Complexity at its simplest by interceptive orthodontics

Supernumerary teeth are relatively common in the oral cavity and are characterized by an excessive number of teeth. The term "mesiodens" refers to a supernumerary tooth located in the midline of the maxilla between the central incisors. Mesiodens may cause a variety of pathological complications such as impaction of the maxillary central incisors, tooth retention or delayed eruption of the permanent incisors, crowding, eruption within the nasal cavity, formation of diastema, intraoral infection, root anomaly, root resorption of adjacent teeth and cyst formation accompanied by bone destruction. Therefore it is recommended to follow-up with regular radiographic examination. Early diagnosis minimizes treatment needs and prevents associated complications. The present cases focus on early intervention of extracting supernumerary teeth and closure of space followed by minimizing the complexity of crowding

Oral rehabilitation of a patient with ectodermal dysplasia with prosthodontics treatment

Ectodermal dysplasia (ED) is a rare, congenital disease that involves the sweat glands, scalp hair, nails, skin pigmentation, and craniofacial structure. Oral symptoms of ED include multiple tooth abnormalities (such as hypodontia, anadontia, impacted teeth, and peg-shaped or conical anterior teeth) and lack of normal alveolar ridge development. A 12-year-old male patient, in the absence of any other systemic abnormalities, exhibited typical characteristics of ED, visited our department of pedodontics and preventive dentistry at Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre. In the clinical and radiographic evaluation, it was occurred that he had only maxillary and mandibular first molars in his mouth. A maxillary and mandibular denture with clasps for retention was fabricated for prosthodontic rehabilitation after considering his growth and the number and condition of his present teeth. At the 18-month follow-up no major complications occurred and further future treatment included implants retained fixed partial dentures

Effect of casein phosphopeptide-amorphous calcium phosphate (cpp-acp) on caries-like lesions in terms of time and nano-hardness: An in vitro study

Context: Time bound increase in the nanohardness of the enamel after remineralization with casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) in a regular interval of 1 h has not been explored in the literature to a greater extent. Aims: To determine and compare the maximum hardness of the remineralized caries-like lesions, in terms of nanohardness and the rate of achieving maximum hardness at 1-h interval, after treatment with artificial saliva and CPP-ACP, over 12 h. Materials and Methods: Fifty longitudinal sections of extracted sound permanent maxillary central, lateral incisors were immersed in demineralizing solution for 4 days. The samples were then randomly divided into three groups, consisting of 12 sections each for soaking them in three different media-isotonic saline, artificial saliva, and CPP-ACP for 12 h. The nanohardness was measured on the labial surface, at baseline, after erosion, and after remineralization at 1-h interval. Statistical Analysis Used: The data was analyzed with paired t-test, one-way analysis of variance (ANOVA) and post-hoc analysis. Results: CPP-ACP increased the enamel hardness significantly (P < 0.001), at an increased rate, than artificial saliva. Conclusions: This study has provided an insight into the frequency of use of CPP-ACP, once per day, as the nanohardness of enamel samples increased within 1 h of application and remained within the normal limits after 12 h

Immature tooth with the coexistence of dilaceration and radicular dens invaginatus

Trauma to the developing permanent successors leads to alteration in form, size, structure, and quantity of teeth. Management of teeth with such morphological complexity becomes challenging. The severity of the anomaly decides the treatment planning. A case of coexistence of radicular dens invaginatus and dilaceration is reported, which was to be managed surgically due to uneventful endodontic attempts and complicated root anatomy

Nonsyndromic localized aggressive periodontitis of primary dentition: A rare case report

Periodontitis is an inflammatory disease of the gingiva and tissues of the periodontium. It is characterized by pocket formation and destruction of supporting alveolar bone. Periodontal diseases of aggressive nature are not very common in children. They are usually associated with systemic conditions. The present case report is of a 5-year-old male child who reported with rapid attachment loss and bony defects of the gingiva and supporting structures. His family and medical history gave no contribution for the diagnosis. Blood investigations did not reveal any abnormality. The microbial examination of culture revealed the presence of periodontal pathogen Aggregatibacter actinomycetemcomitans. The treatment objective in the present case was to prevent the further progress of the condition, restore esthetic and function in the child which would psychologically benefit the child

Prevalence of dental caries in people attending special schools in Hyderabad-Secunderabad, India

Aim: The present cross-sectional study was conducted to determine the decayed, missing, filled primary and permanent teeth (dmft-DMFT) indices and its association with the type of disability in 856 disabled individuals attending special schools in twin cities of Hyderabad and Secunderabad, Andhra Pradesh State, India. Materials and Methods: Participants were grouped according to their disability such as: Mild, moderate, severe mental retardation, hearing and speech defect and others (39) (including Down′s syndrome [20], autism [9], hyperactive [4], microcephaly [2], border line cases [4]). Examination was carried out at their schools, with participants seated in ordinary chairs and examined under natural light with mouth mirror and probe. Subjects were of different age groups ranging from 1 to 55 years. Statistical Analysis Used: Analysis of variance with post-hoc Games-Howell test was used for statistical analysis. Results: Mean dmft; DMFT scores were as follows: 2-6 years: 1.58 ± 1.9; 2.18 ± 2.94, 7-12 years: 1.1 ± 2.4; 1.9 ± 2.13, 13-30 years: 2.38 ± 2.5, 30+ years: 2.13 ± 3.2. Overall only 23% of subjects were caries free. "dmft" was statistically higher among moderate mentally retarded group while DMFT was statistically higher in mild and moderate mentally retarded groups. Conclusions: These findings emphasize the need of educating parents and caregivers of disabled individuals in preventive dental procedures, especially those of the mild and moderate mentally challenged group

Conservative Approach in the Management of Radicular Cyst in a Child: Case Report

Radicular cyst is the most common odontogenic cystic lesion of inflammatory origin. It is also known as periapical cyst, apical periodontal cyst, root end cyst, or dental cyst. It arises from epithelial residues in the periodontal ligament as a result of inflammation. The inflammation usually follows the death of dental pulp. This paper presents a case report of a patient with radicular cyst associated with a primary molar

Type III B dens invaginatus: Diagnostic and clinical considerations using 128-slice computed tomography

Endodontic therapy is successful only when thorough knowledge of root canal morphology is understood. Dens invaginatus is malformation of teeth resulting from invagination of tooth before biological mineralization occurs. It is clinically significant with an early pulpal involvement and chronic periapical lesion, which are often associated with this anomaly. The present case report describes a 13-year-old female patient who reported to our institution with complaint of pain and swelling in the right maxillary region. Intraoral examination revealed Ellis Type II fracture of right maxillary central incisor and normal appearing right maxillary lateral incisor. On radiographic examination right maxillary, lateral incisor roots are morphologically altered with an immature apex and a large periradicular lesion. Conventional radiographs help in the assessment of complex root morphology, but certain limitations pertaining to detail of complexity needs for the use of more advance imaging modalities. Complex anatomic variations can best be diagnosed with the use of computed tomography (CT). A combined endodontic and surgical treatment was performed followed by postobturation CT images which were reviewed as axial slices and in volume rendering multiplanar reconstruction. The scope of using spiral CT in the endodontic diagnosis and treatments is increasing as it provides better resolution than other methods

Dermatoglyphics as a Non Invasive Diagnostic Tool for Predicting Caries Risk in Specially Abled Children

Aim: The present study was conducted to determine the dermatoglyphic configuration of specially abled and healthy children by comparing the variations that occur in these patterns and evaluating the caries experience associated with it. Materials and Methods: This was a cross sectional study in which dermatoglyphic patterns along with deft and DMFT index was recorded in 100 children of age 6-16 years divided into two groups of 50 each (50-specially abled and 50- normal children). Results: Statistical analysis was done using MANN-WHITNEY U test. Specially abled children showed increased number of loop configurations compared to healthy children and high caries risk children in both the groups showed increased number of arches and decrease in the number of whorls with no statistical significance (P >0.005). Conclusion: With further research in this field, dermatoglyphic patterns can prove to be an effective diagnostic tool in diagnosis of diseases with a genetic cause