Case History
A 16-year-old female presented with the chief complaint that, following the delayed exfoliation of the both primary teeth number 45 and 55; the permanent second premolars had not erupted. Her medical history was free. The patient was referred to an orthodontist for further evaluation and diagnosis. The orthodontist advised that a panoramic radiograph be obtained. The panoramic radiograph (Figure1) revealed the following:
Generalized Short Root Anomaly (SRA) in the permanent dentition. In the majority of cases, the root/crown ratio was approximately 1:1 and apices were slightly rounded. Despite the short roots, all teeth exhibited normal pulp chambers and root canals, and the periodontal tissues appeared normal.
A congenital absence of both upper second premolars (hypodontia).
The roots of the third molars were developed, despite the teeth’s young age. The shape and root/crown ratio did not clearly indicate SRA, as the shape of the apices was normal.
The second mandibular and maxillary molars and the upper third molars exhibited taurodontism. The type of taurodontism is considered to be mesotaurodontism (Type III) (Shifman and Chanannel, 1978).
All primary teeth had been extracted in a normal manner, and there was no previous orthodontic examination or treatment. The clinical examination revealed that all teeth were of normal shape, color and size. No teeth exhibited mobility and all responded normally to vitality tests. Patient demonstrated excellent oral hygiene, with no evidence of soft tissue inflammation. Carious lesions were identified and scheduled for restoration.
The most important clinical observation was that the patient was born with incomplete formation of the left upper limb with a deficiency in 2/3 of the forearm (transverse hemimelia). A comprehensive medical history was obtained from the parents to ascertain any potential contributing factors.