Ankylosed teeth as abutments for palatal expansion in the rhesus monkey

The maxillary permanent lateral incisors of three rhesus monkeys were intentionally ankylosed by a replantation and splinting technique. A 1-pound expansion force was applied to the ankylosed teeth for 5 to 15 weeks. The intermaxillary and interpremaxillary sutural expansion was monitored radiographically during the experimental period. Two animals were killed for histologic examination after 13 and 23 weeks, and the third animal was monitored radiographically for 21 weeks. Skeletal expansion of the maxilla was achieved without concomitant buccal tipping of the abutment teeth. Osteoid tissue was deposited on localized areas of the resorbed cementum and dentin of the ankylosed teeth. The periodontal ligament showed atrophic and degenerative changes similar to those found with increased age in human beings.     

Bone-anchored maxillary protraction long-term outcomes in UCLP:: A case report

This case report presents a 12-year-old boy with unilateral complete cleft lip and palate and severe maxillary retrusion treated with bone-anchored maxillary protraction (BAMP) therapy followed by fixed appliances. The follow-up period extended until the end of growth. Initially, the patient demonstrated a Goslon 4 interarch relationship with an overjet of −3.5 mm and a Wits appraisal of −7.9 mm. Six months after the secondary alveolar bone graft, Bollard miniplates were fixed bilaterally at the infrazygomatic region in the maxilla and between the canines and lateral incisors in the mandible. Class III elastics were used bilaterally full time for 12 months. After treatment, the overjet increased 5.9 mm. Significant maxillary advancement (SNA +3.2°) and skeletal convexity improvement (NA-APo +12.4°) were observed. Retrusion of the anteroposterior position of the mandible was observed (SNB –2.1°). Comprehensive orthodontic treatment was performed after BAMP therapy with nighttime bone-anchored Class III elastics as active retention until the end of growth. Occlusion and facial esthetics were satisfactory at the end of orthodontic treatment and growth. Le Fort I surgery for maxillary advancement was not required. BAMP therapy demonstrated an adequate orthopedic outcome, preventing the need for orthognathic surgery in unilateral complete cleft lip and palate.     

Subconjunctival ecchymosis after extraction of maxillary molar teeth: a case report

Abstract – Extraction of teeth is usually performed by either intra‐alveolar or trans alveolar methods. Subconjunctival ecchymosis occurring after intra‐alveolar extraction of maxillary first and second molar teeth is a rare entity and finds no mention in the latest clinical literature. The etiology of subconjunctival ecchymosis includes traumatic and non‐traumatic causes. We report a case and discuss the possible etiology and management of this complication.     

Subcutaneous emphysema after extraction of maxillary teeth: report of a case

Inappropriate use of dental equipment that is powered by highly compressed air may directly lead to the formation of subcutaneous emphysema that involves the fascial planes of the head and neck. The high-speed dental handpiece and the air and water dental syringe are the instruments that are most commonly implicated in the reported cases. The treatment of such cases requires a reassured patient, prophylactic antibiotic coverage, and close postoperative follow-up care. Patients should avoid maneuvers that could increase intraoral pressure. Complete resolution should be expected within one week.     

Management of misangulated implants for a maxillary overdenture with spherical abutments: a clinical report

Misangulated and malpositioned implants pose a significant challenge for the prosthodontic treatment of edentulous patients. Most reports of maxillary overdenture patients have described the use of a bar to splint malaligned implants, followed by successful fabrication of the prosthesis. Few reports have discussed the use of individual abutments in such situations. This clinical report describes the successful use of spherical/ball abutments for the management of 4 malaligned implants in the edentulous maxilla for an overdenture. The rationale and technique for the use of spherical abutments for overdenture fabrication in such situations are described.     

Traumatically induced maxillary retrusion--a case report of orthodontic management with the protraction headgear

A 46-year-old male Caucasian with traumatically induced maxillary retrusion was referred for orthodontic treatment, eight weeks after the original fracture had occurred. Initial surgical reduction and fixation had been successful, when a second traumatic episode was encountered. This resulted in a further degree of posterior maxillary displacement, which was resistant to further surgical reduction. The resulting Class III malocclusion was treated using maxillary protraction headgear, in conjunction with removable orthodontic appliances and intermaxillary traction. Appliances were worn full time and inter-arch correction was achieved in six months. The resulting occlusion proved to be stable following the cessation of active treatment.     

Supernumerary deciduous teeth with multiple maxillary impacted mesiodens: A case report

Maxillary impacted mesiodens are frequently encountered in pediatric dentistry. Much research has been conducted concerning their incidence, position, and form. Supernumerary teeth erupting in the primary dentition with maxillary impacted mesiodens are very rare. In January 2011, a nine-year-old boy presented for dental treatment and was found to have supernumerary deciduous teeth. Upon panoramic radiography, multiple impacted mesiodens were found; therefore, computed tomography (CT) was performed for further examination. One month later, the boy was referred to our department for extraction of the deciduous supernumeraries and impacted mesiodens. We suspected that these supernumeraries, mesiodens, and remaining primary teeth would lead to problems with the eruption of the permanent teeth. Therefore, by ascertaining the exact position of the mesiodens and the successional permanent teeth using CT, extraction was performed under general anesthesia in March 2011 without any error. Six months postoperatively, panoramic radiographs showed no superfluous structure that appeared to be a tooth. We suggest that when multiple maxillary impacted mesiodens are found, their exact positions can be located using CT before extraction.     

Periapical cemento-osseous dysplasia in maxillary teeth suggesting apical periodontitis: case report

This article describes the case of a 34-year-old woman whose prosthodontist had referred her for root canal treatment of tooth No. 10, due to an initial diagnosis of apical periodontitis. Although periapical radiolucencies were present, teeth No. 10 and 11 responded positively to pulp vitality tests. A series of periapical radiographs revealed circumscribed periapical radiolucencies on teeth No. 21 and 28, while teeth No. 23, 24, and 27 were associated with mixed radiolucent/radiopaque periapical lesions. All teeth responded to cold stimulus. Based on the clinical and radiographic findings, a diagnosis of periapical cemento-osseous dysplasia was suggested. A re-evaluation 12 months later confirmed this diagnosis. Tooth No. 10 was restored and the patient was scheduled to return for clinical and radiographic follow-up after one year and three years.     

Supernumerary teeth: a case report

Supernumerary teeth are the teeth present in addition to the normal set of teeth. They may be single, multiple, unilateral or bilateral erupted or unerupted and in one or both jaws. Multiple supernumerary teeth are rare in individuals with no other associated diseases or syndromes. Our case presents with 12 supernumerary teeth in permanent dentition, of which six were erupted and six unerupted and a history of extraction of three teeth with no associated syndrome.     

乳牙早脱1例

目的:对1例乳牙早脱患儿进行临床研究,初步探讨该病临床特点和病因。方法:首先从常规口腔检查、全口曲面断层X线片、双手尺骨腕关节X线片、双下肢骨、膝关节X线片和系谱分析等方面研究其临床特点。然后从染色体分析(常染色体数、性染色体数、核型、数目畸变率、结构畸变率等)、血清微量元素(钾、钠、氯、钙、镁、磷)和血清碱性磷酸酶(ALP)、骨特异性碱性磷酸酶(B-ALP)、抗酒石酸酸性磷酸酶-5b(TRCAP-5b)检测等方面进行研究。结果:患儿的腕关节、膝关节X线片未见异常,染色体分析未见数目畸变和结构畸变,血清微量元素钾、钠、氯、钙、镁、磷均在正常参考值。患儿血清碱性磷酸酶偏低(23μmol/L);骨特异性碱性磷酸酶偏低(3.38μg/L);抗酒石酸酸性磷酸酶5 b偏高7.89 U/L。结论:该患儿仅碱性磷酸酯酶低而不伴有其他发育异常,可能属于牙齿型低碱性磷酸酯酶症,需进一步研究其基因突变位点进行确诊。     

Bilateral maxillary fused primary incisors accompanied by succedaneous supernumerary teeth: report of a case

Summary. A rare case of fusion between maxillary primary central incisors and supplemental teeth occurring bilaterally, accompanied by succedaneous supernumerary teeth, is presented. The patient was an 8·5-year-old Japanese boy. Intraoral examination revealed fusion of left and right maxillary primary central incisors to supplemental teeth, which had labial and lingual grooves. The maxillary primary lateral incisors were present. Radiographs showed that the fused teeth had separate roots, pulp chambers and root canals. There were two impacted supernumerary teeth and eruption of the permanent maxillary central incisors was delayed. Treatment was performed and the fused primary teeth and the impacted supernumerary teeth were extracted. After 6 months observation, surgical exposure of the two crowns of the permanent maxillary central incisors was performed. The teeth began to erupt and have since been kept under observation.     

Noninvasive aspergillosis as a maxillary antrolith: report of a rare case

Maxillary antrolithiasis is characterized by masses of tissue of endogenous or exogenous origin that calcify within the maxillary sinuses. Aspergillosis is a fungal disease in which the maxillary sinus is a primary site of infection. Aspergillosis mycetoma, its noninvasive form, is the most prevalent modality of the disease in the maxillary sinuses. In approximately half of the cases reported in the literature, calcification of the fungal mycelia, which later became antroliths, was verified. This article reports a rare case of the accidental discovery of a maxillary antrolith associated with noninvasive aspergillosis in an immunocompetent and asymptomatic 56-year-old woman. The diagnosis and therapeutic procedures used in treating the patient are discussed as well as the probable iatrogenic origin of the fungal pathology.     

Inflammatory myofibroblastic tumor of the maxillary sinus related with pulp necrosis of maxillary teeth: case report

Inflammatory myofibroblastic tumor (IMT) is a benign lesion composed of myofibroblasts accompanied by varying numbers of inflammatory cells. Various pathogenetic factors have been proposed, but the etiology of most IMTs remains unknown. This article presents a case of IMT occurring in the left maxillary sinus. A 24-year-old man complained of throbbing pain in the maxillary left molars and swelling of the left cheek. His maxillary left second molar was diagnosed as pulp necrosis and root canal treatment performed. After that, his symptoms continued and he was referred to the Department of Otolaryngology. Computerized tomography disclosed compact soft tissue masses in the left maxillary sinus with obstruction of maxillary ostium. Under general anesthesia, the lesions were fully excised. Histopathologically, the lesions were composed of plump or spindled myofibroblasts. Cells were immunoreactive for smooth muscle actin and β-catenin, and were negative for ALK1, CD34, and EMA. The diagnosis was IMT of left maxillary sinus. Although it is very rare, IMT should be included as a differential diagnosis in patients with compact masses in maxillary sinus.