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Fusion of the permanent molars is a relatively uncommon dental anomaly. In this article, a case of fusion of a symptomatic mandibular third molar with a supernumerary fourth molar is reported. The differentiation with other forms of 'double teeth' is explained and the possibility of the initial panoramic radiograph view being misinterpreted as an artefact is discussed.
INTRODUCTION: A review of the literature relating to supernumerary teeth is presented along with a survey of 152 cases. METHODS: The study population consisted of 152 children who visited the department of Paediatric Dentistry at the Jordan University Hospital. Patients ranged in age from 5 to 15 years. Supernumeraries were detected by clinical examination and radiographs. RESULTS: Males were affected more than females with a sex ratio of 2.2 : 1. Seventy-seven percent of the patients had one supernumerary tooth, 18.4% had double teeth, and 4.6% had three or more supernumeraries. Ninety percent of the supernumerary teeth occurred in the premaxilla, of which 92.8% were in the central incisor region and of these latter 25% were located in the midline. The other 10.4% of the supernumeraries were located in the premolar, canine, molar, and lower central incisor regions. Two cases were of non-syndrome supernumerary teeth. Seventy-five percent of the supernumeraries were conical, 83.1% were in the normal vertical position and 26.5% were erupted. Conical-shaped supernumerary teeth had a significantly higher rate of eruption compared to the tuberculate type.
The purpose of this report was to describe the radiographic findings of 6 uncommon situations of supernumerary teeth in a Brazilian pediatric dentistry and orthodontic clinic. Six cases of supernumerary teeth were diagnosed in association with other dental anomalies such as number, position, and form. The supernumeraries were asymptomatic and were detected through routine radiographic examination. The importance of routine radiographic examination is emphasized for the correct diagnosis of supernumerary teeth, and avoidance of associated complications.
The purpose of the study was to investigate primary and permanent tooth anomalies of 5-year-old children in Taranaki; 1,680 children were examined by school dental therapists, and the presence of hypodontia, hyperdontia, and double teeth recorded. Panoramic radiographs were taken of those children with anomalies of the primary teeth. Anomalies of the primary teeth were detected in 23 children (1.4 percent). Six children (3 boys and 3 girls) had hypodontia, 3 children (2 boys and 1 girl) had a supernumerary tooth, and 14 children (9 boys and 5 girls) had double teeth. Six of the affected teeth (in 4 boys and 2 girls) were diagnosed as fusion, and 8 (5 boys and 3 girls) as gemination. The panoramic radiographs of the 23 children with anomalies of the primary teeth revealed that 14 (60.9 percent) also had anomalies of the succedaneous permanent teeth. Children with hypodontia in the primary dentition all had corresponding permanent teeth missing. In all but three children, only one tooth was involved. Nineteen of the 30 primary teeth (63 percent) and 12 of the 15 permanent teeth (80 percent) affected by hypodontia, gemination, or fusion were lateral incisors. For each type of anomaly, boys were affected more often than girls. The results of the study confirm that, when there is hypodontia, hyperdontia, gemination, or fusion of teeth in the primary dentition, there is an increased likelihood of anomalies of the succedaneous permanent teeth. Because of this close relationship between the dentitions, early identification of anomalies of the primary teeth can allow the dentist to investigate further and plan for treatment at the appropriate time.
Double teeth are not really rare, but it is still enigmatic why and how they develop. Based upon the clinical, morphological and anatomical appearance and the number of teeth in mouths with double teeth, the double teeth are labelled as products of 'fusion' and 'clefting', but the criteria to attach such etiological names are lacking. It is assumed that heredity is involved in the development of double teeth. Therefore it is attempted to explain why only one of a homozygotic twin had a double tooth.
The consequences of disregarding the periodontal tissues through improper restoration design are illustrated. A geminated central incisor is aesthetically restored with a porcelain labial margin ceramometal crown and its normal counterpart with a porcelain laminate veneer to equalize proportions of the two teeth. Prior to restoration, the perio-prosthetic interdisciplinary approach is described in rehabilitation of the damaged periodontal tissues.
Prevalence of anomalies of deciduous teeth has been analyzed in the general population of Zagreb preschool children. The sample comprised 2,987 children from 3 to 6 years of age (1,582 boys and 1,405 girls). Hypodontia was found in 0.47%, hyperdontia in 0.10%, and double teeth in 0.43% of total sample. Total prevalence of all anomalies in the sample was 1.0%. The sample for the analysis of permanent dentition has been enlarged with the clinical sample of children having the same anomalies and comprised 48 children. In all children with anomalies of primary teeth the orthopantomograms were taken and the status of permanent dentition was analyzed. In children with hypodontia in primary dentition hypodontia of permanent teeth was found in 100% of cases. Patients with hyperdontia of primary teeth displayed anomalies in permanent dentition in 85.7%, while in children with primary double teeth, anomalies of permanent teeth were present in 61.1% of cases. Missing deciduous teeth were found in both jaws in only 8.7% of cases, and in 34.8% in permanent dentition. Symmetrical occurrence of hypodontia of primary teeth (i.e. in both sides of jaws) was significantly higher in boys (56.3%) than in girls (28.6%). In permanent dentition symmetrical occurrence of hypodontia was significantly higher than in primary dentition (81.3% in boys and 57.1% in girls). The most frequently missing primary teeth were maxillary lateral incisors (48.8%) followed by mandibular central incisors (34.9%). Hyperdontia of primary teeth has been found only in boys, and it related only to the maxillary lateral incisors. Anomalies of deciduous teeth show a high degree of association with the finding in the permanent dentition.(ABSTRACT TRUNCATED AT 250 WORDS)
Ectopic dental eruption into the nasal cavity is a rare phenomenon with an obscure cause. A case of an early erupted intranasal tooth in a patient with a repaired cleft lip, an unrepaired cleft alveolus, and fusion of lower incisor teeth is reported. Only three similar cases of intranasal teeth in cleft patients have been reported in the literature. The unusual features in the present case are highlighted.
An unusual case of fusion between primary central incisors, lateral incisors, and a supernumerary tooth is reported. The fusion was at the enamel and cementum only, and the tooth was extracted.
Prevalence of double teeth in primary dentition of 0.5% was established in the sample of 2.987 preschool children of Zagreb. Between children with double teeth 60% were female and 40% males. Fusion ocurred in 66.7 percent and germination in 33.3 percent in the sample of children having double teeth. In all children with double teeth orthopantomograms were taken. Analysis of radiographs revealed anomalies of permanent successors in 53.3 percent of all children with double primary teeth. In children with germination in primary dentition anomalies of permanent teeth were present in 20 percent (hyperdontia in all cases), while fusion of deciduous teeth was accompanied by abnormal finding (hypodontia) in permanent dentition in 70 percent. Obtained results pointed out to the need of distinction between type of double teeth in primary dentition, i.e. between fusion and germination because chance of lacking the permanent successors is considerably dependent on the type of anomaly.
AIM: Gemination or fusion is a rare occurrence in the mandibular posterior teeth. Endodontic treatment of these teeth needs special care and attention to the bizarre anatomy. The aim of this article is to describe the problems encountered and the strategy in treating such cases. CASE REPORT: Two cases of complex endodontic treatment of fused/geminated teeth are presented. The first is an 11-year-old girl with an anomalous 'double' first mandibular molar and premolar diagnosed as having necrotic pulp with chronic apical abscess of endodontic origin; the second is a 16-year-old boy with 'double' second and supernumerary mandibular molars, who was diagnosed with irreversible pulpitis. Both cases were treated successfully in multiple appointments. The common features and treatment modalities are discussed. KEY LEARNING POINTS: Failure to diagnose fused/geminated teeth leads to misdiagnosis and a treatment plan that could cause permanent damage and tooth loss. Generally, there is communication between root canal systems of fused/geminated teeth which should be treated as one entity. Use of magnification is an important aid during treatment.
Ellis-van Creveld syndrome, or chondroectodermal dysplasia, is an autosomal recessive disorder with characteristic clinical manifestations. Its incidence in the general population is low. The oral manifestations of Ellis-van Creveld are found in soft tissues and teeth, but the dental literature on the subject is scarce. In the last 20 years, 5 cases of Ellis-van Creveld syndrome have been followed at the Pediatric Dentistry Service of the Hospital Sant Joan de Déu, Barcelona. The present study describes the constant and variable oral findings in these patients, which play an important role in the diagnosis criteria for the syndrome. The presence of a great variety of oral manifestations such as fusion of the upper lip to the gingival margin, presence of multiple frenula, abnormally shaped and microdontic teeth, and congenitally missing teeth requires multidisciplinary dental treatment, with consideration for the high incidence of cardiac defects in these patients.
A dental an omaly causing complaints is described which was cleared up in the course of focus examination. The successful removal and identification of the surplus small molar dens geminatum after clinical and x-ray examinations are reported on.
Double teeth or joined teeth have been described under several different terms and the terminology is often confusing. There are several ways in which union of teeth can occur and the terms that are commonly used to describe the condition are fusion and gemination. Although primary double teeth themselves may be regarded as harmless anomalies, its presence can cause some abnormalities to occur in the permanent dentition. Therefore, early diagnosis of the anomaly is of considerable importance.
The aim of this study was to determine the prevalence of hypodontia, hyperodontia, and double formation of primary teeth in Icelandic children in the dental stage DS 02 (primary dentition complete). The study group comprised 927 children (498 boys and 429 girls). This was about 9% of all children aged 0-83 months in Reykjavik at the time of the registration of these anomalies, during the winter of 1978-1979. The children included those presenting for regular examinations in two health centers, children from three kindergartens, and seven pre-school classes from two schools in Reykjavik. Of these children 61.9% were selected for this study as they proved to be in dental stage DS 02 (primary teeth fully erupted). The prevalences were hypodontia, 0.5%; hyperodontia, 0.5%; and double formation, 0.7%. Comparison was made with earlier results from Iceland and with results from several other nations.
PURPOSE: Radiographs play an important role in the diagnosis of anomalies and pathology of the oral structures of young children as well as in the interception and management of developmental problems in the dentition. The occlusal film, commonly indicated in the young child, is a helpful tool in establishing a baseline and in revealing certain region-specific dental concerns in a timely fashion. The purpose of this retrospective study was to perform a comprehensive examination of maxillary occlusal radiographs in a clinical pediatric population and to determine the prevalence of dental anomalies and pathology in the premaxilla in children between 3 and 5 years of age. METHODS: Radiographs of healthy preschool children (236 males and 264 females), who received their initial examination at the University of Texas-Houston Pediatric Dentistry Graduate Clinic during 1997 and 1998, were reviewed independently by two pediatric dentists, using a 2X magnifying lens and a standard dental light box. Interexaminer discrepancies were resolved by consultation and mutual agreement. RESULTS: Ninety-two (18%) showed no evidence of dental caries, restorations, current pathological conditions, or other anomalies. Frequencies of anomalies such as congenitally missing and supernumerary teeth were consistent with other reports. CONCLUSIONS: These observations emphasize the importance of obtaining intraoral radiographs on preschool children who are in apparent good dental health.
There is now considerable evidence to support the theory that heredity is the origin of this anomaly. The condition in one of the twins described here was the mirror image of the condition of the other.
Dental anomalies can be classified in different groups: anomalies of volume, anomalies of number, anomalies of form, anomalies of position and anomalies by union. Of the latter, we distinguish between fusion, alveolus-dental gemination, concrescence, coalescence and anchylosis. Gemination is more frequent in the anterior teeth, although it can also affect the bicuspids and molars, being an anomaly of infrequent union (prevalence 0.5%). We present the case of a young male patient age 19, without medical antecedents of interest, that goes to consultation for repeated inflammatory accidents at level of the inferior left retromolar area. These episodes are caused by a semi-impacted inferior third molar that is fused to a supernumerary fourth molar, sharing its roots, crown, pulp chambers and canals. After the appropriate radiologic study and suitable planning, the semi-impacted third molar was extracted under local anaesthesia and without any other complications during or after the operation.