Alterations in Tooth Structure and Associated Systemic Conditions

Oro-Dental Characteristics in Patients With Adult-Onset Hypophosphatasia Compared to a Healthy Control Group-A Case-Control Study

BACKGROUND

Hypophosphatasia (HPP) is a rare inherited disease that affects multiple organ systems including bone and teeth. Limited knowledge exists on dental and oral health in patients with adult-onset HPP (aHPP).

OBJECTIVE

The aim of this study was to investigate oro-dental characteristics in patients with aHPP compared to healthy controls.

METHODS

This case-control study included 20 patients with aHPP compared to 31 healthy controls. Oro-dental manifestations were examined by standardised interviews, clinical examinations as well as radiological registrations on panoramic radiograph (OP) and cone-beam computed tomography (CBCT) scans.

RESULTS

The subjective experience of tooth fractures (p = 0.010), caries in permanent teeth (p = 0.032) and early loss of permanent teeth (p = 0.002) was significantly higher in patients with aHPP compared to the controls. In the aHPP group, the presence of specific teeth (p ≤ 0.045) and attrition of 11 were significantly lower (p = 0.012) compared to the controls. Opacity of a few teeth (p ≤ 0.049), presence of denticles (p = 0.024), the distance between the enamel-cement junction (CEJ) and the marginal bone level at specific sites (p ≤ 0.021) and crown height of 11 (p = 0.017) were significantly higher in patients with aHPP than in healthy controls.

CONCLUSION

The results indicate that patients with aHPP have a subjective experience of having poorer dental health. Loss of permanent teeth, less attrition, tooth opacities, denticles and larger distance between CEJ and marginal bone level are possible oro-dental findings in patients with aHPP.

Association between hypodontia of permanent maxillary lateral incisors and other dental anomalies

Introduction:

Tooth agenesis is often associated with other tooth anomalies, such as microdontia, delayed eruption and ectopic eruption. Moreover, they may be found all in the same individual, as certain genetic mutations may have a variable phenotypic expression. Treatment of cases of hypodontia of anterior teeth should not involve only opening or closing space for prosthetic rehabilitation. Individuals with hypodontia of permanent maxillary lateral incisors may have teeth with a mesiodistal width smaller than that of patients with a normal dentition, and which may need reshaping to achieve an esthetic and functional occlusion.

Objective:

This clinical case report discusses the association of hypodontia of permanent maxillary lateral incisors with other tooth anomalies and their treatment alternatives.

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.

Evaluation Distal Caries of the Second Molars in the Presence of Third Molars among Saudi Patients

Objectives:

To evaluate the prevalence of distal caries in second permanent molars in the presence of third molar among patients attending university dental clinics in Riyadh City, Kingdom of Saudi Arabia.

Materials and Methods:

Clinical and radiographic data (orthopantomographs and right and left bite wings) from 313 patients attending Riyadh Elm University dental clinics, department of oral diagnosis were collected and analyzed for the presence of third molars and caries on the distal surface of the second molar. Descriptive statistics of frequency distribution, mean and standard deviation, and binary logistic regression analysis were applied to assess the association between distal surface caries on second molars and impaction status of the teeth.

Results:

The mean decayed, missing, and filled teeth score of the study participants was found to be very high, that is, 23. The prevalence of caries affecting the distal aspect of the second molar was 48.6% (n = 609) in the population. The prevalence of distal caries was significantly high in patients with fully erupted wisdom teeth followed by vertical, horizontal, and mesial impacted third molars (P < 0.05). Wisdom teeth with mesioangular, vertical, and horizontal impactions showed significant association with distal caries of second molars below the contact point, whereas, fully erupted and vertically impacted wisdom teeth showed significant association with distal surface caries of second molars above contact point. Similarly, vertically impacted wisdom teeth were found to have significant association with caries of distal surface of second molars on noncontact areas (P < 0.05).

Conclusion:

This study showed that the distal surface of the second molars is at risk of caries in the presence of third molars. However, this risk depends on eruption status, type of angulation, and contact between third and second molars. All the preventive measures should be taken to avoid caries on distal surface of second molar.

Dental radiographic findings in 18 individuals with SATB2-associated syndrome

OBJECTIVE

To characterize the radiographic dental phenotype of individuals with SATB2-associated syndrome (SAS).

MATERIALS AND METHODS

Participants were evaluated by a multidisciplinary team during a concurrent clinic conducted during the 1st international SAS family meeting held in 2017 at a single institution. Whenever possible, panoramic and/or periapical radiographs were obtained in clinic or previously obtained and provided by the caregiver.

RESULTS

Of the 37 individuals evaluated, 18 (12 males, median age 8.5 years) underwent radiographic examination. Dental radiographs revealed anomalies in all individuals starting at 2 years of age. The most consistent finding was delayed development of the mandibular second bicuspids (83%) with other common radiographic findings including delayed development of the roots of the permanent teeth (78%), severely rotated (56%) or malformed teeth (44%), and taurodontism (44%).

CONCLUSIONS

Dental anomalies are fully penetrant and can be documented radiographically in all individuals with SAS.

CLINICAL RELEVANCE

Dental radiographic findings of delayed second premolar development and delayed development of permanent root formation, especially concurrent with findings of taurodontism and malformed teeth, support a clinical suspicion for SAS and should help differentiate SAS from other neurodevelopmental syndromes.