Compound odontoma is a malformation typical of young adults below the age of 20, with a slight preference for the male gender and the anterior region of the maxilla. Clinically asymptomatic, it can be detected during a radiological investigation in connection with the persistence of deciduous dental elements and the impaction of definitive ones. The treatment of choice is excisional surgery and recurrence is a rare event. The need for orthodontic therapy for impacted elements is usually not necessary because in most cases, odontomas are small, circumscribed lesions the size of a permanent tooth. In this article, the diagnostic and therapeutic surgical excision procedure is presented in three patients at developmental age with large compound odontomas associated with at least one retained canine, and in two of the cases, with serious transmigration to the impacted tooth elements.
This case report describes the orthodontic treatment of a 9-year-old girl who presented with multiple agenesis, maxillary contraction, and skeletal Class III malocclusion after the surgical removal of a melanocytic neuroectodermal tumour of infancy (MNTI) or the so-called melanocytic progonoma at 40 days of age. The lack of dental anchorage in the posterior segment of the second quadrant and the search for maximum control during suture expansion to reduce dental effects led to the use of a hybrid rapid palatal expander (RPE) with dental anchorage in the first quadrant and skeletal anchorage on the two miniscrews placed in the second quadrant, to allow a more even distribution of expansion forces. The expansion procedures performed with the hybrid anchorage device and extraoral traction demonstrate the possibility of solving the contraction in the posterior segments and anterior crossbite in a few months with maximum control of the applied forces, despite the objective difficulties related to the specificity of the case.
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