Idiopathic focal sclerosing osteomyelitis mimicking retained root tip

Socket sclerosis, a rare complication in orthodontic tooth movement

Socket sclerosis is usually asymptomatic and does not require any treatment. The only potential complication arises during orthodontic treatment, wherein sclerosed socket of the premolar teeth may be an obstacle in closing the space by movement of teeth through the extraction space. This article demonstrates the problems encountered during the orthodontic treatment of a 20-year-old Malaysian woman with socket sclerosis and the treatment strategy employed to overcome the same.

Socket Sclerosis—An Obstacle for Orthodontic Space Closure?

Background: Socket sclerosis is a rare reaction to tooth extraction resulting in high-density bone in the center of the alveolar process, where, under normal circumstances, cancellous bone is to be expected.

Materials and Methods: In an adult orthodontic patient, routine extractions of the mandibular first permanent bicuspids were performed, resulting in socket sclerosis and unsuccessful orthodontic space closure. Orthodontic mini-implants were inserted to augment anchorage and aid in space closure.

Results: In the presence of socket sclerosis, conventional orthodontic mechanics failed to close the extraction spaces. However, with absolute anchorage in place, space closure occurred at a nearly normal rate. After treatment, no signs of socket sclerosis were discernible on the periapical radiographs.

Conclusion: Socket sclerosis can be an obstacle for orthodontic space closure if traditional mechanics are employed. However, mini-implant–reinforced anchorage can lead to successful space closure, resulting in complete resolution of the sclerotic sites.

Benign fibro-osseous lesions of the craniofacial complex. A review

Benign fibro-osseous lesions of the craniofacial complex are represented by a variety of disease processes that are characterized by pathologic ossifications and calcifications in association with a hypercellular fibroblastic marrow element. The current classification includes neoplasms, developmental dysplastic lesions and inflammatory/reactive processes. The definitive diagnosis can rarely be rendered on the basis of histopathologic features alone; rather, procurement of a final diagnosis is usually dependent upon assessment of microscopic, clinical and imaging features together. Fibrous dysplasia and osteitis deformans constitute two dysplastic lesions in which mutations have been uncovered. Other dysplastic bone diseases of the craniofacial complex include florid osseous dysplasia, focal cemento-osseous dysplasia and periapical cemental dysplasia, all showing a predilection for African descent individuals; although no specific genetic alterations in DNA coding have yet to be uncovered and most studies have been derived from predominant high African descent populations. Ossifying fibromas are neoplastic lesions with four subtypes varying with regard to behavior and propensity for recurrence after surgical excision. The clinicopathologic and molecular features of this unique yet heterogeneous group of diseases are reviewed.