Ectopic maxillary third molar in Early Pleistocene Homo antecessor from Atapuerca-Gran Dolina site (Burgos, Spain).

OBJECTIVES: Here we describe the case of an ectopic maxillary third molar (M3 ), preventing the eruption of the M2 , in the individual H3 of the hominin hypodigm of level TD6.2 of the Early Pleistocene site of Gran Dolina (Sierra de Atapuerca, Spain). MATERIALS AND METHODS: The fossil remains from the TD6.2 level of the Gran Dolina site (about 170 specimens) are assigned to Homo antecessor. Different geochronological methods place these hominins in the oxygen isotopic stage 21, between 0.8 and 0.85 million years ago (Ma). The immature individual H3 is represented by an almost complete midface (ATD6-69), preserving various teeth in situ. We used high-resolution microtomograhy (mCT) to investigate the abnormal position of the left M3 , virtually reconstruct M2 , and M3 as well as assessing the development stage of these. Finally, we compare this case with extinct and extant populations. RESULTS: Based on the identified signs, we suggest that individual H3 suffered from a unilateral impaction of the M2 as a result of the ectopic position of the developing M3 . DISCUSSION: We conclude that the most likely etiology for the ectopic position of the M3 is the lack of space in the maxilla. We discuss possible contributing factors, such as morphometric aspects of the maxilla and the early mineralization of the M3 , to support the M2 impaction. Finally, due to the early age at death of this individual we did not identify any secondary lesion associated with the M2 impaction.

Space conditions, palatal vault height, and tooth size in patients with and without palatally displaced canines: A prospective cohort study.

OBJECTIVES:: To assess palatal vault height, tooth size, and dental arch dimensions in patients with unilateral and bilateral palatally displaced canines compared with a control group. MATERIALS AND METHODS:: A sample of 66 patients (mean age: 11.5 ± 1.0 years) with 22 unilateral palatally displaced canines (UPDCs), 22 bilateral palatally displaced canines (BPDCs), and 22 controls (C) were consecutively recruited. All three groups had dental casts that were scanned digitally using the OrthoX three-dimensional model scanner. Tooth size, palatal vault height, dental arch width, dental arch depth, dental arch length, and dental arch space were measured by the same examiner using the GOM software. Remeasurements were made in 10 randomly identified patients. RESULTS:: The palatal vault height was significantly lower in the BPDC group compared with controls. A significantly smaller mesial-distal crown width and, in general, more spacing in the maxilla were found in the UPDC and BPDC groups. No differences in arch length or arch width at the molar region were seen between the groups, while the arch length at the canine region was smaller in the UPDC and BPDC groups. However, this was observed in BPDC patients with both deciduous canines present and in most UPDC patients where the deciduous canine was present, compared with the control group, who had more permanent canines present. CONCLUSIONS:: Patients with PDC had greater reduction in tooth size compared with the control group. The arch length and arch width were similar in patients with and without PDC.

Associations between tooth agenesis and displaced maxillary canines: a cross-sectional radiographic study.

BACKGROUND: The aim of present study was to test the association between hypodontia and displaced maxillary canine when compared with a control group. METHODS: The study group was composed of 336 subjects with a mean age of 10.7 ± 1.2 years, presenting with at least one missing tooth. Exclusion criteria included syndromes, craniofacial malformations, extractions and trauma history and previous orthodontic treatment. The control group consisted of 336 subjects with a mean age of 10.7 ± 1.2 years, without agenesis. Stepwise multiple logistic regression using the backwards elimination and the Wald test method was performed to identify the best combination of hypodontia and displaced maxillary canine (P < 0.05). RESULTS: The most represented category in study group consisted in mild agenesis (86.9%); moderate and severe agenesis groups respectively represented the 11.7 and 1.4% of study group. Agenesis was diagnosed in both arches in 46 subjects. Maxillary hypodontia and mandibular hypodontia was respectively detected in 156 and 134 subjects. The most frequent missing teeth were mandibular second premolars (45.8%), lateral incisors (41.7%) and maxillary second premolars (17.8%). A significant correlation between agenesis and displaced maxillary canine was observed in the study group (P < 0.05). Only the agenesis of maxillary lateral incisors remained in the final model during backward stepwise deletion. Significant association between the severity of dental agenesis and prevalence of displaced maxillary canine was not assessed. CONCLUSIONS: The outcomes revealed no difference related to the severity of dental agenesis and prevalence of displaced maxillary canine. Only the agenesis of maxillary lateral incisors should be considered directly connected with displaced maxillary canine.

Ectopic eruption of a lower permanent molar from the mediaeval necropolis of Alcáçova do Castelo, Mértola, Portugal.

The mediaeval necropolis of Alcáçova do Castelo is located in Mértola, Southern Portugal, and dates from the 14th to the 16th centuries. The archaeological campaigns started in 1978 and continue today, having yielded more than 759 graves. This report discusses an ectopic tooth eruption observed in skeleton 535, an adult female individual. A distal right permanent lower molar presents an ectopic eruption at the posterior margin of the coronoid process. On the opposite side, the first and second permanent molars are present, the left permanent lower third molar is absent and the mandibular ramus cannot be evaluated since it is broken off and lost. Tooth migration (heteropia) is a common pathological condition documented in clinical literature. However ectopic eruption of lower distal molars is a rare event, and there are few known cases. This is the first case described in archaeological populations worldwide.

Unusual intrabony transmigration of mandibular canine: case series (report of 4 cases).

Intrabony cross arch migration (transmigration) of impacted teeth is a very rare dental anomaly. Transmigration is commonly seen in permanent dentition of the lower jaw. The tooth most commonly involved is the mandibular canine. The prevalence of transmigrated canine has been found to be only 0.14-0.31%. Transmigration of the canine most frequently occurs in a mesial direction resulting in migration across the mandibular symphysis to the opposite side of the dental arch. We report a case series (4 cases) of rare transmigration of mandibular canines and emphasise the need to use panoramic radiography in cases presenting with either over retained deciduous canines and/or missing permanent canines. We also propose a newer modification to the present classification of transmigration for one of these cases as the present classification does not include all the entities.

Dacryocystitis following a nasolacrimal duct obstruction caused by an ectopic intranasal tooth in a dog.

PURPOSE: To describe a nasolacrimal duct (NLD) obstruction secondary to an ectopic tooth in a 5-year-old male Border collie. The dog was presented with a 1-month history of mucopurulent discharge from the left eye (OS) preceded by a lifelong history of epiphora OS. Treatment with neomycin/polymyxin B/dexamethasone ophthalmic solution had not improved the clinical signs, and the NLD was not patent when irrigated by the referring veterinarian. METHODS: A complete ophthalmologic examination was performed followed by dacryocystorhinography and computed tomography (CT). RESULTS: The ophthalmologic examination revealed marked mucopurulent discharge, mild conjunctivitis, slightly elevated STT measurements, and a negative Jones test OS. Both nasolacrimal puncta OS could be cannulated without resistance for approximately 1.5 cm. Upon irrigation, copious amounts of mucopurulent discharge were exited through the corresponding punctum, while no fluid could be detected at the nares. Dacryocystorhinography was performed. Radiographs revealed an ectopic left canine tooth within the left nasal cavity. A cystic dilation of the NLD was observed proximal to the ectopic tooth. Computed tomography was performed to determine the exact position of the tooth and possible involvement of adjacent structures; CT confirmed the previous imaging findings. Treatment with systemic antibiotics, NSAIDs, and ofloxacin ophthalmic solution led to resolution of the clinical signs within several days. Surgery was declined by the owner. CONCLUSION: This is the first case report describing a blocked NLD due to an ectopic tooth in a dog. Ectopic teeth should be included as a differential diagnosis in cases of dacryocystitis and chronic epiphora in dogs.

Long-term surgical versus functional Class II correction: a comparison of identical twins.

The purpose of this twin case comparison was to assess the short- and long-term effects of nonsurgical treatment vs orthognathic surgical treatment for Class II correction. Two identical twins (age 13 years 3 months) were treated for Class II correction where one patient was treated nonsurgically using a fixed functional appliance, while the other was treated using orthognathic mandibular advancement surgery. The patients were recalled and evaluated 5 years in retention. Comparing changes in the short and long term, surgical treatment led to superior skeletal results compared to the nonsurgical twin. However, the soft tissue profile was remarkably similar for both patients suggesting that soft tissue profile changes may not necessarily follow similar changes in the bony skeletal structures.

Second branchial cleft anomaly with an ectopic tooth: a case report.

Branchial cleft cysts, sinuses, and fistulas are the most common congenital lateral neck lesions in children. They arise as a result of an abnormal development of the branchial arches and their corresponding ectoderm-lined branchial clefts. Of these diverse anomalies, second branchial cleft lesions are the most common, accounting for approximately 95% of all branchial arch pathologies. We describe what is to the best of our knowledge the first reported case of an ectopic tooth in a branchial cleft anomaly. The patient was a young girl who had other congenital abnormalities and syndromic features and who was eventually diagnosed with Townes-Brocks syndrome. We describe the clinical presentation, management, pathologic analysis, and postoperative outcomes of this case, and we present a brief review of Townes-Brocks syndrome.

Periodontal status of ectopic canines after orthodontic treatment.

OBJECTIVE: To evaluate the periodontal health and tooth vitality of palatally impacted and buccal ectopic maxillary canines after completion of orthodontic treatment. MATERIALS AND METHODS: Fifteen patients who had unilateral, palatally impacted canines and 15 patients who had unilateral, buccal ectopic canines comprised the subjects of the study. Clinical and radiographic data was collected by recalling the patients in both groups after a mean period of 3.82 ± 1.54 years following completion of their orthodontic treatment. In both groups, the contralateral, normally placed canines served as controls. RESULTS: Palatally impacted canines had greater pocket depths, higher gingival levels, higher electric pulp testing scores, and reduced bone levels compared to their contralaterals. Buccal ectopic canines had increased plaque and gingival bleeding index, greater pocket depths, reduced attached gingival width, higher gingival levels, increased clinical crown lengths, and higher electric pulp testing scores compared to their contralaterals. Buccal ectopic canines had lower electric pulp testing scores and higher bone levels compared to palatally impacted canines. CONCLUSION: All ectopic canines had increased plaque and gingival bleeding index, greater pocket depths, reduced attached gingival width, higher gingival levels, increased crown lengths, higher electric pulp testing scores, and reduced bone levels compared to their contralaterals.

Associations between palatally displaced canines and maxillary lateral incisors.

INTRODUCTION: The purpose of this research was to investigate relationships among the location and orientation of palatally displaced canines and the dimension and orientation of the maxillary lateral incisor. METHODS: An experimental group of 40 patients with 46 palatally displaced canines (20 from boys, 26 from girls; mean age of the subjects, 13.9 years; age range, 10.5-15.9 years) was selected from the records of patients referred to a radiology practice specializing in cone-beam volumetric tomography imaging. This group was age- and sex-matched with 30 normal subjects with 60 canines (26 from boys, 34 from girls; mean age of the subjects, 13.8 years; age range, 10.4-15.7 years). Digital cone-beam volumetric tomography images were imported into an imaging software and were reoriented and reconstructed into several radiographic images in coronal and sagittal sections; a maxillary arch occlusal view was also produced. The angular and linear variables of the canines and the maxillary lateral incisors were measured by using software measurement tools. Independent t tests or Mann-Whitney U tests were used accordingly based on normality of the data to compare the variables between the palatally displaced canine and the control groups. Multiple linear regressions were used to examine the relationships between the canine variables (dependent variables) and the maxillary lateral incisor variables together with confounding variables (independent variables). RESULTS: The maxillary lateral incisors in the palatally displaced canine group tended to be more upright in the sagittal and coronal planes. Generally, the most significant independent variables according to backward examination of linear regression for canine variables (coronal and sagittal angulations, and distance to the occlusal plane of palatally displaced canines) were the coronal and sagittal angulations of the maxillary lateral incisors, the length and buccolingual root width of the maxillary lateral incisors, and age. CONCLUSIONS: The orientation and location of palatally displaced canines were associated with changes in the angulations of maxillary lateral incisors and small lateral incisors.

Dentigerous cyst associated with dilacerated and inverted maxillary central incisor: an unusual case report / Cisto dentígero associado ao incisivo central superior invertido e dilacerado: relato de um caso incomum

One of the most common types of developmental odontogenic cyst is the dentigerous cyst. It encloses the crown of the tooth and is attached at the cementoenamel junction. Although its association with mandibular molars is common, it is rarely associated with the maxillary central incisors. Discussion: The present case report describes an unusual occurrence of dentigerous cyst associated with the impacted permanent maxillary central incisor in an inverted position and showing dilaceration of the root. The cyst was enucleated along with the extraction of the impacted tooth. We have discussed clinical presentation, radiographic features and treatment modalities of this uncommon and rare presentation of this lesion. Conclusion: Trauma to the deciduous teeth should not be overlooked, since it can result in the development of a pathology which could indirectly affect the permanent successors...

Um dos tipos mais comuns de cisto odontogênico de desenvolvimento é o cisto dentígero. Ele inclui a coroa do dente e está conectado à junção cemento-esmalte. Apesar de sua associação com molares inferiores ser comum, ele raramente está associado com incisivos centrais superiores. Discussão: O presente relato descreve um caso raro de cisto dentígero associado ao incisivo central superior permanente impactado em uma posição invertida, apresentando dilaceração da raiz. O cisto foi enucleado durante a extração do dente afetado. Foram discutidas a apresentação clínica, as características radiográficas e as modalidades de tratamento desta apresentação incomum e rara de lesão. Conclusão: O trauma em dentes decíduos não deve ser negligenciado,pois pode resultar no desenvolvimento de uma patologia que pode afetar indiretamente os sucessores permanentes...

Dental arch parameters of the displacement and nondisplacement sides in subjects with unilateral palatal canine ectopia.

OBJECTIVE: To compare arch perimeter and teeth size, number, and shape between the two sides of the dental arch-the canine displacement side (DS) and the nondisplacement side (NDS)-in subjects with unilateral palatally displaced canine (PDC). MATERIALS AND METHODS: Orthopantomograms (OPTs) of 240 subjects with unilateral PDC and 240 OPT matching controls were used. Additionally, study casts of 100 study subjects and 100 controls were used. The age of subjects ranged between 14 and 25 years. Dental casts were digitized and several parameters were recorded. RESULTS: The transverse width from midpalatal line to the buccal segment and the palatal area on the DS was larger than that in the NDS (P < .05 to .001), with no difference in tooth size between both sides. Maxillary second premolars, canines, and lateral incisors in the PDC group were smaller than those in control group. Peg-shaped lateral incisors were significantly more frequent in the study group (P < .001). CONCLUSIONS: The transverse width of the DS was larger than that of the NDS. Both sides were generally smaller than those of the control group. Tooth size in the DS was comparable to that in the NDS but smaller than those of the control group. A missing or peg-shaped lateral incisor was the most common reported anomaly.

A rare case of unerupted second deciduous molar located inferior to the second premolar: case report.

AIM: Tooth eruption is defined as the movement of a tooth from its site of development within the alveolar process to its functional position in the oral cavity [Massler et al., 1941]. The process of tooth eruption can be divided into different phases: pre-eruptive bone stage, alveolar bone stage, mucosal stage, preocclusal stage, occlusal stage and maturation stage [Andreasen et al., 1997]. Any disturbance in these phases can lead to eruptive anomalies. The incidence of unerupted teeth is usually higher among permanent teeth than among deciduous ones [Walker et al., 2004; Otsuka et al., 2001; Amir et al., 1982; Broadway, 1976; Pinborg et al., 1970]. Of the primary teeth reported as unerupted, second primary molars are the teeth most frequently involved [Walker et al., 2004; Otsuka et al., 2001; Bianchi et al., 1991; Ranta et al., 1988; Tsukamoto et al., 1986; Amir et al., 1982], followed by primary central incisors [Otsuka et al., 2001]. CASE REPORT: This paper presents a case of inversion of the intraosseous position of a second unerupted deciduous molar and the succedaneous second premolar.

Oral and dental manifestations in Rubinstein-Taybi syndrome: report of a rare case.

Rubinstein-Taybi syndrome, or broad thumb-hallux syndrome, is a well-defined rare congenital disorder characterised by postnatal growth deficiency, craniofacial dysmorphism, broad thumbs and great toes, and mental retardation (intellectual disability). Occurrence may be either sporadic or through autosomal dominant inheritance. Reports of Rubinstein-Taybi syndrome are scarce in the literature. This case report describes the oral and dentofacial findings of Rubinstein-Taybi syndrome affecting a 13-year-old Indian female, including the uncommon presence of talon cusps and an unerupted supernumerary tooth.

Dentoskeletal characteristics in patients with palatally and buccally displaced maxillary permanent canines.

The aim of this retrospective study was to analyse dentoskeletal characteristics in patients with eruption disturbances of the maxillary permanent canines. Pre-treatment panoramic radiographs and lateral cephalograms of 636 consecutive orthodontic patients were assessed. The control group included 456 patients with physiologically erupted maxillary permanent canines (261 females and 195 males, mean age 12.6 and 12.4 years, respectively). The other groups comprised 144 subjects with palatally displaced canines (PDCs) (92 females and 52 males, mean age 14.2 and 14.7 years, respectively) and 36 patients with buccally displaced canines (BDCs) (16 females and 20 males, mean age 12.4 and 12.8 years, respectively). The selected dentoskeletal parameters were compared with classic cephalometric norms using the method of analysis of variance, chi-square, and Fisher's exact tests. The PDC patients showed a significantly more prognathic maxilla, a significantly more frequent occurrence of skeletal class I, retroinclination of maxillary central incisors, hypodivergent relationship, and mandibular anteriorotation and less frequent posteriorotation. A significantly more frequent retrognathic maxilla and skeletal class III and less frequent retroinclination of the maxillary central incisors were found in the BDC patients. The results of this study indicate the existence of different facial morphology and more likely also etiopathogenesis of eruption disturbances of the canines in the PDC and BDC patients.

Ectopic canine associated with a dentigerous cyst in the maxilla.

Ectopic eruption of a tooth is common in the dental arch, palate, and nose, but it is rare in the maxillary antrum. We present the case of a 35-year-old man with an ectopic canine and an associated dentigerous cyst in the maxillary sinus that masqueraded as an antrochoanal polyp.

Apoptosis in the human periodontal membrane evaluated in primary and permanent teeth.

OBJECTIVE: Recent studies revealed a highly innervated layer in close proximity to the root surface in the periodontal membrane of human teeth. Persistence of the epithelial cells of Malassez along root surfaces without resorption has also been demonstrated. It is hypothesized that resorption is connected to apoptosis of the epithelial cells of Malassez. The purpose of this study is to localize cells undergoing apoptosis in the periodontal membrane of human primary and permanent teeth. MATERIALS AND METHODS: Human primary and permanent teeth were examined immunohistochemically for apoptosis and epithelial cells of Malassez in the periodontal membrane. All teeth examined were extracted in connection with treatment. RESULTS: Apoptosis was seen in close proximity to the root surface and within the epithelial cells of Malassez. This pattern of apoptotis is similar in the periodontal membrane in primary and permanent teeth. CONCLUSIONS: The inter-relationship between apoptotis and root resorption cannot be concluded from the present study. Apoptosis seen in close proximity to the root surface presumably corresponds to the highly innervated layer of the periodontal membrane. The function of this layer still needs to be elucidated.

Craniofacial and dental dysmorphology in patients with median facial dysplasia: long-term follow-up.

Median facial dysplasia affects a subset of patients with cleft lip and palate exhibiting certain characteristics of median facial structure deficiencies without definable gross abnormalities of the brain. The aim of this study was to describe the craniofacial and dental morphology of almost skeletally mature patients with median facial dysplasia. Patients were selected for this retrospective study if they were diagnosed with median facial dysplasia and ≥15 years old. The craniofacial and dental morphology was evaluated by analysing cephalometric and panoramic radiographs. This sample of median facial dysplasia patients (9 males and 11 females; 6 unilateral and 14 bilateral clefts) had a mean age of 16.7 ± 1.9 years. Controls were age-, sex-, cleft type-matched, and nonsyndromic patients. The results showed that in patients with median facial dysplasia, the anterior cranial base and midface were shorter than in controls. The median facial dysplasia inter-orbital distance was shorter and the nasal bone was more retrusive than in controls. All patients with median facial dysplasia had several missing permanent teeth. These features require extensive surgical, orthodontic, and dental rehabilitation procedures.