Supernumerary teeth are uncommon but have been well documented clinically. They are extra teeth or tooth-like structure, either erupted or unerupted in addition to the 32 permanent teeth. Mesiodens is one of these located in the midline between the two central incisors. Nasal teeth result from ectopic eruption of supernumerary teeth, can be identified by performing Cone Beam Computed Tomography (CBCT). Supernumerary teeth may lead to delayed eruption or non-eruption, displacement of permanent teeth, resorption or malformation of adjacent roots, and cystic formation (rarely). Multiple supernumerary impacted teeth are usually associated with syndromes, metabolic or hormonal disorders. This paper describes surgical management of a rare case of 2 palatally placed, one horizontal and impacted supernumerary, one in the anterior maxilla and other in the floor of the nasal cavity, which were detected during a radiographic examination for labial placement of permanent right central incisor due to a rotated mesiodens in the case of a healthy 14-year-old boy reported at the Dental centre.

Reconstruction within the head and neck is challenging. Defects can be anatomically complex and may already be compromised by scarring, inflammation, and infection. Tissue grafts and vascularised flaps (either pedicled or free) bring healthy tissue to a compromised wound for optimal healing and are the current gold standard for the repair of such defects, but disadvantages are their limited availability, the difficulty of shaping the flap to fit the defect and, most importantly, donor site morbidity. The importance of function and aesthetics has driven advances in the accuracy of surgical techniques. We discuss current advances in reconstruction within oral and maxillofacial surgery. Developments in navigation, three-dimensional imaging, stereolithographic models, and the use of custom-made implants can aid and improve the accuracy of existing reconstructive methods. Robotic surgery, which does not modify existing techniques of reconstruction, allows access, resection of tumours, and reconstruction with conventional free flap techniques in the oropharynx without the need for mandibulotomy. Tissue engineering and distraction osteogenesis avoid the need for autologous tissue transfer and can therefore be seen as more conservative methods of reconstruction. Recently, facial allotransplantation has allowed whole anatomical facial units to be replaced with the possibility of sensory recovery and reanimation being completed in a single procedure. However, patients who have facial allotransplants are subject to life-long immunosuppression so this method of reconstruction should be limited to selected cases [1].

This clinical report describes how to achieve a successful rebonding of a debonded porcelain veneer successfully using several procedures such as grinding enamel to eliminate the remaining adhesive from the first bonding and ultrasonic treatment of the veneer’s surface. Care is given the bonding protocol in order to optimize the durability of the interface.