Permanent Lateral Incisor Research Articles

Dens in Dente - With a Large Radicular Cyst

Dens invaginatus is a developmental malformation of teeth .It shows a deep in folding of enamel and dentine starting from the tip of the cusps and which may extend deep into the root. Commonly affected teeth are maxillary lateral incisors. The malformed teeth shows a morphologic variations and frequently results in early pulp necrosis. Root canal treatment may present severe problems because of complex anatomy of teeth. Here we present a case describing the anomalous development of maxillary permanent lateral incisor indicative of dens invaginatus with a large radicular cyst, in a twenty-year-old female.

합지증 수술 병력이 있는 어린이에서 하악 거대 협소대의 외과적 처치

The lower labial frenum attached to the free gingival margin can promote local tension, resulting in tissue ischemia, promoting the development of gingival recession, as well as complicating oral hygiene, resulting in chronic inflammation. In this case, early diagnosis and surgical treatment is recommended. This is the case about surgical treatment of heavy mandibular labial frenum in pre-school child with a history of syndactyly surgery. A 5-year-old girl visited the clinic with the chief complaint of high labial frenum of the mandible. Hyperplastic lower labial frenum was attached to the free gingival margin on the primary mandibular lateral incisor area. After fifteen month follow-up, right after the eruption of the permanent lower right lateral incisor, 6 years old patient received lower labial frenectomy to prevent periodontal diseases in permanent teeth and to reestablish normal anatomic characteristics. After 2 years of follow-ups, there were no marked complications.

The Prevalence of Peg Shaped and Missing Permanent Maxillary Lateral Incisors in Najaf City

Background: The presence of a missing or peg shaped lateral incisor is a major concern for the subjects facial esthetics. Objectives: The objectives are to find the prevalence of peg shaped and missing permanent maxillary lateral incisors in Najaf City. Methodology: A cross sectional study was constructed and composed of 416 Iraqi students (215 males and 201 females) randomly chosen of 3 colleges of Kufa University in Najaf. Each subject was examined by visual inspection under day light looking for missing or peg shaped permanent maxillary lateral incisors. Results: The prevalence of missing maxillary lateral incisors was 3.8% (16 subjects) with an insignificant gender difference. There were two unilateral missing maxillary lateral incisor and 14 bilateral cases. Prevalence of peg shaped laterals was 4.3% (17 subjects) with an insignificant gender difference. Maxillary median diastema was found in 15.4% of the sample. Presence of missing lateral incisors showed a significant relationship with the presence of a maxillary median diastema. Conclusions: The presence of missing or peg shaped lateral incisors was found to be statistically significantly related to the presence of spacing and the presence of peg shaped lateral incisor showed a non-significant relationship with the presence of a maxillary median diastema.

Management of 2 Teeth Diagnosed with Dens Invaginatus with Regenerative Endodontics and Apexification in the Same Patient: A Case Report and Review

IntroductionThis review and case report present the treatment of a 10-year-old boy with both permanent maxillary lateral incisors demonstrating Oehlers type II dens invaginatus and pulpal involvement. Treatment was complicated by dental anxiety, supraventricular tachycardia, immature tooth development, and facial cellulitis. MethodsAn infected necrotic pulp of the permanent maxillary left lateral incisor was treated by apexification and endodontic treatment with mineral trioxide aggregate. The necrotic pulp of the permanent maxillary right lateral incisor was treated with canal debridement and dressing under general anesthesia. ResultsPeriapical healing of both teeth occurred, with the right lateral incisor showing continued root growth, thickening of the dentinal root walls, and completed apex formation. This tooth responded normally to pulp testing. Twenty-eight months after initial treatment, the right lateral incisor displayed progressive sclerosis of the canal. ConclusionsThis case demonstrates possible pulpal regeneration of an infected maxillary right lateral incisor with dens invaginatus and an immature apex after minimal canal debridement.

WNT10A mutations also associated with agenesis of the maxillary permanent canines, a separate entity

Agenesis or isolated hypodontia of the maxillary permanent canines is a very rare dental anomaly. We report on nine unrelated Thai patients with this condition. Three of them had one affected parent. Three heterozygous missense mutations (p.Arg171Cys; p.Gly213Ser; and IVS2+1G>A) were identified in WNT10A in six patients. The p.Gly213Cys mutation was found in four patients. One of the patients who had p.Gly213Ser mutation also had peg-shaped (microdontia of the) maxillary lateral incisors with dens invaginatus. The mothers of two patients who carried the same mutation as their affected sons (p.Gly213Ser and p.Arg171Cys) had microdontia of the maxillary permanent lateral incisor. Our study has demonstrated for the first time that agenesis of the maxillary permanent canines is a distinct entity, associated with mutations in WNT10A. Inheritance appears to be autosomal dominant. Agenesis of the maxillary permanent canines may accompany by microdontia of the maxillary permanent lateral incisors and dens invaginatus of the maxillary permanent lateral incisors. Mutations could not be identified in the coding exons of WNT10A in three patients. They might be located outside the coding exons, including the promoter regions. However, it is likely that agenesis of the maxillary permanent canines is a heterogeneous disorder.

Prevalence of peg-shaped maxillary permanent lateral incisors: A meta-analysis

The aim of this meta-analysis was to gain more insight into the prevalence of peg-shaped maxillary permanent lateral incisors and their associations with race, population type, sex, and sidedness. Electronic searches and supplementary hand searches initially yielded 3337 records. After applying inclusion and exclusion criteria, 30 articles about 36 studies were included. The overall pooled prevalence estimate was calculated with a random-effects model. An estimated risk ratio was used for sex comparison. The overall prevalence of peg-shaped maxillary permanent lateral incisors was 1.8%. No publication bias was found. The occurrence rates were higher in Mongoloid (3.1%) than in black (1.5%) and white (1.3%) patients, and in orthodontic patients (2.7%) than in the general population (1.6%) and dental patients (1.9%). Women were 1.35 times more likely than men to have peg-shaped maxillary permanent lateral incisors. The prevalence rates of unilateral (0.8%) and bilateral peg-shaped maxillary permanent lateral incisors were approximately the same. However, among the unilateral lateral incisors, the left side (0.4%) was twice as common as the right side (0.2%). In addition, contralateral lateral incisor hypodontia was seen in 55.5% of the subjects with unilateral lateral incisors. The prevalence of peg-shaped maxillary permanent lateral incisors varies by race, population type, and sex. The prevalence rates were higher among Mongoloid people, orthodontic patients, and women. Although the prevalence of unilateral and bilateral lateral incisors was the same, the left side was twice as common as the right side. Subjects with unilateral peg-shaped maxillary permanent lateral incisors might have a 55% chance of having lateral incisor hypodontia on the contralateral side.

Peripheral compound odontoma erupting in the gingiva

BackgroundPeripheral odontoma arising in the extraosseous soft tissues is rare and if not removed early, may enlarge over time and eventually erupt in the oral cavity.Case presentationA 15-year-old girl presented with “denticles on the gingiva”. During the intraoral examination, seven small tooth-like structures were found. These were exposed in the anterior left gingiva between the permanent maxillary lateral incisor and canine teeth, and the left first premolar was absent. Radiographic examination revealed irregular tooth-like structures without evidence of bone involvement.ConclusionThe lesion was surgically removed, and the specimens were analyzed histopathologically. The diagnosis of compound odontoma was established.Clinical significanceThis is the twelfth reported case of peripheral odontoma in the gingiva and the first one that erupted in the oral cavity.

A Case Study of a Rare Case of Turner's Hypoplasia and Unilaterally Fused Deciduous and Permanent Lateral Incisor Caused by Trauma

A Case Study of a Rare Case of Turner's Hypoplasia and Unilaterally Fused Deciduous and Permanent Lateral Incisor Caused by Trauma

Management of ankylosed young permanent incisors after trauma and prior to implant rehabilitation

The objective of this clinical report is to present decoronation of young permanent ankylosed incisors as an option to preserve the alveolar process in young people where implant rehabilitation is not yet indicated. A 13-year-old patient presented with intrusive luxation of the permanent maxillary lateral incisor and lateral luxation of both permanent maxillary central incisors. During 6 months, clinical and radiographic evaluation showed progressive root replacement resorption, and surgical decoronation was recommended for all three incisors and left for a period of 6 years until the implant and grafting procedures be performed. Decoronation in young teeth is a reliable technique in terms of preservation of the width and height of the alveolar process, and improves the aesthetic conditions after installation of the provisional prosthetics. Decoronation may be considered an alternative strategy for complex posttraumatic clinical scenarios, such as young ankylosed incisors.

Evaluation of immediate and delayed post space preparation on sealing ability of Resilon-Epiphany and Gutta percha-AH plus sealer

Aim:To evaluate the influence of immediate and delayed post space preparation on sealing ability of Resilon-Epiphany and Gutta percha-AH plus.Materials and Methods:Eighty extracted permanent maxillary central and lateral incisors were decoronated. Roots canals were prepared and obturated. Samples were divided into four groups depending on the time of post space preparation and obturated material. Group I and II: Immediate and delayed post space preparation respectively with Gutta percha/AH plus as obturating material. Group III and IV: Immediate and delayed post space preparation with Resilon/Epiphany as the obturating material. The samples were kept in methylene blue dye, sectioned and then measured under stereomicroscope and studied under SEM.Statistical Analysis:The data was subjected to statistical analysis using unpaired t-test.Results:There was significant difference found between immediate and delayed post space preparation in Resilon-Epiphany group (P = 0.0109) as well as in AH plus-GP group (<0.0001). Difference in the sealing ability of the two materials was seen in delayed group (P = 0.0202). No statistically significant result was found between the two obturating materials when post space was prepared immediately (P = 0.0875).Conclusion:Within the limitations of this study, there was significantly less leakage when post space is prepared immediately in both the groups. Resilon-Epiphany shows better results when post space is delayed amongst the two whereas in immediate post space preparation there is no significant difference.

Comparative evaluation of etch pattern, the length of resin tags, and shear bond strength of all-in-one adhesive system on intact enamel with and without phosphoric acid pre-etching: An in vitro investigation

Aim: The aim of this study is to compare the etch pattern, resin tag length and the shear bond strength (SBS) of all-in-one adhesive system (Clearfil S 3 bond) on intact enamel with and without phosphoric acid (PA) preetching. Materials and Methods: Freshly extracted 80 caries free cleaned sectioned crowns of upper permanent central and lateral incisors were mounted on acrylic blocks. The samples were divided into four Groups (A, B, C and D). In Group A and B the application of self-etch adhesive (SEA) was carried out without prior etching with PA and light curing performed ( n = 20). In Group C and D etching was carried out with 37% PA before the application of SEA and light curing was carried out. The etch pattern, resin tag length were analyzed using scanning electron microscope and the SBS was analyzed using Instron Universal testing machine. Statistical Analysis Used: Data were analyzed with Mann-Whitney U-test using Statistical Package for Social Science version 11.5 Software. Results: The statistical analysis revealed that there was significant increase in the depth of penetration of resin tags and in the SBS of composite in Group C and D where PA pre-etching carried out in unground enamel than Group A and B ( P Conclusion: The results indicate that out of both treatment groups, pre-etching the intact enamel with 37% PA resulted in deeper etch pattern, formation of longer resin tags and increased SBS of the Clearfil S 3 bond to unground enamel.

An Unusual Case Report of an Erupted Odontoma fused with Permanent Maxillary Lateral Incisor and Its Complex Treatment Modality

An Unusual Case Report of an Erupted Odontoma fused with Permanent Maxillary Lateral Incisor and Its Complex Treatment Modality

Apexification with white MTA in an immature permanent tooth with dens invaginatus

Dens invaginatus, also known as “dens in dente”, is a developmental dental anomaly resulting in an invagination of the enamel organ into the dental papilla. These cases present technical difficulties to the root canal treatment. Apexification using an apical plug of mineral trioxide aggregate (MTA) has been indicated as an alternative to long-term intracanal use of calcium hydroxide in immature permanent teeth. It is considered as a simple and rapid technique. This paper reports a case of Oehlers’ Type 1 dens invaginatus in an immature permanent maxillary right lateral incisor, which presented pulp necrosis secondary to dental trauma and was treated by apexification with white MTA apical plugging followed by conventional root canal therapy. The operative procedures are described and the technique is discussed. The physical and biological properties of MTA, associated with appropriate instrumentation and obturation techniques, make this material an excellent option in the endodontic therapy of immature permanent teeth with dens invaginatus.

Triple tooth in primary dentition: A proposed classification

Triple teeth may result from fusion, gemination or concrescence causing transient esthetic and functional problems in primary dentition and retardation or alteration of development and eruption of permanent successors. We report an unusual case of a boy aged five with fusion among maxillary left primary central incisor, lateral incisor and a supernumerary tooth concomitant with agenesis of permanent lateral incisor. A review of literature on triple tooth was done along with a proposed classification of the triple teeth.

A possible cranio-oro-facial phenotype in Cockayne syndrome

BackgroundCockayne Syndrome CS (Type A – CSA; or CS Type I OMIM #216400) (Type B – CSB; or CS Type II OMIM #133540) is a rare autosomal recessive neurological disease caused by defects in DNA repair characterized by progressive cachectic dwarfism, progressive intellectual disability with cerebral leukodystrophy, microcephaly, progressive pigmentary retinopathy, sensorineural deafness photosensitivity and possibly orofacial and dental anomalies.MethodsWe studied the cranio-oro-facial status of a group of 17 CS patients from 15 families participating in the National Hospital Program for Clinical Research (PHRC) 2005 « Clinical and molecular study of Cockayne syndrome ». All patients were examined by two investigators using the Diagnosing Dental Defects Database (D[4]/phenodent) record form.ResultsVarious oro-facial and dental anomalies were found: retrognathia; micrognathia; high- arched narrow palate; tooth crowding; hypodontia (missing permanent lateral incisor, second premolars or molars), screwdriver shaped incisors, microdontia, radiculomegaly, and enamel hypoplasia. Eruption was usually normal. Dental caries was associated with enamel defects, a high sugar/carbohydrate soft food diet, poor oral hygiene and dry mouth. Cephalometric analysis revealed mid-face hypoplasia, a small retroposed mandible and hypo-development of the skull.ConclusionCS patients may have associated oro-dental features, some of which may be more frequent in CS children – some of them being described for the first time in this paper (agenesis of second permanent molars and radiculomegaly). The high susceptibility to rampant caries is related to a combination of factors as well as enamel developmental defects. Specific attention to these anomalies may contribute to diagnosis and help plan management.

Unilateral fusion of mandibular permanent lateral incisor with canine: A report of a rare case

Fusion is a developmental anomaly which occurs due to a union of one or more adjacent teeth during morpho-differentiation of the dental germs. Early diagnosis of this condition is important because it may cause clinical problems, such as esthetic concerns and arch asymmetry. These anomalies may be unilateral or bilateral and may affect either dentition, although the deciduous teeth are more commonly affected. This report describes a rare case of unilateral fusion between the mandibular permanent lateral incisors and the canine. Only few cases have been previously reported in the English literature. Hence this article aimed at reporting a case of this rare condition and evaluating the presence of any associated pathology.

Timing of Permanent Teeth Eruption in Turkish Children

To identify the mean time of permanent teeth eruption in children aged 5-15 years in Samsun, Turkey. A total of 1,491 children aged 5-15 years (Female: 773; Male: 718) were included in this study. Teeth were recorded as either "not erupted" or "erupted," which was defined as having at least one cusp visible in the oral cavity. Differences between eruption times for males and females and for maxillary and mandibular teeth were analysed using independent t-tests. Eruption tended to be earlier in females than in males, but this difference was significant only for maxillary and mandibular canines and mandibular first premolars (p < 0.05). For both females and males, the first teeth to erupt were the central incisors and first molars, and the last to erupt were the second premolars, molars and canines. Mandibular incisors and canines erupted significantly earlier than their maxillary counterparts in both females and males (p < 0.05). In comparison with other studies, eruption times ofpermanent first molars, central and lateral incisors were delayed by several months, whereas eruption times of other teeth were accelerated by several months. The findings regarding eruption times should be considered when planning dental treatment.

Revascularization for a necrotic immature permanent lateral incisor: a case report and literature review

Revascularization is a valuable treatment in immature necrotic teeth that allows the continuation of root development. This article describes the successful revascularization treatment of an immature maxillary lateral incisor that was initially diagnosed with apical periodontitis. The tooth was asymptomatic and functional clinically and radiographically during the follow-up period of 5 years. The follow-up showed evidence of progressive thickening of the dentinal walls, development of root length and apical closure. The article also discusses the currently available literature regarding revascularization of immature permanent teeth.

Dyschromatosis symmetrica hereditaria with long hair on the forearms, hypo/hyperpigmented hair, and dental anomalies: Report of a novel ADAR1 mutation

We report on a father and his two children who are affected with dyschromatosis symmetrica hereditaria (DSH). Mutation analysis of ADAR1 gene demonstrated a novel splice acceptor site mutation in intron 10, IVS10-2A>C. The hair on the forearm of the affected father became longer, larger in diameter, and hypopigmented (white) after age 40 years. Hyperpigmented hair was also found in normal and hypopigmented skin. The colors of the hair and the skin did not correlate. Transmission electron micrography of cortical keratinocytes of the hair follicles showed that normal hair contained more keratinocytes than those of hyperpigmented and hypopigmented hair. The keratinocytes of the hyperpigmented hair were larger than those of normal and hypopigmented hair and those of the normal hair were larger than those of the hypopigmented hair. The affected daughter had dens evaginatus of the mandibular right second premolar and the son had dens invaginatus of the maxillary permanent lateral incisors. Expression of Adar1 gene during mouse tooth development is demonstrated.

Concurrent Occurrence of Developmental Anomalies-Dens Evaginatus and Dens Invaginatus in Maxillary Lateral Incisor: Report of Two Cases

Developmental anomalies affecting tooth morphology are common in the literature. Dens evaginatus (DE) occurring in anterior tooth, termed ‘talon cusp’ is a relatively rare developmental anomaly. It presents as an additional cusp that project predominantly from the lingual surface of primary or permanent anterior teeth. Dens invaginatus (DI) is a developmental anomaly resulting from infolding of the tooth crown or root before calcification has occurred. Concurrent occurrence of DE and DI within the same tooth is rare. The present article reports two cases with concurrent occurrence of DE and DI in permanent maxillary lateral incisor. In case 1 the DE and DI are associated with nonvital tooth and in case 2 the DE and DI are associated with a vital tooth. The management aspects are discussed. Key messages: The present article demonstrates successful management of two cases with concurrent occurrence of developmental anomalies dens evaginatus and dens invaginatus. Case 1 with necrotic pulp required endodontic therapy, while the vital tooth in case 2 was treated by prophylactic placement of fissure sealant. Early detection of such anomalies may allow early intervention and better prognosis.