Normal Eruption Research Articles

Ectopic Tooth Eruption – Integrative Literature Review

Ectopic eruption designates teeth that deviate from their normal eruption pattern. Its multifactorial etiology includes local and systemic factors, somatic disorders, and genetics. The objective of this study is to know the most common teeth that can present ectopic eruption, their prevalence, and associated clinical factors. A bibliographic search of scientific articles indexed in the PUBMED® and VHL databases was performed in September 2023, with the following descriptors: "Tooth Eruption; Ectopic; Dentistry". A total of 42 articles published in the last 5 years were found. Of these, 16 addressed ectopic eruptions and were included. The reviewed literature highlights the following clinical aspects: delayed eruption, partial appearance of the crown, changes in the eruption axis, transpositions, and gyro versions. The most affected teeth are the first permanent molars, with approximately 2 to 6%, and the canines with approximately 1.5 to 4.6%. It is essential to diagnose ectopic eruption early and identify the etiological factors, to obtain early treatment, preventing the development of this pathology and, consequently, the appearance of malocclusion.

A Deep-learning System for Diagnosing Ectopic Eruption

Objectives: To construct a diagnostic model for mixed dentition using a multistage deep-learning network to predict potential ectopic eruption in permanent teeth by integrating dentition segmentation into the process of automatic classification of dental development stages.Methods: A database was established by reviewing 1576 anonymous panoramic radiographs of children aged 6–12 years, collected at the Stomatology Hospital, xxxxxx. These radiographs were categorised as normal or ectopic eruption, with expert diagnoses serving as a benchmark for training and evaluating artificial intelligence (AI) models. Furthermore, tooth boundaries and dental development stages were manually annotated by three pediatric dentistry experts. The dataset was split into training, validation, and test sets at an 8:1:1 ratio.Results: The diagnostic performance of the deep-learning model was rigorously evaluated. The model demonstrated accuracy in tooth segmentation, with Intersection over Union, precision, sensitivity, and F1 scores of 0.959, 0.993, 0.966, and 0.979, respectively. Furthermore, its ability to identify tooth ectopic eruptions on panoramic radiographs, when compared to evaluations by three dentists. Based on McNemar's test, the model's specificity and accuracy in identifying ectopic tooth eruptions on the test dataset surpassed that of Dentist 1 (P < 0.05), while no significant difference was observed compared to the other two dentists. Besides, the deep learning model also showed its potential in classifying dental development stages, as tested against three different standards.Conclusions: The adaptability of the AI-enabled model in this study was demonstrated across multiple scenarios, with clinical validation highlighting its efficacy in diagnosing ectopic eruptions using a multistage deep-learning approach.Clinical Significance: Our findings provide new insights and technical support for the prevention and treatment of abnormal tooth eruption, laying the groundwork for predictive models for other prevalent pediatric dentistry conditions.

Characteristics of Gubernacular Canal of Impacted/ Unerupted Canine in Relation to Eruption Status by Using CBCT

To evaluate detection rates and morphology of gubernacular canal (GC) in impacted/ unerupted canine, and to determine whether there is a difference in GC characteristics between impacted and unerupted canine. Subjects and Methods: By using CBCT, GCs were retrospectively analyzed in 300 patients with 432 impacted/ unerupted canine (96 males, 204 females; Age range, 7 to 54 years). Each imaging system software was first converted the CBCT pictures to volumetric data, from which reconstructions on multiple planes were done. Axial, sagittal, and coronal views were provided for each CBCT exposure. Furthermore, coronal sections and corrected sagittal were ready to assess all impacted/ unerupted canines for the presence of GCs, alteration in shape of GC, opening site of GC in the alveolar crest, attachment site of GC to the dental follicle, and canine eruption status. Results: The normal or delay eruption status of canines had high detection rate which were 95.9% and 100% respectively, unlike the impacted canine which had a low detection rate which was 71.2%. Only 8.9% of detected GC had alteration in shape. 54.1% of GC opened palatal or lingual to alveolar crest, 21.9% of GC was continuous with periodontal ligament (PDL) of primary canine, 20.5% of GC opened in the center of alveolar crest, and 3.5% of GC opened Buccally. 59.1% of GC was unusually attached to dental follicle, and 40.9% of GC was usually attached to dental follicle. There was a high significant difference between canine eruption status and characteristics of GC. Conclusion: The findings of this study reveal that the characteristics of GC in impacted/ unerupted canine may be a sign of an abnormal eruption condition.

Root volume measurements of maxillary canines and lateral incisors in patients with unilateral maxillary canine impaction.

This study aimed to assess root volumes of maxillary canines and adjacent lateral incisors in patients with unilateral maxillary canine impaction. This cross-sectional study was performed on cone-beam computed tomography (CBCT) scans of 100 patients (49 females and 51 males) with unilateral maxillary canine impaction. The images were loaded in Planmeca Romexis Viewer, and root layers between the cementoenamel junction and apex were reconstructed at 600-µm intervals. At each layer, the root boundary was marked, and finally, the root volume was calculated by multiplying the layers' area by the thickness of 600 µm. The root size of canines and lateral incisors was compared between the impaction and normal eruption sides. Sixty-two patients showed buccal canine impaction, and 38 presented palatal impaction. The mean root volume of canines on the impaction side was significantly greater than that on the normal eruption side; either the tooth was buccally or palatally impacted (p<0.001). The lateral incisors on the side of buccally-impacted canines showed a significantly smaller root volume than that of the contralateral side (p<0.001). However, there was no significant difference in the root size of lateral incisors between the two sides in cases presenting palatal canine impaction (p=0.177). The difference in root volume of canines between the two sides can serve as an indicator of canine impaction. The reduction in the root size of the lateral incisor on the side of the buccally impacted canine may be due to root resorption created by pressure from the canine's crown.

Relationship between mandibular third molars and mandibular angle and condylar fractures.

Assess the correlation between the position of the third molar (M3) and fractures of the mandibular angle and condyle using panoramic radiographs to offer valuable data references for oral clinical research. A retrospective cross-sectional study was undertaken, involving the collection of 409 cases of mandibular fracture in the Yanbian University Hospital. The case records and panoramic radiographs of mandibular angle fracture (78 cases) and condylar fracture (106 cases) were evaluated. In the comparative analysis between the mandibular angle fracture group and the condylar fracture group, statistical significance was observed in the variables of M3 existence (P = 0.002), eruption of M3 from the alveolar cavity (P = 0.003), P&G position classification (P = 0.001), deep impactions (Classes IC, IIC, IIIB, and IIIC) (P < 0.001), and the presence of impacted M3 in both groups (P < 0.001).Regarding M3 roots, the mandibular angle fracture group exhibited the highest prevalence of multiple roots at 75.4%, surpassing the 64.6% observed in the condylar fracture group. The prevalence of proximal angles in the mandibular angle group and the condyle group was the highest, accounting for 64.6% and 61.5%, respectively. The percentage of M3 in the two groups was 80% and 43.1%, respectively, with a significant difference (P < 0.001). Impacted mandibular third molars (M3) elevate the risk of mandibular angle fractures, while their absence or normal eruption reduces this risk and protects against condylar process fractures. The fracture risk is influenced by the M3's position: P&G Class II and Class B impactions, where M3s emerge partially from the alveolar bone, are significantly associated with mandibular angle fractures. In contrast, the absence of M3 or its placement in P&G Class I and Class A positions tends to correlate with a higher incidence of condylar process fractures.

Ectopic eruption of maxillary first permanent molars: Risk factors and association with alveolar and maxillary characteristics on children

Background/purposeThe etiology of the ectopic eruption (EE) of the maxillary first permanent molars (FPM) remains unclear and controversial. This study was designed to explore the dental and skeletal factors for EE of the FPM in children. Materials and methodsChildren aged 6–10 years were recruited to this study. Subjects were assigned to the ectopic eruption group (EEG) and the normal eruption group (NEG). Lateral cephalometric radiographs and panoramic radiographs were measured by angular and linear indices. ResultsThe prevalence of EE of maxillary FPM was higher in males and at younger ages. Subjects with skeletal class III malocclusion were more likely to be diagnosed with EE of maxillary FPM. The SNA, ANB, FMIA, Wits, Ptm-A, ANS-PNS, overbite, and overjet were significantly different between the EEG and the NEG. The length of the posterior region of the maxillary alveolar bone, U6-OP, and eruptive angulation of the maxillary FPM were statistically different between the two groups. ConclusionMale sex, skeletal class III malocclusion, mesial inclination of the maxillary FPM, hypoplasia of the maxilla, and insufficient length of the posterior region of the maxillary alveolar bone were related to EE of the maxillary FPM.

Various delayed tooth eruption in children, management and outcome: A case series

It is estimated that 4.3% of patients experience delayed eruption of permanent teeth due to local causes. Mandibular second premolars were the most frequent permanent teeth associated with delayed eruption, followed by maxillary canines, and maxillary central incisors. While rare, unerupted permanent teeth should be treated promptly to avoid potential impacts on future function, esthetics, confidence, mental health, and pronunciation. For this reason, parents often seek dental examinations and treatment for their children. Delayed tooth eruption (DTE) can also affect treatment planning and orthodontic timing. This report presents three cases of unerupted teeth. All cases were treated with a simple excision of overlying tissue to expose the crown using either a scalpel or electrocautery. Two of three lesion diagnosis was confirmed by Histopathology anatomy (HPA). In all cases, the involved teeth spontaneously erupted immediately following treatment, providing good aesthetics. However, one case experienced complications due to allergies during the wound healing process. In conclusion, proper diagnosis and treatment of DTE, including consideration of developmental disturbance factors, can help ensure normal eruption patterns and satisfactory aesthetic results.

Ectopic teeth in the maxillary sinus

Dental ectopia is a rare developing anomaly characterized by a change in the normal eruption pathway of a deciduous, permanent or supernumerary tooth. In some cases, ectopic teeth are present in the non-dentate area like maxillary sinus. The article presents cone beam computed tomography data of 7 asymptomatic patients with teeth totally or partially located inside the maxillary sinus. Dentigerous cysts and odontomas can cause displacement of impacted teeth into ectopic positions.

Prediction of Mandibular Third Molar Impaction Using Linear and Angular Measurements in Young Adult Orthopantomograms

This retrospective study aimed to evaluate a possible correlation between the characteristics of the mandibular ramus and lower third molar impaction by comparing a group of subjects with an impacted lower third molar and a second group with normal eruption for an early prediction of this pathology. This comparison was made using linear and angular measurements, which were taken on digital panoramic radiographs. Materials and methods: A total of 726 orthopantomographs (OPT) were examined, and 81 were considered suitable for the present study. The results were divided into two groups: a control group and an experimental group. The control group comprised 38 cases in which patients had at least one lower third molar that had erupted, and the experimental group comprised 43 cases in which patients had at least one lower third molar that was impacted or partially impacted. In total, 16 variables (11 linear, 4 angular, and 1 ratio) were determined and measured by an experienced observer. Results: The control group had a larger retromolar space, a larger impaction angle and a higher ratio of retromolar area to the third molar, compared to the experimental group. In contrast, the experimental group showed a deeper sigmoid notch depth than the control group did. In the control group, moderate positive correlations were found between both the length of the coronoid and the width of the third molar, and the retromolar space. Furthermore, in the experimental group, moderate positive correlations were found between both the angular condyle–coronoid process and the inclination of the lower posterior teeth, and the retromolar space. Conclusion: this study showed that the angle of a lower third molar, in relation to mandibular pain, can be an index for predicting tooth inclusion.

Medical Management of Dental Abnormalities Related to Congenital Hypothyroidism in a Cat.

A 5-month-old intact male domestic shorthair cat presenting for routine vaccinations was diagnosed with congenital hypothyroidism. His primary presenting symptom was incomplete dentition with delayed dental eruption. Congenital hypothyroidism was confirmed by baseline thyroxine (T4), free T4, and thyroid-stimulating hormone testing. The cat was treated with oral thyroid hormone supplementation and 16 weeks after initiation of therapy the cat was clinically normal with age-appropriate dentition. No surgical intervention was necessary to achieve normal dental eruption.

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.

Comparison of the Pull-Out Resistance of Grossly Decayed Primary Anterior Teeth Restored With Two Different Intracanal Posts: An In Vitro Study

Background Severely damaged primary anterior teeth that require pulp therapy present a high risk of failure due to the loss of tooth substance, resulting from pre-existing decay and endodontic therapy. The ideal post material should have physical and mechanical properties similar to those of dentin. Another concern in restoring endodontically treated primary teeth is the need to find a material that can resorb similar to the natural tooth structure as a part of the exfoliation process, allowing normal eruption of permanent successors. Accordingly, there is no such material other than dentin itself. The introduction of biological dentin posts offers an excellent alternative for restoring such teeth. This study aimed to assess the effect of using dentin posts on the pull-out resistance of endodontically treated primary anterior teeth in comparison to glass fiber posts. Methodology A sample of 30 primary anterior teeth was collected from the outpatient clinic of the Pediatric Dentistry Department, Faculty of Dentistry, Damascus University. A total of 15 freshly extracted permanent teeth with single roots were also collected from the outpatient clinic of the Maxillofacial Surgery Department, Faculty of Dentistry, Damascus University. The roots of the permanent teeth were used to prepare 30 dentin posts using a CAD-CAM machine. After receiving proper endodontic treatment, the primary teeth were divided into two groups (15 teeth in each group). The first group was restored with dentin posts, and the secondwas restored with glass fiber posts, with the posts measuring 3 mm in length for both groups. Pull-out resistance testing was performed using a Testometric machine. Results The arithmetic mean of the forces applied in the glass fiber posts group was 153.2 ± 39.12 N, while the arithmetic mean of the forces applied in the dentin posts group was 156.7 ± 39.78 N. The data were analyzed at a 95% confidence interval using the independent Student's t-test. There were no statistically significant differences in pull-out resistance between the two groups. Conclusions Dentin posts showed a little increase in pull-out resistance than glass fiber posts. Therefore, the use of dentin posts as intracanal retention in primary anterior teeth is a successful alternative for composite posts.

Comparing the Fracture Resistance of Dentine Posts and Glass Fiber Posts in Primary Maxillary Incisors: An In Vitro Study.

Background/purpose An ideal post material should have physical and mechanical properties similar to dentin. Another problem when restoring primary teeth that have undergone root canal treatment is the availability of materials that are resorbed in the exfoliation process in a manner similar to the structure of the natural tooth, allowing the normal eruption of a permanenttooth. This study aimed to evaluate the effect of using dentine posts on the fracture resistance of endodontically treated primary incisors in comparison to glass fiber posts. Materials and methods The study sample consisted of 30 extracted primary maxillary incisors that were randomly distributed into the following two groups: group I (experimental, n=15), which was restored with dentine posts; and group II (control, n=15), which was restored with glass fiber posts. Initially, 10 extracted single-root permanent teeth were collected to prepare 20 dentine posts using a computer-aided design-computer-aided manufacturing (CAD-CAM) machine. Then, the crowns of maxillary primary incisors were cut and the canals were prepared and filled. Then the preparation for a post was made using Gates Glidden drills, and the posts were placed with an extension of 3 mm within the canal in both groups, then the crown was built and the teeth were placed within acrylic cubes and subjected to 500 thermocycling. Fracture resistance was recorded using a Testometric machine (Rochdale, England: Testometric Co. Ltd.). Data were analyzed using an independent Student's t-test. Results The dentine posts group showed greater fracture resistance (246.3 N) than the glass fiber posts group (206.3 N). A statistically significant difference (p=0.004) was found between the two groups in favor of the dentine posts group. Conclusion Based on this in vitro study, the dentin posts used in restoring severely decayed primary maxillary incisors showed greater fracture resistance than glass fiber posts. Therefore, the use of dentin posts as intra-canal stabilizers in maxillary primary incisors is a good alternative for glass fiber posts.

Do the various interceptive treatment modalities improve the position of palatally displaced permanent canines? A meta-analysis.

Removal of maxillary primary canines and other interceptive treatment modalities in the mixed dentition have been suggested as methods used to increase the rate of normal eruption of palatally displaced permanent canines (PDCs). However, the information on the overall effect on PDCs' position has been inconclusive. To assess whether this practice improves the position of PDCs and to investigate the quality of the evidence. Unrestricted searches in 7 databases and manual searching of the reference lists in relevant studies were performed up to June 2022 (Medline via PubMed, CENTRAL, Cochrane Database of Systematic Reviews, Scopus, Web of Science, ClinicalTrials.gov, ProQuest Dissertations, and Theses Global). We looked for data on the positional changes of PDCs (mesial inclination, vertical position, canine crown cusp tip to midline) from randomized controlled trials assessing the various interceptive treatment modalities. Following study retrieval and selection, relevant data were extracted, and the risk of bias was assessed using the Cochrane Risk of Bias 2 Tool. Exploratory synthesis and meta-regression were conducted using the random effects model and the overall quality of the available evidence was assessed with the Grades of Recommendation, Assessment, Development, and Evaluation approach. Five studies (3 at low risk of bias) were identified, involving 238 individuals, followed for up to 18 months post-intervention with OPG (orthopantomogram) or CBCT (cone-beam computed tomography). Exploratory data synthesis showed that PDCs' position improved more in the extraction sites compared to non-extraction. Analysis of the studies at low risk confirmed the above observations (6- and 12-month). Improvements were observed in patients using headgear after extraction of primary canines compared to extraction alone, but not in patients with double extraction of primary canines and first molars. The quality of available evidence was rated at best as moderate. Interceptive treatment modalities in the mixed dentition may improve the position of PDCs. However, more studies are necessary in order to determine the clinical significance of the changes. PROSPERO (CRD42015029130).

Impacted Lower Third Molar Profile at Dental Hospital of Padjadjaran University

&#x0D; Introduction: Impacted teeth are teeth that erupt incompletely in the normal eruption period. This situation can be caused by hard or soft tissue obstructions or a lack of arch jaw. Objectives: This study aimed to determine the impacted lower third molar teeth profile by age, sex, class, angulation, treatment, and anesthesia at RSGM UNPAD in 2017-2019. Methods: The study was conducted from February 8, 2020, to March 8, 2020. The study represents the impacted lower third molar teeth profile of patients referred to Outpatient Installation, Central Surgical Installation, and the Radiology Installation. Classification of tooth impaction was based on Pell &amp; Gregory and Winter classifications using ImageJ application, while Intraclass Correlation Coefficient (ICC) was used to confirm data validity. Results: There were 146 impacted dental cases, with a total case of 62 (42.5%) for males and 84 (57.5%) for females. Most impacted teeth occurred in the 12-25 years age group up to 72 (49.3%). A total of 177 impacted teeth mostly occurred in 48 teeth, as many as 91 (51.4%). Impaction class Pell &amp; Gregory class B with 110 (62.1%) cases were found the most. Based on the anterior border of ramus, class II with 164 (91.1%) cases was found the most. Horizontal (79 cases, 44.6%) became the most frequent angulation. The procedures taken were all odontectomy 177 (100%) with more use of local anesthesia 136 (93.2%) compared to general anesthesia 10 (6.8%). Conclusion: Cases of impacted lower third molar teeth at RSGM UNPAD in 2017-2019, were most common in females and mostly in the 12-25 years age group, with Pell &amp; Gregory class IIB classification and Winter horizontal angulation classification, all procedures performed were odontectomy, majority using local anesthesia.

Paediatric Mandibular FractureAn Enigma of its Own: A Case Report

Mandibular fractures are very rare in the paediatric age group; however, they remain the most common maxillofacial trauma occurring in children. A paediatric mandibular fracture can cause severe pain and discomfort for the patient. Due to the complex anatomy of the developing mandible, such as the presence of permanent tooth buds and its small size, the treatment of mandibular fractures in the paediatric age group differs markedly from that in adults. Treatment of maxillofacial fractures in the paediatric population has always been a challenge for the operating surgeon. Different treatment modalities for managing paediatric mandibular fractures include closed reduction or surgical intervention. Open/closed cap splint provides closed reduction and stabilisation of paediatric mandibular fractures without any risk of damage to permanent tooth buds. It is more commonly preferred over Open Reduction and Internal Fixation (ORIF) of the fractures. However, for highly displaced fractures, ORIF is the preferred treatment. In the present case report, the author present and describe the management of a mandibular symphyseal and medial pole of the right condyle fracture in a seven-year-old patient. Since the bone fragments were highly displaced and occlusion was severely deranged with an anterior open bite, conservative treatment using a cap splint was not considered. ORIF was performed under general anaesthesia. At the oneyear follow-up, complete clinical and radiological bone healing was observed. Occlusion was satisfactory, and mouth opening was maintained. There was normal eruption of permanent teeth with no complications or delays associated with the eruption pattern.

Evaluation of the Spatial Relationship of Impacted Mandibular Third Molar to Mandibular Canal Using CBCT

Introduction: Impaction is defined as the “lack of eruption of a tooth in the oral cavity within the time and physiological limits of the normal eruption process.” The prevalence of damage to the inferior alveolar nerve during surgical extraction of impacted mandibular third molars, resulting in transient/permanent dysesthesia or paresthesia, is around 0.4% to 13.4%. Aims and Objectives: The study's goal was to use cone beam computed tomography (CBCT) to examine the three-dimensional anatomic association between the impacted mandibular third molars and the mandibular canal and to develop a risk prediction model to screen inferior alveolar nerve injuries. Materials and Methods: DICOM files of 300 cases were retrieved and analyzed according to the parameters. Descriptive statistics and a Chi-square test were used to assess the association between different variables and logistic regression to develop a risk prediction model to screen inferior alveolar nerve injuries. Results: Inter-observer and intra-observer agreements were excellent for all CBCT variables. Direct contact of the third molar with the mandibular canal was seen in 61.7% of the cases. Statistically significant association was found for loss of corticalization (OR-5.95; P = 0.000), narrowing (OR-18.916; P = 0.000), and dilacerations of roots (OR-3.8; P = 0.004) with “direct contact” of the impacted mandibular third molar to the mandibular canal. Conclusion: Preoperative assessment with CBCT entails the opportunity to ascertain the “high-risk” impacted mandibular third molars at a cheaper cost, with less equipment maintenance and reduced exposure, compared to computed tomography (CT) imaging.

Clinical, Diagnostic and Histological Findings Involving Cheek Teeth Hypercementosis in Nine Horses.

Hypercementosis is infrequently reported to affect the cheek teeth of horses and presents as mineral deposits either attached (peripheral) or solitary ovoid (nodular) structures in the tooth bearing region. There is overlap between radiological and histological appearance of hypercementosis, cementoma, and equine odontoclastic tooth resorption and hypercementosis (EOTRH). The clinical presentation, imaging features, surgical management, and histological findings of nine horses that presented for dental lesions and associated hypercementosis of cheek teeth are reported. Horses were 4-15 years old and presented for either nasal discharge or facial swelling. Peripheral and nodular mineral structures were identified using radiographs or computed tomography in six and three horses, respectively. Eight of nine cases involved maxillary cheek teeth. Of six cases with peripheral hypercementosis, three had enlargement of the apical cross-sectional area that was greater than the coronal cross-sectional area thus preventing extraction along the normal eruption pathway and necessitating sectioning (two cases) and repulsion. Nodular hypercementosis lesions were extracted in three of the four cases. Post-extraction complications occurred in five cases; four cases required additional procedures. All horses returned to their intended use, ie riding or pasture. Histology of extracted dental and proliferative mineral material revealed hypercementosis characterized by large sheets of eosinophilic matrix with lacunae (usually empty; presumed artifact) and frequent, irregular, basophilic cement lines. All cases had evidence of chronic inflammation, such as caries, chronic fractures and/or pulpitis. The findings of this case series share many features with previous published descriptions of cementoma and with histological findings of hypercementosis lesions of EOTRH. Further investigation into differentiation of these entities is warranted.

THE BUCCAL BIFURCATION CYST: A CASE REPORT

We present a case of a 6-year-old male patient whose parents reported a painful, slow-growing intraoral mandibular swelling, which was considerably reduced by the time of examination. Clinical inspection revealed a relation to the left permanent lower first molar at normal eruption process and a positive response to sensibility test. A panoramic radiography showed a well-defined homogeneous radiolucent area involving the molar roots on bifurcation zone. A cone beam computed tomography was requested, which was able to confirm the buccal location. The exam also revealed 10 mm of extension and a suggestive image of proliferative periostitis on the overlying cortical bone. The first diagnostic hypothesis was buccal bifurcation cyst, and the chosen treatment was surgical enucleation. The material was sent for histopathologic analysis, which confirmed the diagnosis. Currently, the patient is after 5 months of the procedure, the patient is with good evolution.

Autotransplantation for the correction of unfavorably impacted canines

The canine is diagnosed as impacted when its normal eruption time is significantly exceeded compared to the contralateral canine or the premolars. This case report presents, a female patient 14 years old with bilaterally impacted maxillary canines, retained maxillary deciduous canines, and proclination and spacing of the upper and lower anteriors and peg laterals. The treatment objective was to create a more ideal overjet and overbite relationship, place the impacted canines into position, and improve facial profile. Fixed orthodontic treatment was done with PEA “0.022 × 0.028” ORMCO, MBT prescription. After leveling, aligning, and space closure, extraction of bilaterally retained deciduous canines and autotransplantation of the unfavorably impacted canines were done. To enhance esthetics, composite restoration was done on the peg laterals. The total treatment time was 2 ½ years and the treatment objectives were achieved due to excellent patient cooperation. Facial harmony was good, and proclination and spacing were corrected.