Mandibular lateral incisor-first premolar transposition in early mixed dentition: a rare case.

Dental transposition is an anomaly of eruption which is usually seen in the maxilla and rarely in the mandible. The mandibular lateral incisor's transposition with the permanent canine has a prevalence of less than 0.03%. The following case presents an even rarer situation, of a right lateral mandibular incisor that erupted in the place of the first premolar, in transposition with the temporary canine. In the first phase, a series of extractions have been performed, to ensure the necessary free space for moving the lateral incisor closer to its appropriate place, and after that a fixed orthodontic appliance was used. The biomechanics for intra-arch tooth movement was ingenious enough to ensure a perfect alignment of all permanent teeth and a functional Class I canine and molar final occlusion. Early intervention and successful move of the permanent canine in its correct position ensured the functionality of the mandibular movements and a good long-term prognosis.

Congenitally missing second permanent molars in non-syndromic patients (Review).

Hypodontia (tooth agenesis) is regarded as the most common congenital dental anomaly. The present review discusses the epidemiological characteristics of congenitally missing second permanent molars (CMSPMs) within a systematic review of the literature. The review was based on Pubmed library associated with the search of various scientific databases or academic resources, improved by hand search of reference lists. The terms 'hypodontia' or 'anodontia' in combination with 'prevalence' or 'epidemiology' were searched in the data sources for studies published between January 2001 and December 2020. Abstracts of non-English papers were also analyzed. The inclusion criteria were as follows: i) Study provided precise data about CMSPMs, even if no second permanent molar was reportedly missing; ii) the number of CMSPMs distributed by jaw was provided and iii) studies on subjects >3 years were used. The exclusion criteria were as follows: i) Studies on patients with history of trauma of the maxilla or the mandible, any type of syndrome affecting bone metabolism, metabolic disorders, previous extraction or tooth loss due to dental caries, cleft lip and palate; ii) studies performed on cohorts of patients with hypodontia and iii) studies reporting data including third molars, except for those that presented sufficient data to perform correct calculations. A total of 79 studies were selected, accumulating a population of 281,968 people, with an average sample size of 3,524.60±11,255.25. The prevalence of CMSPMs (IpHSPM) was 2.79±3.16% among all missing teeth (1.03±1.59% for upper CMSPMs and 1.76±2.32% for lower CMSPMs; P=0.011). There were no significant differences (P=0.250) in IpHSPM between men (1.59±1.52%) and women (2.13±1.67%). However, significant differences were recorded between continents. Furthermore, lower CMSPMs were found more frequently in orthodontic samples (P=0.033). The prevalence of CMSPMs is low compared with the overall prevalence of CM teeth. Despite the rarity of these anomalies, early detection is important to enable practitioners to plan and start treatment at the best time for optimal results.

Surface Modification to Modulate Microbial Biofilms-Applications in Dental Medicine.

Recent progress in materials science and nanotechnology has led to the development of advanced materials with multifunctional properties. Dental medicine has benefited from the design of such materials and coatings in providing patients with tailored implants and improved materials for restorative and functional use. Such materials and coatings allow for better acceptance by the host body, promote successful implantation and determine a reduced inflammatory response after contact with the materials. Since numerous dental pathologies are influenced by the presence and activity of some pathogenic microorganisms, novel materials are needed to overcome this challenge as well. This paper aimed to reveal and discuss the most recent and innovative progress made in the field of materials surface modification in terms of microbial attachment inhibition and biofilm formation, with a direct impact on dental medicine.

Base Materials' Influence on Fracture Resistance of Molars with MOD Cavities.

The aim of this study was to compare fracture resistance of teeth presenting medium-sized mesial-occlusal-distal (MOD) cavities using different base materials. Thirty-six extracted molars were immersed for 48 h in saline solution (0.1% thymol at 4 °C) and divided into six groups. In group A, the molars were untouched, and in group B, cavities were prepared, but not filled. In group C, we used zinc polycarboxylate cement, in group D-conventional glass ionomer cement, in group E-resin modified glass ionomer cement, and in group F-flow composite. Fracture resistance was tested using a universal loading machine (Lloyd Instruments) with a maximum force of 5 kN and a crosshead speed of 1.0 mm/min; we used NEXYGEN Data Analysis Software and ANOVA Method (p < 0.05). The smallest load that determined the sample failure was 2780 N for Group A, 865 N for Group B, 1210 N for Group C, 1340 N for Group D, 1630 N for Group E and 1742 N for Group F. The highest loads were 3050 N (A), 1040 N (B), 1430 N (C), 1500 N (D), 1790 N (E), and 3320 N (F), the mean values being 2902 ± 114 N (A), 972 ± 65 N (B), 1339 ± 84 N (C), 1415 ± 67 N (D), 1712 ± 62 N (E), and 2334 ± 662 N (F). A p = 0.000195 shows a statistically significant difference between groups C, D, E and F. For medium sized mesial-occlusal-distal (MOD) cavities, the best base material regarding fracture resistance was flow composite, followed by glass ionomer modified with resin, conventional glass ionomer cement and zinc polycarboxylate cement. It can be concluded that light-cured base materials are a better option for the analyzed use case, one of the possible reasons being their compatibility with the final restoration material, also light-cured.

Supernumerary permanent maxillary canine - a rare finding: case report and literature review.

Supernumerary teeth are dental units that appear in addition to the regular number of teeth. Their most frequent location is the anterior maxilla, especially on the maxillary midline, being called mesiodens, but also paramedian or in the position of a lateral incisor. On the other hand, the permanent canine is one of the most stable teeth regarding the number, with very few cases reported about hypo- or hyperdontia. This article reviews the few data found in the literature about the supernumerary permanent maxillary canine and also presents the case of an 8-year-old female patient with a supplemental permanent canine in the upper left maxilla. The patient was non-syndromic and did not present any other supernumerary teeth in the permanent dentition; she had only one in the temporary dentition. Using cone-beam computed tomography (CBCT) of the region, we were able to evaluate the position, structure, and shape of the supplemental canine and also to establish a treatment plan. The aim of this paper was to present this extremely rare case of a non-syndromic Romanian adult female patient with a unilateral supplemental permanent maxillary canine, and to include a literature review of the few reported such cases.

A rare case of transmigrated mandibular canine and combined orthodontic-surgical management.

Canines are paramount teeth for esthetics and function. Transmigration of the lower permanent canine is a rare process of alteration of the eruption path toward the opposite part of the mandible. The position of the migrating tooth varies at different ages, so early detection of the tendency to cross the midline is crucial; canines that have already passed through the center of the mandible can be impossible to realign. Transmigration can start any time before the normal age of eruption. Comparing two radiographic images taken at different ages offers important diagnosis information. Camilleri & Scerri (2003) described a progressive alteration of the tooth position in four steps, from the normal appearance to a low position inside the corpus of the mandible. Following this classification, this article's aim was to present a case of an impacted lower canine that was diagnosed between the second and third stage of transmigration, around the age of 10, and to detail the combined orthodontic-surgical treatment strategy for "recapturing" and the orthodontic mechanics used to align it. After the examination of cone-beam computed tomography, we have decided to use a lingual arch as a space maintainer and anchorage tool and to surgically expose the tooth. The canine's initial position and the direction of the force of traction used allowed a proper alignment of the tooth inside the dental arch. The periodontal tissues management was important for good healing, stability, and aesthetics. The early detection allowed a proper interdisciplinary orthodontic-surgical management, and a successful outcome.

Unilateral agenesis of permanent superior canine in familial peg-shaped lateral incisors: rare case report and literature review.

Agenesis of permanent maxillary and mandibular canines is very rare; one to all four can be missing, isolated or in association with other missing teeth or with dental morphology abnormalities. Such cases can present functional, esthetic, and psychological problems, since the canine's role in functional occlusion and in obtaining an aesthetic smile is crucial. Frequently, the canine's absence from the arch is caused by impaction; its congenital absence is extremely rare in patients with no associated syndrome. The aim of this paper was to present a very rare case of a non-syndromic Romanian adult female patient with a unilateral permanent maxillary missing canine, in association with peg-shaped maxillary lateral permanent incisors, which can have a genetic cause, since the same morphological abnormality was present in her father and her younger sister, who also presented a rare situation of bilateral upper transposition between the canines and lateral incisors. The association of a permanent maxillary canine hypodontia with bilateral "peg laterals" and transposition between the maxillary canine and the peg-shaped lateral incisors is also rare as a family character in healthy patients. Future statistical studies are necessary to establish the incidence of permanent maxillary canine agenesis in Romanian population. Also, the article includes a detailed literature review of reported cases of agenesis of permanent maxillary canines.

Periodontal clinico-morphological changes in patients wearing old nickel-chromium and copper alloys bridges.

Elderly population frequently presents more than one prosthetic restoration realized from different types of dental alloys which, in time, suffer various alterations in the oral environment. Metallic ions are released in saliva due to its electrolytic qualities, interacting with the contact tissues. Studies regarding cytotoxicity of dental alloys are providing contradictory results. Besides biocompatibility, the microbial factor is also greatly influencing the long-term success of the prosthetic rehabilitation. This study's aim was to assess the response of the gingival tissue to nickel-chromium (Ni-Cr) and copper (Cu)-based dental casting alloys from fixed dentures present in many patients from Romania. Gingival samples were taken from 124 patients wearing fixed dental restorations made from these two types of alloys from injured areas surrounding the abutment teeth; histological specimens were prepared, fixed in 10% neutral buffered formalin, paraffin-embedded and stained with Hematoxylin-Eosin (HE). Histological analysis showed the existence of a chronic inflammatory infiltrate in the gingival chorion, necrosis areas, and vascular congestion. Various morphological alterations appeared, depending on the intensity of the inflammation and the immune response. The surface epithelium suffered a hyperplasic reaction, either limited to acanthosis or involving the whole epithelium, the release of the Cu(2+) and Ni(2+) ions from the dental alloys used in bridges and crowns being responsible for inducing gingival hyperplasia and a chronic inflammation in the areas situated around the abutment teeth. The immunohistochemical study allowed us to observe an increased number of positive cluster of differentiation 3 (CD3) T-lymphocytes in periodontium, proving that the cellular immune response is rapid and intense.

Unilateral supplemental maxillary lateral incisor: report of three rare cases and literature review.

Additional teeth to the normal dentition are called supernumerary teeth; they can be found in higher rates in permanent than in deciduous dentition, in both sexes, associated or not with other diseases or syndromes. The aim of this article is to report three rare cases of unilateral supplemental lateral incisors, in Romanian child and adult patients, and to evaluate the treatment options in each case, considering particularities such as age, physiognomy, associated issues and occlusion. The differential diagnosis between a supernumerary lateral incisor in formation and a rudimentary is sometimes difficult to make using only panoramic X-ray, so a cone-beam computed tomography analysis can be indicated. Usually, due to the pathological issues that they can cause, the supplemental maxillary lateral incisors are removed; although, in some cases, it may be necessary to remove the normal tooth, for example in cases of major crowding, in which the normal tooth is more displaced from the line of the arch than the supplemental one, or when there is a lack of periodontal support surrounding the normal tooth. This article highlights that even if, in younger patients, the majority of these teeth is extracted because later in life they can cause difficulties in orthodontic and prosthetic treatment, there are still rare cases which do not necessitate treatment, because they are asymptomatic, rather well aligned and go unnoticed. Also, the article includes a detailed literature review of reported cases of supplemental maxillary lateral incisor.

Non-syndromic familial hypodontia: rare case reports and literature review.

Congenital absence of the teeth, affecting both physiognomy and mastication, can have a great impact on patients' quality of life. It may appear unilateral or bilateral; frequently, it associates with certain general conditions. Familial hypodontia in clinically healthy patients is rare. Genetic transmission, as a determinant factor in missing teeth, can be autosomal dominant, recessive, or related to the sex chromosomes. In case of congenitally missing permanent teeth, the corresponding deciduous teeth can be still found on the arch at adult age. The aim of this article is to present rare cases of familial non-syndromic unilateral and bilateral hypodontia in Romanian adult siblings, highlighting also a cross gene transmission between aunt and niece and evaluating the treatment options in accordance with patient's age and oral status. It shows that early diagnosis of hypodontia is crucial for the patient's future oral health. The decision to keep the temporary teeth or to extract them is influenced by the presence and status of the deciduous teeth, patient's access to treatment and parent's agreement. Asymptomatic adult patients, in which hypodontia was diagnosed during a routine control, do not usually solicit therapeutic intervention until the deciduous teeth are also lost; still, in situations where complications arise through their loss, the treatment of hypodontia is complex, involving a close collaboration between a team of specialists. The article also includes a detailed review of literature referring to the prevalence of hypodontia among different populations.

A rare case of mandibulary parapremolars in siblings: case report and literature review.

Supernumerary teeth in permanent dentition are influenced by hereditary and environmental, having clinical variations such as location, number and morphology. Parapremolars can be found as a single supernumerary tooth or as multiple, usually in the lower jaw, sometimes in association with other types of supernumerary teeth. Familial inheritance often involves more than one generation. This paper presents a case of two brothers, one with only one parapremolar and a good oral status and hygiene, the other with poor hygiene, multiple parapremolars and one mesiodens, causing various complications. The aim of this paper is to show the presence of parapremolars in brothers with no other medical relevant history, located in the same site, and to point the influence of genetic factors in the etiology of supernumerary teeth. Along with a review of the literature, this article shows the importance of an early diagnosis and follow-up using successive panoramic radiographs of such cases, in order to limit or prevent the inflammatory, carious, periodontal and occlusal complications that can seriously affect both the jaws and the normal dentition.