A longitudinal study of the effects of surgery, radiation, growth hormone, and orthodontic therapy on the craniofacial skeleton of a patient evidencing hypopituitarism and a Class II malocclusion: report of a case

Assessment of hypodontia in the Turkish patients referring to the orthodontic clinic: A retrospective study

OBJECTIVE

The aim of this retrospective study was to assess the prevalence and distribution of hypodontia in the permanent dentition in a sample of Turkish patients who referred to the Ankara Dental Hospital for orthodontic treatment.

MATERIALS AND METHODS

The pre-treatment orthodontic records of 2530 patients, 1382 girls (54.62%) and 1148 boys (45.38%) between the chronological ages of 7 and 16 years, were examined for evidence of hypodontia. The third molars were excluded in this study.

RESULTS

The prevalence of hypodontia in the inspected population was 5% (3.05% for girls, 1.95% for boys). The average number of the congenitally missing teeth per patient was 2.03 (1.08 for girls, 0.95 for boys). The prevalence of the congenitally missing permanent teeth was 34% for the upper laterals, 30% for the lower second premolars, 12.5% for the upper second premolars and 23.5% for the other teeth. Most patients with hypodontia (84.9%) (57.13% for girls, 27.77% for boys) had got missing either one tooth (45.23%) or two teeth (39.67%).

CONCLUSIONS

The prevalence of hypodontia in girls was higher than in boys in this sample of the Turkish patients. The upper laterals and lower second premolars were consecutively the most symmetrically absent teeth. The prevalence of advanced hypodontia was lower than single and symmetrical hypodontia.

Evaluation of catch-up growth from orthodontic treatment and supplemental growth hormone therapy by using Z-scores

Pituitary dwarfism causes short stature due to partial or complete inhibition of growth hormone (GH) secretion. Supplemental therapy with human GH (rhGH) accelerates the statural growth of patients, but there is limited information about its effects on craniofacial growth. This study describes the orthodontic treatment of 2 patients (a boy and a girl) diagnosed with pituitary dwarfism and treated with rhGH therapy. Growing children have different growth velocities depending on age and sex, and this complicates the assessment of treatment effects; therefore, we used the Z-score to evaluate changes in stature and craniofacial components. Growth in craniofacial structures and stature were both enhanced by rhGH therapy during orthodontic treatment.

Velocardiofacial syndrome with single central incisor

Three siblings and their mother are reported who all had cytogenetically proven velocardiofacial syndrome (VCFS). One boy had normal dental and craniofacial findings, except for an increased cranial base angle. His sister had only one central incisor in the maxilla. One central incisor had also been missing in the primary dentition. She had no labial frenulum present. Cephalometry showed a small maxillary unit length indicating mild maxillary hypoplasia, an increased anterior face height, steep mandibular plane angle, retruded chin, and a large cranial base angle. Dental measurements showed retroclined lower incisors and increased interincisal angle. A second sister had a cleft of the secondary palate. All permanent teeth were present with the exception of a missing central incisor in the lower jaw: the single lower central incisor was situated in the midline. Her cephalometry showed similar findings as in her sister. All three siblings required palate surgery for speech. Mother was not available for detailed dental and other oral investigations. A single maxillary central incisor has previously been reported in VCFS, but to our knowledge a single central incisor in the mandible has not been reported previously in this entity.

Report of four familial cases with congenitally missing mandibular incisors

Heredity is one of the possible factors associated with congenitally missing mandibular incisors. We report four cases--a mother and three daughters--in an attempt to examine this hypothesis. Different treatment modalities have been used to treat malocclusions stemming from this problem. The treatment philosophy of consolidating mandibular spaces and obtaining a stable occlusion, thereby preventing the removal of maxillary teeth or the use of a mandibular prosthesis, is presented.