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1.
Genet Med ; 26(7): 101126, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38529886

ABSTRACT

PURPOSE: DISP1 encodes a transmembrane protein that regulates the secretion of the morphogen, Sonic hedgehog, a deficiency of which is a major cause of holoprosencephaly (HPE). This disorder covers a spectrum of brain and midline craniofacial malformations. The objective of the present study was to better delineate the clinical phenotypes associated with division transporter dispatched-1 (DISP1) variants. METHODS: This study was based on the identification of at least 1 pathogenic variant of the DISP1 gene in individuals for whom detailed clinical data were available. RESULTS: A total of 23 DISP1 variants were identified in heterozygous, compound heterozygous or homozygous states in 25 individuals with midline craniofacial defects. Most cases were minor forms of HPE, with craniofacial features such as orofacial cleft, solitary median maxillary central incisor, and congenital nasal pyriform aperture stenosis. These individuals had either monoallelic loss-of-function variants or biallelic missense variants in DISP1. In individuals with severe HPE, the DISP1 variants were commonly found associated with a variant in another HPE-linked gene (ie, oligogenic inheritance). CONCLUSION: The genetic findings we have acquired demonstrate a significant involvement of DISP1 variants in the phenotypic spectrum of midline defects. This underlines its importance as a crucial element in the efficient secretion of Sonic hedgehog. We also demonstrated that the very rare solitary median maxillary central incisor and congenital nasal pyriform aperture stenosis combination is part of the DISP1-related phenotype. The present study highlights the clinical risks to be flagged up during genetic counseling after the discovery of a pathogenic DISP1 variant.


Subject(s)
Alleles , Holoprosencephaly , Phenotype , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Anodontia , Cleft Lip/genetics , Cleft Lip/pathology , Cleft Palate/genetics , Cleft Palate/pathology , Craniofacial Abnormalities/genetics , Craniofacial Abnormalities/pathology , Heterozygote , Holoprosencephaly/genetics , Holoprosencephaly/pathology , Homozygote , Incisor/abnormalities , Membrane Proteins/genetics , Mutation, Missense/genetics
2.
J Esthet Restor Dent ; 36(8): 1093-1099, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38291733

ABSTRACT

OBJECTIVE: 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. CLINICAL CONSIDERATIONS: 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. CONCLUSIONS: 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. CLINICAL SIGNIFICANCE: 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.


Subject(s)
Incisor , Maxilla , Female , Humans , Male , Anodontia/therapy , Biomimetics , Dental Restoration, Permanent/methods , Esthetics, Dental , Incisor/abnormalities , Maxilla/abnormalities , Tooth, Deciduous/abnormalities , Adolescent
3.
Int J Mol Sci ; 25(13)2024 Jun 27.
Article in English | MEDLINE | ID: mdl-39000154

ABSTRACT

Putatively, tooth agenesis was attributed to the initiation failure of tooth germs, though little is known about the histological and molecular alterations. To address if constitutively active FGF signaling is associated with tooth agenesis, we activated Fgf8 in dental mesenchyme with Osr-cre knock-in allele in mice (Osr2-creKI; Rosa26R-Fgf8) and found incisor agenesis and molar microdontia. The cell survival assay showed tremendous apoptosis in both the Osr2-creKI; Rosa26R-Fgf8 incisor epithelium and mesenchyme, which initiated incisor regression from cap stage. In situ hybridization displayed vanished Shh transcription, and immunostaining exhibited reduced Runx2 expression and enlarged mesenchymal Lef1 domain in Osr2-creKI; Rosa26R-Fgf8 incisors, both of which were suggested to enhance apoptosis. In contrast, Osr2-creKI; Rosa26R-Fgf8 molar germs displayed mildly suppressed Shh transcription, and the increased expression of Ectodin, Runx2 and Lef1. Although mildly smaller than WT controls prenatally, the Osr2-creKI; Rosa26R-Fgf8 molar germs produced a miniature tooth with impaired mineralization after a 6-week sub-renal culture. Intriguingly, the implanted Osr2-creKI; Rosa26R-Fgf8 molar germs exhibited delayed odontoblast differentiation and accelerated ameloblast maturation. Collectively, the ectopically activated Fgf8 in dental mesenchyme caused incisor agenesis by triggering incisor regression and postnatal molar microdontia. Our findings reported tooth agenesis resulting from the regression from the early bell stage and implicated a correlation between tooth agenesis and microdontia.


Subject(s)
Fibroblast Growth Factor 8 , Incisor , Mesoderm , Molar , Animals , Fibroblast Growth Factor 8/genetics , Fibroblast Growth Factor 8/metabolism , Mice , Incisor/abnormalities , Incisor/metabolism , Mesoderm/metabolism , Mesoderm/pathology , Molar/abnormalities , Molar/metabolism , Anodontia/genetics , Anodontia/metabolism , Anodontia/pathology , Apoptosis , Hedgehog Proteins/metabolism , Hedgehog Proteins/genetics , Lymphoid Enhancer-Binding Factor 1/metabolism , Lymphoid Enhancer-Binding Factor 1/genetics , Core Binding Factor Alpha 1 Subunit/genetics , Core Binding Factor Alpha 1 Subunit/metabolism , Signal Transduction , Gene Expression Regulation, Developmental , Odontogenesis/genetics , Mice, Transgenic
4.
Eur J Orthod ; 46(3)2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38656537

ABSTRACT

INTRODUCTION: The most common treatment approaches for patients missing maxillary lateral incisors are implant replacement (IT) and orthodontic space closure (SC). Treatment techniques change and improve over time, and it is of interest to know if improvements differ between the methods. AIM: To compare the aesthetic outcome and other clinical findings in patients with one or two missing maxillary lateral incisors who were treated with a 10-year difference in time, with either orthodontic space closure or implant replacement. MATERIAL AND METHODS: A total of 88 patients were included in the study. Forty-four patients treated between 2011 and 2018 were included as the latter cohort (LC). The LC was compared to the early cohort (EC; n = 44), treated between 2001 and 2008. A total of 132 teeth was analysed: 62 teeth in the EC (28 teeth in IT cases and 34 teeth in SC cases) and 70 teeth in the LC (34 teeth in IT cases and 36 teeth in SC cases). Long-term clinical and aesthetic outcomes were evaluated. RESULTS: An improvement over time was found in crown length, BoP, papilla, the inclination of incisors, and overall appearance in IT cases and in crown colour and overbite in SC cases. A deterioration over time was found in crown length and BoP among the SC cases. CONCLUSION: Among the IT cases, an improvement in outcomes was noted over time. When comparing SC cases the colour of the crown and overbite had improved, while crown length and BoP had deteriorated over time.


Subject(s)
Esthetics, Dental , Incisor , Orthodontic Space Closure , Humans , Incisor/abnormalities , Incisor/pathology , Female , Male , Orthodontic Space Closure/methods , Maxilla , Anodontia/therapy , Time Factors , Adult , Adolescent , Treatment Outcome , Retrospective Studies , Young Adult
5.
BMC Oral Health ; 24(1): 225, 2024 Feb 13.
Article in English | MEDLINE | ID: mdl-38350932

ABSTRACT

BACKGROUND: Double teeth are dental anomalies that can lead to aesthetic and orthodontic problems. CASE PRESENTATION: This 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. CONCLUSIONS: Both 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.


Subject(s)
Anodontia , Incisor , Incisor/abnormalities , Tooth, Supernumerary , Female , Humans , Incisor/diagnostic imaging , Follow-Up Studies , Tooth Crown/abnormalities , Crowns , Tooth, Supernumerary/diagnostic imaging , Tooth, Supernumerary/surgery , Maxilla
6.
BMC Oral Health ; 24(1): 592, 2024 May 22.
Article in English | MEDLINE | ID: mdl-38778368

ABSTRACT

BACKGROUND: Treating the coronal dens invaginatus (CDI) with pulp infection commonly involves the removal of invagination, which increases the risk of perforation and fracture, and compromises the tooth structure. Minimally invasive endodontic management of CDI is highly recommended. This report describes two cases of type II CDI with the application of personalized templates. CASE PRESENTATION: Two cases of type II CDI, affecting the main root canal in a maxillary canine and a lateral incisor, were diagnosed. A guided endodontics (GE) approach was applied. Cone-beam computed tomography and intraoral scans were imported and aligned in a virtual planning software to design debridement routes and templates. The MICRO principle (which involves the aspects of Mechanical (M) debridement, Irrigation (I), Access cavities (C), Rectilinear routes (R), and Obstruction (O)) was proposed for designing optimal debridement routes for future applications. The templates were innovatively personalized and designed to preserve the tooth structure maximally while effectively debriding the root canal. Root canal treatment with supplementary disinfection was then performed. The follow-up of the two patients revealed favorable clinical and radiographic outcomes. CONCLUSIONS: The GE approach could be a feasible method for preserving healthy dental structure while effectively debriding the root canal, thereby achieving successful and minimally invasive endodontic treatment for CDI.


Subject(s)
Cone-Beam Computed Tomography , Dens in Dente , Root Canal Therapy , Humans , Debridement/methods , Dens in Dente/therapy , Dens in Dente/complications , Dens in Dente/diagnostic imaging , Incisor/abnormalities , Incisor/diagnostic imaging , Minimally Invasive Surgical Procedures/methods , Root Canal Therapy/methods
7.
BMC Oral Health ; 24(1): 1037, 2024 Sep 04.
Article in English | MEDLINE | ID: mdl-39232693

ABSTRACT

BACKGROUND: Palatal groove represents a relatively uncommon developmental root anomaly, usually found on the palatal aspect of maxillary incisors. While its origin is controversial, its presence predisposes to severe periodontal defects. AIM: This study aimed to provide a systematic review of the literature focusing on the varied diagnostic techniques and treatment modalities for periodontal lesions arising from the presence of palatal groove. Based on the existing evidence and knowledge, the study also provides a comprehensive decisional tree, guiding clinicians in the challenging decision-making process face to a palatal groove. METHODS: The literature search was conducted on Medline and Cochrane databases by two independent reviewers, who also performed the screening and selection process, looking for English written articles reporting on diagnosis and management (all treatment approaches) of periodontal lesion(s) associated with a palatal groove. Based on this literature, a comprehensive decisional tree, including a standardized palatal groove evaluation and tailored treatment approaches, is proposed. Moreover, a clinical case is described to demonstrate the practical application of the developed decisional tree. RESULTS: Over a total of 451 articles initially identified, 34 were selected, describing 40 patients with 40 periodontal lesions associated with palatal grooves. The case report illustrates a deep, large, circumferential intra-bony defect on the palatal side of the tooth #22 associated with a shallow, moderately long palatal groove in an 18-year-old male patient. Following reevaluation, a single flap surgery was deemed necessary, combined with a regenerative procedure. At 2 years post-treatment, the tooth #22 is healthy, in a functional and esthetic position. The decision-making process, based on local and systemic patient's conditions, should allow an early and precise diagnosis to prevent further complications and undertake an adequate treatment. CONCLUSION: Palatal grooves are relatively rare; however, they are frequently associated with severe periodontal defects. The identification, diagnosis, prompt, and tailored management of the associated lesion is essential to mitigate potential periodontal and endodontic complications related to the presence of palatal groove. SYSTEMATIC REVIEW REGISTRATION: [ https://www.crd.york.ac.uk/prospero/ ], identifier [C CRD42022363194].


Subject(s)
Decision Trees , Periodontal Diseases , Humans , Periodontal Diseases/complications , Periodontal Diseases/therapy , Tooth Root/abnormalities , Tooth Root/diagnostic imaging , Incisor/abnormalities , Palate/pathology , Palate/abnormalities
8.
J Pak Med Assoc ; 74(7): 1367-1369, 2024 Jul.
Article in English | MEDLINE | ID: mdl-39028074

ABSTRACT

Concrescence is a rare dental anomaly in which two adjacent teeth are united only by their cementum. Concrescence most frequently occurs in molars, especially a third mandibular molar and a supernumerary tooth. It is rarely seen in the maxillary anterior teeth. This case report is the first in the literature which details the successful treatment of a concrescence between the maxillary central incisor and a supernumerary tooth through multidisciplinary therapy. The treatment plan included root canal treatment, endodontic microsurgery, and prosthodontic treatment.


Subject(s)
Microsurgery , Root Canal Therapy , Humans , Microsurgery/methods , Root Canal Therapy/methods , Incisor/abnormalities , Incisor/surgery , Tooth, Supernumerary/surgery , Tooth, Supernumerary/diagnostic imaging , Male , Female , Adult
9.
Gen Dent ; 72(4): 31-36, 2024.
Article in English | MEDLINE | ID: mdl-38905602

ABSTRACT

Hearing impairments and dental anomalies are found in many genetic syndromes. Otodental syndrome is a rare combination of hearing loss and the presence of a pathognomonic dental phenotype known as globodontia, in which the tooth exhibits an abnormal globe shape. There is no histologic evidence of structural anomalies in the enamel, dentin, or pulp. This report describes the case of a 12-year-old boy who had hearing loss and 2 supernumerary globe-shaped teeth in the sites of the permanent maxillary central incisors. The diagnosis of otodental syndrome was established based on the clinical, radiographic, and histologic features, but other conditions, including dens evaginatus, talon cusp, dens invaginatus, and compound odontoma, should be included in the differential diagnosis. Dental treatment consisted of the extraction of both anomalous teeth, allowing spontaneous eruption of the impacted permanent central incisors. Early diagnosis of otodental syndrome permits a multidisciplinary approach to prevent other pathologic conditions, reduce functional damage, and avoid social problems.


Subject(s)
Incisor , Humans , Male , Child , Incisor/abnormalities , Tooth, Supernumerary/complications , Tooth, Supernumerary/diagnostic imaging , Tooth, Supernumerary/surgery , Tooth Abnormalities/diagnosis , Diagnosis, Differential , Abnormalities, Multiple , Bone Diseases, Developmental , Intellectual Disability , Facies
10.
Am J Orthod Dentofacial Orthop ; 163(2): 233-242, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36400643

ABSTRACT

INTRODUCTION: The alveolar bone is an essential consideration when planning treatment for patients with tooth agenesis. This study evaluated the changes in the alveolar bone and adjacent teeth in patients with a congenitally missing mandibular lateral incisor using cone-beam computed tomography. METHODS: Twenty-three nonorthodontically treated adults with a unilateral congenitally missing mandibular lateral incisor were the missing group (M group). The control group (C group) consisted of 23 nonorthodontically treated adults with normal occlusion and no missing teeth. First, the difference in the arch perimeter between the groups was compared at the cementoenamel junction (CEJ) level and the root apex (RA) level. Next, the root divergence of the anterior teeth in the M group was observed. Finally, the alveolar bone thickness ratio was compared between the M and C groups at different vertical levels. RESULTS: The arch perimeter was significantly decreased in the M group at the CEJ and RA levels (P <0.05). Root divergence was observed adjacent to the missing site (P <0.0001). There were a reduction in total and cancellous cortical alveolar bone thickness (ABT) ratios at the 3-, 6-, and 9-mm positions (P <0.05). The buccal cortical ABT ratios decreased at the 3-and 6-mm positions. The lingual ABT ratio increased at the 9-mm position (P <0.05). CONCLUSIONS: The congenitally missing mandibular lateral incisor caused a reduction in the arch perimeter in the CEJ area and the RA area. The root divergences were observed in the teeth adjacent to the missing areas. A significant decrease in the buccal cortical bone and cancellous bone was observed in the missing area.


Subject(s)
Anodontia , Incisor , Adult , Humans , Incisor/diagnostic imaging , Incisor/abnormalities , Tooth Root , Anodontia/diagnostic imaging , Anodontia/therapy , Tooth Cervix , Cone-Beam Computed Tomography , Maxilla
11.
J Clin Pediatr Dent ; 47(2): 108-116, 2023 Mar.
Article in English | MEDLINE | ID: mdl-36890748

ABSTRACT

Kabuki syndrome (KS) is an epigenetic machinery multisystem disorder with peculiar facial gestalt and dental-oral anomalies. This report describes the case of a KS patient with congenital hyperinsulinism, growth hormone deficiency and novel heterogenous missense mutations in exon 25 of the KDM6A (c.3715T>G, p.Trp1239Gly) and exon 1 of the ABCC8 (c.94A>G, p.Asn32Asp) genes. She presented with solitary median maxillary central incisor (SMMCI) and mandibular incisor hypodontia, which could be a unique dental manifestation in KS 2.


Subject(s)
Anodontia , Female , Humans , Mutation, Missense , Incisor/abnormalities , Histone Demethylases/genetics , Mutation , Sulfonylurea Receptors/genetics
12.
J Clin Pediatr Dent ; 47(2): 40-49, 2023 Mar.
Article in English | MEDLINE | ID: mdl-36890741

ABSTRACT

Maxillary central incisor impaction is one of the most common types of dental anomalies in children. Treatment of impacted central incisors is complicated and challenging given the position of the impacted central incisors, root development, and the complexity of the crown eruption direction. This study aimed to describe the use of a new multifunctional appliance for the treatment of impacted maxillary central incisors. This article reports the use of a novel appliance for the treatment of impacted maxillary central incisors. We describe the cases of two young patients with labial horizontally impacted maxillary central incisors. Both patients were treated using this novel appliance. Therapeutic effects were evaluated by comparing the pretreatment results, posttreatment cone-beam computed tomography images, and posttreatment clinical examination results. At the end of the treatment period using the novel appliance, the impacted central incisors had successfully been properly aligned in the dental arch, and the tooth roots had not resorbed. Both patients exhibited good dental alignment, with restored function and acceptable aesthetics. This article demonstrates that the new appliance was comfortable, convenient, safe, and effective in the treatment of impacted maxillary central incisors and that its clinical use should be promoted in the future.


Subject(s)
Incisor , Tooth, Impacted , Child , Humans , Incisor/diagnostic imaging , Incisor/abnormalities , Maxilla , Tooth Root/abnormalities , Tooth Eruption , Tooth, Impacted/diagnostic imaging , Tooth, Impacted/therapy , Cone-Beam Computed Tomography/methods
13.
Bull Tokyo Dent Coll ; 64(2): 67-74, 2023 Jun 10.
Article in English | MEDLINE | ID: mdl-37183009

ABSTRACT

Dens invaginatus is a morphological abnormality of the tooth that results from a developmental anomaly during tooth formation, in which part of the enamel and dentin of the crown invaginates into the pulp cavity. This report describes a case of a maxillary lateral incisor with apical periodontitis apparently caused by Oehlers Type III dens invaginatus. The patient was a 69-year-old man who visited our clinic complaining of discomfort in the maxillary right lateral incisor. Cone-beam computed tomography (CBCT) revealed dens invaginatus of the maxillary lateral incisor and a sinus tract in the maxillary central incisor region, which was derived from apical periodontitis of the maxillary lateral incisor. The dens invaginatus was accompanied by a complex root canal morphology. Treatment, which was performed using a dental surgical microscope, had a favorable outcome. The patient remains in good condition at 1 year postoperatively.


Subject(s)
Dens in Dente , Periapical Periodontitis , Male , Humans , Aged , Dental Pulp Cavity/abnormalities , Dens in Dente/diagnostic imaging , Dens in Dente/therapy , Dens in Dente/complications , Incisor/diagnostic imaging , Incisor/surgery , Incisor/abnormalities , Root Canal Therapy/methods , Periapical Periodontitis/diagnostic imaging , Periapical Periodontitis/surgery , Inflammation , Cone-Beam Computed Tomography/methods
14.
Clin Oral Implants Res ; 33(8): 844-857, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35763401

ABSTRACT

OBJECTIVES: To report the clinical, radiographic, esthetic, and patient-reported outcomes after placement of a newly developed narrow-diameter implant (NDI) in patients with congenitally missing lateral incisors (MLIs). MATERIALS AND METHODS: Patients with MLIs with a mesio-distal distance between the canine and the central incisor of 5.9-6.3 mm received a dental implant with a diameter of 2.9 mm (Test), while a diameter of 3.3 mm (Control) was used when the distance was 6.4-7.1 mm. After healing, a cement-retained bi-layered zirconia crown was fabricated. At the 1-year follow-up (T2), implant survival rate, marginal crestal bone level (CBL) changes, biological and technical complications were registered. The esthetic outcome was assessed by using the Copenhagen index score, and the patient-reported outcomes were recorded using the OHIP-49 questionnaire. RESULTS: One hundred patients rehabilitated with 100 dental implants Ø0.9 mm (n = 50) or Ø3.3 mm (n = 50) were included. One Ø3.3 mm implant was lost, and seven patients dropped out of the study, yielding an implant survival rate of 99% (p = 1.000). At T2 a. CBL of -0.19 ± 0.25 mm (Test) and -0.25 ± 0.31 mm (Control) was detected, with no statistically significant difference between the groups (p = .342). Good to excellent esthetic scores (i.e., 1-2) were recorded in most of cases. Technical complications (i.e., loss of retention, abutment fracture, and chipping of veneering ceramic) occurred once in three patients with no statistically significant difference between the groups (p > .05). OHIP scores did not differ significantly at follow-ups between groups (p = .110). CONCLUSION: The use of Ø2.9 mm diameter implants represents as reliable a treatment option as Ø3.3 mm implants, in terms of CBL changes, biological and technical complications. Favorable esthetics and patient-reported outcomes were recorded for both groups.


Subject(s)
Dental Implants, Single-Tooth , Dental Implants , Crowns , Esthetics, Dental , Incisor/abnormalities , Prospective Studies
15.
J Prosthet Dent ; 128(1): 1-3, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35963642

ABSTRACT

Predictable shade matching and communicating shade information to the dental laboratory technician have proved to be a capricious undertaking. Numerous confounding variables exist for the observer-which may be extrinsic (such as light source and background color), intrinsic (such as genetics and eye fatigue), or a combination of both. To address these shortcomings, low-cost, easy-to-operate, color analysis instrumentation and software programs have been engineered for objective shade selection and precise color analysis. The shade matching protocols that now exist have made even the most challenging esthetic treatments predictable for both the clinician and the dental laboratory technician.


Subject(s)
Esthetics, Dental , Incisor , Anodontia , Calibration , Color , Incisor/abnormalities , Technology
16.
J Prosthet Dent ; 128(6): 1265-1274, 2022 Dec.
Article in English | MEDLINE | ID: mdl-34034898

ABSTRACT

STATEMENT OF PROBLEM: Patients diagnosed with a cleft palate often have a congenitally missing maxillary lateral incisor. The congenital cleft presents the practitioner with challenges including the quantity and quality of bone, a surgically managed cleft correction, and limited clinical space. PURPOSE: The purpose of the present prospective investigation was to report preliminary results at the 1-year follow-up for this planned 5-year investigation of narrow diameter implants used to restore a missing lateral incisor in patients with a cleft palate. MATERIAL AND METHODS: Fourteen study participants with a cleft palate and a missing maxillary lateral incisor were enrolled based on established criteria. Narrow diameter implants (AstraTech OsseoSpeed TX 3.0S and 3.5 mm) were placed by using a 2-stage protocol and restored. All study participants received an Atlantis abutment and a cement-retained crown. Four probing depth measurements and bleeding on probing were measured at baseline and at 1 year. Probing depth measurements were evaluated using a 2-way repeated measures ANOVA with Tukey-Kramer multiple comparisons tests. Radiographic marginal bone loss was measured at 1-year by using a digital subtraction technique and evaluated by using a repeated measures ANOVA. Pretreatment cone beam computed tomography (CBCT) images were used to measure a mean gray level that was proportional to bone mineral density (BMD) in the implant site. One-way mixed ANOVA was used to compare the mean gray level and average implant stability quotient (ISQ) loading. A Pearson correlation was also tested between those parameters (α=.05) for each statistical analysis. RESULTS: The mean marginal bone loss at 1 year was 0.601 ±0.48 mm. Regarding probing depth measurements, a 2-way repeated measures ANOVA found both the location (P=.012) and time (P=.009) were significant. The Tukey-Kramer multiple comparisons test showed a significant difference between the buccal and distal site (P=.006) from baseline to 1-year follow-up. CONCLUSIONS: Narrow diameter implants are a reliable treatment for replacing a missing lateral incisor in patients with a cleft palate at 1 year, with an implant survival rate of 100% and implant success rate of 94% using the established criteria. A negative association was found between the bone mineral density and the implant stability in the alveolar cleft site of a patient with a cleft palate. The peri-implant soft tissue probe depths exhibited significant change during the first year.


Subject(s)
Alveolar Bone Loss , Cleft Palate , Dental Implants, Single-Tooth , Dental Implants , Humans , Incisor/surgery , Incisor/abnormalities , Cleft Palate/complications , Cleft Palate/surgery , Prospective Studies
17.
Am J Orthod Dentofacial Orthop ; 161(6): 866-877, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35123837

ABSTRACT

This case report presents an unusual multidisciplinary treatment and longitudinal follow-up of a female patient with complete agenesis of the mandibular incisors, diagnosed with Hanhart syndrome. The orthodontic treatment started when aged 11 years and comprised orthodontic traction of the impacted permanent maxillary canine, followed by a Herbst appliance for mesial movement of the mandibular posterior teeth and reduction of the agenesis space. The mandibular canines replaced 2 out of 4 absent incisors, and 1 dental implant was placed between the mandibular right canine and the first premolar. A satisfactory final occlusion was achieved, and the 12-year follow-up showed the stability of results. Multidisciplinary and individualized treatment is important for an adequate rehabilitation of craniofacial patients presenting multiple agenesis.


Subject(s)
Incisor , Orthodontic Appliances, Functional , Abnormalities, Multiple , Craniofacial Abnormalities , Cuspid , Female , Follow-Up Studies , Humans , Incisor/abnormalities , Limb Deformities, Congenital , Maxilla
18.
Am J Orthod Dentofacial Orthop ; 162(2): e82-e95, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35752511

ABSTRACT

INTRODUCTION: This study aimed to evaluate the 3-dimensional tooth crown symmetry and the crown volumes of maxillary and mandibular teeth in patients with unilateral or bilateral missing or peg-shaped maxillary lateral incisors. METHODS: Six groups were established for the possible clinical variations in patients with unilateral missing or peg-shaped maxillary lateral incisors, bilateral presence of these tooth anomalies, and a control group (CG) with normal lateral incisors. The study was conducted on digital dental models of 132 patients. The morphologic symmetry of the antimere teeth was investigated using 3-dimensional deviation analysis. Volumes of contralateral teeth were compared within and among groups for the maxilla and mandible. Furthermore, volumes of teeth were compared in missing and peg-shaped quadrants and quadrants of CG. Intergroup differences were tested using one-way analysis of variance and Kruskal-Wallis tests, whereas paired t and Wilcoxon tests were used for parametric and nonparametric variables, respectively, for intragroup comparisons. RESULTS: Significant deviations in symmetry of antimere teeth were not detected (P >0.05). The volumes of mandibular central and lateral incisors in missing or peg-shaped lateral incisor groups were smaller than in the CG (P <0.05). Per quadrant analysis, volumes of the maxillary central incisor and mandibular central incisors, canines, and first molars in quadrants with missing or peg-shaped lateral incisors were smaller than in the control quadrants (P <0.05). CONCLUSIONS: Neither unilateral nor bilateral presence of missing or peg-shaped maxillary lateral incisors affected the morphologic symmetry of antimere teeth but did affect tooth volume, especially in the mandibular arch.


Subject(s)
Incisor , Maxilla , Tooth Abnormalities , Humans , Imaging, Three-Dimensional , Incisor/abnormalities , Incisor/diagnostic imaging , Mandible/diagnostic imaging , Maxilla/diagnostic imaging , Tooth Crown/anatomy & histology , Tooth Crown/diagnostic imaging
19.
BMC Oral Health ; 22(1): 608, 2022 12 15.
Article in English | MEDLINE | ID: mdl-36522742

ABSTRACT

BACKGROUND: The aim of the study was to evaluate the cephalometric and dentoalveolar characteristics of maxillary lateral incisor agenesis patients, and to compare the findings to a matched control group without tooth agenesis, excluding third molars, from the same population. METHODS: The pre-orthodontic records of 72 non-growing patients, who were treated at the Orthodontic Department, Faculty of Dentistry, Alexandria University, were used to address the aim of this retrospective study. Patients having unilateral or bilateral maxillary lateral incisor agenesis, with no history of previous orthodontic treatment, congenital craniofacial malformations, facial trauma, or surgeries were divided into two test groups based on the pattern of maxillary lateral incisors agenesis (group I: unilateral (UMLIA), group II: bilateral (BMLIA)). A control group (group III (CTRL)) having a complete set of permanent dentition (excluding third molars), and having no dental anomalies was age-matched with the test groups. Measurements were performed on the pre-orthodontic lateral cephalometric radiographs and the pre-orthodontic digital dental casts. The measured variables were compared between the groups using one-way ANOVA and Kruskal Wallis tests according to the normality of the variable. In case of significant results, both tests were followed by multiple pairwise comparisons using Bonferroni adjusted significance level. Significance level was set at P < 0.05. RESULTS: BMLIA group showed a smaller SNA angle and maxillary length, a more negative ANB angle and Wits appraisal, and a larger Maxillo-mandibular differential than UMLIA and/or CTRL group. The dental and soft tissue cephalometric measurements did not show any significant differences between the groups. Dentoalveolar cast measurements showed that BMLIA patients presented with significantly smaller maxillary inter-canine width than UMLIA and CTRL patients. CONCLUSIONS: Cephalometric analysis has shown that subjects with BMLIA have a statistically significant reduced ANB and maxillary length. Tooth eruption may play a role in the development of the maxillary arch.


Subject(s)
Anodontia , Incisor , Humans , Incisor/abnormalities , Cross-Sectional Studies , Retrospective Studies , Anodontia/epidemiology , Cuspid , Maxilla
20.
BMC Oral Health ; 22(1): 583, 2022 12 09.
Article in English | MEDLINE | ID: mdl-36494650

ABSTRACT

BACKGROUND: The radicular groove (RG) is one of the developmental anomalies that is commonly found in maxillary incisors. The formation of radicular groove is initiated around the cingulum and can reach the root at different levels. The incidence of radicular grooves was reported in different countries but there was no published data about the incidence of RG in Saudi Arabia. Therefore, this study aimed to evaluate the incidence of radicular grooves on maxillary lateral incisors in the Saudi population using cone-beam computed tomography (CBCT). METHODS: The dental records of 490 patients (N = 490) with CBCT images of maxillary anterior teeth were screened for inclusion criteria. Then 264 included cases were evaluated independently by two Endodontists. The evaluation was performed on CBCT images in the axial, sagittal, and coronal sections using Planmeca Romexis® software. The following data were recorded for each patient: Patients' age and gender, radicular groove presence or absence, and if it is bilateral or unilateral. The type of radicular groove was recorded according to Gu's classification (type I, II, or III). RESULTS: The incidence rate of radicular grooves in maxillary lateral incisors was 4.9%. RG was found to be unilateral in 61.5% and bilateral in 38.5%. The majority of RG were classified as type I in 69.2%, followed by type II in 15.4%, and type III was found in 15.4%. CONCLUSION: 4.9% of the Saudi population has RG in the upper lateral incisor. This anatomical variation is mostly present as type I on one side only (unilateral).


Subject(s)
Maxilla , Tooth Root , Humans , Tooth Root/diagnostic imaging , Tooth Root/abnormalities , Maxilla/diagnostic imaging , Incidence , Incisor/diagnostic imaging , Incisor/abnormalities , Cone-Beam Computed Tomography/methods
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