Braided Glass Fiber Reinforced Composite Resin Bridge - An Alternative Treatment for Management of Missing Anterior Tooth: A Case Report

Missing anterior teeth is of great concern during a patient's lifetime in many communities. A variety of treatment options, from implants to traditional bridges are often used in order to replace missing anterior tooth. However, it is often accompanied by variety of barriers such as an increased number of chairside visits and better costs. Fibre-reinforced composites (FRCs) have gained increasing and great acceptance in mainstream prosthodontics as viable alternatives to alloy-based restorations recently. In compaison to other restorative systems this is often a conservative approach that carries a minimum risk of pulp exposure or sensitivity and periodontal inflammation, which maintains the health of supporting tissues. Therefore the aim of this case report was to present a clinical case of a congenitally missing mandibular central incisors bilaterally which were replaced by means of a FRC bridge wherein, we employed a semi-direct (direct and indirect) technique. This technique provides a conservative, esthetic, and noninvasive treatment, economically more acceptable, nonirritating, and noniatrogenic. FRC bridges can therefore be considered as a permanent treatment modality.

Age estimation from developing third molars

We investigated the development of third molars among Malaysians (including variations between jaws and genders) using Demirjian’s method. Dental panoramic radiographs of 1224 subjects aged 8 to 24 years were examined, and the molars were assigned Demirjian et al.’s development grades (A–H). Results indicated that 18.8% had congenitally missing or extracted third molars. Development of molars begins earlier in females (also in the mandible), but by age 9, male children's molar development speeds up with more advanced grades in their middle teens than females. Grade C indicates the subject is a juvenile, while initiation of root development (Grade E), was observed from 13 years on. Grade H can occur in a child aged 18 years who technically is still a juvenile. We compared the development and growth patterns of the third molar from both the maxilla and the mandible.

Prevalence and Distribution of Nonsyndromic Dental Anomalies in Children in Eastern Saudi Arabia: A Radiographic Study

Objectives. To report the prevalence and distribution of nonsyndromic dental anomalies in children in eastern Saudi Arabia. Methods. This retrospective records review study involved radiographic examination of 6–18 years old pediatric patients who attended the Dental Hospital of the College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. Four calibrated examiners recorded nonsyndromic dental anomalies from patients’ digital orthopantomograms (OPG). The anomalies recorded were related to tooth number, shape, and location. Descriptive statistics, chi-square test, and Fisher exact tests were used to report prevalence and differences by gender, nationality, and medical history at the 5% significance level. Results. Of 2226 reviewed patients’ records, 1897 met the inclusion criteria and were included in the study. The study sample had equal distribution of males (52.6%) and females (47.4%) and comprised 81.2% Saudi children with a mean age of 8.8 ± 1.84 years. Most study subjects (97.8%) were in mixed dentition and 88.7% were healthy. The prevalence of dental anomalies was as follows: teeth rotations (24.5%), ectopically erupted teeth (6%), congenitally missing permanent teeth (5.4%), peg lateral (1.1%), supernumerary (0.5%), gemination (0.3%), and fusion (0.1%). No statistically significant differences were found in the distribution of dental anomalies by patients’ gender, medical history, and nationality ( p value ≥0.05). Conclusion. This study showed that teeth rotations were the most common dental anomalies followed by ectopic eruptions and congenitally missing teeth. The study findings may guide dental practitioners to better diagnose and manage children with dental anomalies in eastern Saudi Arabia.

Characteristics of phantom limb pain in U.S. civilians and service members

Objectives The population of Americans with limb loss is on the rise, with a different profile than in previous generations (e.g., greater incidence of amputation due to diabetes). This study aimed to identify the key characteristics of phantom limb sensation (PLS) and pain (PLP) in a current sample of Americans with limb loss. Methods This cross-sectional study is the first large-scale (n=649) study on PLP in the current population of Americans with limb loss. A convenience sample of military and civilian persons missing one or more major limbs was surveyed regarding their health history and experience with phantom limb phenomena. Results Of the participants surveyed, 87% experienced PLS and 82% experienced PLP. PLS and PLP typically first occurred immediately after amputation (47% of cases), but for a small percentage (3–4%) onset did not occur until over a year after amputation. Recent PLP severity decreased over time (β=0.028, 95% CI: −0.05–0.11), but most participants reported PLP even 10 years after amputation. Higher levels of recent PLP were associated with telescoping (β=0.123, 95% CI: 0.04–0.21) and higher levels of pre-amputation pain (β=0.104, 95% CI: 0.03–0.18). Those with congenitally missing limbs experienced lower levels of recent PLP (t (37.93)=3.93, p<0.01) but there were no consistent differences in PLP between other amputation etiologies. Conclusions Phantom limb phenomena are common and enduring. Telescoping and pre-amputation pain are associated with higher PLP. Persons with congenitally missing limbs experience lower levels of PLP than those with amputation(s), yet PLP is common even in this subpopulation.

BILATERAL CONGENITALLY MISSING SECOND PREMOLARS IN A GROWING FEMALE PATIENT

Purpose- The aim of the current hypothesis is to contemporary a rare case report of congenitally missing bilateral mandibular second premolars in an adolescent patient and describe its management. The second premolars have the utmost incidence of congenital absence, after the third molars. The delinquent resides not in the prevalence of congenitally missing premolars but in the assortment of a management plan that will yield the best outcomes over the prolong period of time. The currenteducation reports a case of a 12-year-old female growing patient with bilaterally congenitally missing second permanent mandibular premolars with supplementary crowding of teeth. The case has been managed using a multi‑specialty methods, in which both deciduous mandibular second molars were sectioned and the distal half retained. The retained half was prepared to receive a full coverage restoration which was contoured as a premolar. The space created was then utilized to correct the crowding by fixed orthodontics. A two year follow up shows retained distal half of the deciduous mandibular second molar with correction of crowding and space closure.

Auricular Prosthesis for Congenitally Deformed Ear with Acrylic Template for Colour Depiction - A Case Report

Prosthodontists usually stick to the dictum by MM Devan, “preservation of what remains than meticulous replacement of what has been lost.1” “Microtia” is a term used to describe congenital anomaly of the external ear. It is a combination of the words “micro” and “otia” each of the term denoting small and ear respectively. It includes a range of deformities which may consist of presence of a rudimentary ear, a grossly normal or smaller ear or complete absence of the entire external ear. These deformities usually account for 3 in every ten thousand births, with less than 10 % of all the cases showing bilaterally missing ears.2-4 Facial deformities are common for the microtia patient as the auricle develops from tissues of the branchial arches. Figure 1 describes the patient having congenitally missing unilateral ear. Maxillofacial prosthodontics deals with prosthetic rehabilitation of disfigured or missing parts of head and neck. Prosthetic replacement of the exterior part (Epithesis) can be related to as old as civilization. References to it are available in Indian, Greek, Roman, Egyptian Civilizations.5 Ambroise Pare is credited with making various contributions to the materials and techniques in facial prosthetics. Fabrication of an extra-oral prosthesis is probably more of an art than science. Throughout the recorded history, humans have attempted to restore missing parts of the body by using various artificial materials. MPF materials have evolved since centuries right from metals, ivory, porcelain, waxes, natural rubber, gelatin, and latex to modern day materials such as methacrylate or acrylic resins, polyurethane elastomers, and silicone elastomers each having their own set of advantages and disadvantages. But silicone is most commonly used because of its assorted benefits over other MFP materials. This case report describes an auricular prosthesis for the patient with congenital ear deformity using an acrylic template for colour depiction and room temperature volcanizing (RTV) silicone.6

Third Molar Agenesis Is Associated with Facial Size

Individuals with congenitally missing permanent teeth, other than third molars, present smaller craniofacial configurations compared to normal controls. However, it is not known if agenesis of third molars is part of the same mechanism. Therefore, this study assessed individuals with and without isolated third molar agenesis and tested the relation of this condition to the size of their facial configurations, using geometric morphometric methods. We show that the absence of one or more third molars is associated with a smaller maxilla, smaller mandible and a smaller overall facial configuration. The effect was larger as the number of missing third molars increased. For example, the size of the mandibular centroids in five 16-year-old females with no, one, two, three or four missing third molars showed a size reduction of approximately 2.5 mm per missing third molar. In addition, in cases with third molar agenesis in one jaw only, the effect was also evident on the opposite jaw. Our findings suggest that isolated third molar agenesis is part of a developmental mechanism resulting also in craniofacial size reduction. This might be the effect of an evolutionary process observed in humans, leading to fewer and smaller teeth, as well as smaller facial structures.