João Alfredo Farinhas

Developmental dental alterations in permanent teeth after intrusion of the predecessors: clinical and microscopic evaluation

This case report describes the management of developmental dental alterations in permanent dentition as a consequence of severe intrusive luxation in its predecessors in a child of 2 years. At 10 years of age, this patient was referred for consultation due to lack of permanent maxillary right central and lateral incisors. Radiographic examination revealed impaction of hypoplasic permanent maxillary central incisor, absence of the lateral incisor and compound odontoma in region of the permanent maxillary lateral incisor. The odontoma was surgically removed and unerupted central incisor was placed in orthodontic traction over a period of 8 months. The central incisor presented with abnormal shape and was restored with composite resin. Odontoma histologic analysis was carried out through Hematoxylin and Eosin coloration and Scanning Electron Microscopy. Cement and osteocement formations were found in soft tissue, as well as some irregularly distributed dentine islands of tooth-like structures, indicative of compound odontoma. We followed up this patient for 5 years and orthodontic management was successfully performed for correct alignment of the maxillary right central incisor impacted by compound odontoma.

Autogenous bonding of tooth fragment retained in lower lip after trauma

In cases of trauma, dental fragments occasionally penetrate into the soft-tissues and may cause severe complications, if neglected. Clinical and radiographic examinations can provide a diagnosis and help in the surgical removal of any dental fragment embedded in soft-tissue. This case report concerns an 8-year-old boy who was diagnosed with a fragment of a fractured permanent central incisor crown located in the lower lip. The patient was seen initially at a general hospital, where the dental fragment went unnoticed. After 2 days, the patient was seen at the pediatric dentistry clinic, where a fragment embedded in the lower lip, causing a large swelling, was diagnosed. The fragment was removed surgically and bonded to the fractured tooth. A mouth guard was prescribed for sports. The importance of soft-tissue exploration even post-trauma was highlighted in this paper.