Diverse morphological, structural and tooth number aberrations can occur within human dentition secondary to genetic and epigenetic influences. These deviations can manifest as microdontia, macrodontia, hypodontia, oligodontia to name a few. Non-syndromic microdontia is rarely noted, especially in the permanent mandibular incisors. This case report records two such rare cases of peg shaped microdont mandibular central incisor. In one case microdontia occurred synchronously with hypodontia. The facts about these malformations collectively form a body of knowledge with which would serve as a data base in monitoring the evolutionary process of human dentition.

Context:One of the most important goals of periodontal therapy is connective tissue reattachment to previously diseased root surfaces. In the recent years, laser therapy has been considered as an important tool in improving the treatment of periodontal disease.Aims:To evaluate the neodymium-doped yttrium aluminum garnet (Nd: YAG) lasers effects on root surfaces affected by periodontal disease and compare this treatment with scaling and root planning (SRP) in terms of fibroblast attachment.Materials and Methods:A sample of 30 single-rooted human teeth extracted because of advanced periodontal disease was used in this study. Sixty specimens obtained by longitudinal sectioning were randomly divided in three groups. Group A control (untreated); Group B SRP; Group C laser (Nd: YAG) and ultrasonic scaling. All specimens were incubated with fibroblast suspension and then fixed and observed under scanning electron microscope.Results:With a median of 8, the control group (Group A) exhibited the least number of total fibroblasts among all the three groups. The laser and scaling - treated group (Group C) showed the highest number of fibroblasts (median = 49, mean ± standard deviation [SD] = 48.28 ± 17.18), followed by SRP only (Group B, median = 22, mean ± SD = 22.24 ± 8.67).Conclusions:Nd: YAG laser irradiation at specific energy densities can be used as a useful tool to condition the root surfaces, enhancing fibroblast attachment. Hence aiding in re-establishment of the connective tissue attachment to the root surfaces of previously diseased teeth.

Rationale: Papillon-Lefèvre syndrome (PLS) is a rare genodermatosis with autosomal-recessive genetic inheritanceand has features mainly palmoplantar hyperkeratosis and rapidly progressing severe periodontitis leading to early loss of deciduous and permanent dentition. Patient Concerns: The patient in the presented report was concerned with loose teeth, gingival bleeding and oral malodour and wanted to get missing teeth replaced. Diagnosis: The diagnosis was made based on medical history, clinical and radiological findings. Interventions: Periodontal phase I therapy included extraction of hopeless teeth, manual and ultrasonic scaling, mechanical and chemical plaque control and periodic maintenance. Missing teeth were restored by removable and fixed prosthesis. Dermatological lesions were conservatively managed. Outcomes: A comprehensive treatment stabilised periodontal disease of the patient and prosthetic rehabilitation improved oral health related quality of life of PLS patient. Lessons: PLS patients require an early diagnosis and a team approach for dermatological, periodontal complications and prosthetic rehabilitation.