Impacted Permanent Teeth Research Articles

Diagnostic Dilemma of Radicular Cyst Mimicking a Dentigerous Cyst

Abstract Radicular cyst is the most common odontogenic cyst of the jaw; however, its association with overretained deciduous teeth involving impacted permanent teeth is a rare entity and hence may pose a diagnostic dilemma. The aim of this report is to present a case of radicular cyst that mimicked the dentigerous cyst. A 31-year-old female reported to the department of oral medicine with the chief complaint of swelling on the lower left side of the face. Intraoral examination revealed over-retained carious 75. Based on the clinical features, differential diagnosis was given as a radicular cyst and a dentigerous cyst on radiographic examination; intraoral periapical revealed a cystic lesion involving the crown of the deciduous tooth. Cone-beam computed tomography further confirmed that the cystic lesion was not involving the crown of the impacted premolar. Hence, the three-dimensional radiographic evaluation of the lesion helps to rule out the differential diagnosis.

Cleidocranial dysplasia associated with dentigerous cyst-review of literature and case report of two siblings.

Cleidocranial dysplasia (CCD) is a developmental anomaly of the skeleton and teeth which may be inherited, be transmitted as dominant characteristics in either male or female or even appear spontaneously. A case was reported in the department of oral medicine and radiology of two sisters age 17 and 19 years old with a chief complaint of milk teeth not falling since childhood. They presented specific physical and oral findings in common which suggested the idea of an undiagnosed syndrome. The sisters showed CCD characteristics including short stature (4 feet) and frontal bone resorption indicating delayed closure of fontanels. The stature is moderately shortened with the neck appearing long and narrow and the shoulders markedly dropped. Dental abnormalities such as retention of primary dentition, multiple supernumerary teeth, and delayed eruption of permanent dentition. OPG showed the presence of multiple impacted permanent and supernumerary teeth with radiolucency involving the crowns of impacted teeth revealing a cystic lesion. Lateral cephalogram also revealed the presence of multiple impacted teeth. The provisional diagnosis of CCD with dentigerous cyst was given. The enucleation of cyst was done and submitted for histopathological examination. Histopathologically, the soft tissue section suggested the features of dentigerous cyst. The final diagnosis of CCD associated with dentigerous cyst was confirmed.

Comprehensive repair of the alveolar cleft using cortical and cancellous bone layers: A retrospective study

To retrospectively review the clinical effect of comprehensive treatment of alveolar cleft (CTAC) using the mandible as the bone source.Patients with alveolar clefts who met the inclusion criteria were subjected to a CTAC protocol that included the following: (1) preoperative orthodontic treatment for creating good soft-tissue conditions; (2) ‘area-like grafting’ with subperiosteal osteogenic chin bone instead of cartilaginous osteogenic iliac bone; (3) simulation of normal bone anatomy via a sandwich-like bone graft consisting of ‘cortical bone + cancellous bone + cortical bone’; and (4) strong internal fixation to ensure initial bone block stability. At 6 months postoperatively, the titanium plate was removed and cone-beam computed tomography was performed to evaluate the surgical results.A total of 54 patients underwent treatment with the CTAC protocol. The average age at the initial operation was 10.3 ± 2.1 years, and the average hospital stay was 2.8 ± 0.6 days. At 6 months postoperatively, 49 patients (90.7%) showed good clinical results. The transplanted bone block formed a ‘cortical bone + cancellous bone + cortical bone’ structure similar to that of the normal jawbone. A mature bone bridge formed, and the impacted permanent teeth continued to erupt and enter the bone graft area.CTAC is a comprehensive restorative solution for alveolar cleft repair that integrates multiple concepts, including orthodontics, embryology, anatomy, and improvements to surgical methods. The method is easy to perform, causes little surgical trauma, and shows a stable success rate, and is thus worth promoting.

Case report on CBCT guided management of compound odontoma with 2 denticles in a 9-year-old patient

Odontomas are benign developmental tumors formed by the improper growth of completely differentiated epithelial and mesenchymal cells of odontogenic origin. The etiology of odontoma is unknown and it is detected during routine radiographic examination. The ideal management is early detection and surgical enucleation. The commonly associated clinical problems of odontomas are delayed exfoliation of primary teeth, delayed eruption or impaction of permanent teeth, displacement of teeth, root resorption, congenital missing, and widening of follicular space. Here, we describe a unique case of compound odontoma with two denticles managed in the right anterior maxillary region underwent surgical management of a case of compound odontoma in a 9-year-old girl patient who presented with a complaint of swelling in the maxillary right anterior region.

Surgical and Orthodontic Management of Multiple Supernumerary Teeth Associated with Impacted Permanent Teeth: A Case Report

Background: Clinical problems are frequently detected when there are various irregularities in the number, structure, quantity, size, and eruption of the teeth. Supernumerary teeth can be found in almost any part of the dental arch, and because they are typically asymptomatic, they are frequently found by radiographic screening. Case report: The existence of the supernumerary teeth is the most frequent reason for impacted permanent teeth. This article describes the surgical and orthodontic treatment of a 20-year-old female with many supernumerary teeth and an impacted permanent tooth. All supernumerary teeth in the maxillary arch were extracted as part of the patient's treatment, and then the maxillary teeth were aligned using fixed appliances. The mandibular arch is left untreated, as the surgical removal of mandibular supernumerary teeth could damage the inferior alveolar nerve and result in numbness in the lower lip. Conclusion: In this case, we removed the extra teeth and used orthodontic traction to bring the remaining teeth into the proper position. After the procedure, the cosmetic outcome was greatly improved, and the patient's confidence increased.

Congenital Dentigerous cyst: A Rare Case Report

Dentigerous cysts comprise the second most common type of odontogenic cysts, after radicular cysts, representing nearly 20% of all the true jaw cysts. A vast majority of the dentigerous cysts are associated with impacted permanent teeth. We report a case of full term one day old male neonate, presented with an intraoral mass in the anterior sector of the mandible suggestive of Dentigerous cysts. Our case, which is a rare presentation of dentigerous cyst in a 1 day old neonate—the earliest case to be documented—points to the fact that the cyst may be manifested even before the eruption of the first permanent tooth, and can be actually associated with it.

Characterization of Oral Pathology in Cats Affected by Patellar Fracture and Dental Anomaly Syndrome (PADS).

Patellar fracture and dental anomaly syndrome (PADS) is a congenital bone disease of cats that is characterized by atraumatic bone fractures (most commonly the patella), the persistence of deciduous teeth, and impaction of permanent teeth. Jaw swelling due to osteomyelitis is often the reason that cats with PADS are presented for veterinary dental care. The clinical history, oral examination findings, dental radiological findings, and histopathology were evaluated for 13 cats with dental and skeletal pathology consistent with PADS, including 9 with osteomyelitis. Cats in this study were predominantly domestic shorthair (12 of 13 cats), and there was no apparent sex predilection. All cats had multiple persistent deciduous teeth and multiple impacted permanent teeth, although the number of persistent and impacted teeth varied. Osteomyelitis of the jaw typically occurred within the first 4 years of life. Osteomyelitis of the mandible was 4 times more common than osteomyelitis of the maxilla. Histologically, osteomyelitis was chronic, neutrophilic, and osteoproliferative. Necrotic bone was confirmed in 67% of osteomyelitis lesions. Histological evaluation of jaws without inflammation demonstrated abnormal amounts of unmodeled bone, abnormally dense bone, and retention of cartilage in the caudal mandible. Three cats in the study had mandibular distoclusion and 2 had concurrent paronychia. To obtain a favorable clinical outcome in PADS cats with jaw swelling, prompt and aggressive surgical treatment of osteomyelitis is required. Extraction of persistent deciduous teeth and impacted permanent teeth is recommended when there is associated periodontitis or osteomyelitis.

CBCT Assessment of the Anatomical Characteristics of Gubernacular Canal in Impacted Teeth.

Gubernacular canal (GC) is a canal that extends from the follicle of unerupted permanent teeth to the alveolar bone crest filled with remnants of the dental lamina. This canal is thought to guide tooth eruption and be related to some pathologic conditions. This study aimed to determine the presence of GC and its anatomical characteristics in teeth, which failed to erupt normally on cone beam computed tomography (CBCT) images. This cross-sectional study evaluated CBCT images of 77 impacted permanent and supernumerary teeth obtained from 29 females and 21 males. The frequency of GC detection, its location in relation to the crown and root, the anatomical surface of the tooth from which the canal has originated, and the adjacent cortical table to which the canal opens, along with the length of the GC were studied. GC was observed in 53.2% of teeth. The anatomical tooth aspect of origin was occlusal/ incisal in 41.5% and crown in 82.9% of teeth. Moreover, 51.2% of GCs opened in palatal/lingual cortex and 63.4% of canals were not located along the tooth long axis. Finally, GC was detected in 85.7% of teeth undergoing the crown formation stage. Although GC was introduced as an eruption pathway, this canal is also present in impacted teeth. This means that presence of this canal does not promise the normal eruption of tooth and the anatomical characteristics of GC may influence the eruption process.

SURGICAL EXPOSURE OF TEETH IN CLEIDOCRANICAL DYSPLASIA UNDER PROCEDURAL SEDATION:- CASE REPORT

Cleidocranial Dysplasia (CCD) is a rare autosomal dominant condition which is mainly characterised by skeletal abnormalties like hypoplastic or aplastic clavicles, increase in transverse diameter of the cranium, delayed closure of fontanelles with presence of open sutures and skeletal changes in maxilla and mandible. 2,4 These patients usually presents with delayed exfoliation of deciduous teeth, delayed or failed eruption of the permanent dentition with multiple supernumerary teeth, protruding mandible and mid- face retrusion.2 We present a case report of a 16 year old girl undergoing multiple surgical exposure of impacted permanent teeth under conscious sedation so as to move them in normal occlusion with orthodontic traction

The treatment of different odontogenic cysts in children only using acrylic appliance-guided decompression: A long-term clinical study

Aim: Various odontogenic cysts may rarely occur in the jawbones during childhood, including radicular cysts, dentigerous cysts, and odontogenic keratocysts. Treatment for such cysts ranges from conservative approaches to radical surgical procedures. The present study evaluates the effect of the decompression alone method for treating various odontogenic cysts in children.Methods: A retrospective cohort study was performed that included pediatric patients who applied to the pedodontics clinic between 2014 and 2016. Data such as age, gender, anatomical location, reasons for admission, histopathological diagnosis and dimensions of the cysts, and associated teeth were recorded. All odontogenic cysts were treated using the decompression method with an acrylic obturator. All patients were evaluated clinically and radiologically one, three, six, and 12 months after the operation and annually thereafter.Results: As a result of the pathological examination, it was determined that 10 of the 16 odontogenic cysts were dentigerous cysts, 5 were radicular cysts and 1 was an odontogenic keratocyst. The patients consisted of 4 girls and 12 boys, with a mean age of 108.68±21.01 months. The average duration of the decompression was 7.3±1.41 months and the average follow-up was 9.6±2,56 years. In four patients, spontaneous eruption of the impacted permanent teeth was not observed; these were erupted using orthodontic treatment. In two cases of dentigerous cysts, the impacted teeth were extracted and the cyst was enucleated. In the remaining 14 cases, the permanent teeth erupted (spontaneous+orthodontic guided) successfully (87.5%), and the cysts healed completely after decompression treatment. Conclusion: To avoid developmental problems, conservative procedures should be preferred for the treatment of odontogenic cysts in children. Decompression therapy using an acrylic obturator is an effective treatment for odontogenic cysts in pediatric patients; this approach protects and maintains permanent teeth. However, new clinical studies with larger sample sizes are needed to support these results.

Cystic lesion between a deciduous tooth and the succeeding permanent tooth: a retrospective analysis of 87 cases

The purpose of this study is to investigate the characteristics of dentigerous and radicular cysts that occur between deciduous and succeeding permanent teeth and to propose considerations for differential diagnosis of cysts at the treatment planning stage in the outpatient clinic. A total of 87 patients with a cystic lesion located between a deciduous tooth and the succeeding permanent tooth participated in the study. Twelve variables were analyzed to diagnose such a cyst. For data analysis, Fisher's exact test was used to determine the statistical significance of the variables. Of the total 87 patients who participated in this study, 69 were diagnosed with dentigerous cysts and 18 were diagnosed with radicular cysts. Seven of the 12 differential factors analyzed in this study were statistically significant: age, location, symptoms, dental caries, endodontic treatment, delayed eruption, and size. Several criteria can be considered for diagnosis of dentigerous cysts or radicular cysts. Age, location, presence of symptoms and dental caries, previous endodontic treatment, cystic size, and delayed eruption of impacted permanent teeth are reliable factors that should be considered when diagnosing dentigerous and radicular cysts.

Conservative orthodontic and multidisciplinary approaches for patients with cleidocranial dysplasia in late adolescence or young adulthood

This case series describes conservative orthodontic and multidisciplinary approaches for treating two patients diagnosed with cleidocranial dysplasia in late adolescence and young adulthood. Most of the impacted permanent teeth erupted spontaneously within 3 to 4 years after surgical extraction of the deciduous and supernumerary teeth. The remaining unerupted permanent teeth were facilitated with traction or extracted followed by implantation or restoration. Repositioning of the maxilla and mandible via orthognathic surgery was also applied to correct skeletal and occlusal discrepancies and lead to satisfying results.

Risk assessment of pericoronitis in correlation with the position of the inferior third molar

Introduction. The inferior third molar is the most encountered impacted permanent tooth. Pericoronitis of the lower third molar is a term used to describe the inflammation around the crown of a tooth, usually of an incompletely erupted mandibular third molar. Mandibular molar impactions are usually mesioangular, distoangular, vertical, and horizontal. The position and type of the impaction may affect the development of pericoronitis. This study was conducted to assess the positions of the lower wisdom tooth as a risk factor for pericoronitis. Material and methods. The present study was conducted in the department of Oral and Maxillofacial Surgery and Oral Implantology „Arsenie Guțan”. A number of 120 patients were included in the study (66 women and 54 men) aged between 17-46 years old (mean 27±SD 6). All candidates were subjected to CBCT (cone beam computed tomography) scan and orthopantomography evaluation for a third molar position such as vertical, mesioangular, distoangular, and horizontal type. Data were stored in an Excel spreadsheet and then analyzed statistically using SPSS (Statistical Package for the Social Sciences). Results. Based on the results of our study the greatest number of cases of pericoronitis was observed in the vertical position (92 cases) by Winter, followed by mesioangular position (24 cases) and distoangular position (4 cases). In the study we did not identify any patient with a horizontal position. By the classification of Pell and Gregory, most cases belonged to class I (73 cases). Third molars classified in position A (92 cases) had greater chance of pericoronitis when compared to those in B (24 cases) or C position (4 cases). Conclusions. As a result of a detailed analysis, vertical position of the lower third molar is more associated with the appearance of pericoronitis. Considering Pell and Gregory classification, position A is more associated with the occurrence of pericoronitis compared to the position B or C. The prophylactic removal of the lower third semi-erupted vertical molar, or which is situated in position A, is indicated to prevent pericoronitis.

Frequency of Pericoronal Radiolucency in Impacted Teeth: A Panoramic Radiography Study

Aim All permanent teeth can remain impacted. Impacted teeth can remain in the jaw for years without showing any symptoms and causing a pathological event, and they can also cause neuralgiform pain, infection, teinporomandibular joint complaints, root resorption in neighboring teeth, and pathologies. Pericoronal radiolucency observed over 2.5 mm in radiographic imaging is suspicious. The aim of this study is to investigate the frequency of pericoronal radiolucency in impacted teeth examined on panoramic radiographs.
 Methods The study was conducted by retrospectively examining panoramic radiographs of 1128 patients (633 females, 495 males) over the age of 18. Permanent impacted teeth with complete root development were included in the study, and primary teeth, mesiodens, supernumerary and supplemental impacted teeth were excluded from the study. Pericoronal radiolucency was recorded as 'present' in case of pericoronal radiolucency (>3 mm) associated with impacted permanent tooth on panoramic radiographs. SPSS v.21 (IBM Corp., Armonk, NY, USA) program was used to analyze the data.
 Results The mean age of the individuals included in the study was 31±11 years (18-85). A total of 2247 impacted teeth from 1128 individuals were evaluated. Pericoronal radiolucency was detected in 208 impacted teeth (9.3%). There was a statistically significant relationship between gender and the frequency of pericoronal radiolucency (p

Frequency and Local Etiological Factors of Impaction of Permanent Teeth among 1400 Patients in a Greek Population.

Background: The purpose of this study is to analyze the frequency of impaction of permanent teeth, beyond the third molars, and to highlight the factors causing this condition. Methods: Panoramic radiographs of 1400 patients that sought orthodontic treatment in private practice were retrieved and examined. All teeth that had not been erupted at the time of the examination while their root formation was completed were considered impacted. Results: In total, 212 out of 1400 patients had at least one impacted tooth (15.14%). The highest incidence of tooth impaction was in the canines of the maxilla, followed by the central incisors of the maxilla, the second molars of the mandible and the second premolars of the mandible. The most common etiological factors responsible for the impaction were the ectopic eruption pathway, loss of space in the arch, the ankylosis of the deciduous teeth and the presence of supernumerary teeth. Conclusions: Tooth impaction is frequently seen in everyday orthodontic practice. The upper canines are the teeth most frequently associated with impaction and failure of eruption. It is important to diagnose cases of impaction early on and identify the etiological factors in order to achieve immediate and effective treatment per patient.

Odontoma, an Accidental Finding during Curettage: A Case Report

Odontomas are common occurrences in the oral cavity and can be classified as complex or compound. Compound odontomas are rare and present in the extra-osseous soft tissues. In this case, the odontoma led to the impaction of permanent teeth, due to which removal of the lesion was advised.

Clinical characteristics and comprehensive treatment of patients with cleidocranial dysplasia

Objective: To summarize the clinical characteristics of patients with cleidocranial dysplasia (CCD) and analyze their treatment methods. Methods: From January 2000 to December 2020, patients with CCD who completed comprehensive treatment in the Department of Orthodontics and the First Dental Clinic, School and Hospital of Stomatology, China Medical University were retrospectively analyzed. A total of 14 CCD patients [7 males and 7 females, aged (16.1±4.5) years] were collected. There were 153 impacted permanent teeth in this study. In addition to the teeth that needed to be extracted due to special conditions, 147 impacted teeth were pulled into the dentition using closed traction. Patients were divided into adolescent group (≥12 years and<18 years, 10 patients) and adult group (≥18 years, 4 patients). Failure rate of traction was compared between the two groups. Factors affecting the success rate of closed traction such as vertical position of teeth (high, middle and low) and horizontal position of the teeth (palatal, median and buccal) were analyzed. Results: The incidence of maxillary impacted teeth [69.3% (97/140)] was higher than that of mandibular impacted teeth [40% (56/140)]. The difference was statistically significant (χ2=24.22, P<0.001). The supernumerary teeth were mainly located in the premolar area 61.4% (21/44), and most of them were in the palatal region of the permanent teeth 95.5% (42/44). They were generally located at the same height or the occlusal side of the corresponding permanent teeth. The success rate of closed traction was 93.9% (138/147). The success rate in the adolescent group [98.2% (108/110)] was higher than that in the adult group [81.1% (30/37)], and the difference was significant (χ2=14.09, P<0.05). Failure after closed traction of 9 teeth was found totally, including 7 second premolars. The success rate of traction in impacted second premolars at different vertical (χ2=11.44, P<0.05) and horizontal (χ2=9.71, P<0.05) positions in alveolar bone was different significantlly. The success rates of the second premolars were high (15/16), middle (12/13), low (2/7), and lingual palatine (10/17), median (19/19), lip-buccal (0/0), respectively. Conclusions: The closed traction of impacted teeth in patients with CCD was effective, and the age was the main variable affecting the outcome. The success rate of traction in impacted second premolars located in low position vertically or in palatal position was low, which required close observation during treatment.

Impacted Compound Odontoma in a 13-year-old Child: A Case Report

Odontomas are considered the most common, asymptomatic odontogenic tumors. They are generally found on routine radiographic examination. However, signs and symptoms relating to their presence may occur. It is commonly associated with retained or impacted deciduous teeth, impaction of permanent teeth, and displacement of teeth. The radiographic examination (intraoral periapical, panoramic radiographic as well as cone beam computed tomography (CBCT) enables the identification, thereby ensuring early management. This case reports surgical management of odontoma under local anesthesia with ground sectioning revealing a compound odontome.

Impaction caused by a rare erupted peripheral compound odontoma.

Odontomas are common occurrences in the oral cavity and can be classified as complex or compound. Erupted peripheral compound odontomas are rare and present in the extra‐osseous soft tissues. In this case, the odontoma led to the impaction of permanent teeth, due to which removal of the lesion was advised.

Compound odontoma causing impaction of primary tooth in a 4-year-old child: case report

Objective: to report a rare case of impaction of a primary mandibular incisor due to the presence of a compound odontoma and describe its clinical management. Case report: a 4-year-old boy presented with a“missing” primary left mandibular lateral incisor. Radiographs showed impaction of the unerupted incisorby adjacent radiopaque structures consistent with a compound odontoma. The patient was recalled periodically for 2 years, at which time surgical excision was performed. The diagnosis of compound odontoma was confirmed histologically, and the permanent mandibular central incisors erupted uneventfully; the patient was referred for orthodontic treatment. Final considerations: this case report describes an unusual case of compound odontoma associated with an unerupted deciduous tooth; odontomas are rare in this age range, occurring predominantly in the second decade of life and in association with impaction of permanent teeth. We also propose a protocol for clinical management of such early-onset cases.