# Root Dilaceration and Dentigerous Cyst--A Cause-Effect Relationship?--\"Case-Series Study\"
## 2 Materials and Methods
No improvement regarding the position of the right canine after maxillary expansion. **(d)** The upper left second premolar also has a root DL. continued to grow, in closed contact with the apical half of the first premolar root, the DLs of first premolar root as the flexion of the second premolar root). This could be explained by the pressure applied by the cyst on that area of dense bone structure. The last panoramic X-ray (Figure 1d) showed a root DL of the second upper left premolar. Thus, the DL could have another cause, namely a genetic one, as a dental anomaly pattern (DAP) or associated dental anomaly (ADA), in which many dental anomalies coexist, as in this case, the canine impaction, transposition, DC, and root DL. The root DL of the impacted canine could also be seen on the CBCT (Figure 2a,b). **Case 2**  
A 10-year-old boy sought orthodontic treatment for esthetic reasons due to the absence of the upper left central incisor, and malalignment of upper front teeth, and was without a history of trauma. The patient had permanent dentition with the persistence of the right deciduous canine and left lateral incisors, macrodontia and class 1 Angle malocclusion. A panoramic X-ray revealed the impaction of the left central incisor due to a supernumerary impacted tooth blocking the eruption path of the central incisor. A DC was associated with the impacted left upper incisor, and its root was not in the axis of the crown. The space for the upper left canine was closed because the lateral incisor was displaced in a distal position by the supernumerary tooth, the canine bulging bucucally (Figure 3a). The objective of the orthodontic treatment was to preserve all the permanent teeth, as the replacement of any frontal teeth is very challenging despite the successful techniques in periodontology and implantology. The treatment started with surgery, including extraction of the supernumerary tooth and marsupialization of its DCs. A removable appliance was worn to maintain the space and eventually for orthodontic traction of the impacted teeth. The eruption process of the central incisor was monitored periodically by X-ray exams, and it was found that the central incisor erupted very slowly, with a tendency for impaction, and the decision was made to apply orthodontic traction to bring it into the  
Figure 3: (**a**) Impacted upper left central incisor blocked by a DC surrounding its crown and a supernumerary tooth. (**b**) Abnormal shape of the canine, root DL of the upper left central incisor, and a new tooth bud developing in the lower arch. Figure 2: (**a**) The right maxillary canine also has a root DL, presenting a “hook” bend towards the mesial in the apical third of the root. (**b**) “Bull’s eye” phenomena highlighted in the sagittal section. oral cavity. At the same time, the canine changed its eruption path in a mesial direction, in transposition with the lateral incisor. The abnormal shape of the canine, with a big cingulum, like a supernumerary cusp, root DL of the central incisors and a new tooth bud between left mandibular premolars (Figure 3b), could be seen on the panoramic X-ray. In this clinical case, the root DL was seen only in the impacted central incisor associated with the DC, and the cause of DL could be the lack of space for the root to develop in a normal direction. This case is another case of dental anomaly pattern (DAP) or associated dental anomaly (ADA)--macrodontia, impaction, supernumerary teeth, DL and DC, transposition, an early eruption of permanent teeth, and DL might also have a genetic origin. **Case 3**  
A 10-and-a-half-year-old girl was referred by her dentist after unexpectedly finding two big DCs associated with the mandibular premolars on an X-ray. The patient had a severe class II div 1 malocclusion, being a thumb-sucker, and an early mixed dentition due to a delayed eruption. All mandibular deciduous molars had fillings and root canal treatments that could advocate for DCs of inflammatory origin.