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ORAL PATHOLOGY : Congenital epulis with auto-resolution: case report

Congenital epulis

Congenital epulis is an uncommon benign lesion that affects the oral cavity of newborns, and presents histological features which are similar to those of granular cell tumor.

The origin of this lesion has not been fully elucidated, and many hypotheses are considered due to the large variety of cell types observed in histological sections.

Epulis development occurs further in the prenatal period, and is more common in newborn females, frequently in the maxilla.

This lesion usually is presentend as a nodule covered by normal oral mucosa, which in some cases, interferes with baby's breathing and feeding.

This report describes the case of a two-month-old male baby who presented a pedunculated intraoral lesion in the mandibular alveolar ridge.

Read Also: Reimplantation of avulsed dry permanent teeth after three days

Histological sections revealed presence of mucosal fragments with atrophic squamous stratified epithelium, and fibrous connective tissue composed of cells with granular and eosinophilic cytoplasm.

A few days after initial exam, the lesion detached from alveolar ridge, and healed spontaneously.


° Adriane Sousa de SIQUEIRA, Márcia Regina Dias de CARVALHO, Ana Celina Dourado MONTEIRO, Maria das Graças Rodrigues PINHEIRO, Lucas Rodrigues PINHEIRO, João de Jesus Viana PINHEIRO

Early Premolar Extraction: An Uncommon but Very Effective Treatment Option


The terminology “serial extraction” in Orthodontics was first described in the late 1920’s when Kjellgren decided to plan the extraction of certain deciduous and permanent teeth at early stages of the dentition development.

Since the extractions are under taken at the transitional dentition. This type of treatment is defined as “Early Treatment” in Orthodontics.

The main indication for this treatment approach is for patients with severe crowding caused by tooth size arch discrepancies. In other words, when maxillary and/or mandibular arches cannot accommodate teeth, extraction becomes an interesting option.

Although this treatment option has been used for almost a century in the contemporary orthodontics it’s indication is very specific.

Since it’s an irreversible approach (permanent teeth are early extracted) the clinician should carefully diagnosis the case before selecting this option.

Read Also: ORTHODONTICS : Serial extraction of primary teeth

In addition, as time passed by, orthodontics specialty has dramatically evolved and developed several options to gain space instead of extracting teeth.

On the other hand, the idea to early extract permanent teeth continues to be an interesting treatment option in clinical orthodontics mainly in severely crowded patients.

The aim of this paper is to present a case report of a ten-year-old male patient who presented severe crowding and treatment option was to extract four first premolars at early stages of the dentition development.


° Adeniyi M J, A O Soladoye. Plasma Lipid Profile and Uric Acid in High Fat Fed Female Rats Treated with Oral Contraceptive. Biomed J Sci & Tech Res 1(3)-2017. BJSTR. MS.ID.000256. DOI: 10.26717/BJSTR.2017.01.000256


Inhalation conscious sedation with nitrous oxide/oxygen in pediatric dentistry


Conscious sedation is a technique in which one or more pharmacological agents are employed to produce a mild depression in the central nervous system, without loss of consciousness so that verbal contact can always be maintained with the patient; this allows for certain dental procedures to be performed.

The technique is associated with a great margin of safety.

In Odontopediatrics, the sedative agents generally employed are nitrous oxide (N2O) and benzodiazepines, amongst other agents with sedative properties.

The use of nitrous oxide/oxygen (N2O) is becoming more frequent for general and pediatric procedures in dental medicine and has become common practice in many countries.

Read Also: ORAL SURGERY : Guideline on Pediatric Oral Surgery

It is also frequently used in general pediatric medicine for procedures ranging from minor surgery to more invasive diagnostic procedures.

Nitrous oxide, or protoxide of nitrogen (N2O), is a colorless gas with a sweetish taste. It has an anxiolytic and sedative effect, and also promotes muscular relaxation and analgesia.


° Ana Catarina Barroso Macedo Barbosa / Joana Moura˜oII, Virgınia Milagre / David Casimiro de Andrade / Cristina Areias


ORTHODONTIC : Tongue thrusting habit: A review


Deleterious oral habits are the common problem of pediatricians, which aff ects the quality of life.

Oral habits are repetitive behavior in the oral cavity that result in loss of tooth structure and they include digit sucking, pacifi er sucking, lip sucking and biting, nailbiting, bruxism, self-injurious habits, mouth breathing and tongue thrusting.

Para functional habits are recognized as a major etiological factor for the development of dental malocclusion. Thumb sucking and tongue thrusting is the common ones.

Abnormal tongue function and posture have been long debated as a cause of malocclusion. Lefoulon, in 1839 quoted “prevention is better than cure.”

Understanding the etiology, eff ects and it management at early stages may be helpful to prevent future severe skeletal malocclusion. This review deals with these aspects of tongue thrusting habit.

Read Also: ORTHODONTIC : Serial Extractions in orthodontic – A Review


Tulley 1969 - states tongue thrust as the forward movement of the tongue tip between the teeth to meet the lower lip during deglutition and in sounds of speech, so that the tongue becomes interdental.

Tongue thrust is an oral habit pattern related to the persistence of an infantile swallow pattern during childhood and adolescence and thereby produces an open bite and protrusion of the anterior tooth segment.


°International Journal of Contemporary Dental and Medical Reviews
°Suchita Madhukar Tarvade, Sheetal Ramkrishna

ORAL PATHOLOGY : Dental Anomalies in Children

oral pathology

Human dentitions are subject to considerable variation in size, form, number of teeth and to the structure of the dental tissues.

Disorders of the development of teeth may be inheritedor acquired.

The primary dentition begins to form at approximately six weeks in utero and the permanent dentition continues through late adolescence.

The dentition is thereforesusceptible to environmental influencesfor many years.

Diagnosing abnormal dental development requires thorough evaluation of the patient, including a medical, dental and family history, clinical examination, and radiographic evaluation and, in some cases, special laboratory tests are also required.

Read Also: ORTHODONTIC : Malocclusion in Down syndrome - a review

Genetic consultation is important not merely to put a name to the condition, but also to give appropriate advice on the prognosis and the risk of recurrence in future generations.

It is impossible, in the context of this article, to describe in detail all dental anomalies that occur in children.


Jinous F Tahmassebi / Peter F Day / Kyriacos Jack Toumba


ORTHODONTIC : Diagnosing Early Interceptive Orthodontic Problems – Part 1

Emergency Pediatric Dentistry

It is important to have a clear picture of how a child is changing dentally and skeletally throughout his or her growth period.

In fact the American Association of Orthodontists recommends that every child have an orthodontic examination by the age of seven.

The early treatment examination in the mixed dentition enables the practitioner to identify problems at an early stage, and to determine when to commence treatment and/or refer patients to an orthodontist.

Things to look for during a mixed dentition examination include crowding of permanent teeth, excessive overjet or overbite, missing primary teeth needed for space maintenance, supernumerary teeth, skeletal discrepancies, habits, airway problems, and eruption path problems.

Read Also: ORTHODONTICS : Serial extraction of primary teeth


This continuing dental education article is being written to describe the need for early examination and diagnosis of malocclusions in growing children.


°Diagnosing Early Interceptive Orthodontic Problems – Part 1
°Written by: Michael Florman, DDS / Rob Veis, DDS / Mark M. Alarabi, DDS, CECSMO / Mahtab Partovi, DDS


ORAL MEDICINE : Clinical Management of Regional Odontodysplasia. Clinical Case

Oral Medicine

Regional odontodysplasia (ROD) is a relatively rare localized developmental anomaly of the dental tissues with specific clinical, radiographic, and histologic characteristics.

Crawford ascribed the first report of ROD to Hitchin in 1934, while others suggested that McCall and Wald were the first to describe this condition in 1947.

It was not until 1963, however, that Zegarelli et al coined the term “odontodysplasia” and Pindborg added the prefix “regional” in 1970.

In an extensive review of ROD in 1989, Crawford and Aldred stated females are more often affected than males (1.4:1) and that there was no association with race.

These authors listed several etiological factors such as local circulatory disorders, viral infections, pharmacotherapy during pregnancy, facial asymmetry, local trauma, metabolic disturbances, somatic and neural mutations, and syndromal involvement.

They also suggested that a combination of factors might be involved. In spite of this, ROD’s etiology remains undetermined.

Read Also: ORAL MEDICINE : How to treat oral thrush in newborns

The criteria for ROD diagnosis are based on clinical, radiographic, and histologic findings. The maxilla is typically affected twice as often as the mandible.

Clinically, the condition is usually unilateral and rarely crosses the midline; exceptions are, however, occasionally found. In most cases in which the damage crosses the midline, only the central incisor on the opposite side is affected.

The teeth are likely to be small, brown, grooved, and hypoplastic. Eruption failure or delay is frequently seen as well as abscesses or fistulae in the absence of caries.

Radiographically, there is a lack of contrast between the enamel and dentin, both of which are less radiopaque than unaffected counterparts.

Moreover, enamel and dentin layers are thin, giving the teeth a “ghost like” appearance. The pulp chambers are large, and usually present areas of relatively radiodense tissue (pulp stones or denticles). The follicles of unerupted teeth are enlarged.


° Abel Cahuana, PhD, MD, DDS Yndira González, DDS Camila Palma, DDS


CLINICAL CASES : Crown-Root Fractures in Primary Teeth

Emergency Pediatric Dentistry

Crown-root fractures involve enamel, dentin and cement.

These are not usually found in primary dentition, and approximately 2% of all types of traumatic dental injures (TDI).

Frequently, this kind of dental trauma spreads to the subgingival or intraosseous level, which complicates the establishment of the extent and direction of fracture lines, even with the assistance of radiographic examination.

Read Also: Clinical Management of Regional Odontodysplasia. Clinical Case

The difficulty of tooth maintenance and periodontal health require an interdisciplinary approach to enable the appropriate treatment of this type of TDI.

Crown-root fractures in primary teeth are singular events with wide variations of fracture patterns and that making the correct diagnosis and treatment plan can be complex.

In addition, there have been very few reports regarding this type of trauma and studies that describe the best approaches for each situation are necessary to enable dentists to make the best treatment decision.

Therefore, the aim of the present study was to present a case series of crown-root fractures in primary teeth of patients who were followed-up until the eruption of permanent successor teeth.


Fuente :
Autores : Vanessa Polina Pereira da Costa , Luisa Jardim Correa Oliveira , Denise Paiva Rosa , Mariana Gonzalez Cademartori , Dione Dias Torriani(in memoriam)

BRUXISM : Clinical management of childhood bruxism


Bruxism is considered an involuntary nonfunctional activity of the masticatory system and is characterized by teeth clenching or grinding.

Classified as a psychophysiological disorder, it may occur during sleep or waking, consciously or unconsciously.

This habit is common during childhood and may have negative consequences on the stomatognathic system.

Its prevalence in children ranges from 7% to 15.1%8 and girls are more often affected. The etiology of bruxism is not completely elucidated10 and may involve local, systemic and psychological factors, or be related to sleep disorders.

The diagnosis of sleep consists of clinical signs and symptoms such as tooth wear, pain in the facial muscles, headaches reported or observed by polysomnographic changes (in cases of nocturnal bruxism).

Read Also: BRUXISM in children: A warning sign for psychological problems

Injuries in the tooth structure and supporting tissues of the resulting bruxism can lead to hypersensitivity to temperature changes, tooth mobility, injuries in the periodontal and periodontal ligament, hypercementosis, fracture cusps, pulpitis and pulp necrosis.

Other complications associated with bruxism include gum recession, bone resorption, hypertrophy of mastication muscles and temporomandibular disorders.

Clinical interventions aim to protect dental structures, reduce ranger, relief facial and temporal pain and promote improvements in sleep quality.


°RGO - Revista Gaúcha de Odontologia
°Thays de Almeida ALFAYA / Patrícia Nivoloni TANNURE / Roberta BARCELOS / Etyene Castro DIP / Luciana UEMOTO / Cresus Vinícius Depes GOUVÊA

Fluoride Varnish in the Prevention of Dental Caries in Children and Adolescents

Fluoride Varnish

First developed and marketed in the 1960s in the form of sodium fluoride (Duraphat, Colgate, New York, N.Y.) and in the 1970s in the form of silane fluoride (Fluor Protector, Ivoclar Vivadent, Lichtenstein, Germany), fluoride varnishes prolong contact between fluoride and enamel.

The effectiveness, ease of application and relative safety of these products offer significant advantages over other topical fluoride treatments, such as gels and rinses.

Several reviews of the use of fluoride therapies in preventing dental caries have been published since the year 2000, including 2 evidence-based reports.

The Cochrane reviews of this topic concluded that “Fluoride varnishes applied professionally two to four times a year would substantially reduce tooth decay in children.

Read Also: TOOTH DECAY: How to prevent baby bottle tooth decay

The review of trials found that fluoride varnish can substantially reduce tooth decay in both milk teeth and permanent teeth. However, more rigorous research is needed to be sure of how big a difference the treatment makes, and to study acceptability and adverse effects.”

The Community Dental Health Services Research Unit of the University of Toronto18 concluded that “Both APF [acidulated phosphate fluoride] gel and fluoride varnish are efficacious and can be recommended.

Amir Azarpazhooh / Patricia A. Main

The Stainless-Steel Crown for Primary Molars . Overuse? No, I say underuse

Stainless-Steel Crown

The stainless-steel crown is an important restorative tool in caring for the oral health of children.

Although our focus in providing the best oral health care for children is clearly on prevention, unfortunately there are many children who do not seek or obtain oral health preventive care at an early enough age to prevent what can be devastating disease at an early stage of their lives.

All who care for children’s oral health see many cases of early childhood caries present at the first visit to a dentist.

Children as young as 18 months present to pediatric dental centers all over the country each day with severe early childhood caries in need of treatment to avert progression of significant infection.

Read Also: ORTHODONTIC : Dental disorders are linked to mouth breathing

Further, some children initially present with disease only after the infection has spread beyond the teeth causing facial swelling and a potentially life-threatening condition.

These children often need to be hospitalized, placed on intravenous antibiotics and must have an incision and drainage performed, along with extraction of the offending tooth, to avoid a dangerous situation.


° by Joel Berg, DDS, MS


Guideline on Pulp Therapy for Primary and Immature Permanent Teeth

Pulp Therapy

The American Academy of Pediatric Dentistry (AAPD) intends this guideline to aid in the diagnosis of pulp health versus pathosis and to set forth the indications, objectives, and therapeutic interventions for pulp therapy in primary and immature permanent teeth.

The primary objective of pulp therapy is to maintain the integrity and health of the teeth and their supporting tissues.

It is a treatment objective to maintain the vitality of the pulp of a tooth affected by caries, traumatic injury, or other causes.

Especially in young permanent teeth with immature roots, the pulp is integral to continue apexogenesis. Long term retention of a permanent tooth requires a root with a favorable crown/ root ratio and dentinal walls that are thick enough to withstand normal function.

Read Also: ENDODONTIC treatment for children

Therefore, pulp preservation is a primary goal for treatment of the young permanent dentition.

A tooth without a vital pulp, however, can remain clinically functional.




Esthetic Reconstruction of Teeth in Patient with Dentinogenesis Imperfecta – A Case Report

Dentinogenesis Imperfecta

Dentinogenesis imperfecta (DI) is the result of a dominant genetic defect and affects both the deciduous and permanent dentitions.

It is characterized by opalescent teeth composed of irregularly formed and undemineralized dentin which obliterates pulp chamber and root canal.

DI can appear as a separate disorder or with osteogenesis imperfecta (OI).

The teeth with DI show a grayish-blue to brown hue with dislodged enamel, dysplastic dentine with irregular dentinal tubules and interglobular dentine, short roots and pulpal obliteration, which all may lead to rapid and extensive attrition which require adequate crown reconstruction.

The aim of this study was to show a reconstruction of frontal teeth in upper jaw with direct composite veneers in young adult patient with DI.

Read Also: ORTHODONTIC : Diagnosing Early Interceptive Orthodontic Problems – Part 1

Introduction : Dentinogenesis imperfecta (DI) is a hereditary defect consisting of opalescent teeth composed of irregularly formed and undemineralized dentin that obliterates the pulp chamber and root canals.

DI may be present as a single disorder or in association with osteogenesis imperfecta (OI).


° A. Kne`evi} et al.: Dentinogenesis Imperfecta, Coll. Antropol. 30 (2006) 1: 231–234


Space regainers in pediatric dentistry


Premature exfoliation or extraction of deciduous tooth or teeth can frequently lead to the development of malocclusion. Early orthodontic interventions are often in the beginning of developing dentition help to promote favorable developmental changes.

The term interceptive orthodontics includes timely management of hostile features of a developing occlusion.

Interceptive orthodontics is defi ned as a phase of science and art of orthodontics employed to recognize and eliminate the potential irregularities and malpositions in the developing dentofacial complex.

Guiding the erupting and developing deciduous and permanent teeth and developing occlusion forms an essential part of the preventive care of pediatric patients.

Such assistance will lead to the development of a permanent dentition in a harmonious, functional and esthetically acceptable occlusion.

Read Also: The Importance of Early Orthodontic Treatment for Your Health

In 1998, Hoff ding and Kisling reported that premature loss of primary teeth caused space loss. As a result of space loss, the permanent tooth may remain impacted, or it may erupt buccally or lingually.

In the case of premature loss of primary second molars, the space closure is much more than premature loss of primary fi rst molar. In such circumstances, where there is space loss, routinely we require space regainer.


° International Dental & Medical Journal of Advanced Research (2015), 1, 1–5
° Pratiksha Chandak, Sudhindra Baliga, Nilima Thosar


ORTHODONTIC : Guideline on Management of the Developing Dentition and Occlusion in Pediatric Dentistry


The American Academy of Pediatric Dentistry (AAPD) recognizes the importance of managing the developing dentition and occlusion and its effect on the well-being of infants, children, and adolescents.

Management includes the recognition, diagnosis, and appropriate treatment of dentofacial abnormalities.

This guideline is intended to set forth objectives for management of the developing dentition and occlusion in pediatric dentistry.

Guidance of eruption and development of the primary, mixed, and permanent dentitions is an integral component of comprehensive oral health care for all pediatric dental patients.

Such guidance should contribute to the development of a permanent dentition that is in a stable, functional, and esthetically acceptable occlusion and normal subsequent dentofacial development.

Read Also: ORTHODONTIC : Early interceptive treatment management

Early diagnosis and successful treatment of developing malocclusions can have both short-term and longterm benefits while achieving the goals of occlusal harmony and function and dentofacial esthetics.

Dentists have the responsibility to recognize, diagnose, and either appropriately manage or refer abnormalities in the developing dentition as dictated by the complexity of the problem and the individual clinician’s training, knowledge, and experience.


American Academy of Pediatric Dentistry

The Importance of Early Orthodontic Treatment for Your Health


Many general dentists have indicated during my orthodontic courses that they received little information on the diagnosis and treatment of patients with orthodontic problems as part of their education in dental school.

Many orthodontic clinicians are reluctant to treat patients prior to the eruption of the permanent teeth.

There are many reasons why early orthodontic treatment is good for a child’s self-esteem and is also important for the child’s overall health.

There are basically two different treatment philosophies within orthodontics: the retractive philosophy and the functional philosophy.

Read Also: ORTHODONTIC : Diagnosing Early Interceptive Orthodontic Problems – Part 1

The more traditional approach favors the retractive philosophy. The current school of thought favors early treatment with the functional philosophy.


° Written by Brock Rondeau