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Answer to John's Question

Hi John,
    Both mandibular canines are unerupted and dentigerous cysts are forming around the cementoenamel junction.  This is because the root sheath remnant remains in the bone and will form cysts since it is not in the pocket as the junctional epithelium where it should be.  Both of those canines should be surgically removed.  If not the cyst will expand and destroy the mandibular bone.  I have had these where they have expanded to involve the incisors to the first molar almost necessitating mandibulectomy.  The teeth with the enamel hypocalcification will require cavity preparation bonding and composite restoration or extraction depending on the extent, current apical pathology, root formation and the owners input on a tooth by tooth basis.  309 and 409 will likely develop periodontal diseae and need to be extracted at some point if not now depending on gross evaluation.  I would be glad to approach this case next month when I am at AVS.  Please have the owners call Sarah for an appointment.  Thanks for sharing this case.  Please feel free to call me any time if you have questions.  You and Dr. Blake are ahead of the curve in dentistry, I commend you both.
Take care,
Brett