Isolated bilateral macrodontia of mandibular second premolars is an extremely rare dental anomaly with only 5 cases reported to date. This case report presents clinical and radiographic findings of isolated bilateral macrodontia in a 12-year-old child. The patient was referred to the clinic with local crowding of mandibular posterior teeth. Radiographic findings revealed the presence of impacted macrodont mandibular second premolars and their distinct morphological appearance, characterized by large, multitubercular, molariform crowns, and tapering, single roots. Following surgical removal of the impacted premolars, orthodontic therapy was initiated to correct the malocclusion. Along with the features and treatment of this rare anomaly, this case report also illustrates the benefits, in terms of treatment planning and surgical technique, of supplementing conventional radiography with cone-beam computed tomography to localize the macrodont premolars and accurately establish their relationship with the neighboring roots and anatomic structures.
Developmental disturbances of unerupted permanent tooth result from trauma to primary tooth as there is a close proximity between the root of the primary tooth and its permanent successor. The damage to the unerupted permanent tooth occurs by the transmission of traumatic forces to the permanent tooth germ. In the present case, however, a developmental disturbance on the permanent maxillary central incisor resulting from a direct effect of the inversely intruded primary maxillary central incisor is presented. The intruded tooth was extracted under general anesthesia. Upon eruption of the permanent central incisor, a localized crown malformation along with enamel hypoplasia which was not classified as a developmental disturbance before was observed. The damaged sites were restored with a light-cured composite resin.
A posterior crown fracture due to acute trauma is an uncommon type of dental injury. This case report presents combined endodontic-bioadhesive treatment of a complicated crown fracture of a permanent molar due to a horse riding accident. Endodontic therapy was initiated following surgical removal of the fractured mesiolingual cusp, which was stored frozen until bonding procedures could be carried out. Subgingival and proximal contours of the missing cusp were maintained by an interim glass-ionomer restoration during endodontic therapy. Following root-canal obturation, the fractured cusp was reattached using a total-etch adhesive and composite resin system. The patient was recalled at 1, 3, 6 and 12 months, demonstrating excellent clinical and radiographic findings.
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