# The nucleotide sequences of the caiman and African clawed toad IBSP gene s ha ve been deposited in GenBank under accession nos. EU007686, EU007687, and EU007688.Abbreviations: IBSP, integrin-binding sialoprotein; SPP1, secreted phosphoprotein; DMP1, dentin matrix protein 1; DSPP, dentin sialophosphoprotein; MEPE, matrix extracellular phosphoglycoprotein; PCR, polymerase chain reaction; RT-PCR, reverse transcription PCR; GAPDH, glycerol 3 -phosphate dehydrogenase; poly-A, polyadenylation; mRNA, messenger RNA; Arg, arginine; Asn, asparagine; Asp, asparaginic acid; Glu, glutamic acid; Gly, glycine ; Ser, serine; Thr, threonine; Tyr, tyrosine; poly-E, stretch of poly-glutamic acid.
We present a case of Sotos syndrome. A 2-year-1-month-old Japanese boy diagnosed with Sotos syndrome was referred to our clinic for an oral examination. His growth from birth to the age of 4 years 11 months was pronounced above the 97th percentile. The primary teeth erupted extremely early, with the lower central incisors appearing at the age of 5 months, and all the primary teeth except the lower lateral incisors erupted by the age of 2 years 1 month. In addition, the lower permanent first molar erupted at the age of 4 years 6 months. However, mean dental age did not advance with chronological age. The tooth morphology appeared to be normal, however, the primary teeth were easily degraded by attrition, suggesting the poor calcification. A radiographic examination showed congenital missing of the lower primary and permanent lateral incisors, second premolars, and upper first premolars. In addition, the roots of the primary molars were extremely long and the ration of root length to crown length shown in panoramic radiographs was high. 97th percentile for age 2). It was recently reported that the syndrome is caused by a mutation in the gene for the nuclear receptor-binding SET domain-containing protein (NSD1) 5). There are few studies regarding oral manifestations associated with Sotos syndrome. Callanan et al. 6) reported a patient with Class 1 malocclusion with lower anterior crowding and severe dental caries in the primary molars. Further, congenital missing was found for all premolars, all third molars, the upper lateral incisors, and the lower left second molar in the permanent dentition. In another study, Inokuchi et al. 7) found enamel hypoplasia in all the primary canines and molars, and congenital missing of the upper first and second premolars, though no dental caries were observed. In the present report, the dental manifestations of a patient with Sotos syndrome are presented.
A case of impacted tooth due to the presence of an odontoma identified in a 5Y7M-old girl is presented. An intraoral examination showed that the maxillary right second primary molar had not emerged into the oral cavity, while a periapical X-ray photograph revealed a small round radiopaque mass with a diameter of approximately 2 mm. The calcified mass was suspected to interfere with eruption of the affected tooth and enucleation of the tissue was carried out under local anesthesia. Histopathological examination results showed that the calcified mass consisted of dental enamel, odontogenic epithelium, and pulp-like tissue, and it was diagnosed as an odontoma. At 6Y1M of age, the tooth had not emerged into the oral cavity due to the possibility of interference in the distal cervical area of the adjacent first primary molar or that of strong tension of the gingiva above the affected tooth. Thus, fenestration of the gingiva over the impacted tooth crown was performed and the tooth crown of the affected tooth appeared in the oral cavity at the age of 6Y6M. eruption of affected teeth 3,4) . In addition, orthodontic approaches are applied in some cases, which forces the affected tooth to successfully locate in the appropriate position 5,6) .Herein, we report a rare case of delayed eruption of the maxillary second primary molar due to a small odontoma at the occlusal site of an affected impacted tooth. Case ReportA 5Y7M-old girl was referred to the Pedodontic Clinic, Osaka University Dental Hospital, with the chief complaint of delayed eruption of the maxillary left second primary molar. Her parents were informed of the delayed eruption by a general practitioner approximately 1 year prior to coming to our clinic, during which time periodical examinations had been carried out. Our intraoral examination showed that there were 18 primary teeth, including a fused tooth in the mandibular anterior region, and that the
A 5Y7M-old girl was referred to our clinic by a general dentist for detailed examination of a recurrent gingival abscess in the maxillary left primary central incisor region. An intraoral examination revealed a diffuse swelling in the palatal gingiva area of the affected tooth. A periapical radiograph showed that the affected tooth was actually the primary central incisor and a supernumerary tooth, which had fused and been filled with composite resin at the juncture of the 2 tooth crowns. Removal of the filling induced severe bleeding and root canal treatment was performed. Radiographic examinations revealed 2 independent root canals, thus an additional access cavity to the mesial pulp cavity was produced for further root canal treatment. After the lesion had disappeared, root canal filling was performed using iodoform-calcium hydroxide paste and the affected tooth was restored with composite resin to fashion a single crown. However, the canal filling paste was later observed to be resorbed in the cervical area of the root. At 6Y0M, the patient received a traumatic injury in the anterior teeth region and the fused tooth was drastically displaced in a palatal direction, thus we extracted it under infiltration anesthesia. The root was observed to be wide in the mediodistal direction, and a histopathological examination revealed only dentin between 2 independent root canals. Our findings showed that the fused tooth was composed of 2 crowns and 1 root with 2 independent canals, and indicate that each crown and canal should have been treated separately.
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