The Intriguing Case of Impacted Teeth 11, 12, and 13: Unveiling the Dental Dilemma.

This case study offers a rare and difficult condition involving the impaction of teeth 11, 12, and 13, providing a severe dental challenge. A thorough examination was performed on the patient, which included clinical evaluations and radiographic examinations. Because the impacted teeth were causing discomfort and functional impairment, a multidisciplinary approach was required, which included surgical exposure followed by traction forces to level and align the impacted teeth. The abstract emphasizes the case's complexity, digging into the diagnosis process and the establishment of a personalized treatment strategy. The complexities of handling many impacted teeth are explored in length, including surgical intervention, orthodontic considerations, and postoperative care.

Non-extraction Orthodontic Treatment Protocol of Moderate Crowding.

Dental crowding is referred to as the swarming of teeth, mainly due to the discrepancy between the size of the jaw bases and that of the teeth. When the amount of space required for the teeth is more than that in the jaws, it leads to crowding. The prevalence of crowding has now increased to almost 30-60%. It can be classified into mild, moderate, and severe according to the amount of overlap. Depending on the severity of the crowding, the decision of extraction is made. The given case presents a non-extraction protocol for treating moderate crowding. The present case report explains the non-extraction treatment of moderate crowding using inter-proximal stripping.

A Case of Supernumerary Incisors in a Young Male Child: A Rare Occurrence of Four Central Incisors in the Maxillary Anterior Region.

Multiple supernumerary teeth in the central incisor region are an uncommon occurrence; the most frequently occurring type of supernumerary teeth are mesiodens. A 10-year-old male had reported to Sharad Pawar Dental College with the chief complaint of extra teeth. An intraoral examination revealed the presence of two labially placed incisors and two palatally placed incisors at a transitional phase of dentition. During a radiographic examination, the maxillary occlusal view revealed four incisors with similar morphology. Extraction of the palatally placed incisor was done under local anaesthesia which was followed by alignment of the anterior teeth and closure of space. Supernumeraries that have erupted should always be removed, unless the teeth next to them are absent, in which case they should be left in place. After alignment, closure of spaces was done since the permanent canines had not yet erupted; it was decided against trying to completely close any gaps between the teeth.

Impacted Mandibular First Molar: A Rare Riddle.

Tooth impaction incidence is in the range of 5.6 to 18.8% of the population. Eruption failure of the first permanent molar is very rare; the prevalence is 0.01% of the population. The permanent molars are of particular importance in providing adequate occlusal support as well as coordinating facial growth. Failure of the eruption of permanent molars might lead to an array of complications like a reduction in the vertical dimension, extrusion of the antagonist teeth, a posterior open bite, inclination and resorption of adjacent teeth, and cyst formation. Various treatment modalities for impacted teeth include periodic observation, orthodontic relocation, and partial dislocation. More invasively, surgical exposure and extraction of teeth before prosthetic treatment may be performed. It is imperative to diagnose and manage the condition early, as delayed treatment may result in a myriad of problems, like a decreased force of the spontaneous eruption, a decreased percentage of treatment success, and a prolonged period of treatment, increasing the complications furthermore. Because of the importance of permanent molars, eruptive guidance is required before impacted tooth extraction. This article summarizes a case in which the surgical-orthodontic combined approach to the impacted mandibular first molar avoided the need for prolonged orthodontic treatment that would have required repositioning the deeply impacted first molar to the dental arch. As an outcome, patient satisfaction improves.

Analysis of Variations in Maxillary Second Molar Buccopalatal Inclination in Angle's Class I, Angle's Class III Malocclusion, and Unilateral Cleft Lip and Palate (UCLP) Cases: A Comparative Observational Study.

Introduction Cleft of the lip and/or the palate is commonly inherited defect which involves cleft of lip and palate. Maxillary second molar inclination has been studied in various malocclusion. Every abnormality in body is compensated to some extend by compensation. Our objectives were to evaluate maxillary second molar inclination in Angle's Class I, Class III malocclusion, and unilateral cleft lip and palate (UCLP) patients in transverse plane and to compare variation in maxillary second molar inclination in Angle's Class I, Class III malocclusion, and UCLP cases buccopalatally in transverse plane. Material and method Model of 45 subjects were analyzed. The maxillary second molar inclination was measured using aid of protractor fixed on the surveyor. Axis under consideration was the axis along the long axis of the central fossa of maxillary second molar. Various standardization regarding measurement of second molar inclination were set. The maxillary second molar inclination was compared among 3 groups Angle's Class I, Class III malocclusion, and UCLP cases. Results Data was analyzed using one-way analysis of variance (ANOVA) and post-hoc Tukey test. There was a significant difference between inclination of maxillary second molar when Angle's Class I malocclusion was compared with Angle's Class III malocclusion and UCLP cases (p = 0.003 and p = 0.011, respectively). There was not a significant difference between Angle's Class III malocclusion and UCLP cases (p = 0.87). Conclusion Amongst Class III patients and UCLP patients the inclination of maxillary second molar had greater buccal inclination. Maxillary second molar correction would alleviate the effect of deleterious force on periodontium and bone generated by malpositioned teeth.

Multidisciplinary Approach to Treatment of Midline Diastema With Edge-to-Edge Bite.

Aesthetic treatments have gained massive popularity in the recent past. Patients with midline diastema and spacing are among the most common complaints reported to an orthodontic clinic. The major complaint with such cases is the poor aesthetics that accompany them. Although many restorative treatment options are available to treat these cases, their long-term success is still questionable. The primary aetiology is abnormal frenal attachment, as seen in the case. Getting rid of the etiologic factor is vital to attain a stable treatment. In the present case, a frenectomy was performed to correct the abnormal frenal attachment. Even after correcting the aetiology, correct retention protocol is equally essential. The present article presents the treatment of a case with midline diastema and an edge-to-edge bite, and a high frenal attachment.

The Comparative Evaluation of the Morphology and Dimensions of the Sella Turcica in Skeletal Class III Patients and Patients With Unilateral Cleft Lip and Palate in Post-Pubertal Age Group.

Background The clinical features of unilateral cleft patients have great similarity to class III patients, viz., ANB <2° and Wits appraisal <-3 mm. In this study, we determined the frequency of various shapes of the sella in cleft and class III patients. We also measured the dimensions of the sella turcica in the aforementioned groups. Studying the morphology and dimensions of the sella in different groups can help us to understand the role of the cranial base in the development of malocclusion. Material and methods The study is composed of 46 patients, divided into two groups with an age range of 14 to 21 years. The linear dimensions of the sella were measured, and the shape of the sella was determined. Comparison was done between the two groups using Student's t-test. Result When the two groups were compared, length was found to be similar in both groups, but depth and diameter were greater in the class III group. An abnormal shape of the sella was found predominantly in both class III and cleft cases. The normal morphology accounted for only 13.04% of all the cleft patients, whereas 39.13% of the class III cases exhibited a normal shape of the sella. Sella turcica bridging was seen in 30.43% of cleft patients as opposed to 21.73% of class III patients exhibiting the bridging. Conclusion With the finding that 74% of the subjects exhibited abnormal morphology of the sella, confirming that it can be one of the factors for malocclusion must be given more consideration.

Skin nodules and proptosis in a case of carcinoma urinary bladder: An unusual presentation.

Metastasis to the skin and orbit from bladder cancer is extremely rare. A 76-year-old diabetic male presented with skin nodules and proptosis of the left eye. Punch biopsy from the abdominal wall nodule showed malignant cells with perineural invasion. Immunohistochemistry showed features suggestive of metastatic urothelial carcinoma. We present this case of urothelial carcinoma of the urinary bladder presenting primarily with highly unusual nodular skin metastasis.

Sheathless synchronous flexible ureterorenoscopy with holmium laser lithotripsy in complete duplex renal collecting system with stones.

Duplication of renal system is one of the commonest renal anomalies. It is infrequently associated with renal calculus, ureterocele and vesico ureteric reflux. We report a 29-year male with right complete duplex system having upper moiety multiple ureteric calculi and lower moiety inferior renal calculus. Single sitting fURS was done and calculi in both systems were tackled one at a time. Calculi were dusted with holmium laser and double J stent placed in upper moiety ureter. Calculus management in anomalous kidney is challenging. Single sitting flexible ureterorenoscopy is feasible option in duplex renal system with low burden calculi.

Gummatous Syphilis: A Rare Entity Mimicking Carcinoma Penis.

OBJECTIVE: To describe a rare case of gummatous syphilis of the penis with urethrocutaneous fistula mimicking penile carcinoma causing a diagnostic dilemma. METHOD: A 54 year old man presented with an ulcerative lesion on glans penis. Patient was managed with partial penectomy in view of erosive growth giving rise to urethrocutaneous fistula. RESULTS: Histopathology showed granulation tissue, necrotizing vasculitis and epithelioid cell granuloma. Immunohistochemistry stained positive for Treponema and patient was treated accordingly. CONCLUSION: Syphilis is rarely encountered in daily clinical practice in the penicillin era. Despite a negative serology and the clinical picture highly suggestive of malignancy, the histopathology helped in clinching the rare diagnosis.

"Through Thick and Thin:" Morphological Spectrum of Epididymal Tubules in Obstructive Azoospermia.

Morphological appearance of the epididymal tubules encountered at the time of microsurgical vasoepididymal anastomosis (VEA) is quite variable. They are the indicators of underlying etiology as well as guide further course of management. We present three cases of obstructive azoospermia with three different morphologies encountered during the microsurgical VEA. As the etiologies encountered in our setup are different from that of the western world, this report highlights the morphological variation of tubules encountered in our subpopulation. This also helps us in deciding the customization of microsurgical VEA accordingly.

Bilateral Laparoscopic Nephrectomy in Autosomal Dominant Polycystic Kidney Disease with Bilateral Renal Masses: A Feasible Option.

Background: Autosomal dominant polycystic kidney disease (ADPKD) is most common potentially lethal cystic disease occurring in ∼1 in 1000 live births. It is an important cause of end-stage renal disease, which occurs in 75% of patients by the age of 70 years. APDPKD is a systemic disease with involvement of multiple extrarenal organs. Incidence of renal cell cancer in ADPKD is no more than in normal population. High index of suspicion is required due to gross distortion of renal architecture. Case Presentation: We report a 56-year male, known case of ADPKD on maintenance hemodialysis presenting with hematuria. On evaluation, he was diagnosed with bilateral renal masses on contrast imaging. Bilateral laparoscopic nephrectomy was performed and specimen was retrieved from pfannenstiel incision. Histology showed papillary renal cancer in left kidney and oncocytoma in right kidney with negative margins. Conclusion: Minimally invasive surgery in ADPKD with renal mass is challenging due to space constraints and large size kidneys. However, laparoscopic approach is a feasible option with minimal morbidity, less pain, and speedy recovery, specially in chronic kidney disease patients already immunocompromised status.