The study presents a case of the rarely occurring totally retained fourth molar teeth simultaneously in maxilla and mandible. The appearance of supernumerary teeth is a relatively uncommon dental anomaly and it is rare for patients to have impacted fourth molars in two quadrant. The aim of this work is to describe the presence of unilateral (right) fourth molars in the maxilla and the mandible in a young female patient aged 24 years. Orthopantomogram revealed impacted lower third molars but also unerupted unilateral (right) upper and lower fourth molars. Before orthodontic treatment, the patient was subsequently admitted for removal of third and fourth impacted upper and lower molars under local anesthesia.
In adult life, proper bone metabolism requires efficient regulation of bone formation and resorption processes. Bone turnover markers allow for assessing the rate of bone formation and resorption processes. In menopausal period, female patients experience gradual reduction in blood estradiol levels. The deficit of estrogens leads to enhanced osteoclastogenesis and bone resorption. Alkaline phosphatase (ALP) is a membranebound enzyme that stimulates the osteoblast activity and bone mineralization. It is synthesized by osteoblasts and incorporated into the newly formed bone tissue. The produced enzyme stimulates the osteoblast activity and bone mineralization. The goal of this study is to determine the effect of hormone replacement therapy in postmenopausal women on the expression of alkaline phosphatase gene (ALPL) within the mucosal epithelium of the cheek and in peripheral blood lymphocytes. The studies show that hormone replacement therapy has no significant effect on the increase in ALPL expression within the mucosal epithelium of the cheek. Only in women having undergone ovarectomy (OV), the epithelial ALPL expression level was higher than in the remaining groups.
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