Endodontic Treatment for a Mesiodens: A Case Report

Mesiodens are common supernumerary teeth that prominently erupt in the midline between the maxillary central incisors. If two or more mesiodens are present, they are termed mesiodentes, indicating the presence of multiple supernumerary teeth in the midline. These often cause aesthetic disharmony in the anterior teeth due to their abnormal position, leading to extraction in most cases and resulting in midline diastema when impacted or partially erupted. This case is uncommon, as the patient expressed a desire to preserve their mesiodens as a distinctive feature, considering them a familial trait worth retaining. The family history of the patient revealed the occurrence of mesiodens in three generations, highlighting a hereditary pattern of supernumerary teeth within the family. The endodontic therapy involving root canal treatment successfully treated the mesiodens, alleviating pain, and preserving them as desired.

Three-Dimensional Evaluation of Bifid Condyle by Cone-Beam Computed Tomography

Bifid condyle is a rare developmental anomaly that results from an obstructed blood supply during its development. Bifid condyle is more often unilateral, although bilateral. A case of a bifid condyle is evaluated three-dimensionally in three orthogonal planes namely coronal, sagittal and axial sections. The etiology, clinical features, diagnostic, non-surgical and surgical treatment modalities of bifid condyle are discussed.

Combining globally search for a regular expression and print matching lines with bibliographic monitoring of genomic database improves diagnosis

Introduction: Exome sequencing has a diagnostic yield ranging from 25% to 70% in rare diseases and regularly implicates genes in novel disorders. Retrospective data reanalysis has demonstrated strong efficacy in improving diagnosis, but poses organizational difficulties for clinical laboratories. Patients and methods: We applied a reanalysis strategy based on intensive prospective bibliographic monitoring along with direct application of the GREP command-line tool (to "globally search for a regular expression and print matching lines") in a large ES database. For 18 months, we submitted the same five keywords of interest [(intellectual disability, (neuro)developmental delay, and (neuro)developmental disorder)] to PubMed on a daily basis to identify recently published novel disease-gene associations or new phenotypes in genes already implicated in human pathology. We used the Linux GREP tool and an in-house script to collect all variants of these genes from our 5,459 exome database. Results: After GREP queries and variant filtration, we identified 128 genes of interest and collected 56 candidate variants from 53 individuals. We confirmed causal diagnosis for 19/128 genes (15%) in 21 individuals and identified variants of unknown significance for 19/128 genes (15%) in 23 individuals. Altogether, GREP queries for only 128 genes over a period of 18 months permitted a causal diagnosis to be established in 21/2875 undiagnosed affected probands (0.7%). Conclusion: The GREP query strategy is efficient and less tedious than complete periodic reanalysis. It is an interesting reanalysis strategy to improve diagnosis.

Morphological Diversity of Permanent Maxillary Lateral Incisors and Their Impact on Aesthetics and Function in Orthodontically Treated Patients

The aim of this study was to determine the frequency of different crown shapes and associated dental anomalies of the permanent maxillary lateral incisor (PMLI) and their impact on aesthetics and occlusion (function) in orthodontically treated patients. Materials and Methods: The records of 372 subjects, which consisting of study casts, panoramic radiographs and anamnestic data, were investigated for crown shape and associated dental anomalies of PMLI and potential dental treatment to achieve satisfactory aesthetics and function. Descriptive statistics, including means, standard deviations and percentages for the observed variables, were calculated. Data were analyzed using the chi-square test. p-Values < 0.05 were considered as statistically significant. Results: The results showed that the most common crown shapes of PMLI were trapezoidal-shaped (59.8%), followed by central incisor-shaped (26.7%), canine-shaped (11.2%) and peg-shaped (2.3%), without statistically significant difference between genders. Developmental anomalies were found in 86 (11.6%) PMLI. All subjects with developmental anomalies were included in orthodontic treatment, and 91.2% of them need interdisciplinary treatment to achieve satisfactory aesthetics and function. Conclusions: The morphological diversity and developmental anomalies of the PMLI may affect aesthetics and function and should be considered in treatment planning.

Monsters reveal patterns: bifurcated annelids and their implications for the study of development and evolution

During recent decades, the study of anatomical anomalies has been of great relevance for research on development and its evolution. Yet most animal groups have never been studied under this perspective. In annelids, one of the most common and remarkable anomalies is anteroposterior axis bifurcation, that is animals that have two or more heads and/or tails. Bifurcated annelids were first described in the 18th century and have been occasionally reported since then. However, these animals have rarely been considered other than curiosities, one-off anomalies, or monsters, and a condensed but comprehensive analysis of this phenomenon is lacking. Such an analysis of the existing knowledge is necessary for addressing the different patterns of annelid bifurcation, as well as to understand possible developmental mechanisms behind them and their evolution. In this review we summarize reports of annelid bifurcation published during the last 275 years and the wide variety of anatomies they present. Our survey reveals bifurcation as a widespread phenomenon found all over the annelid tree. Moreover, it also shows that bifurcations can be classified into different types according to anatomy (lateral versus dorsoventral) or developmental origin (embryonic versus postembryonic, the latter occurring in relation to regeneration, reproduction, or growth). Regarding embryos, three different types of bifurcation can be found: conjoined twins (in clitellates); Janus embryos (two posterior ends with a single head which shows duplicated structures); and duplicitas cruciata embryos (with anterior and posterior bifurcation with a 90° rotation). In adults, we show that while lateral bifurcation can result in well-integrated phenotypes, dorsoventral bifurcation cannot since it requires the discontinuity of at least some internal organs. The relevance of this distinction is highlighted in the case of the Ribbon Clade, a group of syllid annelids in which some species reproduce by collateral and successive gemmiparity (which involves dorsoventral bifurcation), while others grow by branching laterally. Although most known cases of bifurcation came from accidental findings in the wild or were unintentionally produced, experimental studies resulting in the induction of bifurcation of both embryos and adults are also reviewed. In embryos, these experimental studies show how mechanical or chemical disruption of the zygote can result in bifurcation. In adults, the ventral nervous system and the digestive tract seem to play a role in the induction of bifurcation. Based on the reviewed evidence, we argue that the long-forgotten study of annelid developmental anomalies should be incorporated into the growing field of annelid EvoDevo and examined with modern techniques and perspectives.

Ruptured Rudimentary Horn Pregnancy: Delayed Diagnosis

Developmental anomalies of the genital tract result from defective fusion and absorption of various parts of Mullerian ducts in fetal life. Rudimentary horn pregnancy is a rare occurrence of one in 76,000 and one in 160,000. We present a case of a 24-year-old primigravida with ruptured rudimentary horn pregnancy initially managed in the line of an intrauterine pregnancy with severe anemia. Hemodynamic instability made us suspect ruptured rudimentary horn pregnancy and lifesaving laparotomy was performed for the same. A 1.5-liter hemoperitoneum was encountered with a right ruptured rudimentary horn. Multiple adhesions were present with necrotic tissue adherent and clumped together as tubo ovarian mass. Resection of the rudimentary horn was performed. We report this case to emphasize the need to consider rare uterine anomalies as a possibility in patients presenting with acute abdomen in early pregnancy. Obstetricians should consider these rare entities in the differential diagnosis to provide efficient management of these cases.

Dentition Anomalies in Nesophontidae (Lipotyphla, Mammalia) from the Pleistocene of Cuba

The study of the remains of Nesophontes micrus Allen, 1917 and N. major Arredondo, 1970 from El Abrón Cave (Republic of Cuba, Pinar del Río Province, Late Pleistocene) allowed to establish for the first time anomalies of the dentition in Nesophontidae. Failures of eruption of teeth (impaction of I₃ in N. micrus, retention or impaction of P₂ in N. major), as well as malformations (aberrant I₃ in N. micrus, P₂ and P₄ in N. major), are the developmental abnormalities. The absence of P₂ and M₂ in combination with reossification of their alveoli in N. major is caused by dental injuries and diseases.

Comparison of inherited neural tube defects in companion animals and livestock

Neural tube defects (NTDs) are congenital malformations resulting from the improper or incomplete closure of the neural tube during embryonic development. A number of similar malformations of the protective coverings surrounding the central nervous system are also often included under this umbrella term, which may not strictly fit this definition. A range of NTD phenotypes exist and have been reported in humans and a wide range of domestic and livestock species. In the veterinary literature, these include cases of anencephaly, encephalocele, dermoid sinus, spina bifida, and craniorachischisis. While environmental factors have a role, genetic predisposition may account for a significant part of the risk of NTDs in these animal cases. Studies of laboratory model species (fish, birds, amphibians, and rodents) have been instrumental in improving our understanding of the neurulation process. In mice, over 200 genes that may be involved in this process have been identified and variant phenotypes investigated. Like laboratory mouse models, domestic animals and livestock species display a wide range of NTD phenotypes. They remain, however, a largely underutilized population and could complement already established laboratory models. Here we review reports of NTDs in companion animals and livestock, and compare these to other animal species and human cases. We aim to highlight the potential of nonlaboratory animal models for mutation discovery as well as general insights into the mechanisms of neurulation and the development of NTDs.

Stafne's bone defects from Spain: report of four cases and brief archaeological literature review

OBJECTIVE

To present for the first time in the north-western Spanish osteological record prevalence data on Stafne's bone defect, to compare the results with those reported by other studies, and to increase the dataset for future inter-population comparisons.

MATERIAL

In all, 143 complete adult mandibles recovered from two necropolises were analyzed (n = 118, San Juan Bautista of Guardo, Palencia province, 16th-19th centuries; n = 25, Plaza del Grano, city of León, 12th-15th centuries).

METHODS

Differential diagnosis of the lesions was made through macroscopic and Computed Tomography (CT) analyses.

RESULTS

Four mandibles (n = 3, Guardo, Palencia; n = 1, León) presented bone cavities on the lingual aspect of the mandible below the mylohyoid channel, between the first molar and the angle of the mandible. CT scan showed unilateral well-defined unilocular oval/round concavities in the lingual mandibular cortex below the inferior alveolar canal. Neither the macroscopic nor the radiological characteristics are compatible with inflammatory or malignant pathology, favoring instead a diagnosis of Stafne's bone defect.

CONCLUSIONS

Four cases of Stafne's defects are added to the bioarchaeological inventory. The calculated prevalence is 2.54% for San Juan Bautista and 4% for Plaza del Grano, values in close agreement to those presented in other osteoarchaeological studies.

SIGNIFICANCE

The identification of all examples of Stafne's bone defects in past populations will contribute to elucidate which factors may be responsible for this trait's cultural, ecological, temporal, and geographical patterning.

LIMITATIONS

The skeletal samples are relatively small.

SUGGESTIONS FOR FURTHER RESEARCH

In future investigations of Stafne's bone defects, CT analysis of dry bone specimens is recommended, whenever possible.

Prevalence of Common Clinically Manifested Developmental Anomalies of the Oral Cavity Among Adults - An Epidemiological Study in a South Indian Population

Introduction

Developmental anomalies are malformation which arises due to the disturbances during the development of the organs. Although there have been many studies that have described the prevalence of these anomalies in the oral cavity, none have specified the prevalence of clinically manifested anomalies and their distribution between gender.

Materials and methods

In this study, 500 patients aged 18 to 50 years were screened for clinically manifested developmental anomalies. These were then divided based on age, sex, and jaws, which were then analyzed using a chi-square test and tabulated.

Results

We detected anomalies in 12.2% of the study population. Supernumerary teeth were the most prevalent anomaly detected (4.25%). The frequency of developmental anomalies was higher in men (57.1%).

Conclusions

Supernumerary teeth were the most widely recognized anomaly. Other anomalies identified were related to the shape and size of teeth. These anomalies can lead to severe orofacial problems. Therefore, proper care of these anomalies should be taken.

Bi-allelic Variations of SMO in Humans Cause a Broad Spectrum of Developmental Anomalies Due to Abnormal Hedgehog Signaling

The evolutionarily conserved hedgehog (Hh) pathway is essential for organogenesis and plays critical roles in postnatal tissue maintenance and renewal. A unique feature of the vertebrate Hh pathway is that signal transduction requires the primary cilium (PC) where major pathway components are dynamically enriched. These factors include smoothened (SMO) and patched, which constitute the core reception system for sonic hedgehog (SHH) as well as GLI transcription factors, the key mediators of the pathway. Here, we report bi-allelic loss-of-function variations in SMO in seven individuals from five independent families; these variations cause a wide phenotypic spectrum of developmental anomalies affecting the brain (hypothalamic hamartoma and microcephaly), heart (atrioventricular septal defect), skeleton (postaxial polydactyly, narrow chest, and shortening of long bones), and enteric nervous system (aganglionosis). Cells derived from affected individuals showed normal ciliogenesis but severely altered Hh-signal transduction as a result of either altered PC trafficking or abnormal activation of the pathway downstream of SMO. In addition, Hh-independent GLI2 accumulation at the PC tip in cells from the affected individuals suggests a potential function of SMO in regulating basal ciliary trafficking of GLI2 when the pathway is off. Thus, loss of SMO function results in abnormal PC dynamics of key components of the Hh signaling pathway and leads to a large continuum of malformations in humans.

Cervical ribs in human early life: morphological variability and first identification as a morbidity criterion in a past population

Despite the medical literature on supernumerary cervical ribs in extant adult samples, little is known about their development and occurrence in early infancy. The documentation of cervical ribs in modern samples of fetuses and neonates is indeed affected by ethical as well as technical limitations. The aim of the present study was to investigate their frequencies and morphological variability in the first known archaeological collection of very young children with this anatomical variant. The study sample comes from the 8B-51 necropolis on the Saï island (Sudan) and dates to the Classic Kerma Period (XVIIIe-XVIe centuries BC). It consists of 64 individuals deceased between 24 weeks of amenorrhoea and 2 years of age. Bilateral or unilateral cervical ribs were found in 27 individuals. A total of 43 cervical ribs were identified, 38 of which are fully preserved. According to these observations, at least 42% of the individuals have unilateral or bilateral cervical ribs, with an average maximum length of < 1 cm. This frequency is very high compared to those observed in contemporary adult samples (up to 3%). First, the comparison of our results with biological and genetic research demonstrating the link between the occurrence of cervical ribs and a reduced chance of survival during infancy allows the first identification of this trait as an indicator of morbidity in an archaeological collection, a morbidity to which a genetic homogeneity or even endogamy could contribute. Second, the number of ribs studied makes it possible to propose a morphological classification based on the general shape and the shape of the articular facets, classification that can be used tos refine the analyses of the trait in future samples.

Diseases of the oral cavity in light of the newest epigenetic research: Possible implications for stomatology

Epigenetics is the study of inheritable changes in gene expression without changes in the underlying deoxyribonucleic acid (DNA) sequence. The main mechanisms of epigenetic regulation include DNA methylation, modifications in histones, and micro-ribonucleic acids (miRNA). Recent research evidence has shown that environmental and lifestyle factors dynamically interact with the genome, influencing epigenetic changes, from development to the later stages of life. This happens across a spectrum, from physiological to pathological conditions, such as genetic defects, developmental disorders, infectious or inflammatory processes, cancers, mental disorders, and substance abuse. Epigenetic studies have been conducted in various medical disciplines (e.g., oncology, internal medicine or psychiatry), adding valuable insight to standard medical approaches. However, in stomatology, epigenetic research is still in its infancy; thus, this review is aimed at presenting the role of epigenetic mechanisms in diseases of the oral cavity, including periodontal diseases, caries, developmental anomalies, and oral carcinoma. In addition, this paper reveals new insights into epigenetic biomarkers that can be helpful in the detection, early diagnosis, prognosis, and treatment of different oral diseases. Moreover, this review is focused on the possible clinical implications (diagnostic and therapeutic) of epigenetics, in the form of some noninvasive methods that can possibly be used in the future for the screening, work-up, outcome prediction and novel treatments of some dental diseases. Finally, this paper highlights that an epigenetic approach can be useful for designing novel interventions that will improve the management of oral malignancies or developmental abnormalities.

Diagnostic exome sequencing identifies GLI2 haploinsufficiency and chromosome 20 uniparental disomy in a patient with developmental anomalies

Clinical diagnostic exome sequencing (DES) is currently infrequently used for detecting uniparental disomy (UPD). We present a patient with a dual diagnosis of GLI2 haploinsufficiency as well as UPD of chromosome 20, both identified through DES. We therefore recommend routine UPD analysis during DES to identify this genetic aberration.

Transposition of Mandibular Molars in a Dog

Tooth transposition is a rare anomaly resulting in the interchanged position of 2 permanent teeth. Etiology of tooth transposition is unclear. In human dentistry, multiple influences are described, and there is strong evidence of a genetic basis. This is the first reported case of tooth transposition in a dog.

Functional Dysregulation of CDC42 Causes Diverse Developmental Phenotypes

Exome sequencing has markedly enhanced the discovery of genes implicated in Mendelian disorders, particularly for individuals in whom a known clinical entity could not be assigned. This has led to the recognition that phenotypic heterogeneity resulting from allelic mutations occurs more commonly than previously appreciated. Here, we report that missense variants in CDC42, a gene encoding a small GTPase functioning as an intracellular signaling node, underlie a clinically heterogeneous group of phenotypes characterized by variable growth dysregulation, facial dysmorphism, and neurodevelopmental, immunological, and hematological anomalies, including a phenotype resembling Noonan syndrome, a developmental disorder caused by dysregulated RAS signaling. In silico, in vitro, and in vivo analyses demonstrate that mutations variably perturb CDC42 function by altering the switch between the active and inactive states of the GTPase and/or affecting CDC42 interaction with effectors, and differentially disturb cellular and developmental processes. These findings reveal the remarkably variable impact that dominantly acting CDC42 mutations have on cell function and development, creating challenges in syndrome definition, and exemplify the importance of functional profiling for syndrome recognition and delineation.

Analysis of the origin of birth defects in pregnant women from the Kujawy-Pomerania Region

OBJECTIVES

The aim of the study was to analyze the origin of birth defects in pregnant women from the Kujawy-Pomerania Region, and to identify factors affecting the formation of developmental disorders in the Province.

MATERIAL AND METHODS

The correlation between maternal age and fetal defects was investigated. We also attempted to determine whether environmental or family factors play a role in the formation of fetal abnormalities.

RESULTS

The analysis confirmed a correlation between the incidence of chromosomal aberrations and maternal age.

CONCLUSIONS

Higher rates of neural tube defects were observed in fetuses born to mothers who did not take folic acid. The influence of other factors on developmental anomalies was not confirmed.

Absent circle of Willis with vascular pollarding in an adult with colpocephaly: A developmental perspective

Absent circle of Willis (COW) has been described in cases of severe forms of cerebral developmental anomalies such as alobar prosencephaly. However, there are no reports of absent COW in patients with a milder form of cerebral abnormality such as colpocephaly. We report a unique case of an adult with colpocephaly and absent COW and discuss their association from a developmental perspective.

[Revaluation of the concept of developmental abnormality: the importance of faulty perinatal imprinting]

The classic definition of developmental abnormalities referred to malformations observed at birth. Later the functional teratogenicity was also recognized and accepted, which can be revealed in functional abnormalities caused by harms during the intrauterine development and can be manifested at any time of life. However, the ontogeny is not closed with the birth, because some systems or organs are developing for a long time after it, and can be influenced by different factors. From this aspect the perinatal period is especially important when the mutual adjustment of the receptor-hormone system is taking place and the hormonal imprinting develops. If this is faulty, it influences the hormone binding capacity of receptors that has consequences for life. The faulty hormonal imprinting is functionally teratogen; it provokes a fault up to the level of a malformation and aggravated with its heredity to the progenies. False imprinting is provoked (in animal experiments, proportioning to human doses) by drugs acting at receptor level, as oxytocin, steroid hormone analogues (pregnancy protectors, oral contraceptives, surfactants), vitamin A and D, environmental pollutant endocrine disruptors (benzpyrene, bisphenol A, pesticides, herbicides) and certain soybean components, etc. From this aspect these are functional teratogens, and their evasion in prevention as well as therapy seems to be vital. This means that the concept of developmental abnormality must be broadened, as developmental abnormalities: 1.) can originate not only in the intrauterine period, but also perinatally or even later, 2.) it can be manifested at any time of life, 3.) it can be present in a latent form which can be activated by inner or outer environmental factors, 4.) the faulty hormonal imprinting is a teratogen factor.

Melorheostosis and a review of the literature in China

Melorheostosis is an uncommon, non-genetic, non-developmental, sclerosing dysplasia of bone and adjacent soft tissues, with deformity of the extremity, pain, limb stiffness and limitation of motion. The characteristic radiographic appearance consists of irregular hyperostotic changes of the cortex resembling melted wax dripping down the side of a candle. In this review, clinical characteristics of Melorheostosis are discussed and reports in the Chinese literature are summarized.

Prevalence of olfactory and other developmental anomalies in patients with central hypogonadotropic hypogonadism

INTRODUCTION

Hypogonadotropic hypogonadism (HH) is a heterogeneous disease caused by mutations in several genes. Based on the presence of hyposmia/anosmia it is distinguished into Kallmann syndrome (KS) and isolated HH. The prevalence of other developmental anomalies is not well established.

METHODS

We studied 36 patients with HH (31 males, 5 females, mean age 41.5), 9 with familial and 27 with sporadic HH (33 congenital, 3 adult-onset), by physical examination, smell test (BSIT Sensonics), audiometry, renal ultrasound, and magnetic resonance imaging of the olfactory structures.

RESULTS

Based on the smell test, patients were classified as normosmic (n = 21, 58.3%) and hypo/anosmic (n = 15, 41.6%). Hypoplasia/agenesis of olfactory bulbs was found in 40% of patients (10/25; 75% hypo/anosmic, 7.6% normosmic, p < 0.01, Fisher's test). Remarkably, olfactory structures were normal in two anosmic patients, while one normosmic patient presented a unilateral hypoplastic bulb. Fourteen of 33 patients (42.4%) presented neurosensorial hearing loss of various degrees (28.5% hypo/anosmic, 52.6% normosmic, p = NS). Renal ultrasound revealed 27.7% of cases with renal anomalies (26.6% hypo/anosmic, 28.5% normosmic, p = NS). At least one midline defect was found in 50% of the patients (53.3% hypo/anosmic, 47.6% normosmic, p = NS), including abnormal palate, dental anomalies, pectus excavatum, bimanual synkinesis, iris coloboma, and absent nasal cartilage. Anamnestically 4/31 patients reported cryptorchidism (25% hypo/anosmic, 5.2% normosmic, p = NS).

CONCLUSION

Hypo/anosmia is significantly related to anatomical anomalies of the olfactory bulbs/tracts but the prevalence of other developmental anomalies, especially midline defects and neurosensorial hearing loss, is high both in HH and KS and independent of the presence of anosmia/hyposmia. From the clinical standpoint KS and normosmic HH should be considered as the same complex, developmental disease.