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      A 25-year-old man with 50 teeth: Astonishing but true!!

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          Abstract

          Retained primary teeth is a well-known process but multiple retained primary, permanent, and supernumerary teeth that too in an asymptomatic, non-syndromic patient is a rare possibility that has rarely been reported in literature. This case report discusses the clinical and radiographic details along with treatment options in a 21-year-old patient having a total number of 50 teeth, i.e., 16 retained primary teeth, 32 permanent teeth, and 2 supernumerary teeth without being associated with any known syndrome complex or metabolic disorder.

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          Cellular, molecular, and genetic determinants of tooth eruption.

          Tooth eruption is a complex and tightly regulated process that involves cells of the tooth organ and the surrounding alveolus. Mononuclear cells (osteoclast precursors) must be recruited into the dental follicle prior to the onset of eruption. These cells, in turn, fuse to form osteoclasts that resorb alveolar bone, forming an eruption pathway for the tooth to exit its bony crypt. Some of the molecules possibly involved in the signaling cascades of eruption have been proposed in studies from null mice, osteopetrotic rodents, injections of putative eruption molecules, and cultured dental follicle cells. In particular, recruitment of the mononuclear cells to the follicle may require colony-stimulating factor-one (CSF-1) and/or monocyte chemotactic protein-1 (MCP-1). Osteoclastogenesis is needed for the bone resorption and may involve inhibition of osteoprotegerin transcription and synthesis in the follicle, as well as enhancement of receptor activator of NF kappa B ligand (RANKL), in the adjacent alveolar bone and/or in the follicle. Paracrine signaling by parathyroid-hormone-related protein and interleukin -1 alpha, produced in the stellate reticulum adjacent to the follicle, may also play a role in regulating eruption. Osteoblasts might also influence the process of eruption, the most important physiologic role likely being at the eruptive site, in the formation of osteoclasts through signaling via the RANKL/OPG pathway. Evidence thus far supports a role for an osteoblast-specific transcription factor, Cbfa1 (Runx2), in molecular events that regulate tooth eruption. Cbfa1 is also expressed at high levels by the dental follicle cells. This review concludes with a discussion of the several human conditions that result in a failure of or delay in tooth eruption.
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            Treatment options for impacted teeth.

            A compilation of treatment options for impacted teeth is presented to assist dentists in discussing the sequelae of impacted teeth as well as the complications of treatment with their patients. A differential diagnosis for an impacted tooth is not possible without clinical assessment. However, an ankylosed tooth or a tooth with failure of its eruption mechanism may be mistaken for an impacted tooth. This review of national and international dental texts, journals and publications concerning impacted teeth spans more than 50 years. Treatment options for the management of impacted teeth are separated into four categories: observation, intervention, relocation and extraction. The indications, contraindications and complications of each option are presented. This information will help the clinician identify developmental conditions associated with an increased probability of tooth impaction and assess available treatment options.
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              Delayed tooth eruption: pathogenesis, diagnosis, and treatment. A literature review.

              Delayed tooth eruption (DTE) is the emergence of a tooth into the oral cavity at a time that deviates significantly from norms established for different races, ethnicities, and sexes. This article reviews the local and systemic conditions under which DTE has been reported to occur. The terminology related to disturbances in tooth eruption is also reviewed and clarified. A diagnostic algorithm is proposed to aid the clinician in the diagnosis and treatment planning of DTE. The sequential and timely eruption of teeth is critical to the timing of treatment and the selection of an orthodontic treatment modality. This review addresses the need for a more in-depth understanding of the underlying pathophysiology of DTE and gives the clinician a methodology to approach its diagnosis and treatment.
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                Author and article information

                Journal
                J Nat Sci Biol Med
                J Nat Sci Biol Med
                JNSBM
                Journal of Natural Science, Biology, and Medicine
                Medknow Publications & Media Pvt Ltd (India )
                0976-9668
                2229-7707
                Jul-Dec 2013
                : 4
                : 2
                : 472-475
                Affiliations
                [1] Department of Prosthodontics, Crown and Bridge and Oral Implantology, Eklavya Dental College and Hospital, Kotputli, Rajasthan, India
                [1 ] Department of Oral and Maxillofacial Pathology, Eklavya Dental College and Hospital, Kotputli, Rajasthan, India
                [2 ] Department of Prosthodontics, Crown and Bridge and Oral Implantology, Kotputli, Rajasthan, India
                Author notes
                Address for correspondence: Dr. Vishwas Bhatia, Department of Prosthodontics, Crown and Bridge and Oral Implantology, Eklavya Dental College and Hospital, Kotputli - 303 108, Rajasthan, India. E-mail: vishwas211@ 123456yahoo.co.in
                Article
                JNSBM-4-472
                10.4103/0976-9668.116978
                3783803
                24082755
                29ef7ffb-b7ab-4696-8c24-ae2785bcf4b6
                Copyright: © Journal of Natural Science, Biology and Medicine

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Case Report

                Life sciences
                asymptomatic,multiple impacted teeth,non-syndromic,retained primary teeth,supernumerary teeth

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