Permanent Maxillary Incisors Research Articles

Treatment of Permanent Maxillary Incisor Associated with Supernumerary Tooth

Treatment of Permanent Maxillary Incisor Associated with Supernumerary Tooth

Bacterial Contamination as an Important Prognostic Factor in Tooth Avulsion and Replantation - Case Series

Tooth Avulsion is a significant traumatic injury in children, replantation and follow up care is the treatment of choice. Maxillary incisors are most affected and sometimes over treated or left untreated. Aim: To understand the role of bacterial contamination for the survival of permanent maxillary incisors in cases of avulsion in children Case Report: This paper presents 3 case reports outlining the treatment stages for the survival of avulsed permanent incisors. Pulp & periodontal damage and its tissue responses are discussed through various clinical factors responsible for good prognosis. Result & Observations: Preserving alveolar bone width, retaining aesthetics and function even for an interim period is a favorable outcome. It helps in the replacement of tooth at a convenient period of late adolescence or young adult stage. Conclusion: Immediate replantation is always recommended for good prognosis of tooth avulsion in children.

Management of white spot enamel lesions with resin infiltration: potentials and future research directions.

The current study1 is a randomized controlled trial with two arm, multicenter and parallel group design. Study subjects were 38 orthodontic patients younger than 17 years who were being treated with metal braces. Patients with at least one white spot lesion (WSL) graded 1 to 2 according to the International Caries Detection and Assessment System (ICDAS) on the labial surface of permanent maxillary and mandibular canines and incisors were included for the trial. Teeth with carious lesions and restorations, anomalies of the enamel, and primary teeth were excluded. Patients were allocated by computer generated random sequence into resin infiltration and fluoride varnish intervention groups. Study subjects were blinded until the allocation, outcome assessors and statisticians remained blinded through the study, however the operators could not be blinded. Resin infiltration treatment involved removal of orthodontic wires and auxiliaries followed by cleaning the teeth with fluoride free prophylactic paste and completing the resin infiltration according to manufacturer's instructions. In the fluoride varnish group, a thin layer of the material was applied after isolating the teeth, and patients were asked not to eat or drink for 1 hour. This was continued twice a month for 6 months. Digital images of the teeth were obtained before, and 1 day (T1), 1 week (T2), 1 month (T3), 3 months (T4) and 6 months (T5) after treatment, using a DSLR camera and a matching polarization filter. The images were processed for calibration and color stability. Regions of interest representing WSL (white spot lesion) and SAE (sound adjacent enamel) were isolated in the images for comparison at different stages the images were captured. Statistical analysis was performed using SPSS version 28. Independent-samples t-test was utilized for comparison between the two groups, and paired-samples t-test for comparison within the groups. A statistical significance level of α = 0.05 was set. At T1, significant color difference was observed between white spot lesion and adjacent sound enamel in the resin infiltration group and it remained stable after 6 months. Whereas in the fluoride varnish group, there were no statistical differences from baseline to 6 months. A statistical difference of 3.27 CIELAB units (p < 0.001) was reported between the infiltration group and the fluoride group at T5. No significant changes were noted in SAE with respect to changes in lightness. Resin infiltration was found to be better at masking the demineralization produced by WSL and also enhanced the esthetic appearance of demineralized areas around the brackets. Resin infiltration did not produce any clinically visible effects in non-affected enamel. These changes remained stable for a period of 6 months.

The Prevalence of Peg-shaped Maxillary Permanent Lateral Incisors in the Turkish Population

Aim The development of human dentition is influenced by a complex interplay of diverse factors spanning epigenetic, environmental, physical, chemical, biological, and genetic realms. Variations in the morphology and dimensions of upper lateral incisors have been documented, commonly resulting in a reduction in mesiodistal size, a phenomenon often referred to as "peg-shaped laterals". This study aimed to explore the prevalence of peg-shaped maxillary permanent lateral incisors while investigating potential correlations with gender and laterality. Material and method The study comprised 1076 Turkish individuals, aged between 18 and 75, who sought treatment at the Istanbul University Restorative Dentistry Clinic. Prior to examination, participants provided voluntary consent by completing consent forms. To ensure precision and consistency, all examinations were conducted by a single clinician with a minimum of twenty years of clinical experience. Patient selection adhered to predefined inclusion and exclusion criteria. Anamnestic data, encompassing age, gender, past dental history, general health status, and intraoral examination findings, were documented. Examinations focused on the anterior region, specifically between the maxillary canine teeth. Results Peg-shaped incisors were noted in 7.2% of cases (n=77), with 54 cases being unilateral and 23 bilateral. Among the cases, 7.4% (n=52) were observed in females and 6.7% (n=25) in males. A total of 97 peg-shaped incisors were identified in both left and right maxillary lateral incisors. Conclusion The research took place in Istanbul, Türkiye, a cosmopolitan metropolis. Expanding such investigations to various regions within Türkiye would yield a richer and more comprehensive dataset, enhancing the study's significance.

Case Report: Managing Odontoma and Molar-Incisor-Hypomineralization Challenges in Orthodontics: A Case Report

This report presents the successful orthodontic management of a case of odontoma associated with impaction of the mandibular right permanent canine and Molar-incisor-hypomineralization (MIH). Although case studies have reported the management of odontomas and MIH as separate entities, there is a lack of evidence regarding the comprehensive management of patients presenting with a combination of odontoma, dental impaction, and MIH. A 15-year, 7-month-old female patient complained of the appearance of her smile and the delayed eruption of her mandibular right permanent canine. She was diagnosed with Angle’s Class I molar relationship and Class II canine relationship with the maxillary permanent right lateral incisor in a lingual crossbite. Furthermore, she had mandibular right permanent canine impaction, retained mandibular right primary canine, and MIH in the permanent anterior teeth and first molars. The management involved the removal of the odontoma to allow for orthodontic traction of the lower permanent right canine. After that, the esthetic appearance of the teeth was improved through restorative treatment.

Bilateral Supplemental Permanent Maxillary Lateral Incisor in a Non-syndromic Pediatric Patient: A Rare Case Report

Bilateral Supplemental Permanent Maxillary Lateral Incisor in a Non-syndromic Pediatric Patient: A Rare Case Report

Orthodontic extrusion with fixed appliances for treatment of intrusive luxation injuries: A prospective study of 28 permanent maxillary incisors.

Limited evidence exists on the treatment options of tooth repositioning after intrusive luxation. The study aimed to investigate the outcomes and complications of orthodontic extrusion in treating intruded maxillary permanent incisors. A prospective study was conducted involving 28 intruded maxillary permanent incisors treated with orthodontic extrusion, compared with a retrospective control group of 29 teeth that underwent spontaneous re-eruption. The success rate of tooth repositioning, as well as pulp condition, periodontal healing, and root development were assessed and compared. The success rate of orthodontic extrusion was 96.4%, excluding one tooth that was ankylosed before treatment. There were no significant differences in pulp condition between the orthodontic extrusion and control groups for teeth with immature root development. Teeth with mature root development in the orthodontic group, however, showed a significantly higher rate of pulp necrosis (100%, p < .05). Periodontal healing outcomes were similar across both groups, regardless of the maturity of root development. The root length continued increasing during orthodontic extrusion treatment. Orthodontic extrusion treatment could effectively reposition moderately to severely intrusive permanent incisors, without increasing the risk of complications compared with spontaneous re-eruption.

Treatment For Type II Dens Invaginatus in a Mandibular Lateral Incisor: A Report of Rare Case

Dens invaginatus is one of the developmental abnormities of the tooth which occurs with an invagination of the enamel organ into the dental papilla during tooth development. This abnormity presents a wide spectrum of morphological variations. According to Oehlers classification, in dens invaginatus type II the invagination invades above the cemento-enamel junction, connecting to the pulp; however, there is no connection with the periodontal ligament. This abnormity presents significant challenge when root canal treatment is necessary. The most frequently affected teeth are permanent maxillary lateral incisors, followed by permanent maxillary central incisors. There are limited case reports of mandibulary central incisors; however, there is no publication of mandibular lateral incisors with dens invaginatus type II. This case report aimed to present cone-beam computed tomography aided diagnosis and treatment for type II dens invaginatus in a mandibular lateral incisor with a talon cusp and a large periapical lesion.

Management of rarely seen internal tunnelling root resorption associated with a maxillary permanent incisor

This case presents clinical techniques and materials that may be applied in the management of internal tunnelling root resorption, a rare condition which has little published literature.A 25-year-old woman was referred to a specialist centre by her general dental practitioner following an incidental finding of a radiographic radiolucency, suggestive of root resorption associated with tooth 21. A provisional diagnosis of external cervical resorption was made, and following cone beam computed tomography (CBCT), a definitive diagnosis of internal tunnelling root resorption given. Non-surgical endodontic treatment was completed using continuous wave compaction with a calcium-silicate based sealer. No further intervention has been required.A summary of the histology, aetiology, prevalence, diagnosis, management and prognosis of internal tunnelling root resorption is provided. The benefits of CBCT for diagnosing and managing internal tunnelling resorption defects and using continuous wave compaction with a calcium-silicate based sealer, compared to cold obturation techniques, are discussed.

Management of compound odontoma associated with unerupted maxillary permanent incisors: A case report

Introduction: Odontomas, the most common odontogenic tumors, result from developmental abnormalities where epithelial and mesenchymal cells grow, forming functional ameloblasts and odontoblasts. Typically asymptomatic, they are often associated with unerupted or impacted teeth. Odontomas are categorized as complex or compound, based on their tissue composition and structure. The preferred treatment is conservative surgical excision, followed by histopathological analysis for confirmation. Case History: A 13-year-old female patient came to the Pedodontic Clinic at RSGM Airlangga University with the chief complaint of unerupted upper front teeth. Intraoral eximination revealed no facial asymmetry. Intraoral examination revealed the absence of maxillary right central and lateral incisors with an asymptomatic swelling and no inflammation of the overlying mucosa. The patient had no history of systemic diseases such as heart disease or blood disorders, and there were no known allergies to food or medications. Discussion: Odontomas are generally asymptomatic and associated with unerupted or impacted teeth or retention of primary teeth. Removal of obstructions like odontome results in a spontaneous eruption of the impacted tooth. Another method currently being undertaken involves surgically exposing unerupted teeth and placing bonded attachment along with ligatures/e-chains for orthodontic traction so that it will speedup eruption process. Conclusion: The odontoma must be removed so that it will not disrupt dental growth and development, especially tooth eruption.

Conservative management of lateral canal biofilm-related persistent intraoral sinus and other complications in traumatized, immature incisors: A case report with 30 months’ follow-up

Conservative or regenerative endodontic treatments are the preferred approaches for managing traumatized (vital or necrotic) immature permanent teeth in growing patients. Diagnosing pulp vitality preoperatively using sensitivity tests can be challenging, especially if multiple teeth are traumatized, potentially leading to the failure of the chosen endodontic treatment. Unexpected complications, such as persistent intraoral sinus related to the lateral canal (often not visible on conventional radiographs) and delayed periradicular bone healing, may also arise. This case report presents the successful conservative management of three traumatized incisors with such complications. A novel intracanal dressing method was used to treat a persistent intraoral sinus related to the lateral canal in the permanent maxillary left central incisor, which was unresponsive to traditional dressing materials and methods, thereby avoiding surgery or extraction. Additionally, delayed bone healing in response to revascularization treatment in the permanent maxillary right central incisor, and the initially involved vital permanent maxillary right lateral incisor, was addressed with re-revascularization and root canal treatment, respectively. This article discusses tailored management strategies and possible reasons for associated complications in traumatized teeth. It emphasizes the importance of high-quality radiographic images, pulp vitality tests based on blood oxygenation, understanding the presence of biofilm in lateral canals, modified dressing methods, appropriate dressing vehicles, and the necessity of patience in treating traumatic dental injuries. Keywords: Biofilm; Conservative Management; Pediatric Dentistry; Root Canal Medicaments; Teeth Injuries

Comparison of push-out bond strength and apical microleakage of different calcium silicate-based cements after using EDTA, chitosan and phytic acid irrigations.

This research was aimed to evaluate push-out bond strength and apical-microleakage after application of three different calcium silicate-based cements with irrigation solutions on simulated immature teeth. 40 maxillary permanent canine teeth were used for push-out bond strength test, and 120 maxillary permanent incisors were used for microleakage evaluation. 120 root slices were divided into four main groups (EDTA, Chitosan, Phytic acid, and Saline) and immersed these solutiouns according to irrigation procedures. Each irrigation group was divided into 3 subgroups (Biodentine, MTA Repair HP, and NeoPUTTY). The prepared teeth were divided into four groups according to irrigation procedure for microleakage test. EDTA irrigation with Biodentine group showed highest push-out bond strength value and saline group with Neoputty showed the lowest push-out bond strength value. The highest microleakage value was seen in saline group with MTA Repair HP, while the lowest microleakage value was observed chitosan with Biodentine group. Chitosan and phytic acid solutions can be recommended as an alternative irrigation solution to 17% EDTA in single-session apexification treatment, since they are non-toxic, naturally occurring materials, effectively remove the smear layer, and have a positive effect on bond strength and apical leakage. RESEARCH HIGHLIGHTS: One of the factors affecting the long-term success of root canal treatment is a hermetic seal. Non-hermetic or inadequate filling triggers a chronic inflammatory reaction in periapical tissues, causing fluids to enter the spaces and negatively affecting the success of the treatment. Therefore, this study will help clinicians choose the right biomaterial and irrigation solution that will affect the success of root canal treatment.

Accidental Finding of Maxillary Lateral Incisor with Two Roots after Extraction of Tooth: A Rare Case Report with Review of Literature

Maxillary lateral incisors have a single root, according to many studies on internal anatomy. The primary objective of this article is to describe the two-rooted permanent maxillary lateral incisor and also a conduct a review on all reported cases of maxillary lateral incisors with two roots emphasizing on its etiology and prevalence among racial population.

Management options and long-term follow-ups for permanent double incisors: six to eleven-year case reports

BackgroundDouble teeth are dental anomalies that can lead to aesthetic and orthodontic problems.Case presentationThis report discusses two cases involving the multidisciplinary management of permanent maxillary left lateral incisors fused with a supernumerary tooth in two girls aged 9 and 10. Following intraoral and radiographic examinations, one was diagnosed with fusion, and the other was diagnosed with concrescence. The crown of the fused incisor was separated using a burs and extracted intraorally. The concrescent incisor was separated along its length using a laser and intentionally replanted extraorally. After a 6-year follow-up, no pathological signs were observed in the fused incisor. However, after an 11-year follow-up, external resorption was observed in the concrescent incisor.ConclusionsBoth incisors remained asymptomatic throughout the observation period. This case report highlights two different and effective methods employed to preserve the natural function, form, and aesthetics of double incisors.

Exploring Dens Invaginatus Types I and II: Diagnosis, Challenges, and Solutions - A Case Report

Dens invaginatus is a common malformation of maxillary lateral incisors with varying anatomical features that impose challenges to diagnosis and treatment. It is considered a real clinical entity which, even if the tooth is clinically healthy, it can cause pulpal damages that can progress silently and lead to necrosis and its complications. The aim of this article is to expose a clinical case of patient with two types of dental invaginations; I and II incidentally discovered during a routine radiological examination, affecting the two permanent maxillary lateral incisors which are clinically healthy, and which required endodontic treatment following pulpal damages. The focus will be on the description of the clinical and radiological characteristics of this abnormality, the difficulties and the strategies employed to manage this clinical condition.

Orthodontic Extrusion of Subgingivally Fractured Lateral Incisor and Canine Using Gold Post: A Case Report: 1 Year Follow-Up

ABSTRACT The case report describes a multidisciplinary approach using orthodontic forced eruption to facilitate prosthetic restoration of a maxillary permanent lateral incisor and canine with poor restorability for a young patient. Restoration after orthodontic eruption presents a more conservative treatment choice in young patients compared with prosthetic restoration after extraction. On examination, the patient had root stumps in the region of 22 and 23. We decided to treat the patient by orthodontic extrusion followed by endodontic post and core. The case was treated with the help of 19 gauge wire and gold posts.

Agenesis of the maxillary permanent lateral incisors with the deciduous retained: Conservative and biomimetic approach using the BAIR technique.

Agenesis of the maxillary permanent lateral incisors is a condition that requires treatment aimed at improving the esthetics, even at an early age. However, traditional therapeutic protocols are long, invasive and have limitations and contraindications imposed by the age of the patient. Recent developments in restorative dentistry have provided a new approach to this clinical situation, in particular when the deciduous laterals are retained. We report two cases regarding the management of missing lateral incisors using Biologically Active Intrasulcular Restoration (BAIR) technique. The BAIR technique allows us to transform the shape of the deciduous lateral incisor into the permanent, acting both on the dental morphology and proportions, and on the appearance of the soft tissues and the gingival parables. The BAIR technique is a valid approach to cases of agenesis of the maxillary permanent lateral incisors, when the deciduous are retained. It does not require any preparation of the dental tissues, is reversible and minimally invasive. It is applicable to patients of all ages, and results are obtained in a single appointment. The BAIR technique allows a biomimetic conservative approach for the rehabilitation of congenitally missing permanent lateral incisors, when the deciduous are retained. It is a non-invasive protocol and effective in successfully restoring esthetics.

Prevalence of Dental Anomalies in Maxillary Lateral Incisors: An Institutional Cross-sectional Study from Karnataka

ntroduction: The majority of dental abnormalities are found in third molars, followed by permanent maxillary lateral incisors. The occurrence of these dental anomalies varies among different ethnic groups; hence, it is of prime importance for clinicians to know and understand the incidence of dental anomalies among the local population. Aim: To analyse the prevalence of dental anomalies in relation to permanent maxillary lateral incisors in the Karnataka region. Materials and Methods: A cross-sectional study was conducted in the Department of Conservative Dentistry and Endodontics of HKES’s S Nijalingappa Institute of Dental Science and Research, Kalaburgi, Karnataka, India from July 2022 to December 2022. A total of 1,116 subjects, aged between 15 and 50 years, were randomly screened. Each subject was clinically examined, and radiographs were taken for patients with dental anomalies. The five dental anomalies studied were congenitally missing permanent maxillary lateral incisors, peg laterals, dens in dente, talon’s cusp, and palato-gingival groove. Statistical analysis was performed using SPSS version 26. Descriptive statistics were estimated in terms of frequency and percentage. Results: A total of 43 subjects were found to have anomalies associated with the maxillary lateral incisor, including pegshaped laterals (1.25%-14), dens in dente (0.81%-09), congenitally missing (0.45%-05), talon’s cusp (0.27%-03), and palato-gingival groove (1.07%-12). Conclusion: Anomalies in permanent maxillary lateral incisors were noted in 3.85% of the Karnataka population.

Alveolodental trauma of the maxillary permanent incisors at Bouaké University Hospital (Côte d'Ivoire)

Introductiondental trauma, particularly to the maxillary permanent incisors, is relatively common at Bouaké University Hospital. The aim was to identify the epidemioclinical characteristics and distinguish the therapeutic methods. Material and methodsThis was a retrospective cross-sectional study carried out in the Odontostomatology and Maxillofacial Surgery Department of Bouaké University Hospital from 2015 to 2021. Alveolar-dental trauma of the maxillary permanent incisors was included in the study. Results346 subjects were enrolled, representing a prevalence of 20.99 % of all maxillofacial injuries. The mean age was 23.5 years (extremes 8 and 73 years) and the sex ratio was 3.55. Road traffic accidents were the cause of trauma in 250 cases (72.25 %), of which 213 (85.20 %) involved motorised 2-wheelers without helmets. Concurrent damage to the central and lateral incisors was observed in 178 cases (51.44 %). The dental organ was affected in 219 cases (63.29 %), the supporting tissue in 183 cases (52.89 %) and the bone tissue in 102 cases (29.48 %). Other associated craniofacial lesions were observed in 135 cases (39.02 %). For lesions of the dental support tissue, reduction and retention were performed in 39 cases (21.31 %). For lesions of the dental organ, dental avulsion was performed in 102 cases (46.58 %). For alveolar bone lesions, For alveolar bone lesions, reduction with maxillo-mandibular blocking was performed in 54 cases (52.94 %). Discussion: Alveolodental traumatic lesions of the maxillary permanent incisors are, in more than a third of cases, included in a multi-traumatic maxillofacial context, and can therefore very easily be relegated to secondary consideration. ConclusionThese traumas most often affect young patients, with major lesions that need to be treated as effectively as possible, at the risk of significant functional and aesthetic sequelae.

Variations in morphology of permanent maxillary lateral incisors and its impact on oral hygiene and diseases

The permanent maxillary lateral incisors are of great importance from an aesthetic standpoint, as any variation in their shape can lead to an unfavorable visual appearance. Furthermore, morphological variations such as peg-shaped, barrel-shaped, shovel-shaped, and canine-shaped teeth can impact oral hygiene and lead to additional health problems. The etiology of these variations is multifactorial, including genetic, epigenetic, and environmental factors. This paper aims to provide a comprehensive overview of the most common morphological variations of the permanent lateral incisors, including their causes, associated dilemmas, treatment modalities, and the various health and hygiene issues associated with these diverse physical characteristics. By highlighting the potential health and hygiene issues associated with these variations, this paper aims to increase awareness among dental professionals and the general public about the importance of regular dental care and check-ups to maintain oral health and aesthetics. A comprehensive understanding of the causes, dilemmas, and treatment modalities of these morphological variations can aid dental professionals in providing effective and personalized care to their patients. In conclusion, the morphology of the permanent maxillary lateral incisors plays a critical role in dental aesthetics, hygiene, and health.