Dens evaginatus in the Hong Kong Chinese population

Current Management of Dens Evaginatus Teeth Based on Pulpal Diagnosis

INTRODUCTION

Dens evaginatus (DE) is a dental anomaly with a supernumerary tubercle projection that typically contains dentin and pulp tissue. However, the tubercle projection can fracture, exposing the dentin and potentially the dental pulp, which induces pulpal diseases. Managing DE should be primarily based on the clinical diagnosis of the pulp.

METHODS

The literature search in prevalence, prophylaxis, and management of dens evaginatus was performed in PubMed database as well as by manual search, in which the related contents were collected and descriptively analyzed.

RESULTS

Of the 264 searched literatures, 62 articles were included for this scoping review. The prophylactic management of the tubercle of DE teeth with a normal pulp should be performed as early as possible by the prep-and-fill technique or the reinforcement technique to preserve tooth vitality and continued root development, with the former reported to be superior compared with the latter. Furthermore, DE teeth with reversible pulpitis should be managed with the prep-and-fill technique. For DE teeth with irreversible pulpitis, vital pulp therapy, ie, partial or full/coronal pulpotomy, should be considered when the pulpal inflammation is limited to the coronal pulp to preserve the vitality of the radicular pulp that induces apexogenesis. A pulpectomy should be performed if the pulpal inflammation has progressed into the radicular pulp. For DE teeth with pulpal necrosis (or after pulpectomy) and immature roots, mineral trioxide aggregate apexification or regenerative endodontic procedures are the treatment options. For DE teeth with pulpal necrosis and complete root formation, nonsurgical root canal treatment is the treatment of choice. A flow chart of the decision-making for managing DE teeth based on pulpal diagnosis is proposed.

CONCLUSION

DE teeth should be properly managed, by prophylaxis or treatment, depending on pulpal diagnosis and related factors.

Prevalence and distribution of selected developmental dental anomalies in Taif, Saudi population

Background: Developmental dental anomalies are seen as abnormalities in tooth size, shape, position, and structure due to multiple reasons during various stages of tooth development. These anomalies can create disturbances in dental arch lengths and occlusions. Hence, it is very important to treat, recognise and perform proper treatment. The purpose of this study was to find out the prevalence and distribution of selected developmental anomalies in shape, size and position of teeth in the Saudi population of Taif Region.

Design and Methods: The study was based on the clinical examination of 2481 adults who are Saudi nationals came for dental treatment from September 2019 to February 2020, at Taif University Dental Hospital, Saudi Arabia. These patients were examined clinically for developmental dental anomalies affecting shape, size and position.

Results:We found that a total of 512 individuals (20.63%) had developmental anomalies and out of which 386 persons (15.56%) had at least one developmental dental anomaly. The frequency and distribution of anomalies of shape and size, number and position were 46.8%, 26.9% and 42.9% respectively. In the present study, 15.56% individuals exhibited at least one anomaly, 8.54% subjects had more than one anomaly and 79.36%.did not any developmental anomaly. On comparison, statistically significant results were seen between different groups of anomalies.

Conclusions: The present study had varying results for the prevalence rate of selected dental anomalies. This variation in results might be due racial differences or discrepancy in sample size or/and diagnostic or inclusion criteria. Treatment of developmental anomalies necessitates a multidisciplinary approach and mostly may comprise of orthodontic correction or prosthetic replacement.

Prevalence of Shape-related Developmental Dental Anomalies in India: A Retrospective Study

Aim and objective

The aim and objective of this study was to review the literature to analyze the prevalence of developmental dental anomalies regarding shape in India.

Background

Although there have been several studies investigating the prevalence of individual dental anomalies related to shape, only a few studies considered all subtypes and their distribution among genders, especially in India.

Results

An electronic search was made in the PUBMED database to review prevalence-based data on developmental dental anomalies related to shape in India up to December 2018. A diverse range of results regarding prevalence of developmental dental anomalies related to shape were seen in these studies due to vast regional, cultural, and ethnic diversities and various environmental factors affecting the tooth development.

Conclusion

There is a necessity to conduct more study on shape-related dental anomalies because there are very limited studies regarding prevalence of concrescence, dilacerations, and accessory root and various associated factors.

Clinical significance

Early diagnosis and timely management of these anomalies can prevent complications. The knowledge on identification and prevalence of dental anomalies helps the dental practitioners improve the treatment plan. The prevalence studies can be of utmost importance in the formulation of oral healthcare programs by using their data to analyze the intensity of dental anomalies.

How to cite this article

Goswami M, Bhardwaj S, Grewal N. Prevalence of Shape-related Developmental Dental Anomalies in India: A Retrospective Study. Int J Clin Pediatr Dent 2020;13(4):407–411.

Prevalence of Premolars with Dens Evaginatus in a Taiwanese and Spanish Population and Related Complications of the Fracture of its Tubercle

Objective:

Dens evaginatus (DE) is an odontogenic developmental anomaly that can be defined as a supernumerary tubercle structure that extends from the occlusal surface of the affected tooth. Tubercular fracture or attrition of the tubercle, invaded by pulp tissue, may cause various pulpal diseases, such as pulpitis, pulp necrosis, and periapical periodontitis. This study aimed to determine the prevalence of premolars with DE in Taiwanese and Spanish study populations and to report associated dental complications.

Methods:

This study was based on the clinical examination of volunteers of Spanish and Taiwanese origin, recruited among the undergraduate dentistry students at CEU-Cardenal Herrera University, Valencia, Spain. Informed consents were obtained from students identified with DE. Additional examinations were performed, including vitality test, percussion, palpation, and radiographs, to diagnosis the status of the pulp and periapical tissue.

Results:

The prevalence of DE among Taiwanese students was 4.08%, compared to 0% in the Spanish Caucasian group. In the Taiwanese group, the occurrence of DE in premolars was more common in the mandibular (78.9%) compared to the maxillar region (21.1%). In 84% of the cases, DE-affected teeth were found bilaterally. The mandibular second premolar was the most commonly involved tooth (57.8%). When investigating the complications related to DE among six affected Taiwanese students, it was found that two teeth (10.5%) had received pulp treatment, one of them prior to complete root formation.

Conclusion:

DE appears to be more prevalent in people of Mongoloid origin and rare in those of Caucasian origin. The wear or fracture of DE may affect pulpal tissue, leading to incomplete root growth.

Endodontic treatment of bilateral dens evaginatus premolars with large periapical lesions

Dens evaginatus is a developmental anomaly characterized by the presence of an accessory cusp composed of enamel and dentine, usually containing pulp tissue. This condition is clinically important because of fracture or wear of the tubercle, which can frequently lead to the major complication of pulp necrosis and periapical infection. Treatment varies according to pulp condition, tubercle integrity, and stage of root development. Here we report a case of bilateral dens evaginatus with large periapical lesions. Non-surgical root canal treatment using calcium hydroxide medication was performed for both mandibular second premolars. At the 3-year postoperative recall examination, the teeth were asymptomatic and radiographically showed healing of the periapical lesions.

Concomitant developmental dental anomalies in Chinese children with dens evaginatus

AIM

To determine the prevalence of concomitant developmental dental anomalies in a group of Chinese children with dens evaginatus.

METHODS

The dental records and orthopantomograms of 10-15 year old children and adolescents who had been diagnosed with dens evaginatus in a school dental clinic were reviewed retrospectively.

RESULTS

Four hundred and forty-eight of 7102 (6.3%) children were found to have dens evaginatus. Concomitant developmental dental anomalies were found in 77 children (17.2%). The most commonly seen dental anomalies in the study population were hypodontia, hyperdontia, microdontic maxillary lateral incisor, and dental impaction. The prevalence of these anomalies did not differ significantly to that found in the general Chinese population. When analysed separately, however, the prevalence of supernumerary premolars was found to be higher in children with dens evaginatus than in the general population, and the difference was statistically significant (P < 0.01).

CONCLUSION

Supernumerary premolars appeared to be more prevalent in Chinese children with dens evaginatus than in the general population. There may be an association of supernumerary premolars with dens evaginatus in this study population.

Dental abscess in a tooth with intact dens evaginatus

This article reports a case of dental abscess in a mandibular premolar with intact dens evaginatus. Dentists are advised to critically evaluate those teeth with dens evaginatus, both clinically and radiographically, before attempting prophylactic treatments. This is particularly important medicolegally in case the tooth develops symptoms shortly after the prophylactic treatment. Dentists practising in Western countries should also be aware of this dental anomaly because of the increasing global migration of people from Asia.

Fractured dens evaginatus and unusual periapical radiolucency

Dens evaginatus (DE) is not uncommon. It can affect the premolars of people of oriental ethnicity, and it can lead to different clinical problems. This article describes the diagnosis and management of a patient presenting with a fractured tubercle of DE and an unusual buccal abscess in relation to periapical radiolucency extending around the mandibular second premolar and first molar.

Management of dens evaginatus: evaluation of two prophylactic treatment methods

Dens evaginatus (DE) is an odontogenic anomaly characterized by an enamel covered tubercle, enclosing dentin and pulpal tissue. It most commonly affects premolar teeth of people of mongoloid ethnicity. The prevalence of DE in Singapore is 2.1%. Fracture or attrition of the tubercle may lead to pulpal necrosis. Thus, prophylactic management of DE is preferred. A retrospective cohort study comparing two common prophylactic restorative methods was conducted. This involved 817 children, aged 10 years at the outset, having 1591 DE. The teeth were observed for 2 years. The results showed that significantly less teeth developed pulpal pathology when an enamoplasty-preventive resin restoration method was used (0.52%) as compared to an amalgam cavity restoration (5.37%) and the control (3.65%) [chi 2 = 9.595 (p < 0.01) df = 2]. Knowledge of the various treatment options and prevalence data is important as there is an increasing global migration of people of mongoloid ethnicity.