Early orthodontic treatment: a new index to assess the risk of malocclusion in primary dentition.

AIM: A new index targeted on the risk of malocclusions in primary dentition, called Baby-ROMA (Risk Of Malocclusion Assessment) index, was set up to assess risks/benefits in early orthodontic therapies. The Baby-ROMA index was designed from the observation that some of the malocclusion signs, observed in primary dentition, can worsen with growth, others remain the same over time and others can even improve. Therefore it would be important to classify the malocclusions observed at an early stage on a risk- based scale. MATERIALS AND METHODS: The reliability of the index was tested on 200 children, referred by their paediatricians to two different Orthodontic Departments, aged 4-6 years and in full primary dentition. The children were evaluated by two operators, both trained and calibrated on the use of the Baby-ROMA index. RESULTS: The K test showed a high reproducibility of the index. It is shown that 50% of patients presented malocclusion and crossbite had the highest prevalence, followed by tooth decay and early loss of deciduous teeth and negative overjet. CONCLUSION: The Baby-ROMA index was helpful to assess the severity of malocclusion and the timing for orthodontic treatment in very young patients (primary teeth).

Papillon-Lefevre syndrome: two case reports.

Papillon-Lefevre syndrome is a rare autosomal recessive disorder in which there is palmoplantar keratinization and premature loss of both deciduous and permanent teeth. The palmoplantar keratoderma typically has its onset between the ages of 1 and 4 years and severe periodontitis starts at the age of 3 or 4 years. An early diagnosis of the syndrome can help preserve the teeth by early institution of treatment, using a multidisciplinary approach. We present two cases of the syndrome having all of the characteristic features.

A rare case report and appraisal of the literature on spontaneous tooth exfoliation associated with trigeminal herpes zoster.

BACKGROUND: Reports of post herpetic maxillofacial complications have been very rarely documented in the literature that includes periapical lesions, calcified and devitalized pulps, resorption of roots, osteonecrosis, and spontaneous exfoliation of teeth. The atypical feature of the case of concern to the dental surgeon is the rare complication of spontaneous tooth exfoliation following herpes zoster. CASE REPORT: This case reports a male patient of age 47 years who reported to the Department of Periodontology with the chief complaint of mobility in the left upper central incisor. Patient history revealed herpes zoster infection that began 11 days earlier along with underlying diabetes mellitus condition. We hereby report a known diabetic patient with history of herpes zoster infection who presented with rare complication of spontaneous tooth exfoliation involving the maxillary division of the trigeminal nerve. DISCUSSION: Limited number of cases has been reported in the literature regarding spontaneous teeth exfoliation secondary to herpes zoster. The exact pathogenesis regarding the spontaneous exfoliation of teeth in herpes zoster patient is still controversial. Thus, an oral health care provider should be aware of this rare complication while managing a case of tooth mobility with the previous history of herpes zoster of trigeminal nerve.

Premature exfoliation of teeth in childhood and adolescence.

Although the premature loss of primary teeth in conjunction with early eruption may be of no clinical significance, the loss of primary or permanent teeth in the absence of trauma should not be overlooked by the clinician. Premature loss of teeth associated with systemic disease usually results from some change in the immune system or connective tissue. This chapter presented some conditions associated with loosening and/or premature loss of teeth that may be encountered in children and adolescents. The most common of these conditions appear to be hypophosphatasia and early-onset periodontitis. Other less common conditions were described to aid in forming a differential diagnosis. Other diseases that may manifest with severe oral infection, such as Wiskott-Aldrich syndrome, diabetes mellitus, or herpes zoster, could result in early tooth loss.

Exfoliation of maxillary central incisors due to misapplication of orthodontic rubber bands.

The patient's problem consisted of a large diastema between the central incisors. The cost-cutting treatment plan recommended to the patient and his parents by the general dentist was to use orthodontic rubber bands to loop the teeth and close the diastema.

Case of idiopathic loss of deciduous teeth and associated alveolus.

We describe exfoliation of the lower left deciduous canine and deciduous first molar (CD) and associated alveolus of unknown cause in a 5-year-old healthy boy. Extraction of the teeth and removal of local bone led to healing without complication.

Dental diagnostic problems of potential genetic significance: the dental practitioner as geneticist in the developmental disabilities clinic.

A high incidence of aberrant dental formation can be anticipated in developmentally disabled children, particularly where the etiologic factors for developmental retardation are presumably of organic origin. The dentist, practicing in the developmental clinic, must frequently determine the developmental significance of such dental variation. In this capacity, his familiarity with the dental features of genetic disease can contribute significantly to more precise diagnosis.