Investigation of prevalence and characteristics of mesiodens in a non-syndromic 11256 dental outpatients

AIM

To investigate the prevalence of mesiodens in a sample of Turkish dental patients and their distribution among genders.

PATIENTS AND METHODS

A retrospective study was performed using panoramic radiography of 11256 patients, who ranged in age from 15 to 55 years old. All data (age, sex and or syndrome) were obtained from the patient files and analyzed for mesiodens. Statistical evaluation of the presence of mesiodens related to gender was performed by the Pearson chi-squared test.

RESULTS

Mesiodens was detected in 15 subjects (0.13%). The prevalence of mesiodens for females and males was 0.20% and 0.057%, respectively (p = 0.037). The most commonly observed mesiodens was maxillary canine-like type (60%). Most of the mesiodens (67%) were found in the vertical position, followed by horizontal position (33%). The age and sex distribution, number of mesiodens per patient, shape, direction, size, and effect on permanent maxillary incisors are also presented in this study. The most common complication caused by mesiodens was midline of the permanent incisors.

CONCLUSIONS

Mesiodens is an uncommon developmental anomaly in Turkish dental patients. Early diagnosis allows the most appropriate treatment, often reducing the extent of surgery, orthodontic treatment and possible complications.

Bilateral impacted inverted mesiodens associated with dentigerous cyst

Mesiodens, the most common type of supernumerary tooth, usually results in malocclusion, poor esthetics and cyst formation. The occurrence of a dentigerous cyst around the crown of an unerupted supernumerary tooth is infrequent. We present a case of a dentigerous cyst associated with a nonsyndromic bilateral impacted inverted supernumerary tooth in a 13-year-old boy. A thorough clinical workup, including 3-D reconstruction image and histological examination confirming the features of a dentigerous cyst is presented in this report.

[Diagnosis and treatment of supernumerary teeth in the premaxillary region: a literature review]

Supernumerary teeth are more frequently located in the premaxillary region. Mesiodentes are the most common supernumerary teeth, occurring in 0.15% to 1.9% of the population. Supernumerary teeth are frequently diagnosed in a random radiograph, or after clinical symptoms appear. The majority of the complications consist of delayed or ectopic eruption of the permanent incisors. It is important for the clinician to be aware of the phenomenon and its implications, in order to diagnose it as early as possible. Extraction of the supernumerary teeth in the late mixed dentition, will minimize the chances of damaging the adjacent permanent teeth, but will reduce the possibility of spontaneous eruption of an impacted permanent incisor. Extraction in the early mixed dentition can expedite the eruption of the permanent incisor, although it may involve sedation or general anesthesia, due to lack of cooperation in the young patient. Because to the risk of uneruption of the permanent impacted incisor, exposure of the teeth and bonding a ligature or bracket at the same procedure, and providing a possibility for the dentist to make the incisor erupt after the first operation, should the incisor not erupt spontaneously. Treating these cases require the cooperation of pediatric dentist, orthodontic and dental surgeon, and sometimes the involvement of an anesthesiologist.

Association of agenesis of mandibular lateral incisors with other dental anomalies in a Japanese population

PURPOSE

The purpose of this study was to explore the association of mandibular incisor agenesis with other dental anomalies in Japanese orthodontic patients.

METHODS

A total of 52 subjects with 1 or 2 congenitally missing permanent mandibular lateral incisors (group A) were selected and divided into group 1a (26 subjects with 1 lateral incisor missing) and group 2a (26 subjects with 2 lateral incisors missing). Fifty two sex-matched subjects without agenesis of the mandibular lateral incisor served as controls (group C). Radiographs, study models, and medical and dental records were used to identify anomalies of teeth.

RESULTS

The prevalence rate of agenesis of teeth other than the mandibular lateral incisors and third molars was significantly increased in group A. Agenesis of the maxillary second premolars was significantly increased in groups 2a and A. Significantly increased prevalence rates of symmetrical tooth agenesis, with third molars excluded, and third molar agenesis were observed in group 1a and A.

CONCLUSIONS

Japanese subjects with agenesis of 1 or 2 permanent mandibular lateral incisors have significantly increased prevalence rates of other permanent tooth agenesis and symmetrical tooth agenesis.

Prevalence of teeth number anomalies in orthodontic patients

OBJECTIVES

The purpose of this study was to determine if the prevalence of teeth number anomalies (TNA) is more frequent in orthodontic patients than in common population and what is TNA clinical manifestation.

MATERIAL AND METHODS

The records of 824 orthodontic patients (average age 15.22 years) from Orthodontic Clinic of Lithuanian University of Health Sciences were analyzed. The radiographs were analyzed by trained observer who followed a pre-established protocol: general observation of the teeth including third molar, followed by a systematic analysis of the erupted and unerupted teeth number in each quadrant. Descriptive statistics were performed for the study variables. A chi-square test was used to determine the difference in the prevalence of hypodontia between the genders. A value of P<0.05 was considered significant.

RESULTS

The prevalence of hypodontia was 17.11 percent with no statistically significant difference between the genders (P>0.05). More frequently teeth were missing in the lower jaw: in the upper jaw - 10.3%, in the lower - 12.5% without statisticaly significant diference. Unilateral occurrence of dental agenesis was 1.5 times more common than bilateral occurrence. If more than one tooth was missing, usually other missing tooth was in the same group and in the same jaw. The upper and lower third molars were the most frequently missing teeth, followed by the mandibular second premolar. The prevalence of hyperdontia was 0.85 percent. Mesiodens was the most frequently found supernumerary tooth.

CONCLUSIONS

It was found, that 17.96% of orthodontic patients had teeth number anomalies. The upper and lower third molars were the most frequently missing teeth, followed by the mandibular second premolar. Hypodontia occurred more frequently than hyperdontia. Mesiodens was the most frequently found supernumerary tooth. The results confirm that TNA are more often found in orthodontic patients and these patients should be treated with multidisciplinary approach.

Treatment of an impacted supernumerary tooth using limited fixed orthodontic appliances

A 42-year and 9-month-old female with an impacted supernumerary tooth was treated with limited fixed orthodontic appliances. As seen in this case, it is possible to successfully treat impacted teeth in adults even though the most common time to treat impactions is during adolescence.

Pre-maxillary hypo-hyperdontia: report of a rare case

Agenesis of bilateral maxillary canines is very rare and mesiodens is a commonly occurring supernumerary tooth type. Concomitant occurrence of both hypodontia and hyperdontia is extremely rare and it is a condition of mixed numeric variation in the same individual. The reported prevalence of this condition ranges between 0.002% and 3.1%. The purpose of this case report is to describe a rare occurrence of hypo-hyperdontia involving agenesis of both maxillary canines, mesiodens and associated with taurodontism.

Impacted incisors associated with supernumerary teeth treated with a modified Haas appliance

Tooth impaction involves factors such as lack of space in the alveolar process, trauma, ankylosis, and mechanical barriers such as abnormal frenum, supernumerary teeth, tumors, and local cysts. When impaction occurs in the anterior region, esthetics are compromised. This report describes the successful approach to treatment for a young boy who had 2 supernumerary teeth associated with impaction of the left central and lateral permanent incisors. Treatment consisted of extracting the supernumerary teeth and performing maxillary expansion with a modified Haas appliance to guide the left central incisor into its appropriate position. The teeth erupted spontaneously after maxillary expansion and an increase in space. A fixed edgewise appliance was placed incrementally to correct the maxillary anterior tooth positions and finish the treatment. Adequate esthetics and function were achieved.

Concomitant hypodontia and hyperodontia: an analysis of nine patients

INTRODUCTION

Congenital absence of tooth germs and presence of supernumerary teeth (CHH) are anomalies which are classified as embryologically determined disorders. Both disorders can occur together (CHH), but relatively rarely.

OBJECTIVE

The aim of the present study was to present and analyze nine cases collected during the past 24 years, where congenitally missing teeth occurred with supernumerary teeth in the same patient.

MATERIALS AND METHODS

Dental records, radiographs and casts of nine patients, six boys and three girls (aged 9-29 years, mean age: 19 years) were examined. All the family members of the patients were also investigated regarding the presence of tooth disorders.

RESULTS

The boys showed hypo-hyperodontia twice as often as the girls (6:3). Congenital absence of tooth germs was more common than the presence of supernumerary teeth (25:11). CAP were not present in the other family members.

CONCLUSIONS

The full diagnosis of hypo-hyperodontia is only possible on the basis of radiographic examination, because some teeth may remain unerupted or missing. The results of this study showed that concomitant hypo-hyperodontia is rare and sex-related, with predominance of hypodontia. The genetic influence seems unclear.

Mandibular midline supernumerary tooth associated with agenesis of permanent central incisors: a diagnostic conundrum

Concomitant hypo-hyperdontia is a rare mixed numeric anomalous condition. The presence of this condition in the same area of dental arch and specifically in the mandibular anterior region is reported very infrequently. This case report presents a case of 20 years old male with congenitally missing permanent mandibular central incisors in conjunction with a mandibular midline supernumerary tooth. Only 3 cases have been documented in English literature till date. The article focuses on the review of mandibular mesiodens and the clarity regarding the usage of the terminology "mesiodens".

Impacted mandibular permanent incisors related to supernumerary teeth: a rare condition

Supernumerary permanent teeth in the mandibular incisor area are rare, and there are very few reported cases of the supernumerary teeth in the mandibular incisor area leading to impaction of incisors. A south Indian boy aged 14 presented with 3 supernumerary teeth in the mandibular right permanent incisor area resulting in impacted permanent central and lateral incisors.

Treatment of supernumerary teeth

AIM

The finding of supernumerary teeth in the oral cavity is a common occurrence, and they are interesting because of their potential to lead to aesthetic and functional alterations. When they are present in the anterior area of the maxilla, they may cause complications, such as late tooth eruption or impaction of the central incisors. They affect from 0.5 to 3.8% of the population, with men being more affected.

CASE REPORTS

This article describes two cases of impaction of the permanent maxillary left central incisor, due to the presence of a supernumerary tooth in the parasagittal area of the pre-maxilla, as well as the surgical and orthodontic procedures adopted.

Interdisciplinary management of dental anomalies: fusion and supernumerary teeth

A 16-year-old boy presented with a fused permanent maxillary left central incisor with a supplemental tooth and an additional supplemental tooth lingual to the permanent maxillary right central incisor. Following leveling, alignment, and endodontic therapy, the maxillary fused left central incisor was sectioned and the mesial portion extracted as planned. Fixed orthodontic treatment commenced after 10 days to align the maxillary anterior segment. After completion, the midline diastema was closed with veneers. This case highlights the treatment options of a fused tooth and the need for multidisciplinary planning and treatment.

[A man with pain in his upper jaw]

A 66-year-old man came to the hospital with pain in the frontal left side of his upper jaw. Pressure along the left nostril could evoke a sharp pain, which radiated upwards. The patient had already consulted several specialists. After extended clinical and radiological investigation a mesiodens was found that gave pressure on the nasopalatine nerve.

Survey of mesiodens and its characteristics in 2500 children of Davangere city, India

AIM

The aim of the present study is to report the prevalence of mesiodens and its characteristics and also to present 25 cases with 27 mesiodentes in 2500 children in Davangere city, India.

MATERIALS AND METHODS

A survey of 2500 children examined in the Department of Paediatric Dentistry was conducted. Their ages ranged from 3 to 12 years. A total of 27 mesiodentes were diagnosed in 25 patients (1%). The patients' records and radiographs were evaluated and the following variables were studied: age and sex distribution, number, shape, position, eruption status, associated dentition and arch, associated complications and anomalies.

RESULTS

In this study were enrolled 16 males and 9 females: 96.2% of the mesiodentes were seen in the maxillary arch while only one in the mandibular arch; 92.5% were observed in the permanent dentition. Most mesiodentes (92.5%) were conical in shape, and about 96.2% were placed vertical in position with only one mesiodens impacted and inverted. Of the 27 mesiodentes, 23 were u%% caused a midline diastema, 14.8% occlusal interference, 7.4% root resorption, and 3.7% had caused delayed eruption of permanent incisors. Rare anomalies like facial talon cusp were found in two mesiodentes (7.4%), and only one (3.7%) had a root anomaly.

CONCLUSION

Mesiodens may occur as an isolated finding or can be associated with other odontogenic anomalies.

An unusual triplication of primary teeth-a rare case report

Odontogenic anomalies can occur as a result of conjoining or twinning defects. This article reports the case of fusion in a 10-year-old boy in relation to the primary maxillary right incisors. Clinicoradiographic examination revealed the presence of triple teeth, ie, fusion between the maxillary right incisors along with a supernumerary tooth on the labial surface. The offending triple tooth was extracted under local anesthesia. The extracted tooth was sectioned using a hard tissue microtome at three levels-the coronal, middle root, and apical levels, respectively-and these sections were visualized under a stereomicroscope. Based on the histologic findings, a final diagnosis of fusion was confirmed. A brief review of the literature on triple teeth is also presented.

Identical unerupted maxillary incisors in monozygotic twins

Mesiodens is the most common type of supernumerary tooth found in the premaxilla. It might be discovered by the orthodontist by chance on a radiograph or as the cause of an unerupted maxillary central incisor. The genetic transmission of supernumerary and impacted teeth is poorly understood. The occurrence of identical unerupted maxillary central incisors and mesiodentes in monozygotic twins suggests that genetic factors might influence the etiology of this problem. In this case report, we discuss the treatment of unerupted maxillary permanent incisors caused by mesiodentes in monozygotic twins.

Delayed eruption of maxillary permanent central incisors due to bilateral tuberculate supernumerary teeth: case report

The purpose of this case report is to discuss the delayed eruption of permanent maxillary central incisors in a 10-year-old boy with retained primary maxillary central incisors. Radiological investigations revealed the presence of impacted bilateral supernumerary teeth and impacted permanent incisors. These supernumerary teeth were surgically removed and were diagnosed as tuberculate type. The patient is on clinical and radiological follow up for spontaneous eruption of the permanent teeth.

Multidisciplinary management of multiple maxillary anterior supernumerary teeth: a case report

Supernumerary teeth are a relatively frequent disorder of odontogenesis. They may occur alone or in multiple; be unilateral or bilateral; and appear in the maxilla, mandible, or both. Mesiodens is a supernumerary tooth in the anterior maxilla between the two central incisors. This case report describes the treatment of maxillary central incisors displaced and impacted because of the presence of four mesiodens in a 12-year-old boy. After clinical and radiographic examination, surgical removal of the mesiodens and exposure of the maxillary right central incisor was performed. This resulted in a 14-mm space between the displaced central incisors. Successively, fixed orthodontic treatment was planned with cephalometric analysis. The central incisors were brought to the occlusal plane and aligned, and the space between the incisors was redistributed. Remaining minor spaces between the incisors were closed with composite resin buildup.

Taurodontism in children with hypodontia and supernumerary teeth: a case control study

PURPOSE

The aim of the present investigation was to compare the prevalence of taurodontism in the permanent mandibular first molars of nonsyndromic children with hypodontia and supernumerary teeth with age- and gender-matched controls.

METHODS

The crown-body root ratios of the permanent first molars were determined from orthopantomograms of 83 children with hypodontia (> or =1 missing teeth) and 37 children with supernumerary teeth (> or =1 extra teeth) compared with normal case controls.

RESULTS

In children with hypodontia, only girls showed a significantly higher tendency for taurodontism compared to case controls (P=.003), while boys with hypodontia showed a similar prevalence of taurodontism as controls (P=.83). Children with multiple missing teeth were significantly more susceptible to taurodontism than children with a single missing tooth (P=.004). By contrast, the prevalence of taurodontism in children with supernumerary teeth was not significantly different from that of controls.

CONCLUSIONS

Compared to normal case controls, children with nonsyndromic hypodontia are more likely to show taurodontism of the permanent first molar teeth whereas children with nonsyndromic supernumerary teeth are not.

Determination of the optimum time for surgical removal of unerupted anterior supernumerary teeth

PURPOSE

The purpose of this study was to determine the optimum time for surgical removal of unerupted maxillary anterior supernumerary teeth.

METHODS

The study population consisted of 126 children. Stages C to H of the Demirjian classification were used to classify the dental development of the adjacent incisors. Associations were sought between the complications and the developmental stage of the adjacent maxillary incisors at the time of surgical removal. Tests of association were carried out using Fisher's exact test with a probability level of P=.05 for statistical significance.

RESULTS

Significant differences were evident: for mature maxillary central incisors (N=170); between all the proportions for root resorption, with the greatest difference being between stages E and H (P<.001); for arrested root development between stages D and E (P=.013), and D and H (P=.02); and for persistent malocclusion between stages E and G (P=.004), E and H (P=.02), F and G (P=.005), and F and H (P=.01).

CONCLUSION

Early removal of unerupted maxillary supernumerary teeth seems to be advantageous with a cutoff point of approximately 6 to 7 years old, after which more complications are expected.

[Correlations between the presence of a mesiodens and position abnormalities, diastemas, and eruption disturbances of maxillary frontal teeth]

A mesiodens is often diagnosed coincidentally during a radiological examination. However, a mesiodens may also be diagnosed in relation to a clinically identified central diastema and an eruption disturbance, or a rotation of a central incisor. In this study of a group of 162 children and adolescents varying in age from 4 to 18 years, with a mesiodens, the frequency of position abnormalities, diastemas, and eruption disturbances of the maxillary frontal teeth was registered retrospectively. One or more of these complications was diagnosed in 72% of the patients. Usually, removal of the mesiodens in children and adolescents results in spontaneous recovery of the complications. Early diagnosis and early treatment are therefore important.