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Supernumerary teeth are more common in the permanent than in primary dentition. In the primary dentition, the anomaly is most frequently observed in the maxillary lateral incisor region, followed by the maxillary midline where they are termed as mesiodens. Supernumerary teeth in the primary canine region are rare. This paper describes a rare case of nonsyndromic supernumerary primary maxillary canine distributed bilaterally in a 4-year-old boy. Both the supernumeraries resembled size and shape of normal primary canine. The right supplemental canine is high labially placed, whereas the left one is seen normally aligned in the dental arch distal to lateral incisor. One of the most significant sequelae of primary supernumerary teeth is their duplication in the permanent series. Radiographic examination of supernumerary primary canine did not indicate any such anomaly in the permanent dentition. The patient was kept under observation.

Instrument separation is one of the most common procedural errors that may occur during endodontic treatment. A separated instrument can create an obstruction in the root canal which can hinder the cleaning and shaping procedures. If an instrument separation takes place, an attempt should be made to retrieve the instrument and if retrieval is not possible, the instrument should be bypassed. Nickel–titanium (NiTi) instruments have several advantages, such as superelasticity and shape memory, which prompted their use in endodontics. Due to these characteristics, NiTi instruments have shown to preserve the original anatomy and shape of the root canal. However, the disadvantage is that they fail to show signs of fatigue prior to fracture unlike stainless instruments. This article describes a case report showing the successful use of a modified tube, loop and file technique for the retrieval of two separated instruments, from a maxillary lateral incisor of a 14-year-old male patient.

Talon cusp is a developmental dental anomaly with supernumerary structure projecting from the dento-enamel junction towards the incisal edge of an anterior tooth. The etiology is usually unknown but studies states that talons cusp can occur due to the hyperactivity of the enamel organ during morph differentiation. The incidence is 0.04-10% and the prevalence is more in maxillary incisors than mandibular incisors and more in palatal aspect of the teeth. The most common complications are esthetics, increased risk for caries and occlusal accommodation. This article reports a case of talon cusp on the palatal surface of the permanent maxillary lateral incisor. Due to its clinical significance the dentist should be able to diagnose the supernumerary tooth and definitive treatment should be done.

Molars and premolars of maxilla and mandible infrequently exhibit a supernumerary inclusion or an anomalous cusp on their buccal surfaces which is known as a paramolar tubercle. When supernumerary cusps are associated with maxillary molars and premolars, they are termed as parastyle, and when associated with mandibular molars and premolars they are known as protostylid. This rare entity occurs singly in permanent dentition and is seen on the mesial half of the molars. The present paper reports two rare cases of bilateral paramolar tubercle in mandibular first molars and maxillary second molars associated with hypodontia of maxillary lateral incisor in both the cases. One paramolar tubercle in the mandibular molar was associated with accessory separate root on the distal aspect.

Dens invaginatus is a developmental malformation resulting from invagination of the tooth crown or root before calcification has occurred. It can range from a deep fissure or pit on the lingual surfaces of anterior teeth to an occlusal pit on the posterior teeth. This article presents a case of type II dens in dente in a 14-year-old female patient, where the invagination extends beyond the cementoenamel junction in maxillary lateral incisor with a large periradicular lesion. Usually, an anomaly such as dens invaginatus remains unnoticed by the patient until any clinical sign appears. Root canal treatment of such teeth with complex root canal anatomy can be difficult because infected pulpal tissues may remain in inaccessible areas of the canal. Hence, it is important to identify this anomaly and manage it as early as possible. In the present case, a nonsurgical root canal treatment of the invagination was performed. The treatment of invagination resulted in resolution of a substantial periradicular lesion.

Objective: The aims of this study were to determine the prevalence of hypodontia in the permanent dentition in a sample of Qatari patients attending a dental center and to compare the results with the reported findings of other populations. Materials and Methods: Orthodontic files including orthopantomographs of 1000 patients (655 females and 345 males, 11-36-year-old) were examined and inspected for evidence of hypodontia. Results: The prevalence of hypodontia in the present Qatari sample was 7.8%; 6.9% was in males and 8.2% in females. Hypodontia was found more frequently in the maxilla than in the mandible. The distribution of missing teeth was noticed in the left side more than the right side. The most frequently missing teeth were the maxillary lateral incisors followed by the mandibular second premolars, maxillary second premolars, and mandibular left lateral incisor. The majority of patients with hypodontia had one or two teeth missing, but rarely more than four teeth were missing in the same patient. Bilateral missing teeth in the current study was commonly seen in the maxillary lateral incisor (14.1%) followed by mandibular second premolar (12.8%) and maxillary second premolar (6.4%). Conclusions: The prevalence of hypodontia in a sample of Qatari individuals was within the range reported in the literature for other populations. The incidence of hypodontia in the anterior segment requires multidisciplinary team approach (orthodontic and prosthodontic) to restore the esthetic and function and improve patient self-esteem.

Mucosal fenestrations, wherein the tooth root apices are clinically discernible in the oral cavity subsequent to loss of overlying alveolar bone and mucosa, are rare pathologic entities. Palato gingival grooves- anatomic aberrations are also infrequent occurrences that notoriously predispose to periodontal pathologies of varying extent. Both conditions independently are known to popularly affect maxillary lateral incisors. Coexistent fenestration defect and palato gingival groove in the same tooth is extremely rare and undoubtedly is a perfect combination to precipitate severe endodontic-periodontal consequences. In this report, a 34-year-old patient presented to the dental department with complaint of esthetics in relation to exposed root of right maxillary lateral incisor. On closer inspection, a palato gingival groove in addition to fenestration defect was evident on the root surface along with a periodontal pocket of >5 mm. An interdisciplinary treatment was instituted which included endodontic treatment followed by root end resection, osseous bone graft placement and guided tissue regeneration procedures for repair of mucosal fenestration defect. Debridement of the palatal pocket, with saucerization of the groove and restoration with glass ionomer cement were simultaneously employed to correct the palatal defect.

Presence of palatal radicular grooves are considered to be an important contributing factor to the development of localized periodontitis, as it favored the accumulation and proliferation of bacterial plaque deep into the periodontium. Pulp involvement could result due to the introduction of bacterial toxins through channels that existed between the root canal system and the groove. Early diagnosis, elimination of infl ammation and correction of anatomic complications are the key to a favorable outcome for managing palatoradicular groove. Present report describes successful management with an interdisciplinary approach of maxillary lateral incisor with combined endodontic periodontic lesion associated with palatoradicular groove.

One of the causes of non-healing periapical pathosis in endodontically treated tooth is root perforation. This can occur pathologically by resorption and caries, iatrogenically during endodontic therapy (zip, strip, furcal perforations). Root perforation results in bacterial contamination, periradicular tissue injury, inflammation, and bone resorption. The purpose of this case report is to describe endodontic retreatment and surgical management of a longstanding periapical lesion on maxillary lateral incisor, associated with perforation and osseous defects using mineral trioxide aggregate (MTA). Although the majority of bone support and root dentin was damaged, an attempt was made to repair the defect and restore the tooth. After the surgical intervention and root canal treatment, the perforation was subsequently sealed with MTA. Later, the root was reinforced with composites and the tooth was restored with direct veneer. Conclusion: Four-and-a-half year (54 months) recall examination showed no evidence of periodontal breakdown, no symptoms of further deterioration, and complete healing of periradicular lesions when examined by radiography. This case report presents a treatment strategy that could improve the healing process and beneficial outcomes for patients with perforation and osseous defect.

Tooth transposition is a rare developmental anomaly in which the adjacent teeth switch/swap their positions and may create problems both esthetically and functionally. The maxillary permanent canine is the tooth most frequently involved, which is often transposed with the first premolar followed by transposition between the maxillary permanent canine and maxillary lateral incisor. This paper reports two cases of tooth transposition, one in mandibular arch involving the right lateral incisor and canine; and the other bilateral transposition in maxillary arch involving the first premolars and canine. It also focuses on the etiology and the prevalence of this interesting phenomenon called transposition.

Variation in the roots and root canal anatomy seems to be the norm rather than an exception. For a successful endodontic treatment, a clinician should have a thorough knowledge of the internal and external dental anatomy and its variations. Maxillary lateral incisors usually exhibit single canal with a single root. In this case, clinical examination and radiographs clearly demonstrates the presence of two root canals with two separate curved roots. This case report emphasizes the need for attention during endodontic management of maxillary lateral incisors.