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PubMed2001

Variations in number and morphology of permanent teeth in 7-year-old Swedish children.

OBJECTIVES: To establish the prevalence of numerical and morphological variations of permanent teeth in Swedish 7-year-olds and to accept or reject the hypothesis of a higher prevalence for these conditions in northern Sweden compared to other areas. DESIGN: Cross-sectional. SETTING: Department of Odontology/Pedodontics, Umeå University, Sweden. SAMPLE AND METHODS: A total of 739 healthy Caucasian 7-year-olds residing in the city of Umeå, northern Sweden in 1976. The children were examined clinically and radiographically. RESULTS: The prevalence of hypodontia (excluding third molars) in girls was 8.4%, in boys 6.5%, and in both sexes combined 7.4%. Of the children with hypodontia, the majority (90.9%) lacked one or two teeth. Lower second premolars were the teeth most frequently missing. The prevalence of hyperdontia was 1.9%; 11 girls and three boys were affected; 78% of the supernumerary teeth were mesiodenses. Of the morphological variations, peg-shaped upper lateral incisors were found in 0.8% of the children, double-formation (gemination) in 0.3%, taurodontism in 0.3% and dens invaginatus in 6.8%. One diagnosis was found in 18% of the children, and in almost 8% of them more than one diagnosis was found. CONCLUSIONS: The results agree with those obtained in similar populations and are considered representative of this ethnic group. The hypothesis of a genetically determined higher prevalence of numerical and morphological variations in the study population was not verified.

Anodontia↗
PubMedDate not supplied

Frequency of supernumerary teeth in Mexican population.

Supernumerary teeth (ST) are a not uncommon developmental anomaly which appears in 0.3 to 3.8 percent of the population. We studied the corresponding radiographs from 2241 patients, both sexes who seeked dental attention at the Outpatient Clinic of the División de Estudios de Posgrado e Investigación, Facultad de Odontología, UNAM in Mexico City. Of them, we found 72 patients (3.2%) with 102 ST. Of the 72 patients, 39 were males (54.2%) and 33 females (45.8%). Mesiodens was the most common ST (48.6%), followed by supernumerary premolars (26.4%), supernumerary laterals (11.1%) and fourth molars (9.7%). This series includes cases with one, two and three ST and one case comprising 10 ST. Our results suggest that frequency of ST in the population studied differs in some aspects with previously reported series and that frequency of ST shows different rates depending the population studied. As our results demonstrate, it is encouraged the need to have panoramic radiographs of all patients attended in dental offices, clinics and schools of Dentistry in order to detect and diagnose undiscovered pathologies.

Adolescent↗
PubMed2005

Supernumerary cheek teeth (n = 24): clinical features, diagnosis, treatment and outcome in 15 horses.

REASONS FOR PERFORMING STUDY: There are few reports of case series of horses with supernumerary cheek teeth (SCT) that document clinical findings, treatment and long-term outcome. OBJECTIVES: To review the clinical and ancillary diagnostic findings and responses to different treatments in horses with SCT. METHODS: The case records of 15 horses were reviewed and long-term outcomes obtained by telephone interview. RESULTS: Fifteen horses with a total of 24 SCT were identified. Two SCT were incidental findings and were not treated. Clinical signs were improved or resolved in 11 of 13 of the teeth treated conservatively and all 6 treated by extraction had a favourable outcome. Four horses were subjected to euthanasia within a short period of diagnosis, either due to a poor prognosis at the outset or failure to respond to initial conservative treatment. CONCLUSIONS: Some SCT are chance findings and do not cause clinical signs. In those instances where clinical signs of dental disease are mild, conservative treatment including the management of diastema and reduction of overgrowths is often effective. Horses with severe clinical signs attributable to an SCT are likely to require extraction of the offending tooth. POTENTIAL RELEVANCE: An SCT is an uncommon dental anomaly but should be considered in the differential diagnosis of cases with signs of severe dental disease. The preferred management for SCT is very variable and determined by the severity of the associated changes, but ranges from conservative measures through forceps extraction per os to major facial flap surgery.

Animals↗
PubMed1994

Effects of the intermediate retinoid metabolite retinal on the pattern of the dental lamina in vitro.

Retinoids have important roles in pattern formation during embryonic development and might act as endogenous morphogens. They are necessary for normal odontogenesis and excess retinol alters the pattern of odontogenesis producing supernumerary buds of the dental lamina in the diastema region of the mouse mandible. Because the metabolism of retinoids in the developing mandible is unknown, the effects of retinal (an intermediate metabolite in the local conversion of retinol to retinoic acid) on the patterning of odontogenesis were examined. Retinal produces supernumerary buds and enhanced epithelial proliferation in day-9 mandibles in vitro. The endogenous levels of retinal in the mandible at the time of initiation of odontogenesis were also measured by high-performance liquid chromatography. Retinal was detected only at day 10 and not at later stages of development. Local metabolism of this intermediate retinoid may be a rate-determining step in the production of active retinoid metabolites that may control the pattern of the dentition, which is established at the time of the appearance of the dental lamina at embryonic day 12.

Animals↗
PubMed1997

Genetic background effects on dental and other craniofacial abnormalities in homozygous small eye (Pax6Sey/Pax6Sey) mice.

Small eye (Pax6Sey) is a semi-dominant mutation affecting development of the eyes, brain and nasal structures. The mutant phenotype arises from defects within the Pax6 gene and several mutant alleles have been identified. A previous study reported that Pax6Sey/Pax6Sey homozygotes, in a random-bred stock, had a median cartilaginous rod-like structure in the nasal region and 80% had supernumerary upper incisor teeth. In this study we show that supernumerary upper incisor teeth and a previously unreported nasal capsule-derived cartilaginous 'spur' occur in compound heterozygous Pax6Sey-Neu/Pax6Sey and homozygous Pax6Sey/Pax6Sey fetuses from several strains of mice. The frequencies of the abnormal phenotypes were not related to allele type but showed variable penetrance, which was dependent on genetic background. The median nasal cartilaginous rod-like structure was present in all homozygous small eye fetuses. The Pax6Sey/Pax6Sey homozygote may provide insight into the complex gene interactions involved in eye, nasal and craniofacial morphogenesis.

Animals↗
PubMed1989

Widespread radiopacity of jaw bones in familial adenomatosis coli.

Abnormalities of jaw bones and teeth were evaluated in 37 patients with familial adenomatosis coli (FAC) by means of orthopantomography. Osteomatous radiopaque lesions were evident in 75.7 percent of FAC patients (focal type: 62.2% and wide spread type: 13.5%), odontomes in 29.7% peripheral osteomas in 13.5%, unerupted teeth in 16.2% and supernumerary unerupted teeth in 16.2%. Five of the 37 FAC patients had an unusual widespread type of radiopacity with other abnormalities. Combined abnormalities were most frequent in patients with this type in comparison with patients with the focal type. Osteomas and peripheral osteomas were revealed in this type with statistical significance. Biopsy performed in one patient revealed an osteoma. These results suggest that the multiple abnormalities seen in oral X-ray examination may predict the occult existence of familial adenomatosis coli and these widespread radiopaque lesions probably represent the most extensive manifestation of FAC.

Adolescent↗
PubMed2003

A case of Zimmermann-Laband syndrome with supernumerary teeth.

BACKGROUND: Zimmermann-Laband syndrome is a rare autosomal dominant disorder that is characterized by gingival fibromatosis, ear, nose, bone, and nail defects, and hepatosplenomegaly. METHODS: This case report describes the clinical presentation and periodontal findings in a 13-year-old female patient with previously undiagnosed Zimmermann-Laband syndrome. RESULTS: Clinical and radiographic findings and genetic counseling confirmed the diagnosis of Zimmermann-Laband syndrome. The most striking oral findings were the presence of gingival enlargement involving both the maxillary and mandibular arches, anterior open bite, non-erupted teeth, and two supernumerary teeth. Periodontal treatment consisted of gingivectomy in four quadrants. Histopathologic evaluation of excised tissue supported the diagnosis of gingival fibromatosis. The patient was referred for appropriate orthodontic treatment and genetic counseling, and has been closely followed for the earliest signs of hepatosplenomegaly. CONCLUSIONS: Dental practitioners should be alert for developmental abnormalities that may occur in patients with gingival fibromatosis as this may indicate the presence of a rare disorder like Zimmermann-Laband syndrome. A comprehensive medical history and physical systemic evaluation are essential for correct diagnosis and treatment of these cases.

Abnormalities, Multiple↗
PubMed1990

[The long-term clinical follow-up of a group of patients subjected to surgical intervention for the extraction of supernumerary impacted teeth].

A long-term clinical control carried out on 34 patients subjected to surgery for the removal of included extra teeth at the Odontostomatological Clinic of the University of Turin is reported. The patients had mostly been treated at ages between 7 and 12 followed up between 4 and 8 years later. Long-term damage, from an orthodontic viewpoint also, is not frequent and when present is not of particular importance. The operation, carried out early and with correct technique, does not cause particular damage to teeth or adjacent bone or nerve structures and does not create psychological traumas for the young patient. It is therefore advisable for the surgical removal of extra included teeth which are causing damage to adjacent structures to be programmed as early as possible so as to permit maximum functional and aesthetic recovery and to minimise to the utmost the consequences of the operation.

Child↗
PubMed2003

[Inter- and intrafamilial expression of cleidocranial dysostosis].

Cleidocranial dysplasia is a bony autosomal dominant disorder, defined by late closure of fontanels and sutures, clavicular aplasia or hypoplasia and supernumerary teeth. The aim of our study was to define the CBFA1 mutations in three families with cleidocranial dysplasia and to describe the phenotype expression within and between the families. While the mutation R225Q caused a similar phenotype within one family, the mutation G146R, located in the same domain, was the cause of a variable expression between two family members. A third mutation, R190Q was responsible for symptoms not commonly associated with this disorder. The results of our craniofacial examination are in agreement with the numerous descriptions in the literature. This study accents the difficulty in establishing a clinical based diagnosis due to the wide variability.

Cephalometry↗
PubMed1998

Characteristics of jaw growth in cleidocranial dysplasia.

OBJECTIVE: The purpose of this pilot study was to assess craniofacial morphology in young and adult individuals with cleidocranial dysplasia (CCD). DESIGN: Craniofacial morphology in young individuals (primary dentition) and in young adults was compared with control data using ratios and angles obtained from lateral head films. SETTING: The CCD individuals were referred to the Center for Craniofacial Anomalies for diagnostic workup and treatment recommendations. SUBJECTS: The sample consisted of 14 Caucasians. The inclusion criterion for the young, prepubertal group (A) was complete primary dentition, and for the adult, postpubertal group (B), the eruption of all four first molars was required. INTERVENTIONS: No treatment other than extraction or surgical removal of selected primary or supernumerary teeth was performed. RESULTS: Both groups showed significantly smaller anterior upper face height compared with controls. Group B subjects demonstrated significantly smaller face height values than the controls in the A point-nasion-B point (ANB) angle, facial axis, mandibular plane angle, palatal plane/mandibular plane angle, and gonial angle. No significant differences were found between group A individuals and the controls for these measurements. The older group had shorter anterior lower face height compared with both anterior upper face height and posterior lower face height. CONCLUSIONS: Whereas young CCD subjects showed relatively normal jaw proportions and morphology of the mandible, older CCD individuals tended to have short lower face height, acute gonial angle, anterior inclination of the mandible, and mandibular prognathism. These differences can be attributed to pronounced horizontal mandibular growth resulting from lack of vertical maxillary growth and impaired eruption of permanent teeth.

Adolescent↗
PubMed1992

Mineralized nodule formation by cultures of human dental pulp-derived fibroblasts.

Pulp fibroblasts were isolated from human deciduous and supernumerary teeth and cultured in vitro. With continued culture in normal tissue-culture medium, six pulp fibroblast strains formed cell nodules after 10-15 days. By electron microscopy the nodules had matrix vesicles, and needle-shaped crystals associated with a dense network of collagen fibrils. The crystalline material exhibited a pattern consistent with hydroxyapatite when nodules were examined by X-ray diffractometry. Furthermore, the cells showed high levels of alkaline phosphatase activity, which could be increased more than seven-fold by the addition of 1,25(OH)2D3 (5 x 10(-9)-5 x 10(-8) M). In addition to the production of type I collagen, these cells also synthesized fibronectin and osteonectin. The formation of mineralized tissue nodules by pulp cells in vitro provides a useful system for study of the pathological calcification of pulp tissues.

Alkaline Phosphatase↗
PubMed1999

Radix paramolaris and radix distomolaris in Danish permanent maxillary molars.

The School of Dentistry in Copenhagen possesses a collection of 96 human permanent maxillary molars (M sup) with a root complex, the macromorphology of which includes a facially located supernumerary root known as radix paramolaris (RP) and/or a distally located supernumerary root called radix distomolaris (RD). Systematic analysis of these teeth enabled the authors to establish precise criteria for the identification of RP and RD on M sup; 91.5% out of a total of 70 RP identified occurred on M3 sup, 7.2% on M2 sup, and 1.4% on M1 sup. The corresponding percentages for 29 RD identified were: 96.5% on M3 sup, 3.4% on M2 sup, and 0.0% on M1 sup; 50.0% of the 70 RP were separate in relation to the 2 facial root components and 31.5% non-separate; in 18.6% of the RP observed, it was impossible to establish whether or not they were separate. Corresponding frequencies for the 29 RD in relation to the distofacial and lingual root components were 41.3% separate and 37.9% non-separate; 20.7% of the roots could not be categorized. The following clinically relevant macromorphological variables regarding RP and RD were also observed: degree of separation in relation to the respective neighboring root components, degree of divergence in relation to the same macrostructures, apical bend, apical gracility, and pattern of fusion.

Denmark↗
PubMed1997

Radiographic findings in the teeth and jaws of 14- to 17-year-old Estonian schoolchildren in Tartu and Tallinn.

Panoramic radiographs were taken of 392 Estonian schoolchildren (33% boys and 67% girls) aged 14-17 years, 197 in Tartu and 195 in Tallinn. The mean number of permanent teeth was 31.5. In 14% of the children one to four teeth (excluding wisdom teeth) were missing. The frequencies of missing wisdom teeth and supernumerary teeth agreed with those in the literature, being 17% and 3%, respectively. The mean number of radiographically detected carious teeth was 1.9 in Tartu and 3.3 in Tallinn. Secondary caries was common, being found radiographically in half of the schoolchildren. Endodontic treatment had been given to 13% of the subjects in Tartu and to 46% in Tallinn, the success rates being 47% and 44%, respectively. The percentage of radiographic signs in the mandibular condyles of girls (5%) was greater than that of the boys (1%). Changes in the maxillary sinuses were found in 16% of the children. Eight odontogenic cysts, one cyst of the incisal canal, and one solitary bone cyst were found. Tumors included two odontomas, two cemento-ossifying lesions, and one osteoma in the maxillary sinus. The health status of the jaws of the Estonian schoolchildren was considered to be fairly good.

Adolescent↗
PubMed2005

Epigenetic influences may explain dental differences in monozygotic twin pairs.

BACKGROUND: Comparisons between monozygotic (MZ) co-twins have tended to focus on the similarities between their dentitions rather than differences. The aim of this study was to determine the prevalence of discordant expression for simple hypodontia and supernumerary teeth in MZ twin pairs and to explain how phenotypic differences might occur despite their similar genotypes. METHODS: Records of 278 pairs of MZ twins, including dental casts and radiographs, were examined and the prevalences of discordant expression for missing upper lateral incisors (ULI) or second premolars (PM2), and of mesiodentes, were determined. Zygosities were confirmed by comparisons of blood markers and DNA. RESULTS: There was evidence of at least one missing ULI or PM2 in 24 of the 278 MZ pairs (8.6 per cent), with 21 of these 24 pairs (87.5 per cent) showing discordant expression. Nine of the 278 MZ pairs (3.2 per cent) displayed evidence of mesiodentes, with eight of these nine pairs (88.9 per cent) being discordant. CONCLUSION: Our findings show that differences in the expression of missing or extra teeth occur often between MZ co-twins whose genetic make-up predisposes them to simple hypodontia or mesiodentes. We postulate that minor variations in epigenetic events during odontogenesis may account for these distinct differences.

Adolescent↗
PubMed2005

A review of equine dental disorders.

Equine dentistry is a very important but until recently rather neglected area of equine practice, with many horses suffering from undiagnosed, painful dental disorders. A thorough clinical examination using a full mouth speculum is a pre-requisite to performing any equine dental procedure. Common incisor disorders include: prolonged retention of deciduous incisors, supernumerary incisors and overjet--the latter usually accompanied by cheek teeth (CT) overgrowths. Overjet can be surgically corrected, but perhaps should not be in breeding animals. In younger horses, traumatically fractured incisors with pulpar exposure may survive by laying down tertiary dentine. Loss or maleruption of incisors can cause uneven occlusal wear that can affect mastication. Idiopathic fractures and apical infection of incisors are rare. The main disorder of canine teeth is the development of calculus of the lower canines, and occasionally, developmental displacements and traumatic fractures. The main indications for extraction of "wolf teeth" (Triadan 05s) are the presence of displaced or enlarged wolf teeth, or their presence in the mandible. Developmental abnormalities of the CT include; rostral positioning of the upper CT rows in relation to the lower CT rows--with resultant development of focal overgrowths on the upper 06s and the lower 11s. Displaced CT develop overgrowths on unopposed aspects of the teeth and also develop periodontal disease in the inevitable abnormal spaces (diastemata) that are present between displaced and normal teeth. Diastemata of the CT due to excessive developmental spacing between the CT or to inadequate compression of the CT rows is a common but under diagnosed problem in many horses and causes very painful periodontal disease and quidding. Supernumerary CT mainly occur at the caudal aspect of the CT rows and periodontal disease commonly occurs around these teeth. Eruption disorders of CT include prolonged retention of remnants of deciduous CT ("caps") and vertical impaction of erupting CT that may lead to large eruption cysts and possibly then to apical infections. Disorders of wear, especially enamel overgrowths ("enamel points"), are the main equine dental disorder and are believed to be largely due to the dietary alterations associated with domestication. If untreated, such disorders will eventually lead to more severe CT disorders such as shearmouth and also to widespread periodontal disease. More focal dental overgrowths will develop opposite any CT not in full opposition to their counterpart, e.g., following maleruption of or loss of a CT. Because of the great length of reserve crown in young (hypsodont) CT, apical infections usually cause infection of the supporting bones and depending on the CT involved, cause facial swellings and fistulae and possibly sinusitis. Diagnosis of apical infection requires radiography, and possibly scintigraphy and other advanced imaging techniques in some early cases. When possible, oral extraction of affected CT is advocated, because it reduces the costs and risks of general anaesthesia and has much less post-extraction sequelae than CT repulsion or buccotomy.

Animals↗
PubMed2003

Dental abnormalities, bone graft quality, and periodontal conditions in patients with unilateral cleft lip and palate at different phases of orthodontic treatment.

OBJECTIVES: To evaluate the dental and periodontal condition of patients with unilateral cleft lip and palate (UCLP) before orthodontic treatment and evaluate whether the dental and periodontal condition of these patients during and after orthodontic treatment was jeopardized by the duration of the orthodontic and surgical treatment. DESIGN: Seventy-five individuals with UCLP (52 males, 23 females), between ages 8 and 20 years, participated in a retrospective study during their final follow-up visit with regard to dental abnormalities, such as hypodontia, external root resorption, crown and root malformation, and supernumerary teeth. Alveolar bone height and periodontal attachment loss on the cleft side were also screened before or after bone grafting and at different stages of orthodontic treatment. RESULTS: Hypodontia of the lateral incisor was found in more than 50% of the patients on the cleft side. Second premolars and/or lateral incisors outside the cleft area were missing in 27.2% of the patients. In 32%, malformations of the teeth near the cleft were noticed. In general, the teeth around and in the cleft of the patients showed normal septal bone heights and a healthy periodontium. Sixty of the 75 patients received a bone graft to restore the interrupted alveolar process. In 93.3% of these patients, the cleft was grafted before the eruption of the canine. CONCLUSION: The periodontium of the teeth in and around the cleft in patients with UCLP observed during and after orthodontic treatment can cope relatively well with the long orthodontic treatment and combined surgical interventions. The children, who had not yet started treatment, also showed enough bone support and no periodontal problems of the teeth besides the cleft. Early secondary bone grafting seems to give optimal periodontal results.

Adolescent↗
PubMed2005

Standing oral extraction of cheek teeth in 100 horses (1998--2003).

REASONS FOR PERFORMING STUDY: Extraction of cheek teeth (CT) by the conventional repulsion technique requires general anaesthesia and carries a high rate of post operative complications. Consequently, an alternative method of extraction, i.e. orally in standing horses, was evaluated. HYPOTHESIS: The need for and risks of general anaesthesia could be avoided and post extraction sequelae reduced by performing extractions orally in standing horses. METHODS: One hundred mainly younger horses (median age 8, range 2-18 years) with firmly attached CT that required extraction because of apical infections, displacements, diastemata, idiopathic fractures and the presence of supernumerary CT had the affected teeth (n = 111) extracted orally under standing sedation. Follow-up information was obtained for all cases, a median of 16 months later. RESULTS: Oral extraction was successful in 89 horses and unsuccessful in 11 due to damage to the CT clinical crown (n = 9) during extraction, for behavioural reasons (n = 1) and because the apex of a partly extracted CT fell back into the alveolus following sectioning (n = 1). Predispositions to extraction-related CT fractures were present in 5 of the 9 cases, i.e. advanced dental caries (n = 2) and pre-existing 'idiopathic' fractures (n = 3). The iatrogenically fractured CT were later repulsed under standing sedation (n = 3) and under general anaesthesia (n = 6). Eighty-one of the remaining 89 horses had successful oral CT extraction with no or minimal intra- or post operative complications occurring. Post operative complications in the other 8 cases included post extraction alveolar sequestration (n = 3), alveolar sequestration and localised osteomyelitis (n = 1), localised osteomyelitis (n = 1), incorporation of alveolar packing material into alveolar granulation tissue (n = 1), and nasal discharge due to continued intranasal presence of purulent food material (n = 1) and to ongoing sinusitis (n = 1). The above sequelae were treated successfully in all cases, with general anaesthesia required in just one case. Following oral extraction, significantly (P<0.001) fewer post operative problems developed in 54 horses with apically infected CT in comparison with 71 previous cases that had repulsion of apically infected CT at our clinic. CONCLUSIONS AND POTENTIAL RELEVANCE: Oral extraction of cheek teeth is a successful technique in the majority of younger horses with firmly attached CT and greatly reduces the post operative sequelae, compared with CT repulsion. Additionally, the costs and risks of general anaesthesia are avoided. Further experience and refinement in the described protocol could potentially increase the success of this procedure and also reduce the incidence of post operative sequelae.

Analgesics, Opioid↗
PubMed1997

Another "new" form, the palagonia type of acrofacial dysostosis in a Sicilian family.

We described another previously apparently unreported form of acrofacial dysostosis (AFD) from Sicily, residing, coincidentally in the same small village as that with the recently delineated Catania AFD. In contra-distinction to the latter, the 4 patients with the Palagonia form of AFD are of normal intelligence, and instead of extensive caries have oligodontia (4), short stature (3), frizzy hair (pili torti) with aplasia cutis verticis (1), mild cutaneous syndactyly of digits 2-5 (4), attenuation of the 4th metacarpals (3/3), unilaterally cleft lip (1), and some vertebral anomalies such as a large atlas (1), mild scoliosis (1), small odontoid process, spina bifida occulta at S1 (1). Casually, this would appear to be an iceberg dominant disorder, with the proposita most severely affected. This could be an X-linked dominant, but more likely an autosomal dominant trait.

Abnormalities, Multiple↗