Supernumerary teeth, dental crossbite, mandibular radiolucency, oral biopsy

September 11, 2009 9:44 am Published by

This week a patient presented that had 4 maxillary canines (instead of 2).
These 2 extra canines are supernumerary teeth (and are very rare). Also one
of her maxillary central incisors (tooth#9) what completely impacted. She
was also in a crossbite. The patient is concerned about her smile, and wants
an esthetic makeover. This is a multidisciplinary case which involved the
consultations of a periodontist (to make sure the gums are in good health
for dental work), an orthodontist (to advise which teeth to extract or keep,
or to extrude the impacted central incisor, and to move the teeth around for
proper alignment and occlusion, an oral surgeon (to safely and
atraumatically extract the impacted, and supernumerary teeth), and finally a
general dentist (to veneer or crown the anterior teeth to give the anterior
teeth the proper size, shapes, and proportions for an esthetic appearance.

There was another patient who presented with a painful feeling and that one
side of her mandible is heaver than the other. Upon taking a panoramic
radiograph had a radiolucency on her mandible. After a thorough clinical
examination by the oral surgeon, the patient was referred to get a CT-scan
for better images and borders to of the lesion. After looking at the CT-scan
the oral surgeon decided to biopsy the lesion. He opened a flap with 2
releasing incisions, to find that the buccal plate of the mandible had
resorbed, and the lesion extended interproximally between 2 of the teeth. An
excisional biopsy was taken and sent to a oral pathology lab for further
investigation. The patient was sutured and scheduled for follow-up.

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This post was written by Dr. Jeffrey Dorfman