Palatal actinomycosis osteomyelitis–Complication of impacted tooth in a diabetic

This article aims to highlight palatal actinomycosis osteomyelitis as an unseen complication of maxillary tooth impactions. A middle aged male with uncontrolled diabetes reported with a complaint of nasal regurgitation of fluids. After clinical and radiographic evaluation, he was diagnosed with actinomycosis osteomyelitis of the hard palate as a sequelae of a long‐standing palatally impacted tooth. He was treated by a combination of medical and surgical therapy. Palatal actinomycosis should be considered a differential in nonhealing lesions of the hard palate and a possibility before leaving maxillary impactions untreated, especially in immunocompromised individuals. Adequate follow‐up is mandatory to note for any radiographic changes and if diagnosed, treatment should be started promptly to prevent grave complications.     

Draining fistulas associated with an endodontically treated tooth

A case of periapical actinomycosis is presented. Although apparently uncommon, actinomycosis should be considered when a chronic periapical lesion, often in the maxilla, is associated with an endodontically treated tooth or a previous history of trauma. Histologic examination of the tissue or the presence of "sulfur granules" in the exudate will usually establish the diagnosis. Treatment consists of local curettage and antibiotic therapy.     

Apical actinomycosis as a continuum of intraradicular and extraradicular infection: case report and critical review on its involvement with treatment failure

This article reports a case of extraradicular actinomycosis that clearly formed a continuum with the intraradicular infection. Histobacteriologic and histopathologic analyses of the root tip and attached apical periodontitis lesion obtained by surgery from a tooth with persistent disease were performed to look for the possible reasons for persistent disease. Although no stainable bacteria were observed in the apparently well-treated main canal, apical ramifications were clogged with dense bacterial biofilms that were contiguous to extraradicular actinomycotic aggregates. A critical review of the literature revealed that there is no clear evidence that apical actinomycosis is indeed an independent entity leading to persistent apical periodontitis lesions.     

Actinomycosis of the mandible. Case report

A bstract — A case of actinomycosis with associated destruction of soft tissue, tooth and bone is discussed.     

Effect of resveratrol on the hyperexcitability of nociceptive neurons associated with ectopic hyperalgesia induced by experimental tooth movement

The present study investigated whether, under in vivo conditions, systemic administration of resveratrol attenuates the experimental tooth movement-induced ectopic hyperalgesia associated with hyperexcitability of nociceptive trigeminal spinal nucleus caudalis (SpVc) neurons. The threshold of escape from mechanical stimulation applied to the ipsilateral whisker pad in rats exposed to experimental tooth movement was significantly lower than seen in control rats from day 1 to 3 following movement of the right maxillary first molar tooth. The lowered mechanical threshold in the rats exposed to experimental tooth movement had almost returned to the level of sham-treated naïve rats at day 3 following administration of resveratrol. The mean mechanical threshold of nociceptive SpVc neurons was significantly lower after experimental tooth movement but the lower threshold could be reversed by administration of resveratrol. The higher discharge frequency of nociceptive SpVc neurons for noxious mechanical stimuli observed in rats exposed to experimental tooth movement was statistically significantly lower following resveratrol administration. These results suggest that resveratrol attenuates experimental tooth movement-induced mechanical ectopic hyperalgesia via suppression of peripheral and/or central sensitization. These findings support the idea that resveratrol, a complementary alternative medicine, is a potential therapeutic agent for the prevention of experimental tooth movement-induced ectopic hyperalgesia.     

An unusual co-presentation of rhinolithiasis and squamous cell carcinoma in the nasal cavity

Rhinoliths are nasal stones that result from mineralisation of salts around an endogenous or exogenous nidus within the nasal cavity. They are uncommon nasal masses and usually unilateral and single, situated in the floor of the nose. The patient typically presents with nasal obstruction, facial pain and foul-smelling nasal secretion. To the best of our knowledge, the occurrence of squamous cell carcinoma with rhinolithiasis has not been previously reported in the English-language literature. In this article, we present a 63-year-old man, who had unilateral rhinolithiasis with squamous cell carcinoma within the nasal cavity.     

Case report of regional alveolar bone actinomycosis: a juvenile periodontitis-like lesion

BACKGROUND: Cervicofacial actinomycosis infection most often involves the mandibular bone and rarely the alveolar crest. METHODS: We describe a 14-year-old patient who had actinomycosis involving the alveolar bone at the left lower dental quadrant region. Resembling juvenile periodontitis, it was difficult to diagnose properly and resulted in devastating dental and periodontal consequences: loss of one tooth with most of its adjacent regional alveolar bone, severely compromising the support of two other teeth. RESULTS: With the diagnosis came successful treatment, including surgical removal of the soft and hard tissues with concomitant prolonged penicillin administration. CONCLUSIONS: We feel that this case should raise the interest and concern of both the periodontist and the general practitioner so that early diagnosis can be obtained, significantly improving the clinical outcome.     

Short root anomaly in families and its association with other dental anomalies

In the present study, we collected a family series with short root anomaly in order to analyze the inheritance pattern of the condition. Another aim was to identify in these families an association with other dental anomalies, such as tooth agenesis, peg-shaped lateral incisors, supernumeraries, ectopia, and such morphological characteristics as invaginations, taurodontism, and a tendency to root resorption. Mesiodistal dimensions of the crowns of the affected teeth were measured in order to reveal any association with reduction or increase in tooth size. The apparent genetic heterogeneity of the pedigrees did not permit definitive conclusions as to the mode of inheritance. Autosomal dominant transmission of short root anomaly was seen in 3/8 families. In 2/8 families, the condition was seen in siblings but not in parents. An association with tooth agenesis and ectopic canines was noted, the prevalences of which were 46% and 33%, respectively. We stress the importance of not misdiagnosing this anomaly as resorption.     

A dentigerous cyst containing an ectopic canine tooth below the floor of the maxillary sinus: a case report

Ectopic eruption into the dental environment is common, whereas eruption into other sites is rare. Diverse anatomical locations such as the mandibular condyle, coronoid process, palate, maxillary sinuses and nasal cavity can infrequently be the site of ectopic tooth eruption. One of the nondental sites for ectopic eruption is the maxillary sinus. Here, we present a case of dentigerous cyst with an ectopic maxillary canine tooth located below the floor of the right maxillary sinus in a 37-year-old man.     

Treatment of triple tooth: report of case

A case of a young girl with a triple primary tooth that retarded normal development of the maxillary left lateral incisor is described. The primary tooth was extracted to encourage normal development of the permanent tooth. Subsequent examination of the extracted triple tooth suggests that it was composed of the primary left lateral incisor fused either to a geminated central incisor or to a fused central incisor and supernumerary tooth.     

Rare lesions of the oral cavity: case report of an actinomycotic lesion limited to the gingiva

Actinomycosis is an infectious disease that frequently has chronic granulomatous and suppurative lesions caused by saprophytic Actinomyces species. Although cervicofacial actinomycosis is known to be the most common type, intraorally and periodontally types occur rarely in a localized fashion. The present case reports on an adult periodontitis patient with a diffuse and atypic actinomycotic lesion which was limited to the gingiva and had an abscess formation, a large desquamation and subsequent exposure of the alveolar bone in the involved region. Diagnosis was based on histopathological examination, the history of the case and clinical nature of the lesion. The patient responded to daily administration of 100 g doxcycycline (first day-bid) for 3 weeks and 0.2% chlorhexidine gluconate irrigation (following tooth brushing) performed with oral hygiene reinforcement and periodontal debridement procedures. Complete improvement of the lesion was observed after 5 weeks. Due to the opportunistic characteristics of the actinomycotic infection, early and adequate differential diagnosis of actinomycosis prior to therapeutic attempts, as well as management steps, are of great importance in the oral cavity to prevent the spread of the disease.     

Nonsurgical management of ectopic teeth

Four cases have been presented involving malpositioned premolars and molars that were brought into the arch. From the cases presented, it appears that aggressive surgical intervention to redirect ectopic premolars creates significant secondary problems. Interference with the bone surrounding the ectopic tooth may compromise the adjacent teeth and bone level. Pressure against the root of the impacted tooth may cause resorption. If the buccal or labial plate is removed, orthodontic movement will be impeded. Specific biochemical changes in bone are induced by the application of orthodontic forces. In these cases, creating space with coiled spring appliances resulted in remarkable reorientation and proper eruption of ectopic, impacted teeth. When surgical intervention is required in cases involving ectopic teeth, close collaboration between orthodontist and oral and maxillofacial surgeon is imperative to achieve successful results without negative sequelae.     

Primary triple teeth: histological and CT morphological study of two case reports.

The macromorphology and micromorphology of two specimens of primary triple teeth using histological and CT analysis approach is analyzed. A single morphological pattern of triple teeth has been found and described: three nearly separate crowns with three separate pulp chambers, and three joined roots with three connected root canals. The characteristic triple teeth appearance occurred because a labial supernumerary tooth is the junction element between two teeth of normal series: the central incisor on the mesial side and the lateral incisor on the distal side. Primary triple teeth suggest an idiopathic abnormality in the distribution of the dental material originated very soon in the dental development. They can be considered as an early double fusion between three tooth germs, initially separate but in close proximity and developing synchronically.     

Apical fenestration and ectopic eruption – effects from trauma to primary tooth: a clinical case report

Abstract – The study describes a multidisciplinary treatment of fenestration in the apical of a primary maxillary right central incisor due a trauma and also its sequel, an ectopic eruption of the permanent maxillary right central incisor, on 7‐year‐old boy. Clinically, the primary tooth had an enamel and dentin fracture with no pulp exposure. There was an apical fenestration in the vestibular region, and the permanent tooth had an ectopic palatal eruption. The primary tooth was extracted, and for the physiological reposition of the permanent tooth, which was crossed with its antagonist, a Haas appliance was used for the rapid expansion of the maxilla for a period of 9 days.     

Ectopic mandibular third molar leading to osteomyelitis of condyle: a case report with literature review

Background

A tooth is said to be ectopic if it is malpositioned either due to congenital factors or displaced due to pathological lesions. The incidence of osteomyelitis of condyle has a rare occurrence, very few cases have been reported, either their etiology is unknown or is due to hematogenous spread or a tuberculous focus. This particular case may be a rare of its kind, as recent literature did not reveal any case where an ectopic mandibular third molar led to osteomyelitis of the condyle.

Case report

This report presents a unique case where an ectopically placed mandibular third molar led to extraoral sinus and scar formation below the ear lobule with osteomyelitis of the mandibular condyle and proposes various indications for its removal along with literature review.

Discussion

Ectopic eruption of a tooth into the dental environment is common, whereas ectopic eruption of tooth in other sites is rare. The exact etiology of ectopic eruption of mandibular third molar in condyle is a rare occurrence and to the best of our knowledge, only 14 cases have been reported in the literature. Management of such cases should be meticulously planned after ruling out various local as well as systemic factors as an underlying cause for osteomyelitis and on the basis of the position and type of ectopic tooth and related potential trauma which could be caused by surgical intervention with less morbidity.

Conclusion

This particular case may be the unique of its kind, as recent literature did not reveal any case where an ectopic mandibular third molar led to osteomyelitis of the condyle. Diagnosis and management in such cases deserve very special attention to rule out various local and systemic causes which can cause osteomyelitis to affect very unusual site like mandibular condyle. The aim of surgical intervention should be to cause minimum morbidity without affecting the functional efficiency of the mandibular condyle. In this report, we also have proposed the indications for surgical intervention to remove ectopically erupted teeth.     

The Alignment of Impacted and Ectopic Teeth using the Easy-Way-Coil (EWC®) System

BACKGROUND: Teeth that do not spontaneously erupt in the dental arch or are ectopic must normally be surgically exposed. For orthodontic correction a traction device must be attached to the affected tooth over which the already-raised mucoperiosteal flap is lowered to improve the periodontal condition. METHOD: The author has developed a system at his private orthodontic practice for this purpose, and it has proven itself over a 10-year period. A traction spring is fastened to a lingual button that is attached to the etched tooth surface using an adhesive. The appliance is activated by systematically shortening the spring. RESULTS: A total of 103 patients were treated successfully in this way, 45 of whom had presented a unilaterally ectopic canine requiring an average treatment time of 17.8 months from surgical exposure to removal of the fixed appliance. None of the patients suffered inflammatory reactions in the oral mucosa adjacent to the traction spring during the treatment. Two impacted teeth were ankylosed and could not be aligned. CONCLUSION: The EWC-System is clinically a reliable, efficient, easy to use and economical system for the alignment of impacted and ectopic teeth.     

自体牙移植术的临床应用研究

目的：评价正畸治疗中自体牙移植的临床效果,并探讨移植牙成功的影响因素。方法：选择17例17颗牙齿异位或埋伏阻生的病例,先行正畸治疗以拓展出合适间隙,局麻下进行自体牙移植,术后固定,移植术后4周行根管治疗并正畸加力,精细调整咬合关系后拆除固定矫治器。结果：经1～3年的随访,17颗移植牙均未发现牙根吸收、松动、疼痛和根骨粘连等并发症。结论：自体牙移植的临床效果满意。对于异位或埋伏阻生牙的正畸治疗,联合自体牙移植术能快速纠正个别牙错位,缩短正畸治疗疗程。     

不同时期大鼠牙齿胚基各部分组织发育能力的研究

目的：比较不同发育时期牙胚各部分异位环境下的发育能力,为牙齿再生重组实验提供参考。方法：分离获取SD大鼠帽状期和钟状末期牙胚,分离成釉上皮与牙乳头间充质,分别将完整牙胚、牙间充质、成釉上皮剪碎后异位移植至同种异体大鼠肾被膜下。4周后取材,对移植物进行组织学观察。结果：帽状期牙胚碎组织块移植物中可见部分不规则的牙齿样结构形成。钟状末期牙问充质碎组织块移植组中既有牙本质牙髓复合体样结构形成,还能观察到大量骨样基质形成。而钟状末期成釉上皮碎组织块移植物生成的组织均为骨样的结构。结论：发育早期牙胚的碎组织较发育末期的牙胚碎组织具有更强的牙齿形成能力,所形成的牙齿结构完整包括釉质、牙本质以及牙髓且顺序正确,提示这个时期牙上皮和间充质之间信号网络所提供的微环境可以更加完善和充分地指导牙齿的发育。     

上颌前磨牙腭中缝异位伴颏部多生牙1例

牙齿异位的情况临床中较常见,大多数异位牙发生于原牙位周围,牙齿远距离异位罕见。本文报道1例上颌前磨牙腭中缝异位伴颏部多生牙病例,并结合相关文献对其进行讨论。     

Alternative transoral approach for intranasal tooth extraction

Intranasal ectopic eruption is an uncommon condition. Even if an intranasal tooth can be completely asymptomatic, sometimes a variety of nasal signs and symptoms may be associated, ranging from mild nasal congestion to recurrent epistaxis and purulent rhinorrhea. As a consequence, surgical removal is often required. Endoscopic extraction of the intranasal tooth has been reported to present several advantages with respect to traditional surgical approaches and thus recommended as routine treatment in such cases. However, when a tooth is impacted next to the nasal floor, an alternative approach could be needed. We suggest an alternative transoral approach to perform extraction of intranasal teeth, aimed at avoiding excessive bone removal to reach the nasal floor area and preventing the complications related to traditional intraoral buccal or palatal approach. It could represent a reliable alternative to traditional removal in the Oral Surgery Department.