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Kim H, Hyun HK, Shin TJ, Kim YJ, Kim JW, Jang KT, Song JS. Criteria for early diagnosis of mandibular third molar agenesis based on the developmental stages of mandibular canine, first and second premolars, and second molar: a retrospective cohort study. BMC Oral Health 2023; 23:650. [PMID: 37684629 PMCID: PMC10492292 DOI: 10.1186/s12903-023-03349-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Permanent first molars with severe dental caries, developmental defects, or involved in oral pathologies are at risk of poor prognosis in children. Accordingly, using the third molar to replace the first molar can be a good treatment option when third molar agenesis is predicted early. Thus, this retrospective cohort study aimed to develop criteria for early detection of mandibular third molar (L8) agenesis based on the developmental stages of mandibular canine (L3), first premolar (L4), second premolar (L5), and second molar (L7). METHOD Overall, 1,044 and 919 panoramic radiographs of 343 males and 317 females, respectively, taken between the ages of 6 and 12 years were included. All developmental stages of L3, L4, L5, L7, and L8 were analyzed based on the dental age, as suggested by Demirjian et al. The independent t-test was used to assess age differences between males and females. The rank correlation coefficients were examined using Kendall's tau with bootstrap analysis and Bonferroni's correction to confirm the teeth showing developmental stages most similar to those of L8s. Finally, a survival analysis was performed to determine the criteria for the early diagnosis of mandibular third molar agenesis. RESULTS Some age differences were found in dental developmental stages between males and females. Correlation coefficients between all stages of L3, L4, L5, and L7 and L8 were high. In particular, the correlation coefficient between L7 and L8 was the highest, whereas that between L3 and L8 was the lowest. CONCLUSION If at least two of the following criteria (F stage of L3, F stage of L4, F stage of L5, and E stage of L7) are met in the absence of L8 crypt, agenesis of L8 can be confirmed.
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Affiliation(s)
- Hyuntae Kim
- Department of Pediatric Dentistry, Seoul National University Dental Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Hong-Keun Hyun
- Department of Pediatric Dentistry, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Teo Jeon Shin
- Department of Pediatric Dentistry, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Young-Jae Kim
- Department of Pediatric Dentistry, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jung-Wook Kim
- Department of Pediatric Dentistry, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Ki-Taeg Jang
- Department of Pediatric Dentistry, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Ji-Soo Song
- Department of Pediatric Dentistry, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Jensen ED, Smart G, Poirier BF, Sethi S. Molar-root incisor malformation - a systematic review of case reports and case series. BMC Oral Health 2023; 23:576. [PMID: 37596569 PMCID: PMC10439578 DOI: 10.1186/s12903-023-03275-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 07/31/2023] [Indexed: 08/20/2023] Open
Abstract
OBJECTIVES Molar-root incisor malformation (MRIM) is a seldom reported condition characterised by disturbances in root development of first permanent molars. This systematic review aimed to collate the clinical characteristics of individuals diagnosed with MRIM. MATERIALS AND METHODS A systematic search strategy using PubMed, Embase, Web of Science, and SCOPUS databases was performed through to March 2023. Inclusion criteria were case reports or case series including a diagnosis consistent with MRIM. Critical appraisal for all included studies utilised the Joanna Briggs Institute (JBI) critical appraisal checklist for case reports and case series and collation of clinical characteristics was performed in JBI System for the Unified Management, Assessment and Review of Information program. RESULTS The search identified 157 studies from which 35 satisfied the inclusion criteria. After full-text review, a total of 23 papers described the MRIM dental anomaly and were included in this paper. A total of 130 reported cases were retrieved, with age ranging 3-32 years, and males affected 1.16:1 females. Presence of neurological conditions, premature birth history, medication, and surgery within first years of life were synthesised and described. CONCLUSIONS The aetiology of MRIM is yet to be determined but epigenetic changes from significant medical history in the first years of life are likely to influence the development of this root malformation. First permanent molars were most commonly affected, but clinicians should be aware that permanent central incisors, primary teeth and other permanent teeth may also be affected.
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Affiliation(s)
- Emilija D Jensen
- Department of Paediatric Dentistry, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.
| | - Gabrielle Smart
- Department of Paediatric Dentistry, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Brianna F Poirier
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Sneha Sethi
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
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Charisi C, Kodonas K, Keklikoglou K, Arhakis A, Arapostathis KA, Kotsanos N. Morphological, histological, and chemical analysis of first permanent molars with molar incisor malformation. Eur Arch Paediatr Dent 2022; 23:601-608. [PMID: 35759186 DOI: 10.1007/s40368-022-00723-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/02/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Molar incisor malformation (MIM) is a dental anomaly rendering first permanent molar pulps inflamed/necrotic at a young age. It often affects permanent incisors, primary second molars and less frequently other teeth. The purpose of this study was to investigate the anatomy and histology of MIM in seeking insight into its pathogenesis. METHODS Five MIM first permanent molars were examined with micro-computed tomography (micro-CT) for 3D morphology, with scanning electron microscopy for microanatomy, with energy-dispersive X-ray spectrometer (EDS) for chemical composition and for histology with optical microscopy. Composition differences were statistically determined using one-way ANOVA. RESULTS Micro-CT confirmed dentin abnormalities in the middle and cervical third of the crown in the form of the radiodense 'cervical mineralized diaphragm' (CMD). This was peripherally intertwined with enamel fjords and projections severely disrupting the integrity of pulp chamber and its continuity with root canals. EDS showed increased Ca in CMD compared to dentin. The histological examination revealed anomalous osteodentin-like hard tissue with denticles in the CMD. CONCLUSION An interconnection of anomalous cervical enamel with crown CMD dentin preceded to the severe pulp chamber and root dysplasias in MIM molar teeth.
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Affiliation(s)
- C Charisi
- Department of Paediatric Dentistry, School of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece. .,, 36, El. Venizelou, 57008, Thessaloniki, Greece.
| | - K Kodonas
- Department of Endodontics, School of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - K Keklikoglou
- Biology Department, University of Crete, 70013, Heraklion, Crete, Greece.,Institute of Marine Biology, Biotechnology and Aquaculture, Hellenic Centre for Marine Research (HCMR), 71500, Heraklion, Crete, Greece
| | - A Arhakis
- Department of Paediatric Dentistry, School of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - K A Arapostathis
- Department of Paediatric Dentistry, School of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - N Kotsanos
- Department of Paediatric Dentistry, School of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
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Song JS, Yang YM, Kim YJ, Kim JW. Management of Severely Aberrant Permanent First Molars in Molar Root-Incisor Malformation Patients: Case Series and a Guideline. CHILDREN-BASEL 2021; 8:children8100904. [PMID: 34682169 PMCID: PMC8534414 DOI: 10.3390/children8100904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/02/2021] [Accepted: 10/08/2021] [Indexed: 11/19/2022]
Abstract
Recently, a new type of dental anomaly, a molar–incisor malformation or molar root–incisor malformation (MRIM), was recognized. The disease phenotype is now relatively well characterized; however, its etiology and disease-mechanism need to be elucidated. The affected teeth do not respond well to conventional treatment because of severe malformation and an unusual root structure. In this study, we present the treatment of MRIM cases with the extraction of severely aberrant permanent first molars (PFMs) and suggest that the PFM extractions are performed when it is clear that third molars will develop. The purpose of this report was primarily to present amendments to the guidelines for the treatment of patients with MRIM.
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Affiliation(s)
- Ji-Soo Song
- Department of Pediatric Dentistry, School of Dentistry & DRI, Seoul National University, Seoul 03080, Korea; (J.-S.S.); (Y.-J.K.)
| | - Yeon-Mi Yang
- Department of Pediatric Dentistry, School of Dentistry, Chonbuk National University, Jeonju-si 54896, Korea;
| | - Young-Jae Kim
- Department of Pediatric Dentistry, School of Dentistry & DRI, Seoul National University, Seoul 03080, Korea; (J.-S.S.); (Y.-J.K.)
| | - Jung-Wook Kim
- Department of Pediatric Dentistry, School of Dentistry & DRI, Seoul National University, Seoul 03080, Korea; (J.-S.S.); (Y.-J.K.)
- Department of Molecular Genetics, School of Dentistry & DRI, Seoul National University, Seoul 03080, Korea
- Correspondence:
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