Fusion and gemination: Report of two cases

Fusion and gemination are rare occurrences in the mandibular posterior teeth. Different treatment methods can be used according to the situation. The purpose of this case report is to show surgical treatment of these teeth and to prove the exact dental anomaly by examining them histologically. A report of two cases of fused and geminated teeth are presented. The first case was an 42 year old male referred with the complaining of pain originated from the right mandibular third molar fused with a supernumerary tooth. The second case was an 23 year old male having pain in the left mandibular third molar with bifid crown. Both teeth were extracted surgically and then cut perpendicular to their long axis to investigate to name the type of the anomaly. The histological examination revealed fusion of cementum between the mandibular third molar and supernumerary fourth molar which is diagnostic for fusion of these teeth in case 1. In case 2, it was observed that the teeth were sharing same pulp chamber which is describing gemination of these teeth. We believe that diagnosing the condition will facilitate endodontic, prosthodontic, periodontic, orthodontic and surgical treatment of such teeth

Autogenous abdominal fat transplantation into temporomandibular joint following removal of osteochondroma

Background: An osteochondroma (OC) of the condylar process is a rare condition which primarily affects the mandibular condyle. There are several surgical treatment protocols of OC. As effective hemostatic agents and space fillers, autogenous free-fat grafts prevent scar formation and helps to hinder the accumulation of blood and serum, which otherwise, may be replaced by a dense collagen (scar), osteoid or bone. We report the autogenous abdominal fat transplantation, following the removal of a condylar OC. Methods: A 42-year-old man presented with the one-year history of progressive facial asymmetry and deviation of the chin, cross-bite to the contralateral side, and difficulty in mastication. Radiographic and clinical findings confirmed the diagnosis of an OC. Computed tomography (CT) showed lateral and inferior displacement of the right mandibular condyle due to the presence of a bone lesion from the medial aspect of the condylar head. Results: The OC was removed; the remaining portion of the condyle was re-shaped and smoothened. Abdominal fat harvesting was done 2–3 cm below the umbilicus and 3–5 cm length on the transverse midline. The defective area was filled with a harvested autogenous abdominal fat. Conclusion: Our results suggest that autogenous abdominal fat graft placement after the removal of OC with condyloplasty is yielded satisfactory treatment outcomes. © 2018 The Author

The impact of handicap severity on oral and periodontal status of patients with mental retardation

PubMed: 25095847AIM: Mental retardation (MR) subjects comprise a considerable amount of the community and are susceptible to oral and periodontal problems due to insufficient oral care. The aim of this cross-sectional study was to determine the oral health and periodontal status of MR patients in Turkey with regard to periodontal indices and Decay missed filling teeth (DMFT) scores and compare findings according to severity of the MR.MATERIALS AND METHODS: One hundred and five MR patients were included to the study and divided into 3 groups according to MR severity diagnoses. Demographic variables like age, gender, disabled sibling, BMI, living an institution and clinical parameters like plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), missing teeth and DMFT scores were recorded from all subjects. Appropriate statistical analyses were used to compare the findings.RESULTS: There were no statistically significant differences between groups according to age, gender, disabled sibling, living status and DMFT scores. Clinical periodontal indices and the number of missing teeth were showed a statistically significant increasing trend with the severity of MR (p < 0.05). Correlation analysis showed significant positive correlations between PI and periodontal disease measures like GI, PD, CAL and BOP and also between PI and DMFT (p < 0.05).CONCLUSION: The deteriorated teeth condition and deprived periodontal health of MR patients may be most likely caused by the poor oral hygiene and may be worsen with the severity of the MR. Clinical significance: Knowledge of oral and periodontal status of mental retardation patients has great importance for public health and family education