Diagnóstico por imágenes de un odontoma complejo. Presentación de un caso / Diagnostic imaging of a complex odontoma. A case report

RESUMEN Los odontomas son los tumores más frecuentes del área bucal y maxilofacial. Presentamos un caso clínico de una paciente femenina de 50 años, con cuadros de sinusitis a repetición y dolor en región maxilar derecha. Se le realiza tomografía axial computarizada simple de macizo facial, donde se observó una imagen amorfa de densidad variable a nivel del hueso maxilar derecho, que involucraba la porción inferior del seno, compatible con tumor odontogénico, probablemente benigno, sugestiva de un odontoma complejo.

ABSTRACT Odontomas are the most common tumours located in the oral and maxillofacial region. We present a 50-year-old female patient with recurrent sinusitis and pain in the right maxillary region. A simple computed axial tomography of the facial mass was performed, where an amorphous image of variable density was observed at the level of the right maxillary bone, involving the lower portion of the sinus, compatible with an odontogenic tumour, probably benign and suggestive of a complex odontoma.

Dental and maxillomandibular incidental findings in panoramic radiography among individuals with mucopolysaccharidosis: a cross-sectional study

Abstract Mucopolysaccharidosis (MPS) is a group of rare and inherited metabolic disorders caused by the accumulation of macromolecule glycosaminoglycans inside lysosomes. Affected individuals may have dental and craniofacial tissue alterations, facilitating the development of several oral diseases. Objectives To assess, with panoramic radiographic images, the frequency of dental and maxillomandibular incidental findings among MPS individuals and compare them with non-MPS individuals. Methodology A cross-sectional study evaluating a sample of 14 MPS individuals and 28 non-MPS individuals aged from 5 to 26 years was carried out. They were matched for sex and age on a 2:1 proportion. Panoramic radiographs were assessed for the presence/absence of the following dental and maxillomandibular alterations: dental anomalies of number (hypodontia/dental agenesis, supernumerary teeth); anomalies of form (microdontia, macrodontia, conoid teeth, taurodontism, and root dilaceration); anomalies of position (impacted tooth, inverted tooth, tooth migration, partially bony teeth, complete bony teeth); periapical alterations (furcation lesion, circumscribed bone rarefaction); other alterations (radiolucent bone lesions, radiopaque bone lesions, radiopacity in the maxillary sinus, condylar hypoplasia). Differences between groups were tested by the Fisher's exact test and chi-square test (p<0.05). Results For intrarater agreement, Kappa values were 0.76 to 0.85. The presence of supernumerary teeth (p=0.003); conoid teeth (p=0.009); taurodontism (p<0.001); impacted teeth (p<0.001); partial bony teeth (p=0.040); complete bony teeth (p=0.013); and root dilaceration (p=0.047) were statistically more frequent in MPS individuals compared to non-MPS individuals. Bone rarefaction/furcation lesions (p=0.032), condylar hypoplasia (p<0.001), radiolucent bone lesions (p=0.001), and dentigerous cysts (p=0.002) were also more frequent in MPS individuals. Conclusion The presence of specific oral manifestations is more common in MPS individuals than non-MPS individuals.

Radiographic evaluation of dental anomalies in patients with congenital Zika virus syndrome

Abstract: Numerous studies have reported abnormalities in the development of oral structures in congenital infections that also involve microcephaly. In this context, it is necessary to identify possible dental anomalies of shape and/or number in patients with Zika virus syndrome using radiography. The study population consisted of 35 children born with congenital ZIKV who underwent intraoral radiographic examinations for 24 consecutive months. A modified periapical technique was performed in an occlusal position for the maxilla and mandible. Categorical data were expressed as absolute and percentage frequencies and compared using Pearson's Chi-square test, with a 95% confidence interval. Of the entire sample, eight children (22.8%) had dental anomalies of shape and/or number, and four children (11.4%) presented with both anomalies, with agenesis of the upper and lower deciduous/permanent incisors and dental form modifications, such as microdontia and anomalous cusps. When we considered age and sex, there was no statistically significant difference between patients who presented with agenesis and those who presented with modifications. Children with congenital Zika virus syndrome were more likely to have dental modifications in the number and shape of their teeth, and it is essential to implement medium- to long-term monitoring to diagnose other possible alterations throughout the development of the mixed and permanent dentition, favoring their treatment.

Síndrome Nance-Horan, cataratas congénitas y anomalías dentales / Nance-Horan syndrome, congenital cataracts and dental anomalies

RESUMEN Introducción: La presencia de estructuras dentofaciales atípicas puede ser el primer indicador de otros defectos congénitos relacionados con síndromes también de origen genético. El síndrome Nance-Horan es un trastorno monogénico ligado al cromosoma X, caracterizado fenotípicamente por alteraciones dismorfológicas dentales y craneofaciales distintivas, cataratas congénitas y déficit cognitivo. Objetivo: Describir un caso inusual de anomalías dentarias en el curso del síndrome Nance-Horan. Presentación de caso: Paciente de 13 años de edad, masculino, de piel blanca. Al examen clínico se constató un patrón dismórfico dado por facies alargada y estrecha, orejas prominentes con anteversión de la aurícula, nariz grande con puente nasal alto, diastema generalizado en ambas arcadas, todos los dientes con anomalías de forma y microdónticos. En el estudio radiológico periapical se constataron raíces cortas y cámaras pulpares amplias. Los antecedentes patológicos personales de nuestro paciente, el patrón dismórfico cráneo facial y las radiografías coinciden con características de otros casos de síndrome Nance-Horan reportados en la literatura. La mutación del gen síndrome Nance-Horan se expresa completamente solo en los varones. Como los varones son hemicigóticos para los genes ligados al cromosoma X, basta con una copia del alelo mutado para que aparezca una enfermedad de herencia recesiva ligada al sexo. Conclusiones: Se evidenció que es de crucial importancia realizar un cuidadoso examen, tanto clínico como radiográfico, de los pacientes con anomalías dentales. Se insiste en el trabajo mancomunado entre diferentes disciplinas y especialidades, tanto médicas como estomatológicas(AU)

ABSTRACT Introduction: The presence of atypical dentofacial structures may be the first indicator of other congenital defects related to syndromes of likewise genetic origin. Nance-Horan syndrome is a monogenic X linked disorder phenotypically characterized by distinctive dysmorphic dental and craniofacial alterations, congenital cataracts and cognitive deficit. Objective: Describe an unusual case of dental anomalies in the course of Nance-Horan syndrome. Case presentation: A case is presented of a white male 13-year-old patient. Clinical examination revealed a dysmorphic pattern characterized by long narrow facies, prominent ears with auricular anteversion, a big nose with a high nasal bridge, generalized diastema in both arches, and all the teeth microdontic and abnormally shaped. Periapical radiological examination found short roots and broad pulp chambers. The personal pathological antecedents of the patient, the dysmorphic craniofacial pattern and the radiographs correspond to characteristics of other cases of Nance-Horan syndrome reported in the literature. Mutation of the Nance-Horan syndrome gene is completely expressed only in males. Since males are hemizygous for X linked genes, one copy of the mutated allele is sufficient for the appearance of a sex-linked recessive inheritance disease. Conclusions: Evidence was found of the crucial importance of conducting careful examination, both clinical and radiographic, of patients with dental anomalies. Emphasis is placed on the joint work of various disciplines and specialties, both medical and dental(AU)

Agenesis of third molars and its association with other dental anomalies in a peruvian population / Agenesia de terceros molares y su asociación con otras anomalías dentales en una población peruana

Objective: The purpose of the present study was to determine the association between agenesis of the third molar and other dental anomalies. Materials and Methods: This was an observational, retrospective, cross-sectional and analytical study. The sample included 367 patients, aged 14 to 20 years old with adequate digital panoramic radiography. Patients with syndromes, who had extractions of any third molar and with orthodontic treatment prior to panoramic radiographic examination, were excluded. For data collection, each radiograph was recorded with patient code, sex and age. Results: The prevalence of third molar agenesis was 20.71%. Subsequently, patients were divided into two groups, with agenesis of at least one third molar and a control group; the prevalence of other dental anomalies was 48.69% of third molar agenesis group and 21.31% in the control group. A highly significant association was found between the presence of third molar agenesis and the presence of other tooth abnomalities (p= 0.0000; contingency coefficient = 0.2425).The most frequent dental anomaly was dental inclusion with 20.44% of the population studied; followed by the agenesis of other teeth (7.90%) and finally the presence of supernumerary teeth (1.63%). Conclusions: This study demonstrates that there is an association between third molar agenesis and other dental abnormalities, with a higher prevalence of dental abnormalities in patients with third molar agenesis.

Objetivo: La presente investigación tuvo como finalidad determinar la asociación que existe entre la agenesia del tercer molar y otras anomalías dentarias. Material y Métodos: El estudio fue observacional, retrospectivo, transversal y analítico. La muestra que incluyó 367 pacientes de 14 a 20 años de edad con radiografía panorámica digital con parámetros adecuados. Se excluyeron pacientes con algún tipo de condición sindrómica, con exodoncias de algún tercer molar y con tratamiento ortodóntico previo al examen radiográfico panorámico. Para la recolección de datos, cada radiografía fue registrada con código de paciente, sexo, edad. Resultado: Se reportó una prevalencia de 20,71% de casos con agenesia de terceros molares. Los pacientes fueron divididos en 2 grupos, con agenesia de al menos un tercer molar y un grupo control, en ambos se calculó la prevalencia las otras anomalías dentarias, la cual fue de 48.69% de los pacientes que presentan agenesia de tercer molar tienen otra anomalía dentaria y 21.31% del grupo control tienen otra anomalía dentaria. Se encontró una asociación altamente significativa entre la presencia de agenesia de tercer molar y presencia de otras anomalías dentales (p=0.0000; coeficiente de contingencia=0.2425). La anomalía dental encontrada con más frecuencia es la inclusión dentaria con 20,44% del total de la población estudiada; seguido de la agenesia de otros dientes con 7,90% y finalmente la presencia de dientes supernumerarios con 1,63%. Conclusion: Este estudio demuestra que existe asociación entre la agenesia de tercer molar y otras anomalías dentarias, existiendo una mayor prevalencia de anomalías dentales en pacientes con agenesia del tercer molar.

Frecuencia de anomalías dentales de número en niños costarricenses atendidos en la Facultad de Odontología de la Universidad de Costa Rica / Frequency of Teeth Number Anomalies in Costa Rican Children at the Faculty of Dentistry University of Costa Rica

Resumen 16. Las anomalías dentales pueden producir alteraciones de forma, número, tamaño y estructura dental, afectando la función y la estética. El objetivo del presente estudio es determinar la frecuencia y localización de anomalías dentales de número en niños sanos costarricenses entre los 6 y 12 años. Se realizó un estudio observacional y retrospectivo con 157 radiografías panorámicas de los expedientes de los pacientes de la Clínica de Odontopediatría y Ortodoncia de la Universidad de Costa Rica entre los años 2015-2017; las anomalías que se observaron fueron hiperdoncias e hipodoncias. Los datos fueron analizados utilizando la prueba de Fisher con un nivel de significancia del 5%. Se encontró un 8.3% de anomalías de número, 4.5% fueron hiperdoncias y 3.8% hipodoncias, ambas anomalías se presentaron tanto de forma única como doble o múltiple. No se encontró diferencia estadísticamente significativa según el género. Las hiperdoncias fueron más comunes en maxila y las hipodoncias en mandíbula. Los dientes supernumerarios más frecuentes fueron los mesiodens y las ausencias más recurrentes fueron los segundos premolares inferiores.

Abstract 20. Dental anomalies can produce alterations in dental shape, number, size, and structure, affecting function and aesthetics. The objective of this study is to determine the frequency and location of teeth number anomalies in healthy Costa Rican children between 6 and 12 years old. An observational and retrospective study was carried out with 157 panoramic radiographs of the patients of the pediatric dentistry and orthodontics clinic of the University of Costa Rica between the years 2015-2017. Hyperdontias and hypodontias were the anomalies observed. Data were analyzed using a Fisher exact test with a significance level of 5% . The results showed that the overall frequency of dental anomalies was 8.3%, 4.5% were hyperdontias and 3.8% hypodontias. Double or multiple hyperdontia and hypodontia were also found. The difference between sex was not significant (p= 0.145). Supernumeraries were more frequent in maxilla and hypodontias in mandible. Mesiodens was the most frequently found supernumerary teeth. Mandibular second premolars were the most commonly missing teeth.

Clinical and x-ray oral evaluation in patients with congenital Zika Virus

Abstract Objective: The aim of this study was to investigate possible malformations in the soft, bone and/or dental tissues in patients with congenital Zika Virus (ZIKV) by clinical and x-ray evaluation. Methodology: Thirty children born with ZIKV and 30 children born without ZIKV (control group) were included in the study. Patients were evaluated over 24 consecutive months according to the variables: sex, age, cleft palates, soft tissue lesions, alveolar ridge hyperplasia, short labial and lingual frenums, inadequate posture of the lingual and perioral muscles at rest, micrognathia, narrow palatine vaults, changes in the teeth shape and/or number, sequence eruption, spasms, seizures and eruption delay were evaluated. Chi-square test, Student's t-test and nominal logistic regression were used (p<0.05). Results: Among the 30 babies examined, the mean age of the first dental eruption was 10.8±3.8 with almost two-thirds of the children (n=18, 60%) experiencing eruptions of their first tooth after 9 months of age, nine children (30%) had inadequate lingual posture at rest, more than half of the children (n=18, 60%) had short labial or lingual frenums. ZIKV babies showed a high prevalence of clef palate (p<0.001), inadequate lingual posture at rest (p=0.004), micrognathia (p=0.002), changes in the shape and/or number of teeth (p=0.006), alteration in sequence of dental eruption (p<0.001) and muscles spasms (p=0.002). The delay eruption was associated with inadequate lingual posture at rest (p=0.047), micrognathia (p=0.002) and changes in the shape and/or number of teeth (p=0.021). The delayed eruption (p=0.006) and narrow palatine vaults (p=0.008) were independently associated with ZIKV. Moreover, female patients showed the most narrow palatine vaults (p=0.010). Conclusions: The children with ZIKV showed a greater tendency to have delayed eruption of the first deciduous tooth, inadequate lingual posture and short labial and lingual frenums.

Hallazgos incidentales en ortopantomografías maxilomandibulares de pacientes adultos jóvenes / Incidental findings on panoramic radiographs of the maxilla and mandible of young adult patients

Introducción: la valoración radiográfica rutinaria en la práctica odontológicaes esencial para un adecuado diagnóstico y plan de tratamiento. Laortopantomografía o radiografía panorámica es una técnica simple, rápida, de bajo costo y a una baja dosis de radiación. Objetivos: Caracterizarlos hallazgos incidentales más comunes en radiografías panorámicas de pacientes adultos jóvenes de una clínica dental universitaria. Materialy métodos: Se realizó un estudio descriptivo, retrospectivo, de cortetransversal de radiografías panorámicas digitales, tomadas e interpretadas de manera ciega, explorando alteraciones óseas y anomalías dentales. Se realizó la caracterización de su presentación por género de los participantes. Para el análisis de datos se utilizaron pruebas no paramétricas (la prueba χ2, exacta de Fisher y binomial). Resultados: Se tomaron 98 radiografías del mismo número de pacientes, con edad promedio de 19.45 años, predominando las mujeres (69/70.40 por ciento), solteros (94/95.91 por ciento) y de zona urbana (77/78.57 por ciento). Existieron 387 alteraciones, 268 (69.25 por ciento) enmujeres, y 119 (30.74 por ciento) en hombres, con un promedio de 3.88 y 4.10 alteraciones por paciente, respectivamente. La distribución mostró en total 122 (31.52 por ciento) lesiones a nivel de senos maxilares, 124 (32.04 por ciento) en fosasnasales, 16 (4.13 por ciento) lesiones radiolúcidas u opacas, y 125 (32.29 por ciento) anomalías asociadas a retención dental. La comparación de acuerdo al género mostró diferencia (p ≤ 0.001) en la frecuencia de alteraciones, en todos los casos determinada por las mujeres, para cada sitio y tipo de lesión presentada. Conclusiones: El valor de la radiografía panorámica para detectar anomalías de estructuras orofaciales demostró en este estudio su utilidad en la práctica asistencial desde una perspectiva epidemiológica.

Background: doutine dental X-Ray assessment in dental practice isessential for proper diagnosis and treatment. Orthopantomographyor panoramic radiography is a quick, simple, low-cost, and low-doseradiation technique. Objective: To describe the most common incidentalfi ndings on the panoramic radiographs of young adult patients ata university dental clinic. Material and methods: A descriptive,retrospective, cross-sectional study was carried out, in which digitalpanoramic radiographs were taken and interpreted blindly to examinebone disorders, and dental anomalies, and the prevalence of theseaccording to the gender of the participants. Nonparametric statistics(Chi-square χ2, Fisher’s exact, and binomial tests) were used for dataanalysis. Results: 98 radiographs were taken of the same number ofpatients with a mean age of 19.45 years, most of whom were women(69/70.40%), single (94/95.91%), and from urban areas (77/78.57%). 387alterations were found, 268 (69.25%) in women and 119 (30.74%) in men,with an average of 3.88 and 4.10 alterations per patient, respectively. Thedistribution presented a total of 122 (31.52 %) lesions in the maxillarysinus, 124 (32.04 %) in the nostrils, 16 (4.13 %) radiolucent or opaquelesions, and 125 (32.29%) anomalies associated with tooth retention. Acomparison by sex revealed a diff erence (p < 0.001) in the frequency ofalterations, which was greater in women for all sites and types of lesion.Conclusions: The study showed the usefulness of panoramic radiographyin clinical practice to detect anomalies of the orofacial structure from anepidemiological perspective.

Risk of developing palatally displaced canines in patients with early detectable dental anomalies: a retrospective cohort study

ABSTRACT The early recognition of risk factors for the occurrence of palatally displaced canines (PDC) can increase the possibility of impaction prevention. Objective To estimate the risk of PDC occurrence in children with dental anomalies identified early during mixed dentition. Material and Methods The sample comprised 730 longitudinal orthodontic records from children (448 females and 282 males) with an initial mean age of 8.3 years (SD=1.36). The dental anomaly group (DA) included 263 records of patients with at least one dental anomaly identified in the initial or middle mixed dentition. The non-dental anomaly group (NDA) was composed of 467 records of patients with no dental anomalies. The occurrence of PDC in both groups was diagnosed using panoramic and periapical radiographs taken in the late mixed dentition or early permanent dentition. The prevalence of PDC in patients with and without early diagnosed dental anomalies was compared using the chi-square test (p<0.01), relative risk assessments (RR), and positive and negative predictive values (PPV and NPV). Results PDC frequency was 16.35% and 6.2% in DA and NDA groups, respectively. A statistically significant difference was observed between groups (p<0.01), with greater risk of PDC development in the DA group (RR=2.63). The PPV and NPV was 16% and 93%, respectively. Small maxillary lateral incisors, deciduous molar infraocclusion, and mandibular second premolar distoangulation were associated with PDC. Conclusion Children with dental anomalies diagnosed during early mixed dentition have an approximately two and a half fold increased risk of developing PDC during late mixed dentition compared with children without dental anomalies.

Fragile X syndrome: panoramic radiographic evaluation of dental anomalies, dental mineralization stage, and mandibular angle

ABSTRACT Fragile X syndrome (FXS) is a disorder linked to the chromosome X long arm (Xq27.3), which is identified by a constriction named fragile site. It determines various changes, such as behavioral or emotional problems, learning difficulties, and intellectual disabilities. Craniofacial abnormalities such as elongated and narrow face, prominent forehead, broad nose, large and prominent ear pavilions, strabismus, and myopia are frequent characteristics. Regarding the oral aspects, deep and high-arched palate, mandibular prognathism, and malocclusion are also observed. Objective: The purpose of this study was to evaluate the dental radiographic characteristics as described in 40 records of patients with panoramic radiography. Material and Methods: The patients were in the range of 6–17 years old, and were divided into two groups (20 subjects who were compatible with the normality standard and 20 individuals diagnosed with the FXS), which were matched for gender and age. Analysis of the panoramic radiographic examination involved the evaluation of dental mineralization stage, mandibular angle size, and presence of dental anomalies in both deciduous and permanent dentitions. Results: The results of radiographic evaluation demonstrated that the chronology of tooth eruption of all third and second lower molars is anticipated in individuals with FXS (p<0.05). In this group, supernumerary deciduous teeth (2.83%), giroversion of permanent teeth (2.31%), and partial anodontia (1.82%) were the most frequent dental anomalies. In addition, an increase was observed in the mandibular angle size in the FXS group (p<0.05). Conclusion: We conclude that knowledge of dental radiographic changes is of great importance for dental surgeons to plan the treatment of these individuals.

Avaliação da ocorrência de ramificações dos canais mandibulares em regiões afetadas ou não por inflamação por meio de tomografia computadorizada de feixe cônico / Mandibular canal branching and dental inflammation assessed through cone beam computed tomography

O canal mandibular precisa ser considerado em diversos procedimentos odontológicos, com vistas a evitar injúrias do nervo alveolar inferior. A ocorrência de variações anatômicas do canal mandibular aumenta o risco de lesões neurovasculares. Sensibilidade aumentada e falhas em procedimentos anestésicos em mandíbulas, especialmente em casos com inflamação, também podem estar relacionadas com alterações da inervação local. Este estudo visou avaliar a ocorrência de ramificações dos canais mandibulares em regiões afetadas por inflamação dentária, por meio de tomografia computadorizada de feixe cônico (TCFC), com o intuito de verificar se há algum relacionamento entre ramificações e inflamação. Uma base de dados de 2.484 TCFCs foi revisada para identificar ramificações dos canais mandibulares e inflamação dentária. A amostra final foi pareada para idade e gênero. As ramificações próximas aos dentes posteriores foram consideradas como variável dependente. A ocorrência e localização de inflamação dentária, assim como as medidas dos níveis de cinza nas mesmas regiões, foram consideradas como variáveis independentes. Os testes de Kolmogorov-Smirnov, Qui-quadrado, teste-T e análise por regressão logística foram aplicados para verificar o relacionamento estatístico dos dados (P<0,05). As lesões mais relacionadas às ramificações foram lesões endoperio e lesões apicais. Gênero (P=0,308) e idade (P=0,728) não mostraram associação com a ocorrência de ramificações dos canais mandibulares. A ocorrência de inflamação aumentou o risco para a ocorrência de ramificações dos canais mandibulares próximas aos dentes posteriores. (P<0,001; OR=11,640; IC-95%: 4.327-31.311). As lesões mais frequentemente associadas com as ramificações apresentaram origem endodôntica. Foi verificada associação entre as ramificações dos canais mandibulares e inflamação dentária na região dos dentes posteriores

The mandibular canal must be considered in several dental procedures in order to avoid injuries of the alveolar inferior nerve. The occurrence of anatomical variations of the mandibular canal increases the risk of neurovascular injuries. An increased sensitivity and failed anesthetic procedures in mandibles, especially in cases with inflammation, can be also related with alterations of the local innervation. This study aimed to assess the occurrence of mandibular canal branching (MCB) in alveolar ridges affected by dental inflammation by means of cone beam computed tomography (CBCT), in order to verify if there is some relationship between MCB and dental inflammation. A database of 2,484 CBCTs was reviewed for identifying mandibular canal branching (MCB) and dental inflammation in mandibular alveolar ridges. The final sample was matched by age and gender. MCB nearby the posterior teeth was considered as the dependent variable. Dental inflammation occurrence and location as well as measurements of gray levels at the same region were assessed as independent variables. The Kolmogorov-Smirnov, Chi-square, T-test and multiple logistic regression analysis were applied to verify the statistical relationship of the data (P<0.05). The most frequent inflammatory lesion was apical radiolucency with endodontic origin. The lesions mostly related to MCB were combined endodontic and periodontal lesions and apical lesions. Gender had no influence on mandibular canal branching (P=0.308), not did age (P=0.728). The occurrence of dental inflammation increased the risk for occurrence of the MCB nearby posterior teeth (P<0.001; OR=11.640; CI-95% 4.327-31.311). The gray levels had a minor role on the presence of MCB (P=0.002; OR=1.002; CI95% 1.002-1.003). The lesions most often associated with the branches had endodontic origin. An association between MCB situated around the posterior teeth and dental inflammation was found

Impactación por odontoma en asociación con alteración de la fórmula dentaria / Impaction caused by odontoma associated with altered dental formula

Los odontomas son entidades odontogénicas mixtas, compuestas por una mezcla de células odontogénicas epiteliales y mesenquimatosas diferenciadas. Por lo inusual del hecho el objetivo de nuestro trabajo fue presentar un caso de asociación de impactación dentaria por un odontoma con la alteración de la fórmula dental. Se trata de un paciente masculino de 26 años, que acudió a la consulta externa de Cirugía Maxilofacial refiriendo dolor. Al examen físico se detectó asimetría facial por aumento de volumen duro elástico del tercio facial inferior derecho. Al examen físico bucal se observó persistencia del 65 y 85, ausencia clínica del 15, 47 y 48 con expansión de las corticales vestibular y lingual en región mandibular posterior derecha (región molar y retromolar) y presencia de una apertura en la mucosa de aproximadamente 8 mm por distal del 46, en la cima del reborde alveolar, de forma redondeada. En el estudio ortopantomográfico se visualizó una imagen radiopaca irregular en sus bordes, de 3 cm, asociada a la oligodoncia del 48 e impactación del 47, por lo que se decidió realizar la exéresis quirúrgica de la lesión conjuntamente con el 47, indicándose estudio histopatológico que confirmó la presencia de un odontoma complejo con áreas de tejido blando periférico que mostraban inflamación crónica. El paciente se mantiene bajo seguimiento clínico e imagenológico en su tercer mes postoperatorio. El objetivo de nuestro trabajo fue presentar un caso de asociación de impactación dentaria por un odontoma con la alteración de la fórmula dental(AU)

The mixed odontogenic odontomas are entities composed of a mixture of differentiated odontogenic epithelial and mesenchymal cells. The objective of this paper was to presente an unusual case of association of dental impaction caused by odontoma and altered dental formula. A male patient aged 26 years, who felt pain, attended the outpatient Oral and Maxillofacial Surgery service. The physical examination found facial asymmetry with facial hard elastic augmentation in the right facial lower third. The Intraoral physical examination showed persistence of oral 65th and 85th , clinical absence of 15th , 47th and 48th with expansion of the vestibular and lingual cortices in the right posterior mandibular area (retromolar and molar regions) and presence of rounded mucosal opening about 8 mm distal to the 46th , on top of the alveolar ridge. In the orthopantomographic study, a ± 3cm radiopaque image with irregular edges, associated with oligodontia of the 48th and impaction of the 47th , were observed. It was decided to surgically remove the lesion together with the 47th and to indicate histopathological study. It was confirmed that the patient had a complex odontoma with peripheral soft tissue areas that showed chronic inflammation. The patient is still followed-up from the clinical and imaging viewpoints after three months of surgery(AU)

Multiple talon cusps and dens invaginatus associated with other dental anomalies - an unusual report

Talon cusp is a dental anomaly that occurs as an accessory cusp like structure from the cingulum of maxillary or mandibular anterior teeth. Dens invaginatus is a developmental variation which arises as a result of an invagination on the surface of a tooth crown before calcification has occurred. An unusual case of multiple talon cusps affecting the maxillary central incisors and the canines bilaterally together with other dental abnormalities viz dens invaginatus affecting the maxillary lateral incisors, microdontia, short roots, reduced alveolar bone height, dilaceration of the described posterior teeth, anterior open bite and bilateral posterior cross bite in a 35 year old male. The presence of these dental anomalies in a single patient is very rare and this is perhaps the first case report of this nature. None of these anomalies alone are particularly uncommon but they have not previously been reported together. The occurrence of these anomalies is probably incidental as the conditions are aetiologically unrelated and no developmental syndrome was identified

An unusual case of non-syndromic occurrence of multiple dental anomalies.

Dental anomalies have been known to occur in humans due to a variety of genetic and environmental factors. Combinations of dental anomalies are known to be associated with specific syndromes. A few cases of multiple dental anomalies have been reported in patients with no generalized abnormalities. This case report describes an unusual occurrence of a combination of dental anomalies in an apparently normal healthy 12-year-old female patient. The dental anomalies in this patient were multiple dens invaginatus, generalized enamel hypoplasia, generalized microdontia, root resorption and multiple periapical lesions, shovel shaped incisors, cup shaped premolars, taurodontism, hypodontia and supernumerary teeth.

clinical and radiographic survey of selected dental anomalies and conditions in a Saudi Arabian population

The prevalence rates of 10 selected dental anomalies were determined clinically and radiographically among 1,010 dental patients of Saudi Arabian nationality residing in Jeddah. Saudi Arabia. Results showed that hypodontia was the most prevalent [9.41%] followed by taurodontism [8.61%]; microdontia [5.35%]; and diastema [4.46%]. Other anomalies were found at lower frequencies ranging from 0.20% for transposition to 1.19% for dilaceration. Comparing these results with other studies showed that these anomalies occur at different frequencies among various countries and communities in the world