The most commonly involved tooth in localized microdontia is the maxillary lateral incisor, which may also be shaped like an inverted cone (a "peg lateral"). Peg laterals typically occur on both sides, and have short roots. Inheritance may be involved, and the frequency of microdontia in the upper laterals is just under 1%. The second most commonly involved tooth is the maxillary third molars, and after this supernumerary teeth. Causes
There are many potential factors involved. Congenital hypopituitarism
Ectodermal dysplasia
Down syndrome
Ionizing radiation to the jaws during tooth development (odontogenesis)
Chemotherapy during tooth development
Marshall syndrome
Rieger syndrome
Focal dermal hypoplasia
Silver-Russell syndrome
Williams syndrome
Gorlin-Chaudhry-Moss syndrome
Coffin–Siris syndrome
Salamon syndrome
Cleft lip and palateOthers include trichorhinopharyngeal, odontotrichomelic, neuroectodermal and dermo-odontodysplasia syndromes. Treatment
Unerupted microdonts may require surgical removal to prevent the formation of cysts. Erupted microdonts, peg laterals especially, may cause cosmetic concern. Such teeth may be restored to resemble normal sized teeth, typically with composite build ups or crowns. Orthodontics may be required in severe cases to close gaps between the teeth. Epidemiology
Females are affected more than males, and the condition occurs in permanent (adult) teeth more than deciduous (baby teeth or milk teeth). References


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Without proper treatment a permanent deformity of the finger may occur. Diagnosis
The diagnosis is generally based on symptoms and supported by X-rays. The injury can be accompanied by swelling and ecchymosis. Treatment
The management goal is to restore extension of the joint. Treatment is generally with a splint that holds the first joint of the finger straight continuously for 8 weeks. This should begin within a week of the injury. The splint may be worn just at night for a few additional weeks after this. The splint acts to immobilize flexing of the joint. Surgery generally does not improve outcomes. It may be required if the finger cannot be straightened by pushing on it or the break has pulled off more than 30% of the joint surface. Surgery may be preferred over the use of a split if a child is non-compliant. If the problem has been present a long time surgery may also be required. An open fracture may be another reason. Surgery will put the finger in a neutral position and drill a wire through the distal interphalangeal joint (DIP) to the proximal interphalangeal joint (PIP), forcing immobilization. See also
Busch fracture
Jersey finger

References


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