Multidisciplinary approach to multiple dental anomalies in pediatric patients: a case report with 4-year follow-up.

The objective of this article is to report the clinical case and 4-year follow-up of a 5-year-old child with multiple dental anomalies, emphasizing the importance of early diagnosis and use of combined pediatric surgery and orthodontic approaches. A 5-year-old boy, accompanied by his mother, sought dental care for dental caries and tooth pain. Clinical and radiographic examinations revealed active caries, a supernumerary primary tooth in the region of the mandibular right second premolar, and severe ankylosis of the primary mandibular right second molar. The treatment plan involved extraction of the supernumerary tooth as well as sectioning and extraction of the ankylosed molar. When the patient was 6 years old, the permanent mandibular right first molar showed signs of an altered eruptive process, and orthodontic treatment was initiated. A unilateral band-and-loop space maintainer with coil springs designed to move the permanent first molar was placed on the primary first molar. A new panoramic radiograph, obtained when the patient was aged 7 years, suggested the presence of an odontoma in the apical region of the primary maxillary right canine. Surgical removal and histopathologic examination of the lesion confirmed that it was a developing odontoma. After surgery, due to occlusal anomalies that included transverse maxillary deficiency, deep overbite, and midline deviation, the patient underwent rapid maxillary expansion therapy with a Haas-type appliance. When the patient was 8 years old, orthodontic treatment continued with a removable palatal Hawley expander and a orthodontic mandibular lingual arch. Currently, at the age of 9 years, the child is still undergoing fixed orthodontic treatment after surgical exposure of the impacted permanent maxillary right canine and bonding of an orthodontic attachment to enable traction. A multidisciplinary approach to the management of dental anomalies promotes a favorable prognosis and ensures comprehensive treatment of young patients.

[The duration of orthodontic treatment and the number of visits depending on the degree of difficulty when using modern orthodontic equipment]. / Prodolzhitel'nost' ortodonticheskogo lecheniya i kolichestvo poseshchenii v zavisimosti ot stepeni ego trudnosti pri ispol'zovanii sovremennoi ortodonticheskoi apparatury.

OBJECTIVE: The aim of the study is to analyze the estimated and actual duration of treatment and the number of visits to the orthodontist by patients using modern orthodontic equipment. Analysis of the duration of orthodontic treatment of patients with varying degrees of difficulty and comparison of the estimated and actually spent time for its implementation. MATERIAL AND METHODS: 308 medical records of patients who underwent orthodontic treatment were analyzed. According to the Siebert - Malygin method, the degree of difficulty of treatment, its duration, the number of necessary visits were calculated and the data obtained were compared with the actual time spent on correcting dental and occlusion anomalies and the number of visits by the patient to the orthodontist. RESULTS: The results of treatment of 308 patients who underwent orthodontic treatment with modern non-removable equipment (braces) are analyzed in the clinic of LLC «Prime dentistry¼ in Ryazan. Before starting treatment, the preliminary treatment time was calculated using the method of determining the difficulty of orthodontic treatment of Siebert - Malygin. The calculation of the degree of difficulty of treatment, its duration, and the number of necessary visits was carried out. The data obtained were compared with the actual time spent on correction of dental and occlusion anomalies and the number of visits by the patient to an orthodontist. It was found that, despite the use of modern equipment, the treatment time practically does not decrease, but the number of visits to achieve the desired result is significantly reduced. Coefficients have been calculated to clarify the required number of visits to the orthodontist. In the treatment of anomalies in the position of teeth (APD), it is 0.77, APD, combined with distal occlusion - 0.79 deep - 0.78, open - 0.66 and mesial - 0.69. CONCLUSION: The use of modern orthodontic equipment reduces the number of patient visits to the doctor, which saves time, reduces labor costs and allows you to provide the necessary assistance to more people in need. The coefficients calculated during the study to determine the required number of visits to an orthodontist by a patient, depending on the existing orthodontic pathology, make it possible to predict the treatment time with greater accuracy when using the Siebert - Malygin method. This is very relevant when planning upcoming manipulations and to more accurately justify the cost of treatment depending on the required time and number of visits to eliminate APS.

Multidisciplinary management of a tooth with severe root dilaceration and enamel hypoplasia: a case report.

Dental trauma in primary teeth can cause irreversible changes in the development of permanent tooth germs, including enamel hypoplasia, crown dilaceration, and root dilaceration. This article discusses multidisciplinary treatment of enamel hypoplasia and root dilaceration in the maxillary left central incisor of an 11-year-old girl. A 10-year follow-up is reported to demonstrate the long-term clinical outcomes. At the initial presentation, the patient's mother reported that the child had an accident at the age of 2 years, resulting in intrusive luxation of the primary maxillary left central incisor. After the accident, the patient was monitored for eruption of the permanent successor tooth, and different approaches were proposed during each period of the patient's development on the basis of the clinical diagnosis of root dilaceration and enamel hypoplasia. The crown was restored with composite resin, and the root defect was restored with resin-modified glass ionomer cement. After 10 years, the clinical outcomes highlight that the multidisciplinary approach was successful in preserving the natural tooth with good periodontal health conditions.

Endodontic treatment of hypertaurodontic teeth with anatomical variations: case reports.

Taurodontism, usually associated with genetic disorders, is an anomaly in dental development in which the tooth presents with a vertically elongated pulp chamber due to an invagination failure of the Hertwig epithelial sheath. This article presents 2 case reports describing the endodontic treatment of permanent taurodontic molars in systemically healthy patients. In case 1, a maxillary left first molar presented with hypertaurodontism and 5 root canals. In case 2, a mandibular left second molar presented with hypertaurodontism and a C-shaped canal. Treatment of both teeth was based on careful radiographic evaluation with magnification, which allowed the root canal orifices to be identified and the endodontic treatment to be performed. Chemical-mechanical preparation was performed with mechanized instruments and a 2.5% sodium hypochlorite solution. As an auxiliary protocol to finish cleaning, passive ultrasonic irrigation was performed, and a thermoplastic filling technique was used. When complex internal anatomy and accessory root canals are present, endodontic treatment of a tooth presenting with hypertaurodontism can be challenging. Given the complexities of the present cases, the positive outcomes can be attributed to the use of magnification during endodontic procedures and meticulous attention to tooth preparation and obturation techniques.

Contemporary endodontic treatment choices for adult patients with dens evaginatus and apical periodontitis: a case report with a 2-year follow-up.

Dens evaginatus (DE) frequently leads to pulp exposure and subsequent pulpal inflammation, pulpal necrosis, and periapical inflammation. This case report describes the application of regenerative endodontic therapy and mineral trioxide aggregate (MTA) apexification in a 22-year-old man with mandibular second premolars affected by DE and apical periodontitis. Regenerative endodontic therapy was performed after thorough debridement and placement of calcium hydroxide in the root canal of the left premolar. In contrast, an apical plug of MTA was placed prior to gutta percha compaction in the root canal of the right premolar. Both teeth were restored with adhesive composite resin. A 2-year follow-up examination revealed complete periapical healing.

Prevalence of dental developmental anomalies of permanent teeth in children and their influence on esthetics.

OBJECTIVE: The aim of this study was to determine the prevalence of dental developmental anomalies in permanent teeth and their influence on esthetics. MATERIALS AND METHODS: The records of 473 subjects, which comprised of orthopantomograms, clinical examination, and anamnestic data, were explored for dental developmental anomalies. Subjects with dental anomalies completed the modified questionnaire. Data on reasons for seeking the treatment as well as factors affecting the patients' satisfaction were collected. The data were processed using the Chi-square test. RESULTS: It was found that 79 subjects (16.7%) had at least 1 dental developmental anomaly. The most common anomalies were hypodontia (7.2%), followed by talon cusps (3.4%), and microdontia (2.5%). Hypodontia, microdontia, and talon cusps were found more prevalent in females than males, whereas hyperdontia and macrodontia were more common in males. The reason for dissatisfaction with their smile in most cases was due to missing teeth or spacing between anterior teeth (excess space 2.9 mm ± 1.1 mm), followed by crowding of anterior teeth (lack of space 3.1 mm ± 0.8mm), difficulty maintaining oral hygiene and midline asymmetry (1.8 mm ± 0.9 mm). All subjects were treated using a fixed orthodontic appliance and 30 (37.9%) of them had additional dental specialists included to achieve good esthetics and function. Overall, 92.4% of subjects were satisfied with their resulting appearance after treatment. CONCLUSIONS: Dental developmental anomalies are clinically evident abnormalities. They may be the cause of various dental problems and can influence esthetics and the development of orthodontic problems. CLINICAL SIGNIFICANCE: This paper evaluates the distribution of dental developmental anomalies and their influence on esthetics and function. Careful observation and appropriate investigation are required to diagnose the condition and institute treatment. The therapeutic approach to some dental anomalies should be interdisciplinary.

Systematic development of esthetics and function in a young patient with maxillary dental aplasia.

OBJECTIVES: Full-arch rehabilitations in young patients suffering from dental agenesis should compensate for the reduced vertical dimension of occlusion and restore both esthetics and function at minimal biological cost. This requires precise planning and maximum patient compliance during the preprosthetic phase. The pretreatment period with tooth-colored splints promotes a predictable outcome of the final restorations. Clinical considerations: Thanks to better restorative materials and adhesive techniques and increased knowledge of how to preserve sound tooth structures, prosthetic dentistry has increasingly turned toward minimally invasive procedures. The present clinical case documents a minimally/non-invasive maxillary full-arch rehabilitation of an agenesis patient with multiple dental aplasia, primary tooth persistence, and deficits in bone growth. The patient was pretreated with a tooth-colored CAD/CAM polycarbonate splint. Adequate esthetics and function were achieved by two zirconia-based single-wing adhesive fixed dental prostheses to replace the upper lateral incisors, lithium disilicate ceramic partial crowns for the posterior regions, and two feldspathic veneers for the upper central incisors. CONCLUSIONS: Non-invasive pretreatment with a removable tooth-colored splint realizes the treatment goal simply and safely, reduces treatment time, increases predictability, and facilitates the transfer of the prototype to the final restorations. New restorative options permit the minimally invasive treatment of such patients. CLINICAL SIGNIFICANCE: A pretreatment with a removable tooth-colored splint offers a simple and safe way to define the treatment goal, reduces treatment time, increases predictability, and facilitates the transfer of the results to the final restorations even in complex cases. New restorative options permit minimally invasive treatments of young patients with multiple dental agenesis.

Interdental papilla formation after diastema closure.

Due to improvements in esthetic dentistry, the number of patients seeking to obtain a more harmonious smile has increased. A 40-year-old woman was referred for treatment because she was dissatisfied with the effect that diastemas and a conoid tooth had on her smile. Her maxillary anterior teeth were relatively short, resulting in a compromised esthetic relationship between height and width. Orthodontic treatment for better distribution of her teeth was recommended to the patient, but she refused, wanting faster and less expensive treatment. After diagnostic and waxed-up study casts were obtained, composite resin esthetic mock-ups were made to confirm that sufficient space was left for formation of the interdental papilla. After the patient approved the mock-ups, her anterior teeth were submitted to bleaching, definitive restoration, and additional occlusal adjustments. At the 1-year follow-up, the patient exhibited a harmonious, esthetic smile without black spaces or periodontal inflammation.

Dental Findings and Functional Prosthesis use in Child with Hypohidrotic Ectodermal Dysplasia: A Case Report.

Fabrication of maxillary and mandibular esthetic functional prostheses in a 5-year-old female patient with ectodermal dysplasia is reported. This report presents, clinically and radiographically, the orofacial manifestations of a child diagnosed with hypohidrotic ectodermal dysplasia, along with the construction of removable prosthetic devices.

Endodontic Treatment of Hypertaurodontic Mandibular Molar Using Reciprocating Single-file System: A Case Report.

Taurodontism is a developmental tooth disorder characterized by lack of constriction in the cementoenamel junction and consequent vertical stretch of the pulp chamber, accompanied by apical displacement of the pulpal floor. The endodontic treatment of teeth with this type of morpho-anatomical anomaly is challenging. The purpose of this article is to report the successful endodontic treatment of a hypertaurodontic mandibular molar using a reciprocating single-file system.

Management of a Patient with Impacted Maxillary Canine, Peg-Shaped Lateral Incisors and Transmigrated Mandibular Canine: A Case Report.

To treat morphological abnormalities, impaction, and severe malposition of the teeth, the lateral incisors are sometimes extracted, followed by orthodontic space closure. This procedure often requires special consideration, not only with regard to esthetics but also for functional issues. However, thusfar, few reports that have performed a functional evaluation in such cases. The purpose of this article is to report the successful treatment of a 23 year-old male patient with the complaint of irregular placement and abnormal shape of his teeth. The patient had an impacted maxillary unilateral left canine, peg shaped lateral incisor, and transmigrated mandibular canine. Patient was treated with extraction of the upper lateral incisors and eruption of the impacted canines was guided to the place of the lateral incisor and extraction of the transmigrated mandibular canine.

[Orthodontic treatment need in school-age children in the Leningrad region].

Epidemiology of dentoalveolar anomalies is undoubtedly important, but in terms of the organization of orthodontic care, greater interest are data on the needs in this type of treatment. In a situation of limited manpower and resources for the provision of orthodontic care information about needs in orthodontic treatment allows you to define a group of patients with the primary need for orthodontic treatment, and to identify priorities to optimize the organization of orthodontic care in the region. Such data can be obtained by using the Dental Aesthetics Index (DAI) and Index of Orthodontic Treatment Need (IOTN). The aim of the study was to analyze the epidemiology of various forms of dentoalveolar anomalies school-age children of Kirishi district of Leningrad region, as well as their needs in orthodontic treatment in accordance with objective evaluation indices. The study involved 734 pupils of Kirishi lyceum №1 of Leningrad region. Analysis of the prevalence of dentoalveolar anomalies, as well as needs in the orthodontic treatment was conducted in three age groups: I mixed dentition period (6-9 years), II mixed dentition period (10-13 years), and permanent dentition (14-17). To determine the needs in the orthodontic treatment were used two most common international index (DAI and IOTN). In Kirishi district of Leningrad region dentoalveolar anomalies were found in 88.8% of children of school age, which is in accordance with the indices and IOTN DAI needs in orthodontic treatment is 38.8% and 54.5%, respectively. In order to reduce unnecessarily high load volume medical institutions orthodontic profile, optimize utilization of financial resources, as well as reducing social tension it is recommended to introduce the practice of doctors-orthodontists methodology for determining the needs in orthodontic treatment by objective indices.

OROFACIAL FINDINGS AND DENTAL MANAGEMENT OF WILLIAMS SYNDROME.

Williams Syndrome is a microdeletion syndrome characterized by a number of developmental and physical abnormalities. The aim of the present study was to evaluate the oral abnormalities and dental management of patients with Williams Syndrome. Fifteen patients with Williams Syndrome aged between 3-20 years old were evaluated in this study. Oro-facial findings, dental plaque index and DMFT/dmft scores were recorded in each patient. Panoramic radiographs and extraoral, intraoral photographs were taken from all patients. According to the results of this study, the mean DMFT and dmft scores were 0.39 ± 0.12 and 1.81 ± 0.39, respectively. The most common oro-facial findings were detected as high palate (87%), diastema (60%), failure to thrive (60%), feeding difficulties (60%), vomiting (47%), macroglossi (47%), microdontia (40%) and frenulum hyperplasia (40%). All decayed teeth were restored with compomer and composite restorations. In conclusion, dentists play a significant role for improving the quality of life of the patients with Williams Syndrome to minimize or prevent dental abnormalities.

Optimization of dental status improves long-term outcome after alveolar bone grafting in unilateral cleft lip and palate.

Objective : To evaluate the importance of dental status for long-term outcome after alveolar bone grafting in patients with unilateral cleft lip and palate. Design : Retrospective longitudinal study. Setting : Cleft lip and palate-craniofacial center, Uppsala University Hospital, Sweden. Patients : A total of 67 consecutive patients with unilateral complete cleft lip and palate. Interventions : Secondary alveolar bone grafting, prior to the eruption of the permanent canine, was performed at the average age of 10.0 years (range, 8.5 to 12.0 years). Main Outcome Measures : Alveolar bone height was evaluated with the modified Bergland index at 1 and 10 years after surgery. Results : Of the patients, 97% had modified Bergland index grade I and the remaining 3% had modified Bergland index grade II at 1 year after surgery. At 10 years' follow-up, 43% showed modified Bergland index grade I; 55%, modified Bergland index grade II; and 2% (one patient), modified Bergland index grade III. The degree of dental anomalies in the cleft area, such as enamel hypoplasia, incisor rotation, incisor inclination, canine inclination, and oral hygiene registered preoperatively, all correlated negatively to the modified Bergland index at 10 years after surgery. Enamel hypoplasia (ρ = 0.70195, P < .0001), followed by canine inclination (ρ = 0.55429, P < .0001), showed the strongest correlation to reduced bone height in the cleft area. Conclusions : In patients with unilateral cleft lip and palate, excellent results from secondary alveolar bone grafting in terms of bone height in the alveolar cleft tend to decrease with time. This seems to be correlated with factors that might to some extent be treated preoperatively through adequate planning and execution of the orthodontic treatment.

[Peculiarities of microbiological composition of oral fluid during various stages of orthodontic treatment in children and adolescents].

The article presents the results of analysis of spectrum, the rate of frequency and the amount of microorganisms in oral liquid before the beginning of orthodontic treatment of dental abnormalities and deformations and in its stages (6 and 12 months later). As the result of the study the appearance of pathologic microorganisms Staphylococcus aureus and a great number of conditionally-pathogenic fungi of Candida family and Porphyromonas spp. were determined. The obtained results show the need of elaboration of standards for the treatment of orthodontic patients.

[The effect of orthodontic treatment on the change of oropharynx features in patients with dentoalveolar anomalies and nasopharyngeal tonsil hypertrophy].

The paper presents the results of comprehensive survey and orthodontic treatment of 40 children with dentoalveolar anomalies and nasopharyngeal tonsil hypertrophy aged 7-9 years. The linear parameters obtained by cone beam CT and TWH in the lateral projection were analyzed. The study revealed changes, indicating that the presence of nasopharyngeal tonsil hypertrophy, leads to pathology of the dental system and estimated the efficiency of muscle training and combined use of functional devices and elastopositioner «Corrector¼ for the treatment of anomalies of dentition and the formation of physiological occlusion in the process of permanent teeth eruption.

Longitudinal treatment of cleft lip and palate in developing countries: dentistry as part of a multidisciplinary endeavor.

Cleft lip and palate affects roughly 1 in 600 children and predisposes patients to a lifetime of functional and esthetic discrepancies. Disparities in access as well as quality of care exist worldwide, with many children in developing countries unable to receive treatment. In the late 20th century, humanitarian medical missions emerged as a means of delivering surgical expertise to patients in resource-limited settings. These early missions took on a patient-centered approach focused solely on cleft repair, with little emphasis on treating the dental abnormalities that arose after the initial surgery. However, modern cleft care is characterized by a multidisciplinary, team-based approach with significant dental involvement. Recent cleft lip and palate endeavors have shifted from a mission-based approach to a developmental approach facilitating growth of an independent care center. This strategy focuses on creating an institution with expanded access to dental services, thus facilitating the long-term treatment inherent in modern cleft care. One clinic in a developing country that has experienced successful transitioning from a mission site to an independent craniofacial clinic is Operation Smile's Cleft Comprehensive Care Clinic in Guwahati, India. This article will summarize the rationale and planning of the clinic, underscore the team-based approach required in longitudinal treatment of cleft lip and palate, and demonstrate how treatment methodology may differ in resource-limited settings by outlining the therapeutic considerations of each provider in the Guwahati Clinic.

Management of a facial talon cusp on a maxillary permanent central incisor: a case report and review of the literature.

BACKGROUND: A talon cusp is a morphologically well-delineated accessory cusp. This case report discusses the unusual appearance of a talon cusp on the facial surface of the maxillary right permanent central incisor, which was conservatively treated and followed up for a period of 1 year. METHODS: A 21-year-old female was referred for the treatment of a maxillary right central incisor that caused an esthetic problem. Intraoral examination and radiographic and computerized tomographic investigation indicated that there was no connection between the pulp chamber, a "V"-shaped radiopaque structure, and three radiolucent globe areas. The accessory cusp was treated by selective cuspal grinding, followed by resin-based composite placement. The restoration was clinically evaluated 1 week after placement, as a baseline, and after 1 year. The restoration did not exhibit postoperative sensitivity at the 1-year evaluation. No difference was observed in the color match, marginal discoloration, marginal adaptation, or anatomic form compared with the baseline evaluation. CONCLUSION: The management and treatment outcome of a talon cusp depends on its size, presenting complications and patient cooperation. The present case report outlines the conservative management of a talon cusp. CLINICAL SIGNIFICANCE: This paper outlines a viable esthetic treatment option and a review of the relevant literature with regards to managing a facial talon cusp.

[Application of algorithms for treatment of dentition anomalies complicated by crowding of teeth].

100 patient, aged between 4 and 42, with various dentition anomalies exacerbated by crowding of lower and upper teeth, have been examined and given orthodontic treatment. The orthodontic treatment involved a combination method in conjunction with functional (biological), machine, surgical and prothetic methods. The analysis of the results of this study shows that the treatment algorithms used in this study could be recommended for clinical application.