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The objective of this article is to report the clinical case and 4-year follow-up of a 5-year-old child with multiple dental anomalies, emphasizing the importance of early diagnosis and use of combined pediatric surgery and orthodontic approaches. A 5-year-old boy, accompanied by his mother, sought dental care for dental caries and tooth pain. Clinical and radiographic examinations revealed active caries, a supernumerary primary tooth in the region of the mandibular right second premolar, and severe ankylosis of the primary mandibular right second molar. The treatment plan involved extraction of the supernumerary tooth as well as sectioning and extraction of the ankylosed molar. When the patient was 6 years old, the permanent mandibular right first molar showed signs of an altered eruptive process, and orthodontic treatment was initiated. A unilateral band-and-loop space maintainer with coil springs designed to move the permanent first molar was placed on the primary first molar. A new panoramic radiograph, obtained when the patient was aged 7 years, suggested the presence of an odontoma in the apical region of the primary maxillary right canine. Surgical removal and histopathologic examination of the lesion confirmed that it was a developing odontoma. After surgery, due to occlusal anomalies that included transverse maxillary deficiency, deep overbite, and midline deviation, the patient underwent rapid maxillary expansion therapy with a Haas-type appliance. When the patient was 8 years old, orthodontic treatment continued with a removable palatal Hawley expander and a orthodontic mandibular lingual arch. Currently, at the age of 9 years, the child is still undergoing fixed orthodontic treatment after surgical exposure of the impacted permanent maxillary right canine and bonding of an orthodontic attachment to enable traction. A multidisciplinary approach to the management of dental anomalies promotes a favorable prognosis and ensures comprehensive treatment of young patients., Competing Interests: No conflicts of interest reported.

Focal microdontia is a dental anomaly characterized by the presence of a single abnormally small anterior or posterior tooth. The objective of this article is to provide an updated review of the literature on the advanced restorative management of focal microdontia, and to document a clinical case where the reviewed advanced restorative approaches were applied to treat a young adult presenting with a non-syndromic asymmetrical focal microdontia.We conducted a preliminary examination of the existing literature on the advanced restorative management of focal microdontia. Additionally, we presented a minimally invasive approach to the treatment of an 18-year-old female patient with non-syndromic asymmetrical focal microdontia. The primary advantage of adhesive dentistry is that it can better preserve the structure of smaller teeth. A review of literature reveals a paucity of reports on localized microdontia in the maxillary anterior region of the mouth. However, novel minimally invasive restorative procedures satisfy patients' aesthetic and functional preferences. Well-executed additive diagnostic wax-ups and intraoral mock-ups can serve as a permanent restoration blueprint, providing predictable results for focal dental anomalies in the aesthetic zone. In conclusion, the use of minimally invasive dental approaches in young patients with focal microdontia can result in long-term satisfactory aesthetic outcomes.

Objective: The aim of the study is to analyze the estimated and actual duration of treatment and the number of visits to the orthodontist by patients using modern orthodontic equipment. Analysis of the duration of orthodontic treatment of patients with varying degrees of difficulty and comparison of the estimated and actually spent time for its implementation., Material and Methods: 308 medical records of patients who underwent orthodontic treatment were analyzed. According to the Siebert - Malygin method, the degree of difficulty of treatment, its duration, the number of necessary visits were calculated and the data obtained were compared with the actual time spent on correcting dental and occlusion anomalies and the number of visits by the patient to the orthodontist., Results: The results of treatment of 308 patients who underwent orthodontic treatment with modern non-removable equipment (braces) are analyzed in the clinic of LLC «Prime dentistry» in Ryazan. Before starting treatment, the preliminary treatment time was calculated using the method of determining the difficulty of orthodontic treatment of Siebert - Malygin. The calculation of the degree of difficulty of treatment, its duration, and the number of necessary visits was carried out. The data obtained were compared with the actual time spent on correction of dental and occlusion anomalies and the number of visits by the patient to an orthodontist. It was found that, despite the use of modern equipment, the treatment time practically does not decrease, but the number of visits to achieve the desired result is significantly reduced. Coefficients have been calculated to clarify the required number of visits to the orthodontist. In the treatment of anomalies in the position of teeth (APD), it is 0.77, APD, combined with distal occlusion - 0.79 deep - 0.78, open - 0.66 and mesial - 0.69., Conclusion: The use of modern orthodontic equipment reduces the number of patient visits to the doctor, which saves time, reduces labor costs and allows you to provide the necessary assistance to more people in need. The coefficients calculated during the study to determine the required number of visits to an orthodontist by a patient, depending on the existing orthodontic pathology, make it possible to predict the treatment time with greater accuracy when using the Siebert - Malygin method. This is very relevant when planning upcoming manipulations and to more accurately justify the cost of treatment depending on the required time and number of visits to eliminate APS.

Dental trauma in primary teeth can cause irreversible changes in the development of permanent tooth germs, including enamel hypoplasia, crown dilaceration, and root dilaceration. This article discusses multidisciplinary treatment of enamel hypoplasia and root dilaceration in the maxillary left central incisor of an 11-year-old girl. A 10-year follow-up is reported to demonstrate the long-term clinical outcomes. At the initial presentation, the patient's mother reported that the child had an accident at the age of 2 years, resulting in intrusive luxation of the primary maxillary left central incisor. After the accident, the patient was monitored for eruption of the permanent successor tooth, and different approaches were proposed during each period of the patient's development on the basis of the clinical diagnosis of root dilaceration and enamel hypoplasia. The crown was restored with composite resin, and the root defect was restored with resin-modified glass ionomer cement. After 10 years, the clinical outcomes highlight that the multidisciplinary approach was successful in preserving the natural tooth with good periodontal health conditions., Competing Interests: No conflicts of interest reported.

Taurodontism, usually associated with genetic disorders, is an anomaly in dental development in which the tooth presents with a vertically elongated pulp chamber due to an invagination failure of the Hertwig epithelial sheath. This article presents 2 case reports describing the endodontic treatment of permanent taurodontic molars in systemically healthy patients. In case 1, a maxillary left first molar presented with hypertaurodontism and 5 root canals. In case 2, a mandibular left second molar presented with hypertaurodontism and a C-shaped canal. Treatment of both teeth was based on careful radiographic evaluation with magnification, which allowed the root canal orifices to be identified and the endodontic treatment to be performed. Chemical-mechanical preparation was performed with mechanized instruments and a 2.5% sodium hypochlorite solution. As an auxiliary protocol to finish cleaning, passive ultrasonic irrigation was performed, and a thermoplastic filling technique was used. When complex internal anatomy and accessory root canals are present, endodontic treatment of a tooth presenting with hypertaurodontism can be challenging. Given the complexities of the present cases, the positive outcomes can be attributed to the use of magnification during endodontic procedures and meticulous attention to tooth preparation and obturation techniques., Competing Interests: The authors report no conflicts of interest pertaining to any of the products or companies discussed in this article.

Oculodentodigital dysplasia (ODDD) is a rare congenital disorder characterised by developmental abnormalities of the eye, dentition and digits of the hands and feet, with neurological symptoms reported in 30% of individuals. Dental anomalies associated with ODDD include enamel hypoplasia and subsequent caries, microdontia, missing teeth, amelogenesis imperfecta, pulp stones and delayed tooth development. Here, we describe the comprehensive dental management of a 3-year-old girl who presented with rapid deterioration of the primary dentition due to generalised enamel hypomineralisation. Conservative, comprehensive restorative management was performed under general anaesthesia. Within 6 months, further breakdown of the remaining unrestored enamel was noted. This case documents the challenges of conservative management in dental anomalies that are not well documented due to the extreme rarity of the disorder., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Coronoradicular dilaceration is a particular abnormality of the permanent incisors, usually maxillary, and usually occurs around the age of 4 to 5 when the crown is formed and the root is still growing. It follows acute mechanical trauma affecting the temporary incisor. This anomaly of shape is characterized by an angulation between the crown and the root of the permanent tooth. The prognosis may be serious because the affected tooth may not erupt normally. It also compromises possible orthodontic treatment later. Our clinical case is that of a young patient (ES) aged 8 years and 4 months, in good general health condition, consulted for the absence 21 on the arch while the contralateral tooth was present. Interrogation revealed that the patient suffered trauma with severe luxation of the 61 at the age of 3 years. Radiographic examination showed the presence of the germ of 21 with an atypical sickle-shaped position and an image of a hand of a traffic policeman with a crown in a horizontal position. Three-dimensional imaging using a CT scan shows the shape of the 21 with a root angulation. The therapeutic attitude allowed the correction of its axis by an orthodontico-surgical treatment., (Copyright © 2019 CEO. Published by Elsevier Masson SAS. All rights reserved.)

According to the classification of the World Health Organization (WHO), the most common childhood malignant neoplasms include leukemia, lymphomas, and neoplasms of the central nervous system (CNS) and the sympathetic nervous system. Cancer diseases themselves as well as their treatment carry a high risk of both early and distant effects. The most common dentition disorders resulting from the radiotherapy of the head area and chemotherapy in patients up to the age of 6 years include root agenesis, V-shaped roots, microdontia, hypoplasia of the maxilla and the jawbone, hypodontia, and enamel hypoplasia and hypomineralization. Patients undergoing oncological treatment at the age of <6 years should receive adequate and long-term monitoring due to the possible distant effects of the underlying disease and its treatment. The radiotherapy of the head and neck region performed on a growing patient significantly worsens the patient's prognosis and results in a number of irreversible complications. Planning appropriate orthodontic treatment in such patients contributes to increased comfort later in the patients' lives. Oncology patients do not require special orthodontic procedures; however, the high risk of complications does encourage the planning of orthodontic treatment with the least burden. Dental care for a young patient with a history of oncological disease requires the interdisciplinary cooperation of a pedodontist, orthodontist, prosthetist, and dental surgeon.

This case report describes the management of a mandibular first molar with an additional distolingual root (radix entomolaris) and grade III cervical enamel projection through a multidisciplinary approach. Diagnosis for the case was endodontic-periodontal lesion due to non-vitality and associated advanced periodontal destruction. The patient was treated with drainage of the periodontal abscess with adjunct antibiotics, phase I periodontal therapy, endodontic therapy, radiculoplasty, regenerative periodontal therapy, replacement of the missing right mandibular second molar, and long-term maintenance. Follow-up of the patient up to 9 months has been uneventful. Cases of advanced periodontal destruction typically show some degree of tooth mobility, which was absent in this case. The article discusses the tripod effect as well as the increased surface area for periodontal attachment provided by the additional root contributing to the non-mobility of the involved tooth.

Purpose: To explore the methods and characteristics of removable denture restoration in children with congenital missing teeth., Methods: From 1998 to 2018, 61 children aging 3 to 12 years old with congenital dental deficiency were treated with removable dentures. There were 59 males and 2 females. Removable denture prostheses were designed according to the characteristics of the children and the residual teeth in the mouth. There were 42 complete dentures in 21 cases, 40 single jaw complete dentures and maxillary removable partial dentures in 20 cases and 40 removable partial dentures in upper and lower jaw, totally 61 cases and 122 dentures., Results: After wearing the removable denture, the appearance, chewing and pronunciation of the children were improved significantly., Conclusions: Although the etiology of congenital tooth defect is not completely clear, children can have early denture restoration. It solves the difficulty of eating, improves appearance and pronunciation, and promotes growth and physical and mental health of children.

Dens evaginatus (DE) frequently leads to pulp exposure and subsequent pulpal inflammation, pulpal necrosis, and periapical inflammation. This case report describes the application of regenerative endodontic therapy and mineral trioxide aggregate (MTA) apexification in a 22-year-old man with mandibular second premolars affected by DE and apical periodontitis. Regenerative endodontic therapy was performed after thorough debridement and placement of calcium hydroxide in the root canal of the left premolar. In contrast, an apical plug of MTA was placed prior to gutta percha compaction in the root canal of the right premolar. Both teeth were restored with adhesive composite resin. A 2-year follow-up examination revealed complete periapical healing., Competing Interests: Disclaimer: The authors report no conflicts of interest pertaining to any of the products or companies discussed in this article.

The orthodontic-oral surgery interface is important for the multidisciplinary management of patients presenting with complex dental anomalies. This article provides an overview of anomalies of eruption and transpositions, their diagnosis, aetiology, presenting features and the different management options. It also highlights the role of the general dental practitioner (GDP) in identifying such anomalies and the importance of timely referral to specialist care.

Iridogoniodysgenesis is a rare autosomal dominant disorder affecting anterior segment of the eye. Fifty percent cases of iridogoniodysgenesis have glaucoma, which is particularly difficult to manage. We report here a case of 40 years old man with this rare disorder, presenting to our glaucoma department. It was characterised by iris hypoplasia and juvenile glaucoma. To stop fluctuation in his intraocular pressure (IOP) and to save his vision from glaucomatous damage, our team had to do three different surgical procedures, i.e. trabeculectomy with F5U, diode laser cycloablation and aqueous shunt procedure, over a period of 10 months. This case report discusses management of glaucoma in this particular patient and challenges faced during the treatment. Regular follow-up and timely intervention can save such patients from complete blindness. To authors' knowledge, this is the first reported case of iridogoniodysgenesis in Pakistan.

One of the biggest challenges in endodontic treatment is to comprehensively understand the variation of tooth root canal anatomy. To a large degree, the anatomy and furcation distribution of teeth, which vary from nationality and ethnic groups, will influence the clinical diagnosis, treatment plan and even prognosis. Taurodontism, as one of anatomic variation in tooth structures, is relatively hard to be seen in dental clinics. Two special cases of taurodontism with varied root canal anatomies in mandibular second premolar and first molar are reported in this paper., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Due to improvements in esthetic dentistry, the number of patients seeking to obtain a more harmonious smile has increased. A 40-year-old woman was referred for treatment because she was dissatisfied with the effect that diastemas and a conoid tooth had on her smile. Her maxillary anterior teeth were relatively short, resulting in a compromised esthetic relationship between height and width. Orthodontic treatment for better distribution of her teeth was recommended to the patient, but she refused, wanting faster and less expensive treatment. After diagnostic and waxed-up study casts were obtained, composite resin esthetic mock-ups were made to confirm that sufficient space was left for formation of the interdental papilla. After the patient approved the mock-ups, her anterior teeth were submitted to bleaching, definitive restoration, and additional occlusal adjustments. At the 1-year follow-up, the patient exhibited a harmonious, esthetic smile without black spaces or periodontal inflammation.

Objectives: Full-arch rehabilitations in young patients suffering from dental agenesis should compensate for the reduced vertical dimension of occlusion and restore both esthetics and function at minimal biological cost. This requires precise planning and maximum patient compliance during the preprosthetic phase. The pretreatment period with tooth-colored splints promotes a predictable outcome of the final restorations. Clinical considerations: Thanks to better restorative materials and adhesive techniques and increased knowledge of how to preserve sound tooth structures, prosthetic dentistry has increasingly turned toward minimally invasive procedures. The present clinical case documents a minimally/non-invasive maxillary full-arch rehabilitation of an agenesis patient with multiple dental aplasia, primary tooth persistence, and deficits in bone growth. The patient was pretreated with a tooth-colored CAD/CAM polycarbonate splint. Adequate esthetics and function were achieved by two zirconia-based single-wing adhesive fixed dental prostheses to replace the upper lateral incisors, lithium disilicate ceramic partial crowns for the posterior regions, and two feldspathic veneers for the upper central incisors., Conclusions: Non-invasive pretreatment with a removable tooth-colored splint realizes the treatment goal simply and safely, reduces treatment time, increases predictability, and facilitates the transfer of the prototype to the final restorations. New restorative options permit the minimally invasive treatment of such patients., Clinical Significance: A pretreatment with a removable tooth-colored splint offers a simple and safe way to define the treatment goal, reduces treatment time, increases predictability, and facilitates the transfer of the results to the final restorations even in complex cases. New restorative options permit minimally invasive treatments of young patients with multiple dental agenesis., (© 2017 Wiley Periodicals, Inc.)

Objective: The aim of this study was to determine the prevalence of dental developmental anomalies in permanent teeth and their influence on esthetics., Materials and Methods: The records of 473 subjects, which comprised of orthopantomograms, clinical examination, and anamnestic data, were explored for dental developmental anomalies. Subjects with dental anomalies completed the modified questionnaire. Data on reasons for seeking the treatment as well as factors affecting the patients' satisfaction were collected. The data were processed using the Chi-square test., Results: It was found that 79 subjects (16.7%) had at least 1 dental developmental anomaly. The most common anomalies were hypodontia (7.2%), followed by talon cusps (3.4%), and microdontia (2.5%). Hypodontia, microdontia, and talon cusps were found more prevalent in females than males, whereas hyperdontia and macrodontia were more common in males. The reason for dissatisfaction with their smile in most cases was due to missing teeth or spacing between anterior teeth (excess space 2.9 mm ± 1.1 mm), followed by crowding of anterior teeth (lack of space 3.1 mm ± 0.8mm), difficulty maintaining oral hygiene and midline asymmetry (1.8 mm ± 0.9 mm). All subjects were treated using a fixed orthodontic appliance and 30 (37.9%) of them had additional dental specialists included to achieve good esthetics and function. Overall, 92.4% of subjects were satisfied with their resulting appearance after treatment., Conclusions: Dental developmental anomalies are clinically evident abnormalities. They may be the cause of various dental problems and can influence esthetics and the development of orthodontic problems., Clinical Significance: This paper evaluates the distribution of dental developmental anomalies and their influence on esthetics and function. Careful observation and appropriate investigation are required to diagnose the condition and institute treatment. The therapeutic approach to some dental anomalies should be interdisciplinary., (© 2017 Wiley Periodicals, Inc.)

Down syndrome is one of the most common congenital anomaly. It is most frequently caused by trisomy of chromosome 21. Other causes can be mosaicism and translocation. Such patients are commonly encountered in routine dental practice. This syndrome has wide range of medical and dental abnormalities. This paper presents a unique case of fusion and concrescence of retained primary teeth in a child with Down syndrome. The incidence of such anomalies is quite low in these cases. Thus, a better awareness of such conditions on part of a dental practitioner will aid in the provision of enhanced dental care to these patients., (© 2017 Special Care Dentistry Association and Wiley Periodicals, Inc.)

Several treatment options are described in the literature to solve the microdontia-related problems of maxillary anterior teeth. These options are often focused on an orthodontic rather than a restorative approach. The case presented here started with an orthodontic phase followed by a restorative one. The aim of the orthodontic phase was to achieve the correct spacing, respecting ideal average tooth proportions. This was done using a digital setup to restore the six anterior teeth, so that an optimal esthetic and functional result was achieved by the end of the orthodontic treatment. The purpose of the restorative phase was to contribute to the esthetic outcome and occlusal stability. The 12-year-old patient was treated utilizing a CAD/CAM procedure, which took advantage of the mechanical properties and reasonable cost of the chosen resin matrix ceramic material (Vita Enamic). Once stability has been attained and proper periodontal tissue maturation has been reached at the end of the patient's growth, there will then be the option of improving the esthetics by replacing these restorations with ceramic veneers.

Introduction:: The purpose of this study was to evaluate the prevalence of dental anomalies in a subpopulation of orthodontic patients with agenesis of maxillary lateral incisors (MLI)., Methods:: The material of the present study included the records of the 1964 orthodontic patients. Panoramic radiographs and dental casts were used to analyze other associated eight dental anomalies, including agenesis of other teeth, dens invaginatus, dens evaginatus, peg shaped MLI, taurodontism, pulp stone, root dilaceration and maxillary canine impaction., Results:: Out of the 1964 patients examined, 90 were found to have agenesis of MLI, representing a prevalence of 4.6%. The most commonly found associated-anomalies were agenesis of other teeth (23.3%), peg-shaped MLIs (15.6%), taurodontism (42.2%), and dilacerated teeth (18.9%)., Conclusion:: Permanent tooth agenesis, taurodontism, peg-shaped maxillary lateral incisor, and root dilacerations are frequently associated with maxillary lateral incisor agenesis.

Fabrication of maxillary and mandibular esthetic functional prostheses in a 5-year-old female patient with ectodermal dysplasia is reported. This report presents, clinically and radiographically, the orofacial manifestations of a child diagnosed with hypohidrotic ectodermal dysplasia, along with the construction of removable prosthetic devices.

To assess management of non-syndromic dens evaginatus affecting permanent maxillary central incisor, we performed a systematic review and also present a case report. We searched PubMed via MEDLINE and the reference lists of included reports. Eligible studies were any type of clinical studies describing the management of non-syndromic dens evaginatus affecting the crown of a permanent maxillary central incisor. We included 31 studies corresponding to 34 relevant case reports. Therapeutic options were complete reduction of the talon cusp in a single appointment (56%), periodic and gradual reduction of the cusp (26%), abstention (13%) or extraction (5%). We report an 8-year-old girl with unusual two-talon cusp, labial and lingual, on a right maxillary double central incisor. A multidisciplinary approach is key to management of permanent maxillary central incisors affected by coronary anomalies., Competing Interests: Conflicts of Interest: None declared., (2016 BMJ Publishing Group Ltd.)

To treat morphological abnormalities, impaction, and severe malposition of the teeth, the lateral incisors are sometimes extracted, followed by orthodontic space closure. This procedure often requires special consideration, not only with regard to esthetics but also for functional issues. However, thusfar, few reports that have performed a functional evaluation in such cases. The purpose of this article is to report the successful treatment of a 23 year-old male patient with the complaint of irregular placement and abnormal shape of his teeth. The patient had an impacted maxillary unilateral left canine, peg shaped lateral incisor, and transmigrated mandibular canine. Patient was treated with extraction of the upper lateral incisors and eruption of the impacted canines was guided to the place of the lateral incisor and extraction of the transmigrated mandibular canine.

Dens invaginatus (DI) is a developmental anomaly seen infrequently in maxillary canines. This article describes cone-beam computed tomography-guided nonsurgical management of type III (subtype B) DI in a permanent maxillary canine associated with a sinus tract and peri-invagination periodontitis in a 17-year-old female. After gaining access to the root canal, thorough chemo-mechanical preparation was performed and usage of intracanal medicament of calcium hydroxide was prescribed for 3 weeks, during which the sinus tract healed completely. Obturation was completed by a technique of down-packing master-cone gutta-percha, followed by backfilling with thermoplasticized gutta-percha. At 12-months follow-up, the patient was asymptomatic with complete resolution of the sinus tract and radiographic evidence of healing of periapical pathology.

A molar-incisor malformation (MIM) is a newly reported type of dental anomaly that involves a characteristic root malformation in permanent first molars and deciduous second molars and a crown defect in permanent central incisors. This case report describes a nonsurgical root canal treatment of a MIM-affected molar by aid of a reformatted axial view of the tooth cone-beam computed tomography (CBCT). A MIM-affected molar has calcified canal orifices and a few immature accessory furcal canals. Conventional root canal treatment with the aid of CBCT followed by resin restoration was performed on the tooth. The malformed roots of MIM teeth generally make it difficult to apply conventional endodontic treatment; however, it was possible to do with the aid of the reformatted axial view of the CBCT., (Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Rapp-Hodgkin syndrome (RHS) is a rare type of autosomal dominant disorder characterized by association of ectodermal dysplasia (ED) with cleft lip/palate. The main features include dry, brittle hair with alopecia in adulthood, dental anomalies (hypodontia, microdontia with delayed eruption, fissured tongue, and retruded maxilla), hypohidrosis, dysplastic nails, and clefting. Palmar-plantar keratoderma is seen frequently. RHS has signs and symptoms that overlap considerably with those of ankyloblepharon-ED-clefting syndrome and ectrodactyly-ED-clefting syndrome. This manuscript discusses a case of RHS, one of the four members in three generations who had ED with variable degree of involvement of hair, teeth, nail, and sweat glands.

When dealing with excessive gingival display it is important for the treating clinician to properly identify the etiology, as potential etiologic factors can vary widely. Treatment decisions in this case involving a patient with high lip dynamics and a "gummy smile" were complicated because treatment recommendations differed for each of the several etiologies involved. The treatment performed, which included orthodontics combined with crown lengthening and in which the final restorations were segmented anterior to posterior to give both the clinician and laboratory improved control, was designed to meet the patient's desired esthetic outcome while addressing the areas of risk established in the preoperative assessment.

Taurodontism is a developmental tooth disorder characterized by lack of constriction in the cementoenamel junction and consequent vertical stretch of the pulp chamber, accompanied by apical displacement of the pulpal floor. The endodontic treatment of teeth with this type of morpho-anatomical anomaly is challenging. The purpose of this article is to report the successful endodontic treatment of a hypertaurodontic mandibular molar using a reciprocating single-file system.

Background: Microdontia of the maxillary anterior teeth occurs quite frequently but is poorly documented. The literature describes several treatment choices, which are often focused on an orthodontic approach rather than a restorative one. The latest trends in restorative dentistry and the new ceramic materials, such as lithium disilicate, allow clinicians to perform esthetic rehabilitations based on microinvasive approaches that are most appropriate for younger patients., Summary: Four patients, all employed in the field of dentistry, presented at our dental practice complaining of diastemata between their maxillary anterior teeth. Clinical analysis showed that the six anterior teeth were smaller than normal. In this article, we describe the treatment performed in these cases using ceramic veneers. Only one case required a preparatory orthodontic intervention. The esthetic integration of the restorations was excellent, and no fractures or debondings were registered at the 2-year follow-up, resulting in a high degree of patient satisfaction., Conclusion: Since microdontia is a shape defect, we strongly believe that when patients ask for its correction, the treatment should focus on shape adjustments performed with mini-invasive techniques. Orthodontics may be a useful preparatory step to optimize the distribution of the teeth to be restored.

Epidemiology of dentoalveolar anomalies is undoubtedly important, but in terms of the organization of orthodontic care, greater interest are data on the needs in this type of treatment. In a situation of limited manpower and resources for the provision of orthodontic care information about needs in orthodontic treatment allows you to define a group of patients with the primary need for orthodontic treatment, and to identify priorities to optimize the organization of orthodontic care in the region. Such data can be obtained by using the Dental Aesthetics Index (DAI) and Index of Orthodontic Treatment Need (IOTN). The aim of the study was to analyze the epidemiology of various forms of dentoalveolar anomalies school-age children of Kirishi district of Leningrad region, as well as their needs in orthodontic treatment in accordance with objective evaluation indices. The study involved 734 pupils of Kirishi lyceum №1 of Leningrad region. Analysis of the prevalence of dentoalveolar anomalies, as well as needs in the orthodontic treatment was conducted in three age groups: I mixed dentition period (6-9 years), II mixed dentition period (10-13 years), and permanent dentition (14-17). To determine the needs in the orthodontic treatment were used two most common international index (DAI and IOTN). In Kirishi district of Leningrad region dentoalveolar anomalies were found in 88.8% of children of school age, which is in accordance with the indices and IOTN DAI needs in orthodontic treatment is 38.8% and 54.5%, respectively. In order to reduce unnecessarily high load volume medical institutions orthodontic profile, optimize utilization of financial resources, as well as reducing social tension it is recommended to introduce the practice of doctors-orthodontists methodology for determining the needs in orthodontic treatment by objective indices.

Ellis-Van Creveld is a rare syndrome with characteristic dental and orofacial findings. Dental management of patients with Ellis-Van Creveld syndrome can be complicated by the associated skeletal and cardiac abnormalities. Here, we present the dental and orofacial findings in a patient with Ellis-Van Creveld syndrome, describe a new oral finding, and discuss the dental management considerations., (© 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.)

Rothmund-Thomson syndrome (RTS) is a rare autosomal recessive trait disease. It is characterised by skin, eye and skeletal abnormalities. Abnormalities associated with teeth include abnormal crown and root formations, rudimentary or hypoplastic teeth, microdontia and multiple missing teeth. In the present case, there were multiple decayed primary teeth and multiple congenitally missing permanent teeth. Mandibular left primary first molar (tooth 74) was pulpally involved and obturated with mineral trioxide ggregate. Follow-up after 2 years revealed successful obturation., (2015 BMJ Publishing Group Ltd.)

Williams-Beuren syndrome (WBS), also known as Williams syndrome, is a rare congenital disorder involving cardiovascular problems, mental retardation, distinctive facial features and tooth anomalies. It is caused by the submicroscopic deletion of 1.5 to 1.8 Mb on chromosome 7q11.23. This paper reports the dental care to a 7-year-old child with WBS syndrome. The interview also revealed visual impairment, sensorineural hearing loss, hyperacusis, photophobia and hoarse voice. The intraoral clinical examination showed anterior open bite, tongue thrusting, excessive interdental spacing, enamel hypomineralization of the incisors, hypoplasia and caries lesions. The dental treatment included: modulating sessions to control aversion to noises, the photophobia, and the dental fear and anxiety because of his reduced visual acuity; oral hygiene instructions, dietary and daily use of a 0.05% sodium fluoride mouthwash; the permanent mandibular left first molar was treated endodontically, and maxillary and mandibular first molars were restored with amalgam. Due to the patient's heart defect, a prophylactic antibiotic regimen was prescribed prior to the dental procedures. This patient has been followed up for 4 years and this case report underscores the importance of early dental evaluation and counseling for parents of WBS patients.

Background and Overview: Dens invaginatus (DI) is defined as a rare dental malformation. The inherent structural variants of this anatomic disorder make it difficult to perform conventional endodontic treatment procedures by means of a conservative access cavity. In this clinical case report, the authors describe the treatment of a type II DI by means of guided splints for cavity access., Case Description: This is a clinical report of a case of type II DI in a maxillary lateral incisor. The authors established the diagnosis by means of cone-beam computed tomography (CBCT). The authors manufactured 3 splint guides from a Digital Imaging and Communications in Medicine file and a stereolithography file obtained from a plaster model of the patient by using software for guided implant placement, for access opening, and for locating the root canals., Conclusions: CBCT is an effective method for obtaining information about the root canal system in teeth with DI. In addition, guided implant surgery software is effective for manufacturing splint guides for endodontic treatment with conservative pulp chamber access., Practical Implications: Information obtained from CBCT allows the clinician to fabricate splint guides for minimally invasive access opening in this type of case, thus reducing the loss of dental tissue., (Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.)

Objective : To evaluate the importance of dental status for long-term outcome after alveolar bone grafting in patients with unilateral cleft lip and palate. Design : Retrospective longitudinal study. Setting : Cleft lip and palate-craniofacial center, Uppsala University Hospital, Sweden. Patients : A total of 67 consecutive patients with unilateral complete cleft lip and palate. Interventions : Secondary alveolar bone grafting, prior to the eruption of the permanent canine, was performed at the average age of 10.0 years (range, 8.5 to 12.0 years). Main Outcome Measures : Alveolar bone height was evaluated with the modified Bergland index at 1 and 10 years after surgery. Results : Of the patients, 97% had modified Bergland index grade I and the remaining 3% had modified Bergland index grade II at 1 year after surgery. At 10 years' follow-up, 43% showed modified Bergland index grade I; 55%, modified Bergland index grade II; and 2% (one patient), modified Bergland index grade III. The degree of dental anomalies in the cleft area, such as enamel hypoplasia, incisor rotation, incisor inclination, canine inclination, and oral hygiene registered preoperatively, all correlated negatively to the modified Bergland index at 10 years after surgery. Enamel hypoplasia (ρ = 0.70195, P < .0001), followed by canine inclination (ρ = 0.55429, P < .0001), showed the strongest correlation to reduced bone height in the cleft area. Conclusions : In patients with unilateral cleft lip and palate, excellent results from secondary alveolar bone grafting in terms of bone height in the alveolar cleft tend to decrease with time. This seems to be correlated with factors that might to some extent be treated preoperatively through adequate planning and execution of the orthodontic treatment.

Williams Syndrome is a microdeletion syndrome characterized by a number of developmental and physical abnormalities. The aim of the present study was to evaluate the oral abnormalities and dental management of patients with Williams Syndrome. Fifteen patients with Williams Syndrome aged between 3-20 years old were evaluated in this study. Oro-facial findings, dental plaque index and DMFT/dmft scores were recorded in each patient. Panoramic radiographs and extraoral, intraoral photographs were taken from all patients. According to the results of this study, the mean DMFT and dmft scores were 0.39 ± 0.12 and 1.81 ± 0.39, respectively. The most common oro-facial findings were detected as high palate (87%), diastema (60%), failure to thrive (60%), feeding difficulties (60%), vomiting (47%), macroglossi (47%), microdontia (40%) and frenulum hyperplasia (40%). All decayed teeth were restored with compomer and composite restorations. In conclusion, dentists play a significant role for improving the quality of life of the patients with Williams Syndrome to minimize or prevent dental abnormalities.

The article presents the results of analysis of spectrum, the rate of frequency and the amount of microorganisms in oral liquid before the beginning of orthodontic treatment of dental abnormalities and deformations and in its stages (6 and 12 months later). As the result of the study the appearance of pathologic microorganisms Staphylococcus aureus and a great number of conditionally-pathogenic fungi of Candida family and Porphyromonas spp. were determined. The obtained results show the need of elaboration of standards for the treatment of orthodontic patients.

The paper presents the results of comprehensive survey and orthodontic treatment of 40 children with dentoalveolar anomalies and nasopharyngeal tonsil hypertrophy aged 7-9 years. The linear parameters obtained by cone beam CT and TWH in the lateral projection were analyzed. The study revealed changes, indicating that the presence of nasopharyngeal tonsil hypertrophy, leads to pathology of the dental system and estimated the efficiency of muscle training and combined use of functional devices and elastopositioner «Corrector» for the treatment of anomalies of dentition and the formation of physiological occlusion in the process of permanent teeth eruption.

Objectives: Self-ligating brackets are widely believed to be more effective in clinical use and to involve less friction and force. Thus, the goal of this in vitro investigation was to experimentally assess the effectiveness of different bracket-archwire combinations and the force levels exerted in two-dimensional direction during correction of tooth malalignment. An important aspect of this objective was to determine whether the behaviors of conventional bracket systems with an elastic or steel ligature differ from that of self-ligating brackets., Materials and Methods: Three conventional (Mini Taurus®, RMO; Synergy®, RMO; Victory Series™, 3M Unitek) and three self-ligating bracket systems (Speed™, Strite; Smart Clip™, 3M Unitek; Time 3, American Orthodontics) were analyzed. All brackets had 0.018-inch (0.46-mm) slots and--except for the self-ligating brackets-were tested with both a steel ligature (0.25 mm; Remanium, Dentaurum) and an elastic rubber ligature (1.3 mm in diameter; Dentalastics, Dentaurum). They were fitted with four different round wires: a 0.30-mm stainless steel (3M Unitek), 0.38-mm stainless steel coaxial (Advanced Orthodontics), 0.30-mm Thermalloy NiTi (RMO), and 0.30-mm Orthonol NiTi (RMO) archwire. The orthodontic measurement and simulation system (OMSS) was used to simulate a two-dimensional (2 mm of infraocclusion and 2 mm of vestibular displacement) malalignment of tooth 21 inserted in a resin replica of a Frasaco model. Four brackets of the same type were assessed and four individual measurements taken per bracket to analyze initial force systems and corrective malalignment outcomes., Results: The initial force systems and tooth movements varied distinctly between the different material combinations in conjunction with the ligation systems and archwire types used. The force systems generated were readily reproducible across individual measurements. Leveling outcomes and force systems between conventional steel-ligated and self-ligating brackets coincided in most cases. Both of these device configurations corrected the malalignment by 78-99 % on average. Rubber-ligated conventional brackets, by contrast, performed significantly worse due to exertion of significantly higher forces and 60 % less of a leveling effect., Conclusion: Our investigation demonstrates that both conventional steel-ligated brackets and self-ligating brackets, which are highlighted in the literature as highly efficient systems, lead to equivalent corrective outcomes in the treatment of tooth malalignments.

Background: A talon cusp is a morphologically well-delineated accessory cusp. This case report discusses the unusual appearance of a talon cusp on the facial surface of the maxillary right permanent central incisor, which was conservatively treated and followed up for a period of 1 year., Methods: A 21-year-old female was referred for the treatment of a maxillary right central incisor that caused an esthetic problem. Intraoral examination and radiographic and computerized tomographic investigation indicated that there was no connection between the pulp chamber, a "V"-shaped radiopaque structure, and three radiolucent globe areas. The accessory cusp was treated by selective cuspal grinding, followed by resin-based composite placement. The restoration was clinically evaluated 1 week after placement, as a baseline, and after 1 year. The restoration did not exhibit postoperative sensitivity at the 1-year evaluation. No difference was observed in the color match, marginal discoloration, marginal adaptation, or anatomic form compared with the baseline evaluation., Conclusion: The management and treatment outcome of a talon cusp depends on its size, presenting complications and patient cooperation. The present case report outlines the conservative management of a talon cusp., Clinical Significance: This paper outlines a viable esthetic treatment option and a review of the relevant literature with regards to managing a facial talon cusp., (© 2014 Wiley Periodicals, Inc.)