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A 7-month-old, male, Weimaraner dog was presented for maxillary swelling. Clinical evaluation including radiographs and computed tomography revealed a large cystic lesion, unerupted right maxillary canine tooth, and mass presumed to be a compound odontoma. The cyst and mass were expansile and occupied a large portion of the nasal cavity displacing anatomical structures of the maxilla. The mass was excised via curettage through an intraoral surgical approach and the unerupted tooth and cystic lining were removed. Histopathology supported dentigerous cyst and compound odontoma. This case confirms the first report of concurrent development of dentigerous cyst and compound odontoma in a dog with successful treatment and 18-month follow-up with no recurrence., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Cleidocranial dysostosis (CCD) is a congenital skeletal disorder with significant manifestations in facial and dental development. Patients are affected with CCD present maxillary deficiency, late dental eruption, and supernumerary teeth. Early and multidisciplinary approach is necessary to treat CCD patients, especially to manage dental eruption and Class III malocclusion with maxillary deficiency. Several orthodontic and surgical interventions are performed to enable traction and extraction of teeth. Yet the maxillary deficiency may be protracted followed by orthodontic dental compensation. On the other hand, it is important to note that CCD patients' treatment is closely related to the severity of transversal and sagittal deformities, as well as the discrepancies in the lower third of the face. In this context, patients with facial impairment highly affected by CCD may need ortho-surgical decompensation to reach more aesthetic outcomes. The present study reports a case of a 14-year-old young patient affected by CCD. Clinically, the patient presented Class III malocclusion, maxillary deficiency, short lower facial third, posterior crossbite, and anterior open bite leading to facial disharmony. The patient underwent treatment in 2 stages: the interceptive approach aimed to transversally expand the maxilla and promote its protraction; and the corrective phase combined with the orthognathic surgery treated the patients' main complains; the anterior open bite, unerupted teeth, and chin prominence. The treatment approach applied in the clinical report allowed the correction of the malocclusion and facial profile satisfying completely the patient's expectations.

Orthodontic alignment of un-erupted dilacerated teeth is challenging, as the bent roots resist forces applied to move them through the bone. Various treatment options are now available to treat this condition including providing prosthesis after extractions and apicectomies. However, to maintain alveolar bone in the area of the un-erupted tooth, especially if the involved tooth is in the anterior segment, the ideal treatment would be to try and bring the tooth in the arch orthodontically. Treatment requires increased time duration, compliance of the patient, and consistent force mechanics. This case report is of a 9-year boy with un-erupted and dilacerated teeth. Orthodontic treatment of prolonged duration was provided to bring these teeth into the arch, improving the esthetics and function.

A 55-year-old woman presented to Whangarei Base Hospital Emergency Department with a mandibular swelling adjacent to her unerupted tooth 48. She had never had dental radiographs taken, having had a dental clearance 20 years earlier. She wore full dentures. A panoramic dental radiograph revealed 44 unerupted teeth. Based on the clinical, oral and radiographic examinations a diagnosis of cleidocranial dysplasia (CCD) was confirmed. The patient had not been diagnosed with CCD prior to her hospital visit. Treatment included staged extractions of superficial mandibular supernumeraries and enucleation of the mandibular cyst, attempting to avoid pathological fracture. This would be followed by a six-month review and then annually as required. The case outlines the value of dental radiography in dental practice. Little is known about the prevalence of CCD in New Zealand and this is an area where future research could be conducted.

Tooth impaction is defined as any tooth that fails to erupt into a normal functional position and remains unerupted in the jaw beyond the time of its normal eruption. Primary impaction of primary teeth is rare. Furthermore, a combination of eruption failure of primary second molars and horizontally impacted permanent first molars has not yet been reported. The purpose of this study was to present the treatment of two cases of primary impaction of primary second molars combined with horizontally impacted permanent first molars. The impacted primary second molars were extracted, and orthodontic traction was performed to induce normal eruption of the permanent first molars. We then regained space for the eruption of the second premolar and applied a space maintainer to secure the space and induce successful eruption of succedaneous teeth and normal function of permanent first molars in their positions.

Background: The aim of this case report was to describe the surgical-orthodontic treatment of an unerupted mandibular canine tooth in a 9-year-old girl., Case Presentation: A 9-year-old white girl presented with an unerupted right mandibular canine tooth. Combined surgical-orthodontic treatment was performed to correct dental impaction and to achieve good aesthetic and functional results., Conclusion: Orthodontic treatment achieved all of the required objectives.

Background: Factors that can directly influence the extraction of third molars include the position of the tooth and the presence of root dilacerations. Knowledge of these features favors an accurate therapeutic evaluation of third molars; therefore, the aim of this study was to evaluate, using panoramic radiographs, the positioning of unerupted third molars with and without root dilacerations and to verify a possible association between these two variables., Methods: In this study, 16,136 panoramic radiographs were analyzed, including 1756 lower third molars, in which the positioning was assessed according to the Winter classification and the presence of root dilacerations was determined. The data obtained from the assessments of the frequencies of the positions and the presence of root dilacerations of impacted mandibular third molar was described. A χ2 test was applied to verify a possible association between the variables., Results: The results indicated that the most frequent position was mesioangular (44.5%), followed by horizontal (24.9%), vertical (17.4%), distoangular (12.5%), inverted (0.4%), and linguoangular (0.3%). Of the mandibular third molars evaluated, 35% had root dilacerations. The chi-square test revealed a significant association between the position of the tooth and the presence of root dilacerations (P<0.0001, χ2=34.28). The frequency of root dilaceration was statistically higher for the vertical (45.5%) and distoangular positions (40.9%)., Conclusions: The mesioangular position was the most prevalent location for lower third molars, and the highest frequencies of root dilacerations were observed in the vertical and distoangular positions. Knowledge about the prevalence of root dilacerations and the significant association between the position of the third molars and root dilacerations will allow safer surgical planning for dental extractions of third molars.

The purpose of this report is to describe the diagnosis and dental treatment of a medically complex 14-year-old boy with X-linked hypophosphatemic rickets who presented with a pre-eruptive abscess on a mandibular molar and facial swelling.

Cleidocranial dysplasia (CCD), an autosomal dominant disorder with a prevalence of 1 in 1,000,000 individuals, presents with a wide range of variability. Dentists are often the first to encounter patients with CCD, some of whom do not show typical manifestations. Since it has similar features to other pathologies, CCD is misdiagnosed as other conditions. A 10-year-old boy suffering from CCD was misdiagnosed as having rickets and was referred for non-eruption of a few permanent teeth along with an unaesthetic facial appearance. Clinically and radiologically, a diagnosis of CCD was made. Currently, management of this patient's orofacial manifestations is underway., (2015 BMJ Publishing Group Ltd.)

Introduction: Oral health is essential for combat readiness. The classification for combat readiness includes the Dental Fitness Categories, which are used to estimate a soldier's need for emergency dental care while deployed overseas. When the issue at hand is in regard to unerupted or additional teeth, the treating dentist faces a difficult decision since there is no evidence-based practice guidelines., Case Report: An otherwise healthy 20 year-old soldier initially presented to his general physician (Role I) with toothache in the lower jaw. The initial referral to a general dentist (Role II) led to a diagnosis of an additional tooth 45; therefore, he was transferred to the oral surgeon (Role III). A computed tomography scan revealed fully retained besides the additional 45, wisdom teeth, and additional wisdom teeth, as well as retained tooth 23. After careful consideration, osteotomies of all retained teeth were performed under general anesthesia. A titanium miniplate was placed for stabilization., Discussion: Despite variability among dentists in assigning a particular Dental Fitness Class, the clinical and radiologic examination must take into account treatment options that may become necessary for unerupted and retained teeth., (Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.)

Objective: To evaluate the success of autogenous transplantation of embedded/impacted third molars harvested using piezosurgery., Materials and Methods: This prospective pilot study enrolled 20 healthy patients with non-restorable first/second molars and a caries-free retrievable embedded/impacted third molar. Piezosurgery was used for removing inter-radicular bone at the recipient socket as well as for bone removal around the donor teeth., Results: After an average follow-up of 16.4 months (SD = 1.9), 18 cases were successful with formation of periodontal ligament around the teeth. One tooth was lost due to infection at 1 month. One patient was lost to follow-up. There was no root resorption or ankylosis in any of the cases. In six donor teeth with complete root formation, root canal treatment was carried out. All the remaining teeth responded positively with vitality testing., Conclusion: Piezosurgery is an effective device if embedded/impacted third molars are to be harvested for successful autogenous transplantation.

Introduction: The retrieval of unerupted teeth in pedodontics is always significant to preserve the trophism of adjacent tissues, establish the correct space, provide adequate function and maintain good esthetics for the patient. The treatment plan is based on radiographic examinations and measurements, and on an accurate clinical evaluation; it aims to achieve the best treatment possible depending on the complexity of the specific case.In the most difficult clinical cases it is very important to have an early diagnosis, which is essential to plan the treatment and achieve success. In these cases, the pediatrician is in a strategic position to give an early diagnosis through a child's medical history and by counting the child's teeth., Case Presentation: This article presents two different difficult clinical cases of impacted teeth diagnosed during pediatric age, with a radiological analysis, and successfully treated with orthodontic devices designed for these specific cases. Clinical case 1 describes a 13-year-old Italian girl; clinical case 2 describes a 9-year-old Italian girl. The use of these devices achieved the desired treatment goals. The problems associated with impacted teeth and the biomechanical interventions used for these patients are discussed., Conclusions: An early and careful diagnosis followed by an accurate treatment plan for the individual cases can lead to retrieval of the impacted teeth without affecting other anatomic structures and adjacent teeth. In these cases, the pediatrician is in a strategic position to give an early diagnosis through a child's medical history and by counting the child's teeth.

We describe a case of anterior open bite after bilateral sagittal split mandibular advancement osteotomy. The discrepancy in height between the proximal and distal segments at the osteotomy sites damaged the soft tissue and caused bony interferences. Removal of the maxillary third molars and bilateral removal of bony interferences of the distal segments using a bur led to full resolution and a good orthognathic outcome on follow-up., (Copyright © 2014. Published by Elsevier Ltd.)

There is a resurgence of interest in coronectomy, but its appropriate application in the management of third molar teeth has yet to be defined. Dentigerous cysts associated with unerupted teeth are most commonly associated with mandibular third molars. In this case series we evaluate outcome after coronectomy of teeth with associated dentigerous cysts in cases where the inferior dental nerve was thought to be at risk, or there was an increased risk of mandibular fracture. We retrospectively studied 21 consecutive patients treated by coronectomy for dentigerous cysts at the Oral Surgery Department at Guy's Hospital. The most commonly affected teeth were mandibular third molars (20/21). One patient had permanent injury to the inferior dental nerve, but no mandibular fracture or recurrence of cyst was reported. One patient required secondary retrieval of the retained root because of eruption. Coronectomy of unerupted teeth associated with dentigerous cysts is an effective treatment when there is high risk of injury to the inferior dental nerve injury or potential for mandibular fracture. Further work with larger numbers and longer follow-up is required to discover the long-term outcome of the electively retained root., (Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Aim: To compare the use of the 810nm diode laser with conventional surgery in the management of soft tissue mucogingival problems associated with orthodontic treatment., Methods: Orthodontic patients requiring different soft tissue surgical procedures were randomly assigned to receive conventional surgery or soft tissue diode laser, (wavelength 810 nm)., Main Outcome Measures: Parameters documented include the type of anaesthesia used, intra and post operative pain, bleeding, the use of scalpel and sutures. The chi-squared test was used to test for significance at 95% confidence level. Probability values (p-values) less than 0.05 were regarded as significant., Results: Only 2(16.7%) of the procedures carried out with the soft tissue laser required infiltration anaesthesia compared to 10 (90.9%) with conventional surgery and this was significant (P<0.001). Post operative pain was significantly reduced in all cases treated with the diode laser (P<0.001). There was also a significant difference (P<0.05) in post operative bleeding in all cases treated with the diode laser. No sutures were used in all soft tissue cases managed with the diode laser and this was significant (P<0.001). There was no statistically significant difference in treatment time in the use of the laser compared with conventional surgery., Conclusion: Orthodontic patients treated with the diode laser required less infiltration anaesthesia, had reduced bleeding during and after surgery, rapid postoperative haemostasis, elimination of the need for sutures and an improved postoperative comfort and healing.

The most common of the supernumerary teeth in humans are mesiodentes, which arise in the midline of the maxilla between the central incisors. The most common pathologic findings associated with a mesiodens are retention of the adjacent incisors, malposition, and diastema. The development of a dentigerous cyst in association with an impacted mesiodens is relatively uncommon. We report the case of a 35-year-old man with an extensive dentigerous cyst associated with a mesiodens who presented with a painful swelling in the left nasolabial area. We discuss the imaging findings in this case, particularly the contribution of computed tomography, and we review the literature on this interesting condition.

Introduction: The aim of this prospective clinical trial was to examine the predictability of the protocol for premolar transplantation when applied by an inexperienced surgeon. Additional objectives were to examine the hard and soft tissues and to compare the findings with control premolars and also to record the patients' opinions of the treatment provided., Methods: The sample comprised 23 consecutively transplanted developing premolars in 19 patients. Their mean age at surgery was 12 years 8 months (range, 9 years 10 months-17 years). The mean observation time was 35 months (range, 6-78 months). Plaque accumulation, pocket depth, gingival recession, mobility, and pulp sensitivity were recorded for the transplanted and the control teeth. Standardized radiographs were used to examine hard tissues and crown-to-root ratios. Questionnaires were used to register each patient's opinion about the treatment and its outcome., Results: The survival rate was 100%, and the success rate was 91.3%. No significant differences were recorded between transplanted and control teeth. The patients' perceptions of the surgical management and the treatment outcome were favorable., Conclusions: The protocol for autotransplantation of developing premolars in growing patients was successfully adopted, regardless of lack of previous experience with this type of treatment., (Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Autotransplantation is a well-known method used in oral surgery. However, risk of failure, most commonly resulting from root resorption of the transplanted tooth or ankylosis, is quite high. Piezosurgery with specific device tip vibration frequencies enables selective tissue cutting, and therefore, tooth buds or teeth can easily be removed from bones with little injury to periodontal fibers or bud follicles.

Introduction: Orthodontic-surgical treatment was performed in patient with skeletal Class III malocclusion due to exceeding mandibular growth. Patient also presented upper and lower dental protrusion, overjet of -3.0 mm, overbite of -1.0 mm, congenital absence of tooth #22, teeth #13 and supernumerary impaction, tooth #12 with conoid shape and partly erupted in supraversion, prolonged retention of tooth #53, tendency to vertical growth of the face and facial asymmetry. The discrepancy on the upper arch was -2.0 mm and -5.0 mm on the lower arch., Methods: The presurgical orthodontic treatment was performed with extraction of the teeth #35 and #45. On the upper arch, teeth #53, #12 and supernumerary were extracted to accomplish the traction of the impacted canine. The spaces of the lower extractions were closed with mesialization of posterior segment. After aligning and leveling the teeth, extractions spaces closure and correct positioning of teeth on the bone bases, the correct intercuspation of the dental arch, with molars and canines in Angle's Class I, coincident midline, normal overjet and overbite and ideal torques, were evaluated through study models. The patient was submitted to orthognathic surgery and then the postsurgical orthodontic treatment was finished., Results: The Class III malocclusion was treated establishing occlusal and facial normal standards.

Purpose: The purpose of this study was to evaluate the radiological and histopathological findings of 11 patients with unerupted first molars to verify the factors obstructing spontaneous eruption., Methods: The patients' clinical, radiological, and histopathological data were evaluated retrospectively to determine histopathological diagnosis, radiographic findings, methods of surgical management, and postoperative course., Results: This study involved 4 male and 7 female patients (mean age=9.5 years old). Nine cases involved the mandible. The patients' histopathological diagnoses included 3 odontogenic tumors, 2 odontogenic cysts, and 6 hyperplastic dental follicles. Radiographically, 10 cases showed characterless enlargement of the follicular space, while only 1 displayed radiopaque bodies. One patient with a tumor underwent enucleation, and 1 with a cyst underwent cystectomy and tooth extraction. The others underwent wide excision or partial excision of the surrounding tissue at the top of the impacted tooth. Tumor relapse was observed in 3 cases., Conclusion: Surgeons should perform aggressive treatment for patients with unerupted teeth because spontaneous eruption is rare in cases involving non-neoplastic lesions such as hyperplastic dental follicles.

Case Report: To salvage an uneruputed tooth within a dentigerous cyst, the retransplantation of the unerupted premolar involved in the dentigerous cyst was performed. In the present case a dentigerous cyst with the impacted maxillary second premolar of a 10-year-old boy was removed, because of the missing eruption after marsupialisation of the premolar 4 months earlier. Covering the crown and the one third of root, the cyst was removed from the tooth, and the premolar was retransplanted into a cavity created between the premolar and first molar in the maxilla. The tooth was fixed with resin and a twisted wire for 1 month. Two years after transplantation, the tooth responded positively to pulp vitality tests but did not move toward the occlusal line, and dental X-ray showed a lamina dura, mineralisation of the pulp cavity, no root resorption and development.

Adenomatoid odontogenic tumors (AOTs) are an uncommon benign odontogenic tumor. Both central and peripheral forms occur. Radiographically, the central variants are comprised of a follicular type (those associated with the crown of an embedded tooth) and an extrafollicular type (those with no embedded tooth). A review of the literature showed that only 3 cases of an association between AOT and unerupted primary teeth have been published. The purpose of this paper was to report a rare case of adenomatoid odontogenic tumor associated with an unerupted primary first molar in a 7-year-old boy.

The objective of this study was to verify, using periapical radiographs, whether a partially erupted mandibular third molar is a factor in the presence of dental caries on the distal surface of the adjacent second molar. Two-forty six high quality periapical radiographs were selected, each showing a partially erupted mandibular third molar. The variables analyzed were: tooth number; gender; age; radiographic presence of caries on the distal surface of the adjacent molar; Pell and Gregory classification; Winter classification; angulation and distance between the second and mandibular third molar. The examiners were previously calibrated to collect data (kappa statistics from 0.87 to 1.0). The prevalence rate of caries on the distal surface of the second molar was 13.4%. In the logistical multivariate regression analysis, the angulation (OR=8.5; IC95%: 1.7-43.8; p=0.011) and the gender (OR=3.3; IC95%: 1.4-7.7; p=0.005) remained statistically significant after an age adjustment was made. The results indicate that the presence of a partially erupted mandibular third molar with an angulation of 31 degrees or more, is a risk factor for caries on the distal surface of the mandibular second molars., (Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

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.

The maxillary central incisor is the tooth most often affected by trauma, especially in the age range of 7 to 10 years, when high-impact sports are prevalent. The options for conservative treatment should be prioritized in these patients, aiming to achieve a biologic response that might provide continuity of growth of the alveolus, to provide functional and esthetic development of the affected region. This case report describes a patient with a history of trauma during the deciduous dentition with consequent intrusion, root dilaceration, and retention of the maxillary left central incisor. The treatment involved extraction of the traumatized tooth and mesial movement of the lateral incisor and posterior segments., (Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

The preventive removal of third molars (M3s) should be based on evidence. To optimize the timing of removal of M3s, it is essential to predict the eruption of the tooth and, even more importantly, to recognize beforehand which teeth will become involved in pathologic conditions later in life. The first aim of this review was to determine how well physicians currently can predict the eruption of an M3. The second aim was to review how frequently impacted M3s are removed. The third aim was to summarize the indications for preventive removals as presented in the evidence-based Current Care Guideline for the management of M3s in Finland. The prediction of eruption can be made at accuracies from 80% to 97%. In addition, the decrease in the number of M3s is very rapid, with only 31% remaining at 38 years of age. According to the Current Care Guideline, preventive removals at a young age are justified for 3 groups of teeth in the mandible: partially impacted teeth in the horizontal position, partially erupted teeth in the vertical position, and incomplete roots growing close to the mandibular canal. In conclusion, one fourth of retained and disease-free M3s need to be removed preventively at a young age, whereas the rest should be treated according to signs and symptoms., (Copyright © 2012. Published by Elsevier Inc.)

Purpose: The objectives of this study were to examine 1) the patterns of the impacted maxillary wisdom tooth and 2) the proximity of the impacted maxillary wisdom tooth to the maxillary sinus in relation to oroantral perforation during the removal of a maxillary wisdom tooth., Materials and Methods: This retrospective study reviewed the clinical records and dental pantomograms of patients who underwent the removal of maxillary wisdom teeth under general anesthesia over a 6-month period. Using a modified version of the Archer classification of impacted maxillary wisdom teeth, types of impaction were classified according to depth, angulation of impaction, and proximity to the floor of the sinus. Clinical records showed the occurrence of oroantral perforation., Results: In total, 845 maxillary wisdom teeth were removed; 66.8% were by routine extraction and 33.2% were removed surgically. The most common type of impaction was vertical followed by mesioangular. Most impacted teeth were at the level between the occlusal and cervical level of the adjacent second molar. Only 7 of the 278 excised wisdom teeth produced an oroantral perforation. Only 0.9% of all cases with a close sinus approximation showed an oroantral perforation. Statistical analysis with the Fisher exact test showed statistically significant associations of depth of impaction (P < .001), eruption status (P = .001), and long-axis position (P < .001) to the occurrence of an oroantral perforation. Sinus approximation showed no association with the occurrence of an oroantral perforation (P = 1.000)., Conclusion: The depth of impaction of the maxillary wisdom tooth is a possible predictor of the possibility of oro-antral perforation if removal of the tooth is required. Due to the limitation of the radiograph, it is not a reliable to use radiographic close proximity of the sinus to predict the occurrence of oro-antral perforation when the maxillary wisdom tooth is removed., (Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Odontodysplasia is a rare, non-hereditary developmental anomaly affecting dental tissues derived from both the mesoderm and ectoderm which results in a bizarre clinical and radiographic appearance. Regional odontodysplasia describes the segmental and localized nature of the condition. Odontodysplasia occurring in a single tooth is a rare occurrence. A case of Solitary odontodysplasia in an eleven year and half old male whose chief complaint was the absence of eruption of permanent maxillary right central incisor teeth is presented. Clinical, radiographic and histological findings of a single tooth, odontodysplasia are described in this case report.

This article presents a case of bilateral unerupted supernumerary teeth in the mandibular premolar region. Surgical removal of the right-sided supernumerary tooth had to be carried out as it was impeding the eruption of the mandibular first premolar. However, its supernumerary antimere, lay dormant.

Background: Many soft tissue pathologies in children can be treated by paediatric dentists. New technologies such as laser surgery enable simpler treatments to be carried out than with conventional techniques., Case Reports: A case series of 7 children aged 6 to 14 years old were treated for various soft tissue problems including crown lengthening, exposure of an unerupted molar, lingual and maxillary fraenectomies, gingivectomy, excision of a pyogenic granuloma and for a pulpotomy., Treatments: All children were treated using a Er,Cr:YSGG laser for removal of appropriate soft tissues. FOLLOWUP: All cases healed satisfactorily and were followed up for 3 to 4 years., Conclusion: It is essential to have a good knowledge of laser operation and of which type of laser is most appropriate for each lesion.

This literature review assessed the risk factors linked to inferior dental nerve (IDN) and lingual nerve (LN) deficits following lower wisdom tooth surgery. A computer search of several databases with specified key words was performed. 32 articles were selected; the risk factors for IDN deficit were reported in 4 articles, LN in 9 and both IDN and LN in 19. Data were analysed statistically to evaluate the potential risk factors. Literature review showed specific radiographic signs and intra-operative IDN exposure increased the risk of IDN deficit. Raising the lingual flap significantly increased the risk of LN deficit. Unerupted tooth and lingual split technique increased IDN and LN deficit risks significantly. Age was linked to IDN and LN deficits, and deep impaction was related to IDN deficit, but no statistical tests were performed on these two risk factors owing to the heterogeneity of data from the studies. This literature review found increased age, unerupted tooth, deep impaction, specific radiographic signs, intra-operative IDN exposure and lingual split technique were risk factors for IDN deficit; increased age, unerupted tooth, distal impaction, raising of lingual flap and lingual split technique were risks factors for LN deficit in lower wisdom tooth surgery., (Copyright © 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Patients with impacted ectopic canines often present to Orthodontic and Oral and Maxillofacial units, with 85% being displaced palatally. Current orthodontic opinion suggests that the creation of adequate space ultimately allows the spontaneous eruption of most impacted canines, but we are often requested to operate to facilitate their eruption. There are several approaches, techniques that vary depending on whether orthodontically assisted or spontaneous eruption is expected. There are few publications that describe either the techniques or their merits. We have used a gingival-sparing technique for more than 10 years in this unit. To determine current practice, we carried out a national postal survey of consultant oral and maxillofacial surgeons and staff grade/associate specialists. A total of 564 questionnaires were sent, and 353 replies were received (63%). There was considerable variation in the design of mucosal flaps used for exposure of the canines. Only 9% of clinicians avoided the gingival margin of the adjacent erupted teeth during operation. We describe this unit's practice of sparing the gingival margins, and highlight the merits of this technique., (Copyright © 2009 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Hajdu-Cheney syndrome is a rare, probably autosomal dominant connective tissue disorder with a variable expressivity. It is characterized by an osteoporotic skeleton, acro-osteolysis, a proportionate short stature, and distinctive orofacial anomalies. The aim of this article is to focus on the orofacial manifestations in two sporadic cases and one familial case with Hajdu-Cheney syndrome. Several common dental and craniofacial features are described. In contrast to earlier proposed diagnostic features, these patients show persisting deciduous teeth, problematic tooth eruption, and tendency toward a Class III malocclusion.

Osteopetrosis (Albers-Schonberg disease) is the name given to a group of diseases that affect the growth and remodeling of bones. It is characterized by overgrowth and sclerosis of bone, resulting in thickening and narrowing of the marrow cavities throughout the skeleton. The exact cause is unknown, although failure of bone resorption related to defective osteoclasts is considered to be the basis of the problem. These patients present a significant challenge to the dentist for management of jaw and dental problems, as the disease process demands special strategies which are often at variance with conventional dentistry. The purpose of this paper was to report the management and follow-up of a child with intermediate autosomal recessive osteopetrosis who primarily complained of dental problems.

Objective: To describe surgical technique and outcome in 10 horses with impacted cheek teeth that were removed by a transcortical osteotomy and buccotomy technique., Study Design: Case series., Animals: Horses (n=10) with impacted cheek teeth., Methods: Medical records (2002-2008) of horses with impacted cheek teeth requiring removal were reviewed; surgical technique and outcome were determined., Results: Exodontia of 11 cheek teeth was performed surgically in 10 horses; 3 horses had complications (residual swelling of the mandible) that resolved and all horses returned to their previous use., Conclusions: Transcortical buccotomy technique is effective for removal of incompletely erupted impacted cheek teeth in horses and has a good long-term prognosis for remission of clinical signs., Clinical Relevance: Transcortical buccotomy approach is an effective technique for removal of unerupted impacted equine cheek teeth., (© Copyright 2010 by The American College of Veterinary Surgeons.)

Eruption disturbance of a permanent tooth is challenging to clinicians. Eruption failure of a posterior tooth causes lateral open bite that severely interrupts function. This case report describes the treatment of nonerupting permanent molars by segmental repositioning followed by orthodontic fine adjustment. Two nonerupting permanent molars at different eruption stages were repositioned with a one- or two-step single-tooth segmental osteotomy technique. Final location of the repositioned tooth-alveolar bone segment was adjusted via orthodontic means.

Aims: To evaluate the predictive potential of preoperative psychological and psychophysiological variables in estimating severity of postoperative pain following mandibular third molar surgery (MTMS)., Methods: Following ethical committee approval and informed consent, 40 consecutive patients scheduled for MTMS were included. Preoperative psychometric indicators of anxiety, depression, and vulnerability were evaluated by patient questionnaires. Thermal thresholds and heat pain perception (1 second phasic stimuli: 44 degrees C to 48 degrees C) were evaluated with quantitative sensory testing techniques. Standardized surgery was performed during local anesthesia. Postoperative pain management was with rescue paracetamol and ibuprofen. The patients were instructed to record each day their pain at rest and during dynamic conditions, and their requirement of analgesics for 14 days following surgery., Results: Thirty-eight patients completed the study. Eight patients were readmitted because of pain. During the postoperative period, one or more episodes of moderate to severe pain (> 30 on a visual analog scale) was reported by 60% (23/38) at rest, 63% (24/38) during mouth-opening, and 73% (28/38) during eating. In a multiple regression model, the combination of psychological vulnerability and heat pain perception rendered a predictive model that could account for 15 to 30% of the variance in postoperative pain during resting and dynamic conditions (P = .03 to .001)., Conclusion: Implementation of clinically relevant preoperative screening methods may offer more efficacious postoperative pain therapies to pain-susceptible individuals undergoing mandibular third molar surgery. J Orofac Pain 2010;24:189-196.

This article describes the nonextraction treatment of a girl in the late mixed dentition with a severe arch-length deficiency. Rapid maxillary expansion and molar distalization were combined with a lip bumper in the mandible, followed by fixed appliances. Although the literature has reported a high rate of relapse with this method of treatment, excellent stability was achieved at 5 years 3 months posttreatment. The merits of extraction vs nonextraction treatment and stability are discussed., (2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Purpose: The purpose of this study was to determine the optimum time for surgical removal of unerupted maxillary anterior supernumerary teeth., Methods: The study population consisted of 126 children. Stages C to H of the Demirjian classification were used to classify the dental development of the adjacent incisors. Associations were sought between the complications and the developmental stage of the adjacent maxillary incisors at the time of surgical removal. Tests of association were carried out using Fisher's exact test with a probability level of P=.05 for statistical significance., Results: Significant differences were evident: for mature maxillary central incisors (N=170); between all the proportions for root resorption, with the greatest difference being between stages E and H (P<.001); for arrested root development between stages D and E (P=.013), and D and H (P=.02); and for persistent malocclusion between stages E and G (P=.004), E and H (P=.02), F and G (P=.005), and F and H (P=.01)., Conclusion: Early removal of unerupted maxillary supernumerary teeth seems to be advantageous with a cutoff point of approximately 6 to 7 years old, after which more complications are expected.

The orthodontic records of 685 patients referred for surgical exposure of an unerupted impacted maxillary canine tooth were examined. The condition was more common among females than males, slightly less than 2:1. The impacted teeth had a palatal-labial ratio of 3:1. All of the teeth were exposed using the open surgical technique and in 98% of cases the tooth erupted and was orthodontically aligned. In 2% of cases ankylosis occurred and the teeth were subsequently extracted. The presence of peg-shaped lateral incisors associated with the impacted maxillary canine tooth was 3.4% of the total number of impacted teeth and congenital absence was found in 1.7% of impacted teeth.

Dentigerous cysts are the most common odontological cysts of the jaws, being associated with the crowns of permanent teeth, especially unerupted mandibular third molars. Multiple dentigerous cysts are rare and most often occur in association with a developmental syndrome. This article presents an unusual case of nonsyndromic adjacent dentigerous cysts associated with a mandibular third molar and a supernumerary molar. This occurrence has not been previously reported.

An impacted left mandibular second molar (tooth 37) was extracted, but most of its dental follicle remained in the socket. The crown and dental papilla of an unerupted, left mandibular third molar (tooth 38) were then placed into the socket of tooth 37. Successful interaction between the dental follicle of tooth 37 and the crown and dental papilla of tooth 38 led to the formation of a new tooth 37 at the recipient site. This suggests that the dental follicle may function non-specifically with the crown and dental papilla of other tooth germs.

Unlabelled: Unerupted supernumerary teeth, depending on the morphology, number and distribution can give rise to various alterations in the eruption and development of those permanent teeth to which they are related., Objectives: We aimed to make an epidemiological and descriptive study of the clinical characteristics of patients in Barcelona, their surgical treatment and how said treatment was hindered., Materials and Methods: A descriptive study including 113 supernumerary teeth from 79 healthy pediatric patients between 5 and 19 years of age, which underwent surgery in our hospital during a 2 year period (May 2005 / May 2007), taking into account the variables of personal data, gender, age, location, number, morphology, position-axis, radiological study, surgical treatment, related pathologies, and surgical complications., Results: Male patients (51) were more frequently affected than female (28) patients mainly within the central incisors-mesiodens (53.16%), in which the unique form (68.52%) predominates in conoid morphology (69.62%). Surgical treatment was done by palatal/lingual extraction (49.37%), with few surgical complications (only 1 case of post-surgical bleeding)., Conclusion: Incidence in supernumerary teeth is higher among male patients (ratio M:F of 1.82:1). They are most frequently located in the maxilla (82%), specifically, in the premaxilla (77%). Most cases presented only one supernumerary tooth (68.5%) and, in multiple cases, the premolar region is predominant. The conoid shape is the commonest morphology (69.62%). Surgical extraction, was done by palatal/lingual in 49.37% of the cases, as opposed to the vestibular approach in 45.57%.

Background: Interventions to enhance the implementation of evidence-based practice have a varied success rate. This may be due to a lack of understanding of the mechanism by which interventions achieve results., Purpose: Use psychological models to further an understanding of trial effects by piggy-backing on a randomised controlled trial testing 2 interventions (Audit & Feedback and Computer-aided Learning) in relation to evidence-based third molar management., Method: All participants of the parent trial (64 General Dental Practitioners across Scotland), regardless of intervention group, were invited to complete a questionnaire assessing knowledge and predictive measures from Theory of Planned Behaviour and Social Cognitive Theory. The main outcome was evidence-based extracting behaviour derived from patient records., Results: Neither intervention significantly influenced behaviour in the parent trial. This study revealed that the interventions did enhance knowledge, but knowledge did not predict extraction behaviour. However, the interventions did not influence variables that did predict extraction behaviour (attitude, perceived behavioural control, self-efficacy). Results suggest both interventions failed because neither influenced possible mediating beliefs for the target behavior., Conclusion: Using psychology models elucidated intervention effects and allowed the identification of factors associated with evidence based practice, providing the basis for improving future intervention design.

Introduction: The dental surgeon is often confronted by complications particularly after extraction ofunerupted lower third molars. The most common complication is alveolar periostitis. The healing process after extraction is accompanied by physiologic atrophy of the alveolus involving on the average 30% of bone tissue. Beta-tricalcium phosphate (TCP) is a synthetic material used in medicine to fill up bone defects caused by pathologic processes. The properties of TCP are appropriate for the material to be used as a carrier for drugs, in particular antibiotics. This study was undertaken to determine whether lincomycin applied to the alveolus on TCP carrier can be used to accelerate wound healing and reduce inflammation after surgical extraction of a third molar., Materials and Methods: We enrolled 80 patients (males and females between the age of 18 and 50 years) who underwent extraction of a third molar at the Department of Dental Surgery, Pomeranian Medical University in Szczecin. Surgical difficulty in the patients according to the Pederson scale corresponded to grade 2 or 3 (medium or high difficulty). The study group consisted of 40 patients who received lincomycin on TCP. Beta-tricalcium phosphate (300-700 microm pores) obtained from the Department of Technology of Ceramics and Refractories, AGH University of Science and Technology in Cracow, was soaked with 500 mg of lincomycin in solution and applied to the dental alveolus after tooth extraction. The alveolus was tightly sutured. The control group comprised 40 patients not treated with lincomycin. The patients reappeared for examination on the first, third, and seventh day after surgery. Attention during follow-up was directed to alveolar periostitis, pain, and trismus. Pain intensity was assessed with the 10-degree Visual Analog Scale (VAS)., Results: We analyzed the subjective pain intensity reported during follow-up by the patients. In the study group, 20 patients reported no pain 24 hours after extraction. On the third day after surgery, alveolar periostitis was present in 15% of patients in the study group and 75% of patients in the control group. On the last day of follow-up, periostitis was present in only 2.5% of patients in the study group as opposed to 45% of patients in the control group. The differences were statistically significant (chi-square 36.05, p < 0.0001)., Conclusions: (1) Lincomycin on TCP can be used to prevent alveolar periostitis. (2) Lincomycin on TCP reduces complications in the form of pain and trismus. (3) Beta-tricalcium phosphate prevents atrophy of the alveolar process.