Impacted mandibular primary second molar: A case report

We present a case of 6-year- and 10-month-old boy with an impacted primary molar. An x-ray photograph revealed the impacted mandibular right primary second molar with small hard tissue on the crown of the tooth as an obstacle. We extracted the small hard tissue and the mandibular right primary second molar.A histopathological examination of the obstacle revealed a tooth germ containing dental papilla, dentin, and enamel. The obstacle was diagnosed as the tooth germ of the mandibular right second premolar.In conclusion, the early detection of impacted primary molars is important for children's healthy growth and development.     

Treatment of space loss caused by submerged maxillary second primary molar

Submersion is a clinical term describing a tooth depressed below the occlusal plane. In this case report, we present the treatment of a patient who had totally submerged primary maxillary second molar, which caused impaction of the second premolar and space loss in the maxillary arch due to tipping of adjacent teeth. A 12-year-old girl was referred to the pediatric dentistry clinic. The intra-oral examination revealed that right maxillary second primary molar was localized buccal side of posterior maxillary alveolar process, being almost completely covered by gingiva and adjacent teeth inclined closing the space of the related teeth completely. Periapical radiograph demonstrated that maxillary second premolar was impacted. Based on clinical and radiographic findings, maxillary primary second molar was extracted. Headgear was used for the distalization of maxillary right first molar in order to create space for the impacted second premolar. Eruption begun spontaneously 6 months later.     

Unerupted mandibular second primary molar with an unusual histopathological finding: a case report

This is the case of a healthy 6-year old female with a clinically absent right mandibular second primary molar with no history of that tooth ever being present. Radiographic examination revealed a well-circumscribed pericoronal radiolucency surrounding the mandibular right primary second molar. The mandibular right second premolar was displaced mesially. Treatment consisted of enucleation of the lesion with removal of both the unerupted primary second molar and second premolar. The histopathology of the excised lesion revealed a hyperplastic dental follicle with a focal proliferation of odontogenic epithelium and duct-like structures, probably representing an incipient adenomatoid odontogenic tumor.     

Long-term follow-up of delayed development of maxillary right second premolar with inversely positioned corresponding primary molar

Impaction is defined as a condition in which a tooth fails to erupt within a normal range of functional position. The condition is generally found in permanent teeth, while impaction of primary teeth is considered to be uncommon. We previously presented a rare case of delayed development of a maxillary right second premolar with an inversely positioned corresponding primary molar identified in a girl aged 10 years and 4 months. In the present report of the same patient, we show transitional changes in location and developmental stage of the affected permanent tooth and impacted primary tooth noted during periodical examinations over a 5.5 year period. At 13 years and 2 months, the root of the permanent tooth began to develop, after which the root extended to half of the entire length at 15 years and 3 months. At the most recent examination conducted at 15 years and 9 months, the permanent successor had emerged into the oral cavity and the impacted primary molar maintained a similar position close to the inferior wall of the maxillary sinus without any symptoms. Throughout the observation period, the dental age of the maxillary right second premolar was calculated to be approximately 3 to 4 years behind those of the other second premolars. Our findings in the present case led us to consider that careful observation of the developmental stage of an unerupted permanent tooth is important, while no intervention is required before confirming tooth development as the patient grows, even if the dental age of the corresponding tooth is much later than the ages of other teeth.     

Supernumerary tooth in the primary molar region: a case report

Supernumerary teeth are among the most common dental anomalies affecting the primary and permanent dentition. They are usually found in the anterior maxilla and occur infrequently in the primary dentition. The purpose of this paper was to report a case diagnosed with primary supernumerary tooth in the primary second molar region. The crown and root shape of the primary supernumerary tooth resembled that of the primary first molar. On radiographic examination, the primary supernumerary tooth was followed by a permanent supernumerary successor with an unusually big crown. The primary supernumerary molar was immediately extracted to avoid interference with the development of the second premolar's tooth bud. This dental anomaly is rarely observed, as only primary supernumerary teeth in the anterior region have been reported in the dental literature.     

Conservative management of lower second premolar impaction

Lower second premolars account for approximately 24 per cent of impactions, excluding third molars, even though most reports in the literature relating to impacted teeth address the maxillary canine, with relatively few reports on the lower second premolar. Conservative management involves surgical exposure of the crown, however, subsequent premolar eruption is unpredictable. A case is described in which removal of a deciduous second molar was followed by eruption of an unfavourably inclined premolar located deep within the alveolus. Sufficient time must be allowed for eruption and in the present case 16 months elapsed before the tooth had erupted to the level of the occlusal plane.     

Total impaction of deciduous maxillary molars: two case reports

AIM: The purpose of this report is to present two cases of totally impacted maxillary deciduous molars, considered a rarity in dental practice. BACKGROUND: Primary tooth impaction is quite rare during the development of primary dentition. Various factors contribute to the impaction of a deciduous tooth, including anklyosis, congenitally missing permanent teeth, defects in the periodontal membrane, trauma, injury of the periodontal ligament, precocious eruption of the first permanent molar, defective eruptive force, or a combination of these factors. REPORTS: Case #1: An 18-year-old male presented with a complaint of spontaneous repetitious pain in the maxillary right premolar region. The maxillary right second premolar was clinically absent. Panoramic and periapical radiographs revealed an impacted second premolar close to the inferior wall of the maxillary sinus and an impacted deciduous molar deeply embedded in bone within the maxillary sinus. Case #2: A 14-year-old girl presented with a complaint of crowding of the maxillary teeth. The maxillary right second premolar and the maxillary permanent canines were clinically absent. A panoramic radiograph revealed an impacted maxillary right second premolar and an impacted deciduous molar embedded within bone close to the inferior wall of the maxillary sinus. SUMMARY: The total impactation of deciduous teeth is a rare condition, and few cases have been reported in the literature. The condition generally affects the mandibular second deciduous molar and the maxillary first deciduous least often. In this paper, two cases of totally impacted maxillary deciduous molars are reported.     

Impaction of mandibular molar by supernumerary tooth: case report

The occurrence of supernumerary teeth in the lower molar region is rare. A prevalence of less than 2% of cases occurring in this region has been estimated. The aim of this study was to present a clinical case of a 7-year-old female patient who had a supernumerary tubercular tooth between the distal root of the primary mandibular left second molar and the impacted permanent mandibular left first molar. Treatment consisted of surgical removal of the supernumerary tooth and case follow-up until the permanent molar's eruption, which occurred in 13 months. This study emphasizes the importance of: early diagnosis, appropriate intervention, and recommended preservation. Thus, it is possible to prevent or reduce complications, simplifying the case outcome.     

下颌支内阻生第二磨牙自体移植1例报告

本文报告1例下颌支内阻生第二磨牙自体移植病例。利用数字化外科、微创拔牙等技术将下颌支内阻生第二磨牙取出后即刻自体移植至原第二磨牙区,同期将自体骨粉填入移植牙颊侧和远中骨缺损区,弹性固定移植牙。术后咬合关系良好,即刻动度I度,骨缺损得到填充修复。术后6个月行根管治疗,1年后经临床和影像学检查移植牙愈合良好。下颌支内阻生磨牙自体移植至缺失磨牙区可以成为自体牙移植术的适应证。     

A Case of Impacted Supernumerary Fourth Molar in the Bilateral Mandibular Ramus

The occurrence of multiple supernumerary teeth in individuals without any associated syndrome is rare. In this report, a rare case of a 48-year-old woman who had an impacted supernumerary fourth molar in the bilateral mandibular ramus is described. She presented with a swelling in the left cheek region. Radiographic examination revealed an impacted supernumerary tooth in the left mandibular ramus with pericoronal resorption of the bone, suggesting peripheral inflammation. She also had an impacted supernumerary tooth on the right side. After administering an antibiotic and antiinflammatory drug, tooth extraction was performed under general anesthesia.     

Management of occlusal and developmental disturbances resulting from an ankylosed maxillary second primary molar: case report

This case report presented the orthodontic management of an ankylosed primary molar. Trauma to the maxillary right second primary molar resulted in the infraocclusion of the affected tooth as well as the mesial tipping of the adjacent first permanent molar and displacement of the permanent successor. After extraction of the ankylosed primary molar, orthodontic therapy was performed to upright the adjacent permanent molar and to gain the lost space of its permanent successor. By the application of orthodontic mechanics, the maxillary right permanent first molar was uprighted and the maxillary right permanent second premolar was brought to its proper position.     

Complete infraocclusion of a previously erupted primary molar: A case report

The prevalence of infraoccluded or impacted primary molars was reported to be from 1.3% to 8.9% of the population with higher incidence between siblings. This is a report of a rare case of a 10-year-and-11-month-old boy with a previously erupted primary maxillary right second molar that was restored by with an amalgam filling at about three years of age. After seven years, the said tooth was found X-ray photographically to be completely embedded into the alveolar bone with an “impacted” maxillary permanent second premolar. There was also mesial tipping of the adjacent permanent first molar. The management of this case included the use of a space regainer to correct the molar tipping, surgical removal of the ankylotic infraoccluded primary molar and the use of a palatal holding arch to correct the torsiversion. This report underscores the need for early recognition of infraoccluded/ ankylosed primary teeth by dentists for regular monitoring and timely and appropriate intervention.     

Endodontic treatment of a supernumerary tooth fused to a mandibular second molar: a case report

Since abnormal tooth morphology can predispose to caries and periodontal disease, careful management of fused teeth is essential. In this paper we report a rare case of a fused molar and supernumerary tooth and describe its management. Caries was removed from the tooth complex under local anesthesia. The pulp chamber of the supernumerary tooth was exposed without involvement of second molar pulp chamber. The root canal of the supernumerary tooth was prepared using the step back technique and copious irrigation with 2.6% sodium hypochlorite. Obturation using the lateral condensation technique with gutta-percha and AH26 sealer was subsequently performed and final restoration was accomplished with composite resin. Nine months after the treatment, no clinical or radiographic concern is apparent, and the second molar tooth has remained vital.     

Autotransplantation of maxillary second premolars to mandibular recipient sites where the primary second molars were impacted,predisposes for complications

Abstract

Objective. The aim of the study was to elucidate whether ankylosis of a transplanted permanent tooth can be predicted based on an evaluation of the primary and permanent dentitions. Materials and methods. The study comprised 162 maxillary second premolars and 49 third molars transplanted to the mandibular second premolar region in 157 patients treated in the period 1980–2003. Selection criteria: panoramic radiograph available; agenesis of the mandibular permanent premolar/s; persistence of the primary molar at the recipient site. The 211 transplanted teeth were observed for a period of between 1–29 years. Results. Seven per cent (95% confidence interval, CI = 3–11%) of the transplanted second premolars ankylosed during the first 10 years after operation. The success rate for transplantation of the third molar to the mandibular second premolar region was significantly lower (p = 0.001), as 40% (95% CI = 24–57%) of the third molars had ankylosed 10 years after operation. A significant association (p = 0.022) was found between ankylosis of a second premolar and infra-position of the primary second molar located at the recipient site. The infraposition group had 13% (CI = 4–23%) ankylosis after 10 year, whereas the non-infraposition group had 5% (CI = 1–9%) ankylosis after 10 years. Conclusions. The present study concludes that there is an increased risk of ankylosis of the transplanted permanent tooth if the primary tooth at the recipient site is in infraposition. This observation may be decisive for treatment planning, especially in young individuals in whom excessive growth of the alveolar process is expected from the cephalometric analysis.     

Simultaneous presence of a congenitally missing premolar and supernumerary incisor in the same jaw: report of case

Supernumerary teeth and hypodontia can be regarded as opposite developmental phenomena. An eight-year-old girl presented a concomitant occurrence of a supernumerary tooth and two congenitally missing teeth. The supernumerary tooth was found in the left maxillary incisor region, while the left second premolar in the maxilla and the left lateral incisor in the mandible were congenitally missing. The supernumerary tooth showed a similar color and morphology to those of the maxilla lateral incisor, and the lateral incisor on the mesial side was diagnosed as a supernumerary tooth from dental age, eruption time, and mesiodistal crown dimension. The supernumerary incisor was guided labially to cure an anterior cross-bite, and the lateral incisor, canine, and first premolar were guided distally to compensate for the space left by the congenitally missing left second premolar.     

Endodontic and orthodontic treatment of a cross-bite fused maxillary lateral incisor

AIM: To describe combined endodontic and orthodontic treatment of a maxillary lateral incisor fused with a supernumerary. SUMMARY: A rare case is presented in which combined endodontic and orthodontic treatment was performed on a cross-bite fused tooth. Clinical and radiographic examination showed the maxillary lateral incisor fused with a supernumerary and an impacted canine. The fused tooth required nonsurgical and surgical endodontic treatment for functional and aesthetic reasons. The root canals were dressed with calcium hydroxide for 2 months before they were obturated with thermoplasticized injectable gutta-percha. Then, the distal part of the fused tooth was removed and the mesial part of the tooth was replanted and fixed. Three months after the completion of orthodontic therapy, the impacted canine erupted between the remaining tooth and the first premolar. Recall examination, 3 years after completion of root canal treatment, showed clinical and radiographic evidence of healing. KEY LEARNING POINTS: Fusion has been described as a development anomaly characterized by the union of two adjacent teeth. Proper combined endodontic and orthodontic treatment resulted in maintaining one tooth half and solving the aesthetic and functional problem of a fused tooth.     

Root resorption of first permanent molar by a supernumerary premolar

A case is presented of root resorption of the lower right first permanent molar caused by a supernumerary premolar tooth. The first permanent molar was subsequently extracted.     

Inadequate treatment: a pathway to surgery

A patient developed postendodontic pain 3 years after undergoing root canal therapy in a maxillary first premolar tooth. Radiographic examination revealed that a recently extracted impacted second premolar had originally obscured the x-ray view of a third root on the first premolar. Endodontic therapy in the unfilled root was rejected because the tooth had been restored with full coverage. Apicoectomies and retroseals were performed on all roots, and the tooth became asymptomatic.     

Ankylosis of primary molar along with congenitally missing first permanent molar

Ankylosis of primary mandibular molars has been routinely found to be associated with various developmental disturbances in permanent dentition such as aplasia of the succedaneous tooth, ectopic eruption of the premolar, infraoclusion of the ankylosed tooth leading to tipping of the first permanent molar etc. This article describes a rare case where there was ankylosis of a mandibular second primary molar along with congenitally missing first permanent molar which resulted in the transposition of second premolar. Treatment options and prognosis of the case are discussed.     

Anatomical studies on a supernumerary tooth considered to be a successional tooth of the lower first molar

The purpose of this study is to investigate features of the successional tooth of the lower first molar. Materials investigated in this study deal with a supernumerary tooth formed at the distolingual deep part to the lower right first molar of a male patient aged twenty-four. It was observed with binocular microscopy and under X-ray. The occlusal surface of it was observed with scanning electron microscopy. Horizontal ground sections of it were prepared and observed with polarizing microscopy, fluorescent microscopy, and scanning electron microscopy. It is thought that this supernumerary tooth is a true successional tooth of the lower first molar because it was formed at the distolingual deep part to the lower first molar and the fissure of it is Y-shaped and it has five cusps. It is considered that two impressions at buccal and distal surfaces of it isn't original hereditary features but was accidentally formed by pressures of mesial and distal roots of the lower first molar. The rough form of it has most resemblance to the lower second premolar and distal and lingual parts of it are smaller than that of the lower first molar. But fundamental features of the lower first molar are preserved in it. It is thought that the center of the molarization field of human lower successional teeth lies at the successional tooth of the lower first molar because the form of the occlusal surface of it is more complex and functional than those of the lower first and second premolars.