Objective: The objective of this study is to determine the incidence of impacted teeth and the frequency of pathologies they caused by cone beam computed tomography (CBCT) retrospectively. Materials and Methods: In this study, 608 patients' CBCT images were analyzed retrospectively. Detected impacted teeth were classified as incisor, canine, premolar, molar, third molar, and supernumerary teeth. The pathologies caused by impacted teeth are classified as cysts or tumors, tooth decay, root resorptions, and periodontal bone loss. Results: Impacted teeth were detected in 34.37% of the 608 CBCT images included in the study. The distribution of impacted teeth was 9.4% incisor, 29.4% canine, 9.9% premolar, 2.9% molar, 9.3% supernumerary, and 39.9% third molar teeth. Approximately 63.7% of the impacted teeth caused a pathology. The pathology that was most commonly caused by impacted teeth was periodontal bone loss (44.4%), and respectively others were root resorptions (33.3%), cysts or tumors (8.6%), and tooth decay (2.3%). The most common cause of this pathology was right mandibular third molar teeth. Conclusion: Impacted teeth were common and they often caused a pathology. CBCT is a useful device to assess the impacted teeth. When the impacted teeth are evaluated, each tooth should be assessed within itself. If the impacted teeth are not caused by pathology, they can be kept under control.

A retrospective study: Do all impacted teeth cause pathology?

Surgical Exposure of Impacted Teeth.

A dentigerous cyst is a developmental odontogenic cyst occurring most commonly in the third molar region of mandible and maxilla and maxillary canine region followed by mandibular premolar areas. However, dentigerous cyst occurring in association with impacted maxillary premolars is a very rare presentation accounting for less than 0.5% of total dentigerous cyst cases. In the following case report, a dentigerous cyst was reported in maxillary premolar region in a nonsyndromic patient having one missing premolar and another malformed one associated with the dentigerous cyst. How to cite this article: Jain N, Gaur G, Chaturvedy V, Verma A. Dentigerous Cyst associated with Impacted Maxillary Premolar: A Rare Site Occurrence and a Rare Coincidence. Int J Clin Pediatr Dent 2018;11(1):50-52.

/pdf/dentigerous-cyst-associated-with-impacted-maxillary-premolar-5tzbukc6f2.pdf

Dentigerous Cyst associated with Impacted Maxillary Premolar: A Rare Site Occurrence and a Rare Coincidence.

In spite of the advances in prevention of dental caries in dentistry, the emergence of primary teeth with pulp involvement is still a challenge causing premature loss of teeth. Pulpectomy of the irreversibly inflamed or necrotic pulp of primary teeth remains the common treatment approach with variable prognosis. The variation in prognosis by and large is due to the anatomical root variations and the complex canalicular system; making the debridement and biomechanical preparation of canals difficult to achieve [1]. Untreated carious primary teeth or failure of endodontically treated primary teeth may cause deleterious effects as a result of periapical infection spread to the hard and soft tissues in the vicinity. It is crucial to remember that the follicular tissues of the succedaneous teeth are very close to the bifurcation and apices of primary molars and an infection may easily reach the follicle of a developing tooth causing inflammation of the follicular tissues or development of a cyst. Dentigerous cyst (DC) is a developmental odontogenic cyst that invariably occurs between the second and third decade with low incidence in young individual. However, they may develop in association with unerupted premolars or supernumerary teeth [2,3]. Although the DCs are developmental in origin, there is a strong association between the DC development and the inflammation spreading from nonvital predecessor teeth [4]. In this report, we present a case of pulp therapy of primary tooth with no evidence of post-therapeutic follow up causing development of inflammatory DC in association with unerupted mandibular 2nd premolar and massive bone destruction in a 10year-old child. The child was presented to the pediatric department, RAKCODS clinic with severe pain and swelling on the left side of the mandible for 4 weeks before presentation. Extra-oral examination revealed a single diffuse swelling on the left side of the mandible. Intra-oral examination showed a bony hard swelling in the 74, 75 regions obliterating the buccal vestibule. Mandibular buccal cortex expansion was evident but not the lingual. The primary left 2nd mandibular molar tooth was nonvital, showing evidence of pulp therapy and composite filling. The involved tooth was slightly mobile and the adjacent soft tissues were normal with no signs of inflammation. The permanent first molar (36) was sound and the pulp vitality was not compromised. Orthopantamograph revealed an oval-shaped unilocular radiolucency around the developing second premolar with partial sclerotic border. The mesial root of 74 showed resorption with loss of bone in the bifurcation area. The cone beam computed tomography images revealed thinning of the buccal and lingual cortex [Figure 1–3]. A provisional diagnosis of dentigerous or bifurcation cyst was made. Owing to the behavior of the lesion, it was decided to refer the patient to the oral surgery department, Saqr hospital, RAK for enucleation of the cystic lesion including the associated teeth. During surgery, the cystic lining was found attached to the cervical margin of the 2nd premolar crown revealing a diagnosis of DC. Furthermore, the histopathology report of the surgical specimen confirmed the diagnosis; in addition, the cystic lining was heavily inflamed masking the classical microscopic appearance. Soon after the full eruption of 34 crown a space maintainer (band and loop) was fitted in place until further treatment [Figure 4]. The 3-months radiographic follow up showed progressive bone regeneration filling the cavity and excellent soft tissue healing. DC is commonly associated with mandibular 3rd mandibular molar [5]. However, in the current case, the cyst was associated with unerupted mandibular 2nd premolar. Although such cases are relatively uncommon, a few cases have been reported [6]. Shibata et al. [7] studied the occurrence of DC in association with succedaneous teeth during the transitional dentition phase and reported a prevalence of 77.1% in the premolar region. There have been several explanations for the development of inflammatory and non-inflammatory DC. Benn and Altini [8] suggested three pathways for histogenesis of DC. In the first scenario, the developmental DC arises from the dental follicle and becomes secondarily infected as a result of a non-vital tooth. The second form occurs when a permanent successor erupts into radicular cyst that forms at apex of a nonvital deciduous resulting into a DC that is extra follicular in origin. Nevertheless, a radicular cyst developing at

https://www.tandfonline.com/doi/pdf/10.1080/19932820.2019.1643208

Relevance of periodic evaluation of endodontically treated primary teeth.

Background: Impacted or blocked out teeth present a challenge in orthodontic treatment. Impacted/ blocked out teeth have an impact on the functional loss of the missing tooth and also the loss of alignment and function of adjacent and opposing teeth. There are various treatment options to manage an impacted tooth such as observation, intervention, relocation and extraction.Often just creating a space for the impacted or blocked out teeth results in a spontaneous resolution of the impaction or an easily corrected alignment without the need for extractions. Aim: The purpose of this article is to present cases with different situations and the conservative interventional treatment options and considerations. Discussion: Impacted teeth are a deviation from normal physiological eruption.

https://www.genesispub.org/resource/images/articles/pdf198.pdf

Conservative Management of Impacted Teeth: Report of 9 Cases

Impacted teeth are commonly encountered in clinical practice. Apart from their symptomatic nature and the probable functional disruption they can cause, impacted teeth have the potential to cause more severe and serious problems such as development of dentigerous cysts and other complications due to their proximity to the nasal and oral cavity. In this report, we highlight a series of four cases involving maxillary second premolars, teeth that are not often impacted.

/pdf/impacted-maxillary-second-premolars-a-report-of-four-cases-3w5asi2vgr.pdf

Impacted maxillary second premolars: a report of four cases.

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Impacted maxillary second premolars: a report of four cases.