A 2-year 6-month male presented after an intrusive injury sustained at 15 months of age. Intra-oral radiographs showed coronal dilaceration of the germ of the permanent central incisor and the presence of a calcified tissue mass in the area of the trauma which was identified after surgical removal as the permanent upper left lateral incisor. Immediate treatment and long-term options are discussed.

Primary molars are a determining factor in the development of occlusion. Given their importance, when restorative treatment is not feasible and a primary molar must be extracted, the practitioner should keep in mind the risk of losing space, and the consequent malocclusion. Preservation of the space can eliminate or reduce the need for prolonged orthodontic treatment. For that reason, there are various kinds of space maintainers and the pediatric dentist must decide which one to utilize, on the basis of general and local factors related to the child. In the selection of a treatment option for space maintenance, the greatest complications occur when the first permanent molar has not yet erupted. A large variety of appliances have been devised to deal with this situation. This article proposes the use of a removable space maintainer that is open on one end and can be employed to guide the first permanent molar, maintaining the integrity of the mucous membrane and serving as a prosthetic appliance, preventing the complications and contraindications often caused by sub-gingival maintainers.

Unhealthy oral habits may be involved in the etiology of a malocclusion, since they may affect development of the orofacial region. There is little information on the habit of sucking the lower lip, to which practitioners attribute less clinical consequences. However, lower lip sucking is a harmful habit which appears frequently in children, especially during situations requiring increased attention and mental concentration. In patients presenting lower lip sucking, strong contractions of the lower lip's orbicular's muscle and the mentalis muscle, associated with hypertonicity of the upper lip caused by sucking, has to be balanced by lingual thrusting during the act of deglutition. A case is presented in which failure to identify the habit of lower lip sucking led to an atypical lesion on the tongue, caused by the tongue's impaction against the orthodontic appliance prescribed to correct a malocclusion. The recognition and elimination of an unhealthy habit is of great importance in diagnosis and the establishment of a treatment plan, so that undesirable complications can be avoided.

The talon cusp is a relatively uncommon dental anomaly manifested as an accessory cusp-like structure on the crown of anterior teeth. The presence of a talon cusp can cause clinical problems. This article reports the case of a patient presenting a talon cusp affecting the permanent maxillary right central incisor causing clinical problems related to caries, displacement of the tooth, occlusal position and tendency to dental traumatism. The management of this tooth included caries removal and reduction of the cusp. Pulp-capping with calcium hydroxide was required because of the presence of pulp horn extensions in the talon cusp.