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.