Monday, August 2, 2010

What is the cause of this central incisor notching?

What is the cause of this central incisor notching?
The patient is 32 years old male, presented with the chief complaint of sensitivity in anterior teeth.
Bilateral Central Incisor Notching
The story of this and similar cases is based on a very old tradition of Rajasthan, Uttar Pradesh And Some Areas of Bihar. Some people in these areas get their teeth tattooed with gold in various forms. Most common pattern is a triangle with three dots at each corner and apex at the superior end. Small round holes are drilled in the teeth with the help hand driven drills. The holes are placed at about 2 to 3 mm superior to the incisal edges. Gold is then filled in the prepared cavities.
In this patient, the teeth underwent severe attrition which lead to the expulsion of the tattoos and conversion of round holes into semicircles which appear as notches.
Finally the complete correct answer was given by Dr. Zulfiqar Hafeez (AMU) and a closest best was given by Dr. Anshul Gupta (JDC) and Dr. Kritika Roy (JDC).