Fusion of Unerupted Mesiodens with a Regular Maxillary Central Incisor: a Diagnostic and Therapeutic Challenge.

The mesiodens is the most frequent type of supernumerary tooth which can appear in the maxillary midline area. The etiology of mesiodentes is not fully understood. This report shows a case of incomplete fusion of an unerupted mesiodens with a permanent maxillary central incisor, aligned in the dental arch. Intraoral and radiographic examinations indicated fusion of the crown and cervical part of the root of the supernumerary tooth with the permanent incisor. The clinical situation was further complicated by the presence of another supernumerary tooth located palatally. The treatment approach has included two phase surgical therapy to extract the supernumerary teeth. Early diagnosis and appropriate surgical treatment of mesiodentes are important to decrease the risk of clinical complications. Pre-operative 3D imaging is strongly advisable since it allows accurate data to be obtained, and reduces the extent of surgery and the possibility of procedural complications. In most cases, a multidisciplinary collaboration is necessary for precise diagnosis and predictable treatment outcome.

Prevalence of periodontal diseases in North Herzegovina.

AIM: To investigate effects of smoking on periodontal tissue and the occurrence of periodontal disease in the population of North Herzegovina. METHODS: The study included 800 persons of 20-49 years of age (400 smokers and 400 non-smokers), inhabitants of Prozor-Rama Municipality, Bosnia and Herzegovina. Periodontal condition assessment was made by the Community Periodontal Index of Treatment Needs index (CPITN) at representative teeth: 16, 17, 21, 26, 27, 36, 37, 31, 46, and 47.Statistically significant difference between non-smokers and smokers was tested by χ2 test with the level of significance set at p=0.05. RESULTS: The prevalence of healthy periodontal tissues was lower in smokers than in non-smokers, 25 (6.3%)and 36 (9%), respectively. The prevalence of gingival bleeding, calculus, shallow and deep periodontal pockets was higher in smokers than in non-smokers, although it was not significant. There was a risk between occurrence of deep periodontal pockets and smoking (RR=2). A total of 64 (8%)participants neededonly instructions on proper oral hygiene, 654 (81.8%) prophylaxis and initial treatment,while 21 (2.6%) needed complex periodontal treatment. CONCLUSION: Obtained results indicate a high need of preventive measures and the improvement of oral health in the population of North Herzegovina.