Turner Hypoplasia
Turner Hypoplasia
Turner Hypoplasia
Abstract
Orofacial trauma is a serious orodental and general health problem that may have medical, esthetic
and psychological consequences for children and their parents. When the root of the primary tooth is
close to the unerupted permanent tooth, primary tooth trauma may result in developmental
disturbances and pulpal reaction in that permanent tooth. We report an unusual case of an 8 year old
girl who met with trauma at 15 months of age in which injury to the primary dentition resulted in
developmental disturbances in the crown of the permanent tooth and fusion between permanent and
deciduous tooth. Localized malformation of the crown and enamel hypoplasia was treated with a light-
cured composite resin restoration. The treatment of fused permanent and deciduous incisor is also
discussed.
to them
both dentitions could be affected by
enamel hypoplasia; however, the
incidence is more severe in permanent
dentition. The characteristics of clinical
enamel hypoplasia include unfavorable Fig. 2
permanent lateral incisor was fused with The fused teeth <22-62> had an
deciduous lateral incisor (Figure 1). irregular labial and lingual surface with an
incisal ditch with a labial groove. Both the
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A Case study of a Rare Case of Turners Hypoplasia and Unilaterally Fused Deciduous and Permanent Lateral Incisor
Caused By Trauma Verma, Leena
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Journal of Exercise Science and Physiotherapy, Vol. 9, No. 1: 69-73, 2013
reported from their longitudinal study of 8 always appears to be joined in some region
years that discolorations of enamel and/or with separate pulp chambers and canals.
enamel hypoplasia (46.08%) were the In the rare case report we reported
most prevalent sequelae on permanent here, the patient had a history of trauma in
dentition due to traumatic injury. 7 their deciduous dentition below the age of
Tooth fusion is defined as union 3 years and had type-IV enamel
between the dentin and/ or enamel of two hypoplasia (enamel discoloration,
or more separate developing teeth.1,2 The abnormal coalescence, some parts of
fusion may be partial or total depending enamel missing) along with fusion of
upon the stage of tooth development at the deciduous left lateral incisor and
time of union . If the contact occurs before permanent left lateral incisor. The brown
the calcification stage, the teeth unite discoloration occurs due to disturbances in
completely and form one large tooth. ameloblastic layer, leading to defective
Incomplete fusion may be at root level if matrix formation caused by traumatic
the contact and union occurs after injuries, but the stretched inner enamel
formation of crown. Fusion can occur at epithelium continues to induce the
the level of enamel or enamel and dentin, differentiation of new odontoblasts and
which results in the formation of one hence the dentine formation is not
clinically enlarged crown. Fused teeth can disrupted. The fusion between deciduous
have separated pulpal space, one pulp lateral and permanent lateral incisor also
chamber and two canals or take the form occurred due to traumatic injury in the
of a large bifid crown with one pulpal deciduous dentition which had led to
space. Etiology of fusion is not fully fusion between the two teeth.
explained. Some authors state that it is a Thus, this a rare case report in
result of physical forces that lead to the which following trauma to deciduous
necrosis of epithelial tissue between the dentition, there occurs fusion between
two joining buds, they come into contact deciduous lateral and permanent lateral
and fuse.5, 6 .According to other authors, incisor and turners hypoplasia in
fusion is a result of the persistence of the permanent central incisor. This is a rare
interdental lamina between the two buds occurrence not yet reported so far.
during embryological development. Fusion Conclusion: An injury to a young childs
may be unilateral or bilateral and most teeth can be physically and emotionally
commonly occurs in primary teeth with traumatic. The dentist must take time to
more predilection for anterior teeth. 7 carefully examine and analyze not only the
Fusion may occur between two normal damage itself, but also the possibilities of
teeth or between a normal tooth and a sequelae to the permanent tooth germ and
supernumerary tooth. Clinically fused the overall health of the child. For this
anterior teeth frequently have a groove or reason, treatment of trauma in primary
notch on the incisal edge that goes in dentition must include long-term follow-up
buccolingual direction and of sequelae in the permanent dentition.The
radiographically, the dentin of fused teeth case we report here stresses the
importance of traumatic injuries to
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A Case study of a Rare Case of Turners Hypoplasia and Unilaterally Fused Deciduous and Permanent Lateral Incisor
Caused By Trauma Verma, Leena
primary dentition because of their effects White, S.C. & Pharaoh, M.J. 2006. Oral
on the permanent tooth germ. radiologyth Principles and Interpretation 5th
edition page: 345-346. Publisher: Elsevier
References Velasco, L.F.L., Araujo, F.B, Ferreira, E.S.,
Ozturk, N, Zafar, S., Ozturk, B. 2004. Faculty of Velasco, L.E.L. 1997. Esthetic and
Dentistry, University of Selcuk, Konya, functional treatment of a fused permanent
turkey. An interdisciplinary approach for tooth: A case report. Quintessence Int., 28:
restoring function and esthetic in patient 677-80.
with amelogenesis imperfecta and Andreasen, J.O. 1971. The effect of traumatic
malocclusion: A clinical report. J. Prosthetic injuries to primary teeth on their permanent
Dentistry, 92(2): 112-115. successor. Scand. J. Dent. Res., 145: 229.
Andreasen, F.M. & Andreasen, J.O. 1994. do Esprito Santo Jcomo, D.R., Campos, V. 2009.
Textbook and color atlas of traumatic Prevalence of sequelae in the permanent
injuries to the teeth. Mosby Co; p. 457-94. anterior teeth after trauma in their
Shafer's textbook of oral pathology, 5 edition: page predecessors: a longitudinal study of 8 years.
75 Publisher: Elsevier 2007 Dent Traumatol., 25(3): 300-4.
Golpaygani, V.M., Mehrdad, K., Mehrdad, A.,
Ansari, G. 2009. An evaluation of the rate of
dental caries among hypoplastic and normal
teeth: A case control study. Res. J. Biol. Sci.,
4: 53741.
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