Search Results (98)

Odontogenic cutaneous fistulas (OCFs) are relatively uncommon in veterinary patients. They are typically caused by chronic periapical infections of the maxillary teeth. Mandibular OCFs that extend through the cortical bone into submandibular soft tissues are extremely rare. This report describes the case of a 14-year-old male mixed-breed dog that presented with a submandibular cutaneous lesion initially misdiagnosed as a salivary mucocele. OCFs are frequently misdiagnosed because atypical presentations may lack obvious intraoral abnormalities and mimic salivary gland disease, lymphadenopathy, or cutaneous neoplasia. Computed tomography (CT) revealed a periapical lesion associated with the right mandibular first molar, cortical bone lysis, and extension into the adjacent submandibular tissues, which formed an external fistulous tract. Surgical management included extraction of the affected tooth, resection of the fistulous tract, and excision of the associated lymph nodes, which resulted in a complete and uneventful resolution of the fistula. At the 3-month follow-up, the patient remained clinically stable without evidence of recurrence. This case underscores the clinical pearl that odontogenic origins should always be considered in the differential diagnosis of submandibular or cervical cutaneous lesions and that cross-sectional imaging modalities, such as CT, are indispensable for confirming anatomical continuity and guiding surgical planning. Full article

Background/Objectives: Non-syndromic tooth agenesis (NSTA) is a congenital condition that causes the absence of one or more teeth without accompanying systemic abnormalities, which significantly affects quality of life. Genetic factors, including mutations in several specific genes, contribute to the pathogenesis of NSTA. This study investigates a novel EVC2 mutation in a patient with NSTA and explores its potential pathogenic mechanism, with the aim of enriching the spectrum of pathogenic genes. Methods: Whole-exome sequencing (WES) was performed on peripheral blood samples from a patient diagnosed with NSTA. Bioinformatics analysis was utilized to identify the mutation and assess its potential impact on protein structure and function. Molecular dynamics simulations were conducted to analyze structural alterations in the EVC2 protein. The binding affinity between EVC2, EVC, and Smoothened (SMO) was to determine the effect of mutation on protein–protein interaction. Protein localization and expression were analyzed using immunofluorescence and Western blotting. Reverse transcription quantitative PCR (RT-qPCR) was employed to evaluate downstream signaling pathway alterations. Results: A novel EVC2 mutation (c.1657_1660delinsA, p.Glu553_leu554delinsMet) was identified in the proband, and the mutation was maternally inherited. Molecular dynamics simulations revealed that the mutation resulted in a decrease in α-helical content and significant conformational changes in the protein structure. This led to reduced binding affinity between EVC2 and its ligands EVC and SMO, destabilizing the structural integrity of the protein complex. Despite these structural changes, EVC2 protein localization and expression were unaffected. Furthermore, a downregulation of GLI1 and SHH expression was observed, indicating impaired Hedgehog (Hh) signaling. The downregulation of the Hh signaling pathway impairs the tooth development process and may lead to the occurrence of tooth agenesis. Conclusions: A novel EVC2 mutation was identified in a patient with NSTA. Based on molecular dynamics simulations, it is hypothesized that this EVC2 variant could contribute to the pathogenesis of NSTA by impairing the EVC2-EVC-SMO complex formation, which may lead to downregulation of downstream GLI1 and SHH. These findings provide new insights into the molecular mechanisms underlying EVC2-mediated NSTA, suggesting that disruption of Hh signaling may represent a critical pathogenic mechanism. Full article

Alpacas are frequently affected by dental pathologies, with periapical infection of the cheek teeth being a significant concern. While radiography is commonly used as the primary diagnostic imaging modality, it has known limitations, particularly due to anatomical superimposition. Computed tomography (CT), with its superior spatial resolution, allows for more detailed evaluation and can detect early or subtle changes that may not be visible on radiographs. To date, direct empirical comparisons between radiography and CT in diagnosing apical infections in alpacas have not been documented. In this study, 158 teeth from 19 alpacas were assessed using both radiography and CT, evaluating 16 diagnostic parameters. Inter-modality agreement demonstrated variable consistency across assessed features: No agreement was observed for certain findings such as pulpar changes and the presence of cementomas. Agreement was weak for features including periodontal ligament space widening, periapical halo, lamina dura visibility, root lysis and fragmentation, sequestration, cortical destruction, clinical crown fractures, and the overall impression of periapical infection. Moderate agreement was found for radicular changes, periapical sclerosis, periosteal reaction, mandibular expansion, and alveolar bone alterations. Overall, CT identified more dental abnormalities than radiography, highlighting its value as a complementary diagnostic tool for detecting periapical infections in alpaca cheek teeth. Full article

Tooth agenesis (TA), the congenital absence of one or more teeth, is the most common manifestation of defective dental morphogenesis in humans. TA can occur as an isolated (non-syndromic) condition or as part of a broader syndromic presentation. In this review, we analyzed a total of 73 manuscripts to provide a comprehensive update on the genetic landscape of TA. To investigate the genes, variants, and associated phenotypes, we reviewed data from curated databases including Human Phenotype Ontology (HPO), OMIM, ClinVar and MalaCards. Based on the current evidence, the genes most frequently implicated in TA are MSX1, EDA, and PAX9. However, chromosomal abnormalities, such as those seen in Down syndrome and Williams syndrome, along with structural variations (e.g., deletions and duplications), also contribute significantly to TA etiology. The most involved pathways include TNF receptor binding, encompassing genes such as EDA, EDA2R, EDAR, and EDARADD, and the mTOR signaling pathway, which includes AXIN2, FGFR1, LRP6, WNT10A, and WNT10B. The aim of this review is to provide an critical synthesis of the genetic mechanisms underlying TA, highlighting the contribution of major signaling pathways, regulatory networks, and emerging molecular insights that may inform diagnostic and therapeutic advances. Full article

Introduction: In clinical practice, the presence of abnormal physiological root resorption frequently results in the retention of deciduous teeth. Also, unilateral mastication may contribute to the altered physiological process of root resorption. This delayed exfoliation and retention of deciduous teeth may compromise the integrity of adjacent soft tissue. In recent years, ozone therapy can be considered a promising strategy in accelerating healing and reducing pain in both traumatic and autoimmune ulcers. Case Presentation: This case report describes a 12 year-old male patient with localized damaged gingival tissue resulting from chronic trauma due to the retention of a deciduous tooth. Following the application of gaseous ozone therapy, complete mucosal healing was achieved. Conclusions: This case supports the potential of ozone therapy in paediatric soft tissue management. Full article

This retrospective study aimed to evaluate the prevalence, morphological types, and distribution patterns of palatoradicular grooves (PRGs) in maxillary anterior teeth using cone-beam computed tomography (CBCT) in a Turkish population. CBCT images of 1553 patients from the radiology archive of Ordu University Faculty of Dentistry (2021–2022) were reviewed. A total of 920 patients (4012 teeth) met the inclusion criteria. The presence, type, and localization of PRGs were assessed. Groove types were classified as Type 1, 2, 3A, or 3B; localization was recorded as mesial, distal, or midpalatal. Bilateral and unilateral occurrences were also analyzed. Statistical analysis involved chi-square tests, Tukey’s HSD, and Cohen’s kappa for intra-observer reliability. PRGs were detected in 23.6% of patients and 10.42% of teeth. Lateral incisors were most affected (87.56%). Type 1 grooves were most common (71.53%), with midpalatal localization being most frequent (54.07%). Bilateral grooves were significantly more prevalent than unilateral ones (p < 0.001). No significant association was found between groove type and tooth type or between gender and bilaterality. This study revealed a high prevalence of PRGs, especially in maxillary lateral incisors, with a significant tendency toward bilateral and midpalatal presentation. CBCT proved essential for detecting palatoradicular grooves, aiding diagnosis and treatment. Full article

Background/Objectives: Tongue thrust (TT) occurs when abnormal tongue movements cause anterior tongue placement with pressure and contact against or between the teeth, potentially affecting the oral phase of swallowing, impacting eating, breathing and speaking. There is limited literature on the diagnostic and treatment approaches for TT, as well as involvement of health practitioners in its management. This study aims to examine the current knowledge and practices related to TT diagnosis and treatment among health professionals in Australia. Methods: A two-phase explanatory sequential mixed methods approach was adopted, comprising an online survey that collected participants’ demographic information and details on assessment, diagnosis, management, referral practices, and relevant experience and training. Phase one involved 47 health professionals from various disciplines in Australia who completed an online survey in its entirety. Phase two included in-depth interviews with seven speech-language pathologists (SLPs) to gain further insights into their experiences in managing TT. Survey data were analysed descriptively, and interview data was analysed thematically. Results: Most participants diagnosed TT using clinical assessments, such as general observation and oral motor examinations. Treatment approaches commonly included orofacial myofunctional therapy and the use of myofunctional devices. Interviews with SLPs identified four key themes: tongue thrust as a symptom rather than a diagnosis, facilitators to effective treatment, multidisciplinary approaches to management, and training and education gaps in clinical practice. Conclusions: This study provides valuable insights into how TT is identified, assessed, diagnosed, and managed by health professionals in Australia. It highlights the perspectives of SLPs on treatment approaches, as well as their views on the availability and adequacy of training and education in this field. The findings suggest the need for a broader understanding of TT management, emphasising the importance of multidisciplinary collaboration and professional development. These insights are globally relevant, as they stress the shared challenges and the value of international collaboration in improving TT diagnosis and treatment practices. Full article

Background/Objectives: Hypohidrotic ectodermal dysplasia (HED) is a rare hereditary disorder affecting ectoderm-derived tissues including teeth, hair, and sweat glands. The dental abnormalities associated with HED, such as oligodontia and conical teeth, often result in significant functional, esthetic, and psychosocial challenges, particularly during childhood. Methods: A 10-year-old child presented with psychosocial concerns related to missing and malformed teeth. Clinical examination revealed oligodontia, conical anterior teeth, and a resorbed mandibular ridge. Based on clinical findings and a positive family history, a diagnosis of HED with significant dental involvement was confirmed. Results: A conservative prosthodontic approach was selected. A maxillary overdenture was fabricated over the retained primary teeth to enhance retention and preserve the alveolar bone, and a resin-bonded bridge was placed in the mandible due to poor ridge anatomy. The treatment restored oral function and esthetics and improved the child’s self-esteem. A recall visit after three months confirmed good prosthesis adaptation and a positive response from the patient and parents. Conclusions: This case highlights the importance of early, conservative, and developmentally appropriate prosthetic rehabilitation in pediatric patients with HED. Interim prostheses can significantly improve oral function, appearance, and psychosocial well-being while preserving future treatment options as the child matures. Full article

Lop-eared and brachycephalic conformations have inconsistently been associated with dental abnormalities in pet and rescue rabbit populations. We investigated conformational risk factors for dental abnormalities in a pedigree population where conformation could be confirmed. Otoscopic oral examination was performed on breeder-volunteered pedigree rabbits at British Rabbit Council shows and studs. Multivariable models were used for risk factor analysis of 14 possible dental disease signs. In 435 rabbits examined, 68.28% showed no incisor abnormalities and 55.40% showed no cheek teeth abnormalities. Lop-eared rabbits had higher odds than erect-eared rabbits for ocular discharge (odds ratio [OR]: 4.034, p = 0.007) but not for any dental abnormalities. Erect-eared rabbits showed higher odds of reacting to incisor examination than lop-eared rabbits (OR: 1.666, p = 0.003). Brachycephaly showed no associations with dental abnormalities, whilst more dolichocephalic rabbits had increased odds of cheek teeth step or wave mouth (OR: 1.394, p = 0.004). Other conformational and signalment-related risk factor results were mixed. Brachycephaly showed no significant predisposition to dental abnormalities, and the clinical relevance of predisposition to ocular discharge in lop-eared rabbits is unclear. Conformation appears less important than husbandry factors for preventing rabbit dental disease. Generalising the results to companion rabbits is not advised due to husbandry and population differences. Full article

The occurrence of triplication in the deciduous teeth is rare. However, it can cause several problems in primary dentition, alteration of development, and eruption of permanent successors. Case Presentation: A three-year-old boy presented with an exuberant acute periapical abscess in the left front teeth region of the upper jaw. Examination revealed a presence of a triple tooth involving the central and lateral left primary incisors and a supernumerary tooth. Radiographs showed that the fused teeth had separate roots, pulp chambers and root canals. The implemented treatment was extraction under local anesthesia. After 2 years of observation, surgical exposure of the crowns of the permanent maxillary central incisor was performed. After seven years, the permanent dentition was completed without any sequelae. Discussion: Triple tooth, as observed in this case report, results from the union of three tooth germs, potentially influenced by physical, hereditary, or environmental factors, leading to esthetic and functional issues and increased susceptibility to caries. Treatment is challenging, requiring preventive care, complex endodontic procedures, and, in some cases, extraction with space maintenance to avoid future orthodontic complications. Conclusion: Early diagnosis, an adequate treatment plan and clinical monitoring should be performed, aiming at preventing the possible disturbances. Full article

In clinical pediatric dentistry, dental professionals may encounter some dental abnormalities. It may progress in various ways; therefore, long-term follow-up is essential. We describe the case of a 5-month-old male, and how the mandibular incisor was lost due to trauma. He was referred to our hospital two days later, but the calcified tissue was detected in the oral cavity, confirming the residual tooth. We extracted the tooth, and a regular dental checkup revealed another residual tooth in the same region one year later. A residual tooth is considered to be affected by the Hertwig’s epithelial sheath, and it may occur when the root is immature. It is important for dental professionals to share this information and to continue long-term follow-up when they encounter patients at young ages who have had such teeth extracted or lost due to trauma. Full article

Background/Objectives: Smith–Lemli–Opitz syndrome is a metabolic autosomal recessive disease, characterized by congenital defects, with concomitant psychomotor developmental delay. The symptoms are variable and depend on the clinical form of the disease. The aim of this study was to assess the prevalence and types of oral abnormalities in children and adolescents with Smith–Lemli–Opitz syndrome. Methods: The study enrolled 30 patients, including 15 subjects with Smith–Lemli–Opitz syndrome, confirmed by a genetic examination. We performed an extra- and intraoral examination, paying attention to the presence of dysmorphic features, including the shape and symmetry of the face; the condition of the skin and lips; the gingival and hygienic status; dental caries; lesions of non-carious origin; abnormalities of size, shape, and number; and alignment of teeth in the dental arch. Results: Patients in the study group presented with micrognathia, a short neck, ptosis, and an upturned nose. More frequently than in the control group, we observed occlusal abnormalities and dental crowding, anatomical abnormalities or gingivitis. The prevalence of dental caries in both groups was similar; however, the study group recorded higher dmft and DMFT values. Conclusions: The phenotypic features of patients with Smith–Lemli–Opitz syndrome increase their risk of developing dental caries and gingivitis. Full article

Background: This retrospective study aimed to analyze the frequency and extent of apical root resorptions (EARR) during orthodontic treatment in the upper and lower incisors, as well as lower molars, using orthopantomograms (OPG). Potential influencing factors such as age, gender, root shape, type of orthodontic appliance, and treatment duration were examined as well. Methods: A total of 57 patients who completed their treatment at the orthodontic department of the Goethe University of Frankfurt between 2011 and 2018 were included in the study. These patients had a combined total of 570 teeth, which were divided into two groups. Group 1 consisted of 20 patients (average age at T0: 10.1 ± 1.2 years old) received a one-phase fixed orthodontic treatment using passive self-ligating Damon bracket system (average duration of 2.1 years ± 6 months), while group 2 consisted of 37 patients (average age at T0: 12.4 ± 2.8 years old) underwent a two-phase therapy, which involved a phase-one functional therapy (average duration of 1.7 years ± 6 months) prior to the phase-two fixed orthodontic treatment with the Damon system (average duration of 1.5 ± 4 months) with a total treatment time of 3.2 years ± 7 months. To determine the extent of post-treatment root resorption of the upper and lower incisors, as well as the first lower molars, crown–root ratio was calculated for each tooth using the pre- and post-treatment OPGs. Additionally, each tooth was assigned a degree of resorption according to the Levander and Malmgren classification. The inter-group comparisons were conducted using the Wilcoxon Mann–Whitney U test. Spearman’s correlation analysis was used to assess the relationship between age, treatment duration, and EARR. The association between gender, root morphology, and EARR was evaluated using the Wilcoxon Mann–Whitney U test. For nominally scaled variables, the Chi-square test was used. The statistical significance was set at p < 0.05. Results: No statistically significant differences were seen between groups 1 and 2 regarding the degree of root resorption (p = 0.89). The study found that the average root resorption for all examined teeth was −5.14%, indicating a slight reduction in the length of the tooth roots after orthodontic treatment. However, no significant differences were observed concerning gender, age, type of orthodontic appliance or treatment duration. Comparisons between upper and lower jaws also did not yield statistically significant differences. The majority of teeth in the study exhibited a normal root shape. The short root length and a pipette formed roots were significantly associated with a higher risk of root resorption (p = 0.001). Conclusions: The study’s findings suggest that the two-phase orthodontic treatment does not increase the risk of EARR compared to one-phase therapy significantly. Some degree of root resorption occurred as a result of orthodontic treatment in both groups. Notably, abnormal root forms were identified as influential factors that could help predict the likelihood of root resorption following orthodontic treatment. Full article

Background/Objectives: Childhood cancer is the leading cause of death among children, although medical advances are improving the prognosis. During cancer treatment, nausea or vomiting may occur and eating habits may become irregular; therefore, it is important to prevent the development of oral diseases. We encountered a childhood cancer patient with rapidly progressive multiple dental caries, and this report describes the progress. Methods: A boy aged 2 years 9 months was referred for perioperative oral management. No caries were detected in the oral cavity at the initial visit. Results: As the patient had difficulty eating because of nausea and vomiting during cancer treatment, he began to consume probiotic drinks frequently. At 8-month follow-up, dental caries localized to the primary molars was detected. However, caries had occurred in all erupted teeth by 9 months later, confirming the diagnosis of severe early childhood caries. Dental treatment and long-term oral management contributed to good oral health except for dental abnormalities caused by chemotherapy. Conclusions: Childhood cancer patients, particularly at an early age, are at risk of rapid deterioration of oral disease even over a short time period. It is important to cooperate with medical or dental professionals from other hospitals to provide dietary and oral health instruction and continue long-term oral management to improve patients’ quality of life. Full article

(1) Background: Microcracks and structural fragility in teeth, often undetected by traditional methods until severe complications like fractures or pulp exposure occur, are evaluated in this study using electrical impedance analysis (EIA) as a non-invasive tool for early detection and assessment. (2) Methods: A total of 57 patients were recruited, including individuals with bruxism (n = 20), dental restorations (n = 18), and no significant dental history (control group, n = 19). Electrical impedance measurements were performed on all teeth using a portable device, with data collected from occlusal and proximal surfaces. Patients with abnormal values underwent additional imaging (standard radiographs) to confirm the presence of microcracks. Statistical analyses included ANOVA to compare impedance values between groups and logistic regression to assess the predictors of structural fragility. (3) Results: Teeth with microcracks confirmed by standard radiographs exhibited significantly lower impedance values (mean 50 kΩ) compared to healthy teeth (mean 120 kΩ, p < 0.01). Patients with bruxism showed the highest proportion of teeth with abnormal impedance (45%). Logistic regression identified bruxism as a significant predictor of reduced impedance values (p < 0.05). (4) Conclusions: Electrical impedance analysis demonstrates promise as a non-invasive method for detecting microcracks and assessing structural fragility in teeth. Its application in routine dental check-ups could enable early interventions, particularly for high-risk patients with bruxism or restorations. Full article