Maxillary Sinus and Surrounding Bone Anatomy With Cone Beam Computed Tomography After Multiple Teeth Loss: A Retrospective Multicenter Clinical Study.

PURPOSE: The aim of this multicenter study was to examine the residual alveolar bone anatomy and sinus mucosa pattern at maxillary sinus regions in multiple teeth loss. MATERIALS AND METHODS: This study was conducted with cone beam computed tomography images of 518 patients (267 females and 251 males) with multiple posterior maxillary teeth loss. Variables associated with sinus membrane (SM), sinus dimensions, ostium, septa, sinus neighborhood, alveolar bone height and ridge width, posterior superior alveolar artery, and adjacent roots were evaluated. RESULTS: No (58.2%) or flat (19.3%) thickening morphology was detected at most of the SMs. Membrane thickening and mucosal-like morphology was more prevalent for male patients (P = 0.005). The mean sinus width was relatively low (3.64 ± 3.33 mm) at the 5-mm level and showed an expected increase toward upper levels. Most of the sinus spaces were dimensionally average (39.5%) or wide (44.7%), and no effect of gender was observed in terms of sinus dimensions (P > 0.05). CONCLUSION: Multiple teeth loss plays a role in creating an imaginary sinus anatomy constituted of a relatively narrow space compared with single-tooth loss cases, from 3.6-mm mean coronal width to 11.3 mm in the apical portion.

Combined application of Er:YAG and Nd:YAG lasers in treatment of chronic periodontitis. A split-mouth, single-blind, randomized controlled trial.

BACKGROUND: The aim of the present study was to compare the effectiveness of combined Er:YAG and Nd:YAG laser therapy to that of scaling and root planing with hand instruments in non-surgical treatment of chronic periodontitis. MATERIAL AND METHODS: Twenty-five systemically healthy patients with chronic periodontitis were selected for this study. The quadrants were randomly allocated in a split-mouth design to either combined Er:YAG (160 mJ/pulse, 10 Hz) and Nd:YAG laser (100 mJ/pulse, 20 Hz) therapy (test group) or scaling and root planing alone (control group). At baseline, 1 month and 3 months after treatment, plaque index, gingival index, probing depth, clinical attachment level and bleeding on probing (%), were recorded and gingival crevicular fluid and subgingival plaque samples were taken. The gingival crevicular fluid levels of interleukin-1ß and tumor necrosis factor-α were analyzed by enzyme-linked immunosorbent assay. Quantitative analysis of red complex bacteria was performed using quantitative real-time polymerase chain reaction. RESULTS: The clinical parameters had significantly improved for both groups after treatment. There were statistically significant differences in probing depth and clinical attachment level between the test and control groups only for deep pockets (≥7 mm) (P<.05). No significant differences between the two groups were observed for the biochemical and microbiological parameters at any time points (P>.05). CONCLUSIONS: The present study suggests that a combined course of Er:YAG and Nd:YAG laser therapy may be beneficial particularly in inaccessible areas such as deep pockets on a short-term basis. Further, well-designed studies are required to assess the effectiveness of the combination of these lasers.

General health and oral health status in elderly dental patients in Isparta, Turkey.

The aim of this study was to describe the oral health, general health status and medication use of elderly dental patients 709 voluntary patients, aged 60 years and over, who attended Suleyman Demirel University Faculty of Dentistry for routine dental treatment between March 2008 and April 2009 in Isparta, Turkey, were interviewed for demographic data, systemic diseases, and lists of medications. The majority of the patients (84.4%) had poor oral hygiene according to the Oral Hygiene Index (OHI). The mean level of the study population's decayed, missing, and filled teeth (DMFT) index score was 19.1 ± 7.3. The prevalence of systemic diseases was high (90%). Women were affected by a significantly higher incidence of systemic diseases than men (96.4% vs. 84.3%; P < 0.001). The percentage of the elderly taking medication regularly was 72.6%. Drug adverse effects were determined in 25.5% of the study population, with more adverse effects observed in women (53.3%) than men (46.7%) (P < 0.001).Dentists must be aware of the dental implications that may arise from systemic diseases and medications and should properly modify elderly patients' treatment accordingly.

Oral hygiene and oral flora evaluation in psychiatric patients in nursing homes in Turkey.

CONTEXT: The World Health Organization has stated that psychiatric patients are a group of people who have oral and dental illnesses. AIMS: The aims of this study were to document the oral hygiene of individuals with chronic psychiatric illness, to determine the extraoral and intraoral findings, to detect the dominant microorganisms in oral flora, and to inform clinicians of these findings. SETTINGS AND DESIGN: The study included 100 patients (69 men and 31 women) with different psychiatric illnesses living in a nursing home. They were 19-96 years old (median, 48 years). SUBJECTS AND METHODS: The participants completed a questionnaire about patients' oral health. They underwent extraoral and intraoral examinations. Two swab samples were obtained from the oral mucosa of these patients. Gram preparations were analyzed for leukocytes, bacteria, and yeast. STATISTICAL ANALYSIS USED: Chi-square test and z-test were used. RESULTS: All patients (100%) had the necessary equipment for oral hygiene; however, many (43%) patients had poor oral hygiene. There was a high prevalence of xerostomia (56%) and fissured tongue (61.4%) (among other tongue anomalies). The most commonly isolated microorganisms were coagulase-negative Staphylococcus0 (35.9%), Streptococcus spp. (30.3%), nondiphtheroid Bacilli (16.9%), Staphylococcus aureus (2.3%), Candida spp. (11.8%), and Gram-negative Bacilli (2.8%). CONCLUSIONS: The oral hygiene of most patients was insufficient. The presence of Gram-negative Bacilli growth in the oral flora can be explained by poor hand hygiene. These findings suggest that it is useful to educate individuals about oral hygiene and hand hygiene and to inform the staff and families about this issue.

Clinical and scanning electron microscopy evaluation of the Er,Cr:YSGG laser therapy for treating dentine hypersensitivity: short-term, randomised, controlled study.

Er,Cr:YSGG laser is a rising treatment option for dentine hypersensitivity (DH). However, there is no data available concerning the scanning electron microscope (SEM) evaluation of the clinical application of Er,Cr:YSGG laser in the treatment of DH. The aim of this study was to evaluate and compare the desensitising and tubule occlusion effects of Er,Cr:YSGG laser with different power settings. Twenty patients (60 teeth) participated in this study. For each patient, teeth were randomised to 3 groups. In groups 1 and 2, patients were treated with Er,Cr:YSGG laser at 0.25 and 0.5 W, respectively. In control group, same laser was applied without laser emission. DH was assessed for all groups with a visual analogue scale (VAS). When compared with the baseline data and control group, in both active treatment groups laser irradiation provided a desensitising effect immediately after treatment (P < 0.001). In group 2, VAS scores were significantly lower than group 1. The tubule diameters in the both laser groups were significantly smaller than the control group (P < 0.01). When group 1 compared with group 2, group 2 showed significantly smaller tubule diameters (P < 0.001). Both 0.25 and 0.5 W laser irradiation were effective for the treatment of DH; however, 0.5 W laser irradiation showed best results for the decrease in VAS scores. The SEM findings of the reduction in number/patency of dentine tubules seem to be related to the clinical findings, which were associated with improvement in treatment efficacy.

Dentofacial characteristics of patients with rheumatoid arthritis.

OBJECTIVES: The aims of this study are to evaluate the dentofacial morphology of patients with rheumatoid arthritis (RA) and to compare the morphological data with those of healthy age- and sex-matched control subjects. METHODS: Twenty-seven RA patients (mean age, 45.77 ± 8.64 years) and 25 healthy subjects (mean age, 44.80 ± 8.24 years) participated in this prospective study. Clinical and functional evaluations of the RA patients were assessed. The erythrocyte sedimentation rate, C-reactive protein level, rheumatoid factor level, and anti-citrullinated peptide antibodies (ACPA) titers of RA patients were determined, and DAS28 scores were calculated. Linear and angular measurements were performed on cephalometric tracings and condylar erosion was evaluated on lateral panoramic radiographs. Statistical comparison of the two groups was performed with an independent samples t test. Pearson correlation analysis was used to assess the relationship between the clinical and laboratory parameters. RESULTS: Based on DAS28 scores, no patient with RA was in the remission period, 3 patients had low, 23 had medium, and 1 had high disease activity. Sixteen (59.26 %) patients with RA had positive ACPA titers. Lateral cephalometric radiographs revealed statistically significant difference between the two groups for the measurement of U1-NA (millimeter; p = 0.047), U1-NA (degrees; p = 0.031), L1-NB (degrees; p = 0.030), IMPA (L1-MP; p = 0.001), interincisal angle (U1-L1; degrees; p = 0.022) and midface length (Co-A; millimeter; p = 0.033). A significant positive linear correlation was found between disease duration time and DAS28 scores (r = 0.066, p = 0.040). CONCLUSIONS: Dentoalveolar effects of RA on dentofacial morphology are more significant than the skeletal effects. Future studies with larger sample sizes are required to evaluate the exact effects of RA on dentofacial morphology. CLINICAL RELEVANCE: Clinicians should consider the fact that RA-associated dentoalveolar changes can be observed and may affect the orthodontic treatment process.

Clinical evaluation of chlorhexidine and essential oils for adjunctive effects in ultrasonic instrumentation of furcation involvements: a randomized controlled clinical trial.

BACKGROUND: The aim of this clinical study was to evaluate and compare the clinical efficacy of subgingival ultrasonic mechanical instrumentation (UMI) irrigated with essential oils (EOs) and chlorhexidine (CHX) at the furcation involvements (FI). METHODS: Forty-five patients (244 FI) who presented with Class II FI were recruited to the study. Patients were randomly assigned to CHX (UMI irrigated with 0.2% CHX), EO (UMI irrigated with EOs) or control (UMI irrigated with distilled water) groups. All treatments were performed in one session. For all groups, plaque index (PI), gingival index (GI), position of gingival margin (PGM), pocket depth (PD), bleeding on probing (BOP), clinical attachment level (CAL) and horizontal attachment level (HAL) scores were recorded at baseline and 1 and 3 months after therapy. RESULTS: In all groups, there were significant reductions in PI, GI, PD and BOP, increase in PGM scores and gain in CAL and HAL scores, at 1 and 3 months compared to baseline. Except in BOP scores, there were no significance differences among the groups at any time point. At 1 and 3 months, there were significant reductions in the BOP scores of the EO group compared with the CHX and control groups. CONCLUSION: Within the limits of this study, the use of EOs as a cooling liquid of UMI may promote slight adjunctive effects at FI compared to CHX and water.

Three-dimensional evaluation of treatment results of the Alt-RAMEC and facemask protocol in growing patients.

PURPOSE: The aim of this retrospective study was to evaluate the skeletal, dental, and soft tissue effects of the alternating rapid maxillary expansions and constrictions (Alt-RAMEC) protocol combined with a facemask in prepubertal patients. METHODS: The study group (mean age 9.74 ± 1.46 years) consisted of 20 patients with class III malocclusion characterized by maxillary retrognathism. They were treated with a facemask for 7 months following a 9­week Alt-RAMEC protocol. Cone-beam computed tomography (CBCT) records and three-dimensional (3D) photographs taken before (T0) and after the protraction and retention period (T1) were evaluated. The study group was compared with a well-matched control group of 16 untreated patients (mean age 9.44 ± 0.79 years) with the same malocclusion. The records for the control group included cephalometric radiographs and 3D photographs. RESULTS: In the study group, significant forward movements of A point (3.49 mm), nasal (2.91 mm) and zygomatic bones were achieved. Intermolar, internasal, and interzygomatic widths increased. Soft tissue points followed the hard tissue movements, apart from b and pog. In the control group, A (0.97 mm), B (1.69 mm), Pog, and b points presented forward movement. Significant differences were found regarding the forward movement of the maxilla between the groups. CONCLUSION: The Alt-RAMEC/facemask protocol was effective not only in the maxillary region but also in the midface.

Effectiveness of different gutta-percha techniques when filling experimental internal resorptive cavities.

AIM: To determine the quality of root fillings in teeth with artificial internal resorptive cavities filled with Thermafil, JS Quick-Fill, Soft Core, System B and Microseal, and by cold lateral compaction (LC) technique. METHODOLOGY: Sixty maxillary incisor teeth were selected. After access cavity preparation and root canal instrumentation, the roots were sectioned horizontally and artificial internal resorption cavities were prepared on the canal walls. The tooth sections were cemented together and the root canals were filled using one of six different techniques: Thermafil, JS Quick-Fill, Soft Core, System B and Microseal, and by LC. The roots were then divided at the level of the previous section and each root surface was photographed. Image analysis program was used to calculate the percentage of sealer, gutta-percha and void in the internal resorptive cavities. All measurements were analysed statistically using One-way ANOVA and Newman-Keuls tests. RESULTS: The Microseal technique filled 99% of the artificial resorptive area followed by LC (92%), SystemB (89%), Quick-Fill (88%), Thermafil (74%) and Soft-Core (73%). Warm gutta-percha compaction techniques filled the resorption areas with more gutta-percha than sealer (Microseal 68%, System B 62%) compared to the other techniques (LC 48%, Quick Fill 41%, Soft Core 34%, Thermafil 35%). In addition, core techniques left a considerable volume of voids in the resorptive areas (Quick-Fill 12%, Thermafil 26%, Soft Core 27%). CONCLUSIONS: Warm gutta techniques filled artificial resorption cavities significantly better than the other gutta-percha techniques.

Maxillary canine transposition to incisor site: a rare condition.

Tooth transposition is defined as positional interchange of 2 adjacent teeth within the same quadrant. The incidence has been reported as about 0.4%, and the maxillary permanent canine has been reported as the tooth most frequently involved. Several etiologic factors like genetics, interchange in position of the developing tooth buds, trauma, mechanical interferences, and early loss of incisors have been associated with tooth transposition. Articles in the literature report various kinds of transpositions, but there are only a few reported cases of transposition of the maxillary canine to central incisor site. This kind of transposition has been suggested as resulting primarily by opportunistic canine migration into the space left from an early lost central incisor. However, there are only 2 long-term roentgenographic follow-up studies documenting maxillary canine migration and substantiating this hypothesis. This report shows 2 cases of this rare condition, with 1 of them documented with long-term records.

Comparison of the bond compatibility of titanium and an NiCr alloy to dental porcelain.

OBJECTIVES: The aim of this study was to investigate the bond compatibility between porcelain and titanium, by using three-point bending, oxide adherence and thermal expansion tests, and to compare the results with those of a conventional NiCr alloy-porcelain system. METHODS: The three-point bending test was used and the results were evaluated according to DIN draft 13927. Fractured surfaces of the metal and porcelain were examined macroscopically. The oxide adherence test was applied to titanium and NiCr alloy with appropriate oxidation degrees. After an oxide film was formed on the specimens, tensile strength test was applied. Oxide adherence strength values were set and fractured surfaces were examined macroscopically. In the thermal expansion test, thermal expansion curves and thermal expansion coefficients of titanium, NiCr alloy and tested porcelains were determined. Differences in thermal expansion values (delta alpha) in all metal-porcelain pairs were calculated to allow inferences to be made about residual stress levels. RESULTS: The bending strengths of all groups were found to be within the acceptable standard levels. At the end of the oxide adherence test, the results indicated that the adherence of the formed oxides to the metals were at a desired level. As a result of the thermal expansion test, the titanium-porcelain and NiCr-porcelain systems showed compressive thermal stress. However, the titanium-porcelain pair exhibited large positive delta alpha values. This results is found to be above the proposed thermal compatibility. CONCLUSIONS: It was concluded that the bond compatibility between titanium and porcelain was comparable with the NiCr-porcelain system.

Clinical evaluation of submerged and non-submerged implants for posterior single-tooth replacements: a randomized split-mouth clinical trial.

The aim of this study was to evaluate clinical and radiographic results of submerged and non-submerged implants for posterior single-tooth replacements and to assess patient-based outcomes. Twenty patients were included in the study. A split-mouth design was used; implants inserted using a submerged technique were compared to those inserted with a non-submerged technique. Implants were restored with metal-ceramic crowns after 3 months. Reconstructions were examined at baseline, 6, 12, and 24 months. Standardized radiographs were made. Radiographic crestal bone level changes were calculated, as well as soft tissue parameters, including pocket probing depth, bleeding on probing, plaque index, and gingival index. Results were analyzed by two-way repeated measures of variance (ANOVA). To evaluate patient-based outcomes, patients were asked to complete a questionnaire at the 6-month follow-up; the Wilcoxon paired signed rank test was used to compare scores. The data of 18 patients were reviewed. During 24 months, non-submerged implants (0.57 ± 0.21 mm) showed significantly lower bone loss than submerged implants (0.68 ± 0.22 mm) (P<0.01). Patient satisfaction with non-submerged implants (median 87.5) was significantly higher than with submerged implants (median 81.5) (P<0.01). Non-submerged implants showed comparable clinical results to submerged implants and resulted in higher patient satisfaction due to decreased surgical intervention.

Cephalometric comparison of obstructive sleep apnea patients and healthy controls.

OBJECTIVE: This study aimed to compare the cephalometric characteristics of obstructive sleep apnea (OSA) patients with those of healthy subjects and to determine possible relationships between cephalometric measurements of OSA patients and control subjects. METHODS: Standardized lateral cephalograms of 16 OSA patients and 16 healthy controls were obtained. Airway dimensions and dentofacial parameters were measured using a cephalometric analysis program (Dolphin Imaging Cephalometric and Tracing Software, Chatsworth, CA, USA). All statistical analyses were conducted using SPSS version 17.0.0 (SPSS Inc., Chicago, IL, USA). Descriptive statistics were calculated for all measurements, and the Mann-Whitney U test was used to evaluate intergroup differences. RESULTS: Midface length was significantly shorter and upper lip E-plane length was significantly longer in the OSA group than in the controls (P<.05). SNA, SNB, and mandibular plane angles (GoGn-SN), anterior and posterior facial heights, and posteroanterior face height ratio were similar in both groups. Maxillary length was slightly longer in the OSA group, whereas the mandibular length showed a slight increase in the control group (P<.05). The axial inclination of the lower incisor to its respective plane was normal, whereas the upper incisor was significantly protrusive (P<.05) in the OSA group. Distance between the hyoid and mandible was significantly greater in the OSA group than in the controls, indicating that the hyoid bone was positioned more downward in the OSA group (P<.05). CONCLUSIONS: In this study, the patients with OSA demonstrated significant differences in several craniofacial measurements. OSA patients showed reduced midface length and inferiorly placed hyoid bone and tended to have smaller airway dimensions.

The influence of fining agents on the removal of some pesticides from white wine of Vitis vinifera L. cv. Emir.

The influences of fining agents (activated carbon, casein, kieselsol-gelatine, bentonite and polyvinylpolypyrrolidone) and their doses (low, middle, high) on the removal of six pesticides used in viticulture (vinclozolin, penconazole, α-endosulfan, imazalil, nuarimol and tetradifon) from white wine were investigated. The pesticides were added into white wine obtained from the Emir grape, and then the wine was clarified with the use of fining agents at low, middle and high doses. After the fining, extraction of pesticides from the wine was made by liquid-liquid extraction. Quantification and identification were performed by the multiresidual method using GC-MS and GC-ECD techniques. The effect of the fining agents on these pesticides ranged from little to large. Of the fining agents, activated carbon showed the largest effect on the removal of pesticides. The pesticide removal efficiencies of the fining agents were in the following order: activated carbon, casein, bentonite and kieselsol-gelatine. Polyvinylpolypyrrolidone (PVPP) had the least effect on the removal of pesticides. A linear relation was not found between fining agent doses and the amount of removed pesticides. α-Endosulfan, penconazole, imazalil and tetradifon were removed by the fining agents at the highest levels. Vinclozolin and nuarimol were the pesticides least affected, except activated carbon and casein.

Evaluation of mental index, mandibular cortical index and panoramic mandibular index on dental panoramic radiographs in the elderly.

OBJECTIVES: The aims of this study were to evaluate the influence of gender and dental status on the mental index, mandibular cortical index and panoramic mandibular index from dental panoramic radiographs in elderly who had osteoporosis or did not have osteoporosis. METHODS: Panoramic radiographs of 487 elderly dental patients (age range 60-88 years) were evaluated. It were recorded osteoporotic status according to the patients' medical anamnesis and values of the mandibular cortical index (MCI), panoramic mandibular index (PMI), mandibular cortical width (MCW) RESULTS: Dental status was statistically significantly associated with the mandibular cortical width, panoramic mandibular index and the categories of MCI (P<.05). There were statistically different mandibular cortical width and panoramic mandibular index values in patients with osteoporosis and without osteoporosis (P<.05) CONCLUSIONS: Our study showed that there were statistically significant differences according to gender, dental status, and values of the MCW, MCI and PMI between patients with and those without osteoporosis.

General health and oral health status in elderly dental patients in Isparta, Turkey

The aim of this study was to describe the oral health, general health status and medication use of elderly dental patients 709 voluntary patients, aged 60 years and over, who attended Suleyman Demirel University Faculty of Dentistry for routine dental treatment between March 2008 and April 2009 in Isparta, Turkey, were interviewed for demographic data, systemic diseases, and lists of medications. The majority of the patients [84.4%] had poor oral hygiene according to the Oral Hygiene Index [OHI]. The mean level of the study population's decayed, missing, and filled teeth [DMFT] index score was 19.1 +/- 7.3. The prevalence of systemic diseases was high [90%]. Women were affected by a significantly higher incidence of systemic diseases than men [96.4% vs. 84.3%; P < 0.001]. The percentage of the elderly taking medication regularly was 72.6%. Drug adverse effects were determined in 25.5% of the study population, with more adverse effects observed in women [53.3%] than men [46.7%] [P < 0.001]. Dentists must be aware of the dental implications that may arise from systemic diseases and medications and should properly modify elderly patients' treatment accordingly

La présente étude avait pour objectif de décrire la santé bucco-dentaire de patients dentaires âgés, leur état de santé général et leur recours aux médicaments; 709 patients volontaires, âgés de 60 ans et plus, qui avaient consulté à la Faculté de Dentisterie de l'Université de Suleyman Demirel pour des soins dentaires de routine entre mars 2008 et avril 2009 à Isparta, en Turquie, ont été interrogés pour obtenir des données démographiques, ainsi qu'au sujet des maladies systémiques et des listes de médicaments qui les concernaient. La majorité des patients [84,4%] avaient une mauvaise hygiène bucco-dentaire selon l'indice d'hygiène buccale. Le niveau moyen de l'indice CAO [dent cariée, absente ou obturée] de la population étudiée était de 19,1 +/- 7,3. La prévalence des maladies systémiques était élevée [90%]. Les femmes étaient significativement plus affectées par les maladies systémiques que les hommes [96,4% contre 84,3% ; p < 0,001]. Le pourcentage de personnes âgées pregnant des médicaments sur une base régulière était de 72,6%. Les effets secondaires provoqués par les medicaments ont été déterminés pour 25,5% de la population étudiée, avec davantage d'effets secondaires observés chez les femmes [53,3%] que chez les hommes [46,7%] [p <0,001]. Les dentistes doivent avoir connaissance des implications dentaires pouvant être causées par des maladies systémiques et des traitements médicamenteux, et devraient modifier les soins apportés aux personnes âgées en conséquence

Prevalence of tooth transpositions and associated dental anomalies in a Turkish population.

OBJECTIVES: The aims of this study were to determine the prevalence of tooth transposition in a Turkish population, possibly associated dental anomalies and whether side laterality, gender expression or genetic influence exist or not. METHODS: Panoramic radiographs of 5486 patients referred to Department of Oral Diagnosis and Radiology, University of Suleyman Demirel between April 2003 and March 2004 were examined retrospectively. All patients with tooth transpositions were recalled for detailed clinical examination and medical history. Age, sex, history (trauma), location of transposition, and associated congenital dental anomalies were recorded with details. RESULTS: 22 transpositions were found in 21 of 5486 (0.38%) patients. The most frequently seen transposition was maxillary canine-lateral incisor (1.64/1000), secondly maxillary canine-first premolar (0.91/1000) and maxillary canine-second premolar (0.18/1000) was the least frequently seen one. The frequencies of right and left side occurrence were equal (11/11). Each sex was affected similarly (11 males, 10 females). CONCLUSIONS: The prevalence of tooth transposition was 0.38% in a Turkish population. Maxillary canine-lateral incisor transposition was found to have a higher frequency than maxillary canine-first premolar transposition. Maxillary canine-second premolar transposition that had not been previously reported in the literature was observed in one of our cases. Transpositions had similar frequencies in both sexes.

A non-syndrome case with bilateral supernumerary canines: report of a rare case.

Supernumerary teeth are described as the teeth formed in excess of the normal dental formula. Prevalence of supernumerary teeth varies between 0.1% and 3.8% in general Caucasian population. They have been reported in both the primary and the permanent dentition. Supernumerary teeth may occur in any region of the dental arch. However, a supernumerary tooth in the canine region is a rare condition and to our knowledge, a non-syndrome case with bilateral supplemental maxillary canines did not exist in the literature. It was the aim of this report to evaluate this rare case in view of both oral radiology and orthodontics.

Transmigration of impacted canines.

Pre-eruptive migration of a tooth across the midline is termed "transmigration". This condition has not been reported for teeth other than mandibular canines. Bilateral transmigration is extremely rare, and associated pathological lesions are also reported. The aim of this report is to present the first case of maxillary canine transmigration as well as additional cases of transmigrated mandibular canines, with special emphasis on their classification.

Incidence of canine impaction and transmigration in a patient population.

In this study, 4500 consecutive panoramic radiographs were prospectively reviewed. The incidence of canine impaction was found to be 3.58% and the incidence of canine transmigration was 0.31%. There were six maxillary and eight mandibular transmigrant canines. The incidence of impacted canine teeth and transmigration of maxillary and mandibular canines may be more frequent than was previously thought, at least in some populations.