Taurodontism

The relevance of taurodontism in forensic dental age estimation

Taurodontism is a dental morphological anomaly characterized by enlarged pulp cavities repositioned towards the apical region of the tooth, coupled with shortened root structures. Molars are commonly affected by this alteration. Certain populations exhibit up to 48% prevalences for this dental alteration, underscoring its significance in dental age estimation (DAE). In the field of DAE, an individual's chronological age is inferred from specific dental features, frequently employed within the forensic context. The effect of taurodontism on the features of DAE is an unanswered issue. The influence of taurodontism on eruption, mineralization, radiographic visibility of root canals, and radiographic visibility of the periodontal ligament space in mandibular third molars- some of the established criteria for DAE as examples-is currently not systematically examined. Some common staging scales for the dental features of DAE cannot technically be applied to taurodontic teeth. Additionally, given the association of taurodontism with syndromes affecting tooth development, caution is warranted in age assessment procedures. Notably, taurodontic teeth may serve as indicators of syndromes influencing skeletal development, further emphasizing the relevance of taurodontism in forensic age assessment. Presumably taurodontic teeth were included in reference data to some extent due to their partially high prevalence in the past, whereby the influence of taurodontism has been statistically absorbed within the overall spread of the features. Future studies should compare the temporal course of these tooth characteristics in affected and unaffected teeth. Subsequent initiatives should focus on raising awareness among forensic dentists regarding taurodontism, necessitating in-depth exploration of the subject.

Developmental and Acquired Abnormalities of the Teeth

This review aims to present a detailed analysis of the most common developmental and acquired dental abnormalities, including caries, resorptive lesions, and congenital anomalies of teeth number, size, form, and structure. This review highlights how diagnostic imaging can aid in the accurate identification and management of these conditions.

High prevalence of taurodontism in North China and its relevant factors: a retrospective cohort study

OBJECTIVE

The purpose of this study was to investigate the prevalence and relevant factors of taurodontism in North China.

METHODS

We retrospectively analysed the cone beam computed tomography (CBCT) of 1025 patients (496 male and 529 female) aged between 10 and 59 years. The crown-body/root (CB/R) ratios of the maxillary and mandibular molars were measured. The prevalence of hypotaurodontism, mesotaurodontism, and hypertaurodontism was then calculated and the incidence of taurodontism along with its relevant factors, was evaluated.

RESULTS

The overall rate of taurodontism in North China was as high as 78.9%. If the third molars (opsigenes) were excluded, which have a big morphological variation from each other, the rate was 52.4%. The mean CB/R ratio of taurodontism differs from tooth position: maxillary mandibular third molars > maxillary third molars > maxillary second molars > maxillary first molars > mandibular second molars > mandibular first molars (P < 0.05). In addition, the 1025 patients were divided into different age groups, and it was found that the mean CB/R ratio decreased with age (P < 0.05). Moreover, the CB/R ratio of the mandibular first and second molars in female patients was higher than males (P < 0.05).

CONCLUSION

This study revealed that taurodontism is widely prevalent in North China. The incidence of taurodontism increases the closer the tooth is to the back end of the dental arch, and quite a few of the maxillary and mandibular third molars teeth have tapered roots. And the taurodontism is decreased by age, as there were more affected female than male patients.

Detecting the presence of taurodont teeth on panoramic radiographs using a deep learning-based convolutional neural network algorithm

OBJECTIVES

Artificial intelligence (AI) techniques like convolutional neural network (CNN) are a promising breakthrough that can help clinicians analyze medical imaging, diagnose taurodontism, and make therapeutic decisions. The purpose of the study is to develop and evaluate the function of CNN-based AI model to diagnose teeth with taurodontism in panoramic radiography.

METHODS

434 anonymized, mixed-sized panoramic radiography images over the age of 13 years were used to develop automatic taurodont tooth segmentation models using a Pytorch implemented U-Net model. Datasets were split into train, validation, and test groups of both normal and masked images. The data augmentation method was applied to images of trainings and validation groups with vertical flip images, horizontal flip images, and both flip images. The Confusion Matrix was used to determine the model performance.

RESULTS

Among the 43 test group images with 126 labels, there were 109 true positives, 29 false positives, and 17 false negatives. The sensitivity, precision, and F1-score values of taurodont tooth segmentation were 0.8650, 0.7898, and 0.8257, respectively.

CONCLUSIONS

CNN's ability to identify taurodontism produced almost identical results to the labeled training data, and the CNN system achieved close to the expert level results in its ability to detect the taurodontism of teeth.

The Human Genetics of Dental Anomalies

The development of tooth is a highly complex procedure and mastered by specific genetic programs. Genetic alterations, environmental factors, and developmental timing can disturb the execution of these programs, and result in various dental anomalies like hypodontia/oligodontia, and supernumerary teeth, which are commonly seen in our clinical practice. Advances in molecular research enabled the identification of various genes involved in the pathogenesis of dental anomalies. In the near future, it will help provide a more accurate diagnosis and biological-based treatment for these anomalies. In this article, we present the molecular phenomenon of tooth development and the genetics of various dental anomalies.

Taurodontism—Prevalence, Extent, and Clinical Challenge in Ashkelon, Israel—A Retrospective Study

Taurodontism, a known morpho-anatomic variation in the shape of teeth, has already attracted substantial attention. The aim of this study is to contribute to this by discussing its direct impact on the dental practitioner via an evaluation of the prevalence of taurodontism in molars in Ashkelon, Israel. This retrospective study analyzed panoramic radiographs of 624 patients (330 males, 294 females), aged of 9–29 years—2849; first and second permanent molars were screened. Objective measurements and variables were used and analyzed using statistical SPSS version 27 (IBM, Chicago, IL, USA). Taurodontism was observed in 33.6% of the patients and was more prevalent among females (53% vs. 47%) and in maxillary molars compared to mandibular molars (57% vs. 43%). The overall prevalence of hypotaurodontism, mesotaurodontism, and hypertaurodontism was 10.8%, 0.5%, and 0.2%, respectively. No statistical difference between right and left sides was discovered, however, taurodont teeth in the upper left side exhibited the highest frequency, while the lower left side had the least. The highest occurrence of hypotaurodontism was on the upper right second molar followed by upper left first and second molars. The clinical challenge posed in endodontic, orthodontic, and restorative dentistry is discussed, and suitable alternative approaches are proposed for dental practitioners.

A retrospective study of incidental findings occurring in a consecutive case series of lateral cephalograms of 12- to 20-year-old patients referred for routine orthodontic treatment

Purpose

Lateral cephalograms of orthodontic patients may contain incidental findings that could potentially lead to harm.

Materials and Methods

The lateral cephalograms of 1765 consecutive 12- to 20-year-old patients, being considered for routine orthodontic treatment, were retrospectively reviewed. These patients were considered normal, because no abnormalities were found either in their medical history or on their clinical examination.

Results

The overall prevalence of incidental findings was 18.8%, of which 10.3% were ponticulus posticus and 4.2% were bridging of the sella turcica. Although occipital spurs and ponticulus posticus were more prevalent in males, the size of the sella turcicas did not differ between sexes. Of the 1156 patients completing treatment about 2 years later, only one lateral cephalogram displayed progression of the ponticulus posticus in that time.

Conclusion

The prevalence of incidental findings on lateral cephalograms of otherwise normal orthodontic 12- to 20-year-old patients was almost a fifth, of which ponticulus posticus, vertebral fusion, and enlarged parietal foramina were clinically significant.

Pulp enlargement in individuals born with cleft lip and palate pulp, a radiographic study from the cleft lip and palate service of paraiba, Brazil'

PURPOSE

Pulp chamber enlargement impacts endodontic treatment planning. The aim of this study was to evaluate alterations in pulp chamber size of posterior teeth in individuals born with cleft lip with or without cleft palate.

METHODS

Ninety individuals were treated at the Cleft Lip and Palate Service of the University Hospital Lauro Wanderley, Federal University of Paraíba, between the ages of 4 and 15 years born with cleft lip with or without cleft palate were selected. Ninety-nine patients from the archives of the residency program in Orthodontics of the Brazilian Dental Association (ABO) were paired by sex and age as a comparison group. Radiographs were evaluated by a single examiner, observing the presence/absence of an enlarged pulp chamber in the first and second permanent molars of all quadrants. Chi square or Fisher's exact tests were used (α = 0.05) in all comparisons.

RESULTS

Pulp enlargement was more frequently found among individuals born with cleft lip with or without cleft palate (p = 0.0005). However, pulp enlargement frequency was different among subjects born with clefts (p = 0.0006). Pulp enlargement was more common in the maxilla, in both groups. Individuals born with cleft lip with or without cleft palate more often had six or more teeth affected (p = 0.02). Furthermore, individuals with a bilateral cleft more often had six or more teeth affected in comparison to unilateral cases (p = 0.002).

CONCLUSION

Pulp enlargement is a frequent finding, particularly among individuals born with cleft lip with or without cleft palate, with a higher prevalence in the maxilla.

Taurodontism in dental genetics

Taurodontism is a dental anomaly defined by enlargement of the pulp chamber of multirooted teeth with apical displacement of the pulp floor and bifurcation of the roots. Taurodontism can be an isolated trait or part of a syndrome. A study was conducted to document the dental and craniofacial aspects of genetic thin bone disorders in South Africa. Sixty-four individuals with Osteogenesis imperfecta (OI), one individual with Pyle disease and one with Torg-Winchester syndrome respectively, were assessed clinically, radiographically and at a molecular level. Ten patients with OI XI and those with Pyle disease and Torg-Winchester syndrome had taurodontism. Taurodontism has been identified in several genetic disorders necessitating cognizance of the possible existence and implications of this characteristic when managing patients in the dental environment. Further studies should be directed toward identifying the incidence, etiology, and molecular pathways leading to taurodontism and its relationship to genetic syndromes.

Taurodontism and C-shaped anatomy: is there an association?

OBJECTIVES

To evaluate the relation between taurodontism and C-shaped configuration, as well as the prevalence and classification according to sex, left/right position, and arc length in the mandibular premolar and molar teeth using cone beam computed tomography (CBCT).

METHODS

The presence of taurodontism and C-shaped configuration were evaluated using CBCT scans and classified by two independent radiologists. The sex, location in the jaw (left-right), and mandibular arc length measurements were recorded. The Chi-square test was used to determine the presence of taurodontism and C-shape configuration according to sex, left/right location, and independent-sample t tests were used to assess the relation between the arc length.

RESULTS

The prevalence of taurodontism was significantly higher in the female population, whereas the C-shaped configuration was more frequent in males (p < 0.05). In both sexes, the most common type was hypotaurodont (7.5%). In the molars, the prevalence was significantly higher in second molars, and the most common C-shaped configuration type was C3 (39.3%). The prevalence was significantly higher in the first premolar, with C2 (22.4%) being the most frequent type in the premolars (p < 0.05). The arc length and location in the jaw were not significantly affected (p > 0.05).

CONCLUSIONS

A high correlation was revealed between taurodontism and complicated C-shape canal configurations. Practitioners should be very careful about the presence of C-shape morphology in taurodontism treatment, and various types of C-shaped morphology ranging from coronal to the apical direction.