Concomitant developmental dental anomalies in Chinese children with dens evaginatus

Dens evaginatus: Current treatment options

BACKGROUND

Teeth with dens evaginatus (DE) are more commonly observed in Western countries than previously. This is due to the increase in populations of patients of Asian origin, in whom DE is more common than in people of European origin. The interest in DE has also increased with the introduction of a procedure called regenerative endodontics.

CASE DESCRIPTION

A narrative review of treatment options for teeth with DE is presented, based on pulpal conditions and maturity of the teeth.

PRACTICAL IMPLICATIONS

Early recognition of teeth with DE allows for treatment choices that generally lead to good outcomes and can aid in preserving developing teeth in young patients.

The prevalence, pattern and clinical presentation of developmental dental hard-tissue anomalies in children with primary and mix dentition from Ile-Ife, Nigeria

BACKGROUND

The study of dental anomalies is important because it generates information that is important for both the anthropological and clinical management of patients. The objective of this study is to determine the prevalence and pattern of presentation of dental hard-tissue developmental anomalies in the mix dentition of children residing in Ile-Ife, a suburban region of Nigeria.

METHODS

Information on age, sex and socioeconomic status was collected from 1,036 children aged four months to 12 years through a household survey. Clinical examination was conducted to assess the presence of dental anomalies. Associations between age, sex, socioeconomic status, prevalence, and pattern of presentation of the developmental hard-tissue dental anomalies were determined.

RESULT

Two hundred and seventy six (26.6%) children had dental anomalies. Of these, 23.8% had one anomaly, 2.5% had two anomalies, and 0.3% had more than two anomalies. Of the children with anomalies, 49.3%were male, 50.7%were female, and 47.8%, 28.6% and 23.6% were children from low, middle and high socioeconomic classes, respectively. More anomalies were seen in permanent than primary dentition. Anomalies of tooth structure were most prevalent (16.1%); anomalies which affect tooth number were least prevalent (1.3%). Dens evaginatus, peg-shaped lateral, macrodontia, and talon cusp were more prevalent in the permanent dentition, and dens evaginatus peg-shaped lateral and macrodontia were more prevalent in the maxilla. There were significantly more macrodontia anomalies in males and in children of high socioeconomic status.

CONCLUSION

This large survey of dental hard-tissue anomalies found in the primary dentition and mixed dentition of children in Nigeria provides anthropological and clinical data that may aid the detection and management of dental problems of children in Nigeria.

Dens invaginatus in ancient Chinese teeth of 2,000 years ago

Dens invaginatus (DI) is a developmental anomaly of teeth. Here we observed the characteristics of DI in 517 permanent teeth from 67 ancient Chinese people using micro-computed tomography (micro-CT) scanning techniques. The individuals were excavated from Shaanxi province of China and identified to be about 2,000 years old. Four DI categories are proposed to distinguish the different types of DI. The invaginated lingual fossa is classified into three classes. The overall prevalence of DI in 67 individuals was 31.34% (21 of 67). DI was found in 25 of 517 teeth (4.83%). All affected teeth were maxillary lateral incisors. The invaginated lingual fossa (Type I DI) occurred most frequently (84%), followed by radicular grooves (Type II; 16%), while Type III and Type IV were not found in the present study. Some of fossae correspond with radicular grooves (8 of 21; 3 located at mesial, 5 were distal). The bilateral incidence of DI was 19.05%. Comparing our results to those of a retrospective survey of DI from 1873 to present, we found a higher rate of DI in the excavated teeth of Chinese individuals 2,000 years ago. The use of the micro-CT technique and ethnic origin might have contributed to the higher incidence of DI.

Supernumerary teeth: Report of four unusual cases

Supernumerary tooth denotes duplication of tooth in the normal series. It is a developmental anomaly and has been argued to arise from multiple etiologies. These teeth may remain embedded in the alveolar bone or can erupt into the oral cavity. The supernumerary tooth might cause esthetic and/or functional problems, especially if it is situated in the maxillary anterior region. Complications reported were delayed or prevented eruption of succedaneous teeth, displacement or rotation, crowding of the affected region, abnormal diastema, dilacerations, cystic formation, and sometime eruption into the nasal cavity. In this case report, four unusual cases of supernumerary teeth that resulted in varying degrees of disturbances in permanent dentition are presented. Conservative surgical intervention and light orthodontic forces were used to bring the teeth into normal position with minimal disturbance to the surrounding oral structures.

Dens evaginatus in proximal surface of mandibular premolar: a rare presentation

Dens evaginatus is a developmental anomaly that is characterized by occurrence of an extra cusp-like structure projecting from the crown portion of the tooth. Unusual extension of enamel has been found in posterior teeth as enamel pearl or as cervical enamel extensions from the cementoenamel junction or at the furcation areas. We hitherto report a case of extra enamel formation from the proximal surface of the crown in a mandibular premolar, a finding that has previously not been reported.

Ehlers-Danlos syndrome (classic type): report of a case presenting with an unusual dental anomaly

Ehlers-Danlos syndrome (EDS) comprises a group of generalised connective tissue disorders. Deficiency or alteration of the collagen present in the tissues results in some classic signs such as skin hyper extensibility, joint hypermobility, and vascular fragility. Multiple supernumerary teeth, congenitally missing teeth, and odontogenic keratocysts have been reported in some patients with EDS. To the author's knowledge, transposition of permanent canines has not previously been reported in any case of EDS. This case report presents the dental findings of a sporadic case of classic-type EDS in a 14-year-old Chinese male who had transposition of a permanent maxillary canine as well as the presence of two supernumerary premolars in the mandible.

An audit of concomitant dental anomalies with maxillary talon cusps in a group of children from Hong Kong

AIM

To investigate the prevalence of various concomitant dental anomalies in Hong Kong children with true talon cusps on the permanent maxillary incisors.

METHODS

Dental records and radiographs of a group of Hong Kong Chinese primary schoolchildren with true talon cusps (half crown height or more) on one or more permanent maxillary incisors were selected and studied retrospectively. The prevalence of various dental anomalies in this group of children was compared with that of the general population of Hong Kong Chinese children of similar age.

RESULTS

A total of 11,537 records were reviewed and 58 children with true talon cusps on one or more permanent maxillary incisors were identified. A total of 69 permanent maxillary incisors were affected, of which all except one were lateral incisors. Dens evaginatus on premolars, supernumerary teeth in the anterior maxilla, and hypodontia were found in 5 (8.6%), 5 (8.6%), and 5 (8.6%) cases respectively. The prevalence of supernumerary teeth was significantly higher in children with true talon cusps as compared with the results of two previous general studies of Chinese children of similar age (P<0.05, Fisher's exact test).

CONCLUSION

Children with true talon cusps on the permanent maxillary incisors were more frequently affected by supernumerary teeth in the anterior maxilla. Further studies with a larger sample are needed to confirm a true association.

A survey of 460 supernumerary teeth in Brazilian children and adolescents

OBJECTIVE

This study aimed to survey the demographic profile of supernumerary teeth (ST) in Brazilian children and adolescents.

METHODS

A retrospective analysis was carried out of all nonsyndromic patients with ST attended at the Pediatric Oral Surgery Service of the Universidade Federal de Minas Gerais between 1995 and 2004. Diagnosis of ST was based on clinical and radiographic examination. Chi-squared test was used for statistical analysis.

RESULTS

This study included 460 ST found in 305 patients. Radiographic assessment (32.1%) was the main care-seeking reason and also the means through which most (97.6%) permanent ST were identified. Most cases were single (63.0%), conical (44.6%), and unerupted (76.8%) ST. Most teeth were fully developed (41.3%), normally orientated (78.9%), placed in a palatal/lingual-sagittal position (84.1%), adjacent to the crown of permanent teeth (50.2%) (P < 0.001). The most frequent clinical complication was permanent teeth displacement (36.0%). Treatment was surgical removal followed by orthodontics (61.6%).

CONCLUSIONS

The demographic profile of ST herein presented will be useful to provide additional epidemiological information. A wide range of factors should be considered when evaluating ST. In addition, it is essential to detect ST as early as possible to avoid complications and to assure successful management. Even after treatment, patients must be followed up.