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Midline Diastema and its Aetiology − A Review
Reji Abraham Geetha Kamath

Dent Update 2014; 41: 457–464

Abstract: Maxillary midline diastema is a common aesthetic complaint of patients. Treating the midline diastema is a matter of concern for
practitioners, as many different aetiologies are reported to be associated with it. The appearance of midline diastema as part of the normal
dental development makes it difficult for practitioners to decide whether to intervene or not at an early stage. The aim of this article is to
review the possible aetiology and management options which will help the clinician to diagnose, intercept and to take effective action
to correct the midline diastema. The available data shows that an early intervention is desirable in cases with large diastemas. Treatment
modality, timing and retention protocol depends on the aetiology of the diastema. Therefore, priority needs to be given to diagnosing the
aetiology before making any treatment decisions.
Clinical Relevance: This article aims to determine and evaluate the aetiology and possible treatment options of midline diastema.
Dent Update 2014; 41: 457–464

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Recurrent CEOT of the maxilla
Geetha Kamath1, Reji Abraham2
1Departments of Oral Medicine and Radiology, and 2Orthodontics, Sri Hasanamba Dental College and Hospital, Hassan, Karnataka, India
Dental Research Journal / Mar 2012 / Vol 9 / Issue 2 233
Dental Research Journal
Case Report
Recurrent CEOT of the maxilla
Geetha Kamath1, Reji Abraham2
1Departments of Oral Medicine and Radiology, and 2Orthodontics, Sri Hasanamba Dental College and Hospital, Hassan, Karnataka, India
ABSTRACT
Calcifying epithelial odontogenic tumor (CEOT) is a rare benign, but locally infiltrating odontogenic
neoplasm. It accounts for less than 1% of all odontogenic tumors. This is a case report of recurrent
CEOT in the maxilla. A 35-year-old patient reported after three years of surgical excision of the
lesion, with a recurrence. It is of particular concern because of its anatomic location in the maxilla.
Maxillary tumors tend to be more aggressive and rapidly spreading and may involve the surrounding
vital structures. Adequate resection of the lesion with disease-free surgical margins and long-term
follow-up is recommended.
Key Words: Calcifying epithelial odontogenic tumor, maxillary tumors, odontogenic tumor
INTRODUCTION
The calcifying epithelial odontogenic tumor
(Pindborgs tumor) is a benign neoplasm of
odontogenic origin.[1] It is a rare tumor accounting
for less than 1% of all odontogenic tumors.[2] It is
a benign, though occasionally locally invasive, slowgrowing
neoplasm. They are localized generally in
posterior part of mandible and rarely occur in the
maxilla.[1,2] This article reports a case of recurrent
CEOT of the maxilla in a 35 year old male patient.
CASE REPORT
A male patient aged 35 years reported with a painless
swelling of eight months duration in the left upper jaw
in 2005. On examination, it was hard in consistency
with expansion of the cortical plates [Figures 1
and 2]. The first premolar tooth was missing with
no history of previous dental extractions. The
panoramic radiograph showed a diffuse honeycomb
type of radiolucency extending from premolar to
third molar region withfew radiopacities [Figures 3
and 4]. The lesion was associated with an impacted
tooth, which resembled a premolar and was displaced
posterosuperiorly. There was no evidence of root
resorption of the adjacent teeth .The lesion was
surgically excised and histopathologically diagnosed
as calcifying epithelial odontogenic tumor (CEOT).
Microscopic examination of the tissue revealed
sheets and strands of polyhedral epithelial cells
with hyperchromatic nuclei, mild to moderate
pleomorphism and prominent intercellular bridges.
Eosinophilic hyaline deposits with calcifications were
found within and between sheets of epithelial cells.
The patient was not regular for the follow up and
reported again in 2008, three years after excision.
The patient had noticed a growth in the same region
five months back and experienced no discomfort.
A computed tomography (CT) scan showed a large,
expansile, radiolucent lesion with multiple areas of
calcification which completely obliterated the left
maxillary antrum [Figures 4 and 5]. The scan showed
the tumor extending and involving the lateral nasal
wall, orbital floor and the medial pterygoid plate
[Figures 6 and 7]. An incisional biopsy confirmed
the lesion to be a recurrence of CEOT. No atypias
or mitoses were found. The lesion was excised
with wide surgical margins and the patient is under
observation for the past three years without any signs
of recurrence.
Received: September 2011
Accepted: December 2011
Address for correspondence:
Dr. Reji Abraham,
Department of
Orthodontics, Sri
Hasanamba Dental College
and Hospital, Vidyanagar,
Hassan 573201, Karnataka,
India.
E-mail: rejiabm@gmail.com

Access this article online
Website: www.drj.ir

ABSTRACT
Calcifying epithelial odontogenic tumor (CEOT) is a rare benign, but locally infiltrating odontogenic
neoplasm. It accounts for less than 1% of all odontogenic tumors. This is a case report of recurrent
CEOT in the maxilla. A 35-year-old patient reported after three years of surgical excision of the
lesion, with a recurrence. It is of particular concern because of its anatomic location in the maxilla.
Maxillary tumors tend to be more aggressive and rapidly spreading and may involve the surrounding
vital structures. Adequate resection of the lesion with disease-free surgical margins and long-term
follow-up is recommended.
Key Words: Calcifying epithelial odontogenic tumor, maxillary tumors, odontogenic tumor

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Habit Breaking Appliance for Multiple Corrections
Hindawi Publishing Corporation
Case Reports in Dentistry
Volume 2013, Article ID 647649, 5 pages

Tongue thrusting and thumb sucking are the most commonly seen oral habits which act as the major etiological factors in the
development of dentalmalocclusion. This case report describes a fixed habit correcting appliance,HybridHabit CorrectingAppliance
(HHCA), designed to eliminate these habits.This hybrid appliance is effective in less compliant patients and if desired can be used
along with the fixed orthodontic appliance. Its components can act as mechanical restrainers and muscle retraining devices. It is
also effective in cases with mild posterior crossbites.

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Comparison of Rate of Canine Retraction into Recent Extraction Site with and without Gingival Fiberotomy: A Clinical Study
The Journal of Contemporary Dental Practice, May-June 2013;14(3):00-00
ABSTRACT
Aim: Retraction of maxillary canines after first premolar
extractions is a very common orthodontic task in cases of
crowding or for the correction of large overjet. Many studies
have been done to increase the rate of retraction. The aim is to
compare the rate of canine retraction into recent extraction site
with and without circumferential supracrestal fiberotomy.
Materials and methods: The rate of movement of the canines
into the recent extraction site of the first premolar with or without
circumferential supracrestal fiberotomy was measured in 14
patients aged 13 to 22 years. The study was done on 9 maxillary
and 5 mandibular arches. The appliance used in the present
study was the preadjusted edgewise (0.022 inch Roth
prescription) and retraction performed by frictionless mechanics
using Composite T Loop. The distalization of canines was
measured at regular intervals (T1, T2, T3 and T4). Recordings
of the positions of the canines at the beginning and at different
intervals were made from dental casts.
Results: The mean difference between the two sides for the
total time span T1-T4, for maxillary arch was 0.36 mm and for
mandibular arch was 0.60 mm respectively.
Conclusion: There can be various factors that affect the rate
of tooth movement. Factors like bone density, bone metabolism,
and turnover in the periodontal ligament, amount of force applied
may be responsible for the variation.
Clinical significance: No clinically significant increased rate
of retraction of cuspids in the recent extraction site with
fiberotomy was found in comparison to the retraction in recent
extraction site without fiberotomy.
Keywords: Canine retraction, Fiberotomy, Circumferential
supracrestal fiberotomy, T loop, Rate of retraction.
How to cite this article: Kalra A, Jaggi N, Bansal M, Goel S,
Medsinge SV, Abraham R, Jasoria G. Comparison of Rate of
Canine Retraction into Recent Extraction Site with and without
Gingival Fiberotomy: A Clinical Study. J Contemp Dent Pract
2013;14(2):00-00.

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Prevalence of malocclusion among adolescents in South Indian population
J Int Soc Prevent Communit Dent 2013;3:97-102http://www.jispcd.org/text.asp?2013/3/2/97/122453

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