Assessment of risk factors and molecular biomarkers in children with supernumerary teeth: a single-center study

Nine-year Follow-up of Autotransplantation in the Maxillary Anterior Region: Replacing a Fused Incisor with a Supernumerary Tooth

The goal of tooth autotransplantation is to restore a missing tooth by using a functional tooth from the same patient. Although this procedure is gaining more recognition as a viable treatment option in dentistry, it is important to monitor and report long-term results. This case report presents the long-term follow-up of a fused maxillary central incisor that was extracted and replaced with a supernumerary tooth. Although the donor tooth displayed favorable characteristics, including an intact periodontal ligament and minimal extraoral time, which contributed to the success of the transplantation, it also presented certain disadvantages, such as having a fully developed root apex. Over a 9-year follow-up period, no clinical symptoms indicative of functional failure were observed. However, external cervical root resorption, first detected at the 6-year follow-up, progressed by the ninth year. Despite the lack of clinical symptoms, radiographic findings suggested that the root resorption was a significant concern. This case underscores the potential for long-term success of autotransplanted teeth, even in complex scenarios involving fused teeth. However, it also highlights the importance of thorough, long-term monitoring to detect complications such as root resorption. The findings suggest that, while autotransplantation can offer favorable outcomes, careful management and periodic evaluations are essential to ensure the longevity of the transplanted tooth.

A Narrative Review of the Association between Dental Abnormalities and Chemotherapy

Dental abnormalities are often detected in childhood and are reported to occur with high prevalence in patients who have undergone cancer treatment or chemotherapy. We performed a literature search of PubMed from 2004 to 2024 using the terms "dental anomaly" and "panoramic examination", and 298 potentially relevant articles were found. Thirty-one articles about dental abnormalities matched the eligibility criteria and were extracted for this review. Although the prevalence of tooth agenesis and microdontia in the general population was reported to be approximately 10% and 3%, respectively, the prevalence in patients who had undergone cancer treatment or chemotherapy was higher in all surveys, suggesting that the treatment is related to the occurrence of dental abnormalities. It is important to continue long-term follow-up with patients not only during treatment but also after the completion of treatment. Dental professionals should provide information about dental abnormalities to patients, their guardians, and medical professionals, which may lead to improvement in the quality of life of patients.

Extraction of an ectopic supernumerary tooth through nasal cavity with piezosurgery under local anesthesia: A case report

Key Clinical Message

The ectopic supernumerary teeth (ST) commonly occur in the oral cavity. Ectopic ST in the maxilla can be extracted not only through an intraoral approach but also through a nasal approach.

Abstract

The ectopic supernumerary teeth (ST) commonly occur in the oral cavity. We are reporting a case of a 23-year-old female patient with one ectopic ST in the anterior midmaxillary region. We extracted the ectopic ST under local tissue anesthesia through the nasal cavity using piezosurgery and minimally invasive extraction tools. During the operation, the adjacent structures remained intact, and the patient discomfort. This case indicates that ectopic ST in the maxilla can be extracted not only through an intraoral approach but also through a nasal approach.

Orthodontic-Surgical Management of Triple Impacted Mesiodens and Maxillary Incisors - A Case Report

Rationale

Mesiodens are supernumerary teeth located in the pre-maxilla between the two central incisors with a prevalence rate of 0.15-1.9%. An impacted mesiodens may cause delayed eruption of permanent incisors, ectopic eruption, pathological disturbances and malalignment of teeth.

Patient Concerns

The patient complained of missing upper front teeth associated with pain in the same region for two weeks.

Diagnosis

Upon clinical and radiographic examination, it was diagnosed as triple impacted mesiodens with impacted permanent maxillary central incisors.

Treatment

The clinicians in the study approached the issue by surgical removal of the impacted mesiodens and orthodontic treatment for extrusion of the impacted permanent maxillary central incisors.

Outcomes

The patient was relieved of the pre-operative concerns and followed up regularly for the eruption of permanent maxillary central incisors.

Take-away Lessons

The authors advocate the importance of timely diagnosis and proper management of such rare pathologies.

[The tooth: A marker of developmental abnormalities]

Tooth formation results from specific epithelial-mesenchymal interactions, which summarize a number of developmental processes. Tooth anomalies may thus reflect subclinical diseases of the kidney, bone and more broadly of the mineral metabolism, skin or nervous system. Odontogenesis starts from the 3rd week of intrauterine life by the odontogenic orientation of epithelial cells by a first PITX2 signal. The second phase is the acquisition of the number, shape, and position of teeth. It depends on multiple transcription and growth factors (BMP, FGF, SHH, WNT). These ecto-mesenchymal interactions guide cell migration, proliferation, apoptosis and differentiation ending in the formation of the specific dental mineralized tissues. Thus, any alteration will have consequences on the tooth structure or shape. Resulting manifestations will have to be considered in the patient phenotype and the multidisciplinary care, but also may contribute to identify the altered genetic circuity.

Salivary Diagnostics in Pediatrics and the Status of Saliva-Based Biosensors

Salivary biomarkers are increasingly being used as an alternative to diagnose and monitor the progression of various diseases due to their ease of use, on site application, non-invasiveness, and most likely improved patient compliance. Here, we highlight the role of salivary biosensors in the general population, followed by the application of saliva as a diagnostic tool in the pediatric population. We searched the literature for pediatric applications of salivary biomarkers, more specifically, in children from 0 to 18 years old. The use of those biomarkers spans autoimmune, developmental disorders, oncology, neuropsychiatry, respiratory illnesses, gastrointestinal disorders, and oral diseases. Four major applications of salivary proteins as biomarkers are: (1) dental health (caries, stress from orthodontic appliances, and gingivitis); (2) gastrointestinal conditions (eosinophilic esophagitis, acid reflux, appendicitis); (3) metabolic conditions (obesity, diabetes); and (4) respiratory conditions (asthma, allergic rhinitis, small airway inflammation, pneumonia). Genomics, metabolomics, microbiomics, proteomics, and transcriptomics, are various other classifications for biosensing based on the type of biomarkers used and reviewed here. Lastly, we describe the recent advances in pediatric biosensing applications using saliva. This work guides scientists in fabricating saliva-based biosensors by comprehensively overviewing the potential markers and techniques that can be employed.

Tooth number abnormality: from bench to bedside

Tooth number abnormality is one of the most common dental developmental diseases, which includes both tooth agenesis and supernumerary teeth. Tooth development is regulated by numerous developmental signals, such as the well-known Wnt, BMP, FGF, Shh and Eda pathways, which mediate the ongoing complex interactions between epithelium and mesenchyme. Abnormal expression of these crutial signalling during this process may eventually lead to the development of anomalies in tooth number; however, the underlying mechanisms remain elusive. In this review, we summarized the major process of tooth development, the latest progress of mechanism studies and newly reported clinical investigations of tooth number abnormality. In addition, potential treatment approaches for tooth number abnormality based on developmental biology are also discussed. This review not only provides a reference for the diagnosis and treatment of tooth number abnormality in clinical practice but also facilitates the translation of basic research to the clinical application.

Nasopalatine Duct Cyst with Impacted Inverted Mesiodens: A Rare Case Report and Literature Review

Nasopalatine duct cyst (NPDC) is a non-odontogenic, developmental epithelial cyst that accounts for 1% of maxillary cysts. It often arises due to the spontaneous proliferation of the epithelial tissue remnants, although trauma, bacterial infection, and mucous retention may also trigger the proliferation. Owing to its slow-growing, asymptomatic nature, the cyst is often discovered as an accidental finding during routine clinical and radiographic examinations. However, the majority of cases present as a tiny, asymptomatic swelling just posterior to the palatine papillae. Radiographically, it appears as a well-defined oval or round radiolucency in the maxillary anterior teeth region and should be differentially diagnosed with inflammatory periapical lesions and a wide incisive foramen. A pulp vitality test is essential to rule out lesions of endodontic origin. Microscopically, NPDCs display a mixed pattern of the epithelial lining and exhibit neurovascular bundles (small to medium-sized nerves, arteries, and veins), and minor salivary glands in the cystic connective tissue, a distinctive feature facilitating a confirmatory diagnosis. Enucleation and marsupialization remain the treatment of choice. NPDC associated with impacted mesiodens is an extremely uncommon entity. A comprehensive literature search carried out on the PubMed and Google Scholar search engines revealed only three cases of NPDC with impacted mesiodens to date. The purpose of this study is to report an extremely rare case of NPDC associated with an impacted inverted mesiodens in a 19-year-old male patient who presented with an asymptomatic swelling in the maxillary anterior teeth region. To the best of our knowledge, this is only the fourth reported case of NPDC with impacted mesiodens.

Genetic, Epigenetic and Environmental Factors Influence the Phenotype of Tooth Number, Size and Shape: Anterior Maxillary Supernumeraries and the Morphology of Mandibular Incisors

The aim of this study is to investigate whether the genetic, epigenetic and environmental factors that give rise to supernumeraries in the maxillary incisor region and larger dimensions of the adjacent maxillary incisors are also associated with variations in the morphology of the mandibular incisors. If so, this would contribute to understanding the distribution and interactions of factors during dental development and how these can be modelled. The sample consisted of 34 patients with supernumerary teeth in the maxillary anterior region, matched for gender, age and White Caucasian ethnicity with 34 control subjects. The average ages of the supernumerary and control groups were 12.8 and 12.2 years, respectively. Study models of all subjects were constructed and imaged using a previously validated system. Using custom software, each of the mandibular incisor teeth were measured to obtain 17 parameters from the labial view and 17 from the occlusal view. Principal component analysis (PCA) was used to summarize the measurements into a smaller set representing distinct features of the clinical crowns, followed by a comparison between the supernumerary and control groups using 2-way ANOVA. Seven factors of tooth size of the mandibular central incisors and six factors of the mandibular lateral incisors were identified as major features of the clinical crowns. All parameters of both mandibular incisors were greater in the supernumerary group than in the control, with three of these, located in the incisal and cervical regions of the mandibular lateral incisors, being statistically significantly larger. The findings of this study indicate that the aetiological factors associated with supernumerary teeth in the maxillary anterior region also affect tooth crown dimensions of mandibular incisors. This new evidence enhances several models of the interactions of genetic, epigenetic and environmental components of dental development and supports a multi-model approach to increase understanding of this process and its variations.