Dental and jawbone abnormalities linked to amelogenesis imperfecta: A retrospective and analytic study comparing panoramic radiographs.

BACKGROUND: Amelogenesis Imperfecta (AI) is a disorder of tooth development characterized by abnormal enamel formation. In order to detect other dental and jawbone abnormalities that could be associated with AI, a retrospective and analytic study was conducted comparing panoramic radiographs of AI and non-AI patients. MATERIAL AND METHODS: Digital panoramic radiographs of 60 AI and 60 non-AI patients were examined. Abnormalities in dental number, size, shape, eruption, and in the shape of the dental arches were checked and blindly recorded by two experimented observers. Descriptive statistics using percentages and chi-square test with .05 level of significance value was used. RESULTS: Prevalence of supernumerary teeth, dental agenesis, microdontia, taurodontism, radicular dilacerations, dental inclusions, temporary teeth persistence, and pulp calcifications was significantly higher in AI patients compared to control patients. Prevalence of periapical images, cysts, and hypercementosis was lower in AI patients compared to control patients, with no statistically significant difference. A significant prevalence of mandibular hypoplasia was also noted in AI patients. CONCLUSION: In addition to enamel defect, panoramic radiography was useful in detecting other dental abnormalities and mandibular hypoplasia associated with AI and should therefore be systematically indicated for AI patients' care.

Endodontic access cavities: Fears and difficulties of Moroccan dental students related to teachers, self-confidence and technical protocol.

Fears and difficulties of Moroccan dental students regarding endodontic access cavity were evaluated among 3 items: (i) teachers, (ii) student confidence and (iii) access cavity protocol. A three Likert scale was used to rate 24 statements. Specific scores between 1 and 3 and mean scores between 0 and 1 were used to assess statements and items, respectively. Among 116 students, the mean score of difficulty related to teachers (0.48 ± 0.14) was significantly low (p < 0.001) compared to student confidence (0.69 ± 0.12) and cavity protocol (0.68 ± 0.08). The number of teachers was esteemed insufficient, additional training sessions were requested and maxillary teeth and molars were rated the most difficult with specific scores of 1.91 ± 0.80, 2.72 ± 0.61, 2.22 ± 0.67 and 2.47 ± 0.74, respectively. The highest specific score referred to the risk of making ledges (2.8 ± 0.56) or perforations (2.76 ± 0.59). Students expressed a lack of confidence, difficulty with upper molars and fears of making procedural errors.

Enamel renal syndrome: A case report with calcifications in pulp, gingivae, dental follicle and kidneys.

BACKGROUND: Enamel renal syndrome is a rare genetic disorder transmitted through an autosomal recessive mode. It is featured by a hypoplastic amelogenesis imperfecta, delayed tooth eruption, gingival fibromatosis, and nephrocalcinosis. The aim of this study was to describe clinically, radiologically, and histologically the main features of enamel renal syndrome and to point out the role of dentists in early diagnosing this genetic disease. MATERIALS AND METHODS: Our case of enamel renal syndrome was initially described by clinical, radiographic, and genealogic data, then complemented by ultrasound examination of the kidneys and microscopic observation of gingivae. RESULTS: The study showed the presence of amelogenesis imperfecta (AI), several teeth impaction, gingival hyperplasia, bilateral nephrocalcinosis, and multiple calcifications in pulp, gingiva, dental follicle, and kidneys. CONCLUSION: The patient was followed for a full mouth rehabilitation and also referred to a nephrology for global medical checkup. The dentist plays a key role in diagnosing genetic diseases and in referring patients for medical comprehensive care.

The therapeutic dental challenge of xeroderma pigmentosum patients: case report.

Xeroderma pigmentosum (XP) is a rare genetic disease characterized by a hypersensitivity to ultraviolet (UV) radiation leading to defective deoxyribonucleic acid (DNA) repair and predisposing to skin tumorigenesis. This paper reports the safe approaches used for the dental treatment of XP patients, controlling the ultraviolet (UV) sources at the dental office. An XP 29-year-old woman was referred for oral pain and sensitivity at the service of periodontology, UV rays were checked with a UV-meter. During the examination, the patient kept her sunglasses while the practitioner was dressed in dark colors using an anti-UV filter over the surgical light. Facial dark brown pigmentations, limited mouth opening, tumor resection scar on the tongue, moderate periodontitis, and dental caries were noticed. Moderate periodontitis and dental caries were diagnosed. Treatment was planned in collaboration with the dermatologist. Soft scaling and root planning were performed in short sessions and self-curing material was used for coronary fillings after caries removal. In taking care of XP patients, particular attention should be given by dental professionals to: i) the office management for a UV-safe environment; ii) the adoption of suitable dental care and safe biomaterials with short sessions and regular controls; and iii) the adoption of personal protections by patients and practitioners.

Osteoid Osteoma of the Basilar Border of the Mandible: A Diagnostic Dilemma.

Introduction. Osteoid osteoma is a benign osseous tumor characterized by an excessive formation of unmineralized bone matrix. The aim of this study was to present, through a case report, the clinical and radiological manifestations of osteoid osteoma affecting the left basilar border of the mandible. Observation. A 30-year-old male patient presented with left mandibular pain of unknown etiology. The chief complaint was mandibular pain accentuating mainly at night, originating in the left basilar border, and radiating to the whole mandibular hemi-arch. Extraoral examination revealed a small, bone-consistent, and slightly painful swelling. Computed tomography scan revealed a well-limited, infracentimetric, and mixed osteolytic image with central nidus and peripheral osteocondensation. Histological examination revealed osteoid osteoma. Surgical excision of the lesion was performed, and the pain stopped immediately. Discussion. This benign tumor presents many clinical and radiological features similar to other lesions. To differentiate osteoid osteoma from these other bone pathoses, practitioners should have a clear concept and keen observation skills. Confrontation of the clinical, radiological, and anatomopathological data is therefore essential to establish the correct diagnosis and to determine the appropriate treatment plan.

DMF Index among Amelogenesis Imperfecta Patients: Systematic Review of the Literature.

OBJECTIVES: The aim of this study was to explore the literature in order to assess systematically the association between amelogenesis imperfecta (AI) and caries development and to evaluate the DMF index among AI patients. Basic Research Design. PubMed was used to explore the database Medline. The key words used were "Amelogenesis Imperfecta" [Mesh], "Dental Caries" [Mesh], "Tooth Loss" [Mesh], "DMF Index" [Mesh], and "Dental Restoration, Permanent" [Mesh]. Moreover, an ad hoc search was performed in order to make the study as exhaustive as possible. RESULTS: Fifty-five articles were retained. The total number of patients gathered was 499. A percentage of 68.8% of the articles dealt with cases with a relatively low dental caries process, 20.8% dealt with cases in which the dental caries process was relatively moderate, and 10.4% dealt with cases in which the dental caries process was severe. Teeth extraction due to dental caries was mentioned in 10 articles. Eleven articles, concerning 53 patients, mentioned dental fillings. Four patients did not have dental filling due to dental caries. DMF index was very low in 2 articles and low-to-high in 3 articles. CONCLUSION: Low dental caries susceptibility with AI patients was noticed in this study. A possible factor could be the lack of proximal contacts and elimination of fissures through enamel loss. The lack of dental caries susceptibility was also explained by the microbacterial specificity of hypoplastic AI patients. Moreover, it was also noted that the prevalence of dental caries among AI patients depends on sociodemographic change.

Scanning electron microscopy approach to observe bacterial adhesion to dental surfaces.

AIM: To describe the in vitro bacterial adhesion protocol of Streptococcus mutans and Lactobacillus casei on dental surfaces for a qualitative approach by Scanning Electron Microscopy (SEM) observations. A control and Amelogenesis Imperfecta (AI) affected teeth were used to validate the protocol. METHOD DETAILS: Eight teeth were collected and fixed in 10% formalin during 10 days. Crowns were fragmented into 4 parts and kept in the freshly prepared artificial saliva. For the preparation of bacterial suspensions, bacterial strains (S. mutans and L. casei) were incubated in a freshly prepared culture medium. After two successive cultures at 37 °C and 3 rinces, bacterial suspensions were prepared in artificial saliva and adjusted to correspond to 108 CFU ml-1. Bacterial adhesion was carried out by sedimentation. Dental fragments were immersed in bacterial suspensions and rinsed with PBS to remove non adherent bacteria. Adherent bacteria were fixed with glutaraldehyde. Finally, teeth samples were dehydrated, coated, dried and observed using high-resolution SEM (JEOL, JSM-5400). RESULTS: SEM observations showed adherence of spheric stuctures, identified as S. mutans and bacilic structures identified as L. casei. CONCLUSION: Adhesion of bacteria could be observed by SEM and depends on the quality of dental mineralized tissues.

Dental Prosthetic Treatments in Cleidocranial Dysplasia: Case Report and Literature Review.

Cleidocranial dysplasia (CCD) is a rare inherited skeletal syndrome. There is no consensus regarding the dental treatment strategy. Objectives. To report a rare case of cleidocranial dysplasia and to summarize the current clinical and dental features and prosthetic treatment of similar CCD patients reported in the literature. Results. A 17-year-old girl was diagnosed with CCD. She had a short stature with the ability to bring the shoulders under the chest. All remaining teeth were deciduous except the four first molars were permanent. The maxilla was hypoplastic with a relative prognathism of the mandible. The cone-beam computed tomography examination showed a distorted and incomplete root formation of the permanent teeth. She was treated with both, complete and partial, removable overdentures. PubMed was used for the literature research using the following keys words "Cleidocranial Dysplasia"[Mesh], "Prosthodontics"[Mesh], "Dental Care"[Mesh], "cleidocranial dysostosis," and "dental treatment." The retention of deciduous teeth was described in the majority of cases. All the patients had supernumerary teeth. The most used treatments were dental prosthetics and orthodontics. The fixed prosthetic implant was the most used type of prosthetic treatment. Among the 15 cases who specified the type of prosthetic treatment, seven patients received removable dentures. Prosthetics was indicated especially for aged patients. Conclusion. Removable prostheses are a good solution that rapidly restores esthetics and functions. The use of implants for these patients needs to be validated by a long-term follow-up.

A treatment algorithm for adult ameloblastomas according to the Pitié-Salpêtrière Hospital experience.

During a 13-year period (from 1994 to 2007), in the Oral and Maxillofacial Surgery Department of the Pitié-Salpêtrière Hospital, 116 new cases of adult ameloblastomas, were analyzed for treatment composed against radiographic presentation, size, histological type. Follow-up and recurrence were also analyzed. Treatment was surgical consisting of enucleations (82%), segmental mandibulectomy (8.3%) resections (24.7%) 85% of them underwent reconstruction. The follow-up was documented for 97%. More than two recurrences occurred in 21% of the patients after the first enucleation: 66% with a "follicular" histological diagnosis. Lenthly, a therapeutic algorithm is suggested for adult ameloblastomas that underlines the importance of the conservative enucleation treatment as far as possible.