer undesirable complications

CASE SUMMARY

A 47-year-old woman who complained of left maxillary first molar loss for half a year presented to our department seeking treatment by dental implant restoration. Panoramic radiography and cone-beam computed tomography (CBCT) showed an unclear boundary between the distal root of the second molar and the mesial root of the third molar. The teeth were extracted under local anesthesia, and a definite diagnosis of concrescence was made by histopathological examination.

CONCLUSION

CBCT is a useful tool for diagnosing and planning the management of tooth concrescence and may be beneficial for reducing unnecessary complications.

Concrescent Teeth: Extraction Implications - A Case Report

Background:

Concrescent teeth belong to the group of double teeth with disturbed anatomy of shape and structure. The concrescence consists of the aggregation of root cementum of adjacent teeth. This anomaly usually concerns the upper teeth in the lateral part of the jaw. Concrescent teeth can be treated conservatively, endodontically, orthodontically and surgically.

Objective:

The aim of this article is to present the case of the concrescence of upper teeth, a second molar tooth with an impacted third molar, and to draw the attention of clinicians to this rare anomaly that may cause medical and legal problems.

Case presentation:

This article presents the case of a 53-year-old woman who reported to the dentist’s office to extract tooth 17 due to chronic periodontitis and an impacted and abnormally placed tooth 18.

Result:

During the extraction, concrescence of the teeth was noted. The teeth were removed, and the alveoli were surgically treated. The postoperative period was uncomplicated.

Conclusion:

In this paper, the authors draw the attention of clinicians to the fact that the occurrence of concrescent teeth in clinical practice is rare and that it is difficult to diagnose this anomaly on the basis of routine radiological diagnostics based on 2D images. They also point to the necessity of a thorough physical examination and a thorough assessment of teeth before extraction, the extension of imaging diagnostics by conical CT scan in justified cases, and informing the patient about possible complications. In order to avoid serious complications, the extraction of the concrescent teeth should be performed by an experienced specialist in dental or maxillofacial surgery.

Unusual finding of concrescence

Concrescence is a rare dental anomaly whereby adjacent teeth are united by cementum. It has been reported to occur in around 0.8% of permanent dental extractions and a correct diagnosis prior to surgical intervention is important to ensure that patients can make an informed decision about their treatment and to reduce the potential for dentolegal action against the responsible clinician. An 83-year-old woman was referred to the Oral and Maxillofacial Surgery Department at the Wirral University Teaching Hospital, for extraction of her upper left first molar tooth. The operator noted that, when the upper left first molar was extracted, the upper left second molar tooth was also removed. Clinically, the roots of the adjacent teeth appeared fused and a diagnosis of concrescence was established. The patient was informed of the complication and provided with a 1-week review appointment, at which stage she was discharged.

Irregular periapical radiopacity in mandibular premolars and molars

Increased deposition of cementum is observed in a wide number of both benign and malignant conditions. Many cases are often diagnosed during routine examination as an incidental finding. Diagnosing correctly without confusing it with other similarly appearing lesions, thus avoiding subjecting the patient to unnecessary investigations and stress, is of prime importance. We report one such case, where the patient presented with the routine complaint of a painful tooth, during the investigation of which he was also diagnosed with hypercementosis affecting the mandibular second premolars and molars bilaterally. The literature review reveals that not many cases of hypercementosis are frequently reported.