title: Kissing molars: report of three cases and new prospective on aetiopathogenetic theories.
abstract: Kissing molars (KMs) is an extremely rare condition of impacted third molars, pointed in the opposite direction in a single follicular space; it consists exactly in a full impacted of permanent molars which occurs only in the lower jaw. Actually, about less than thirty cases have been reported in scientific literatures. The aetiology and pathogenesis of this pathological double dental inclusion remain unknown; above all events that lead two molars to appear, as KMs remain mysterious. The association to metabolic connective diseases such as mucopolysaccharidosis was emphasized. KMs considered as an isolated event, may be associated to an abnormal position of the tooth-bud from lower permanent molars, or fourth supernumerary tooth (distomolar). Recently, hyperplastic dental follicle (HDF), with a down regulation of matrix metal-proteinases and up regulation of several genes of collagens, has been mentioned in association with KMs. In this paper, after having analyzed three new cases of KMs that have been treated, we report a new hypothesis. This last is based on the failure in the dental follicle's ability to initiate or continue properly resorption of the overlying alveolar bone, by many exogenous factors which may act on eruptive phase that would lead to its rotation with its contents coming out a pathological situation of KMs. The therapy of choice is related to the surgical removal of KMs through a double odontectomy with transalveolar method. Other treatments can be, eventually, orthodontic therapy of the impacted teeth and a radiological follow-up without surgery.
authors.affiliation: Department of Multidisciplinary Medicine and Dental Science, Second University of Naples Italy.
authors.forename: Dardo
authors.initials: D
authors.lastname: Menditti
authors.affiliation: Department of Experimental Medicine, University Hospital of Foggia Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Laino
authors.affiliation: Department of Experimental Medicine and Odontostonatology, University Hospital of Messina Messina 98125, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Cicciù
authors.affiliation: Department of Multidisciplinary Medicine and Dental Science, Second University of Naples Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Mezzogiorno
authors.affiliation: Department of Multidisciplinary Medicine and Dental Science, Second University of Naples Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Perillo
authors.affiliation: Department of Multidisciplinary Medicine and Dental Science, Second University of Naples Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Menditti
authors.affiliation: Department of Experimental Medicine and Odontostonatology, University Hospital of Messina Messina 98125, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Cervino
authors.affiliation: Department of Experimental Medicine, University Hospital of Foggia Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Lo Muzio
authors.affiliation: Department of Environmental, Biological and Pharmaceutical Sciences and Technologies Second University of Naples Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Baldi
mesh_terms: D000328:Adult; D001706:Biopsy; D054893:Cone-Beam Computed Tomography; D003795:Dental Sac / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D003803:Dentigerous Cyst / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D008964:Molar, Third / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D011237:Predictive Value of Tests; D011862:Radiography, Panoramic; D012307:Risk Factors; D014081:Tooth Extraction; D014095:Tooth, Impacted / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000601:surgery
keywords: Impacted teeth; dental follicle; hyperplastic dental follicles; kissing molars