Multiple impacted permanent and deciduous teeth

Prevalence of Impacted Teeth: A Radiographical Retrospective Rio de Janeiro Population-Based Study

Background

The early detection of impacted teeth is essential for the prevention of future malocclusions and possible lesions. The aim of this study is to assess the prevalence of impacted teeth and associated pathological lesions.

Methods

One thousand six hundred and two panoramic radiographs were analyzed for this retrospective study. The prevalence of impacted teeth, the presence of supernumerary teeth and cystic or tumoral lesions associated, and the type of angulation of third molars using Winter's classification were accessed. The descriptive statistics and the Chi-squared test were performed (P < 0.05).

Results

One thousand three hundred and ninety-seven panoramic radiographs fulfilled impacted criteria. A prevalence of 541 (38.7%) impacted teeth was observed, with the female gender significantly higher (P < 000.1). Of the total impacted teeth (n = 541), the overall mean impacted of lower third molars was 55.6%. Twenty-nine (5.3%) supernumerary teeth and four lesions were verified. The angulations most observed in the upper (76.6%) and lower (39.2%) third molars were vertical (P < 000.1) and mesioangulated (P < 000.1), respectively.

Conclusion

The impacted tooth prevalence was 38.7%, more common in females than in males. The lower third molars presented the highest prevalence of impacted, and the most common angulations were vertical and mesioangulated. Only four associated lesions were observed.

Non-syndromal multiple supernumerary and permanent impacted teeth in mother and her one child

Multiple permanent impacted supernumerary teeth are rare and are most of the times associated with syndromes. The prevalence for non-syndromic multiple supernumerary teeth is less than 1%. We herein presenting a case of non-syndromic multiple supernumerary impacted teeth in a female patient and her child. The patient has three children; out of them, two had normal dentition and the youngest child had 60 teeth (35 impacted supernumerary with 25 erupted teeth). The patient herself had a total of 54 teeth. Their medical history was not significant. The systemic investigations were not suggestive of any syndrome and disease. Very few cases reported more than 30 supernumerary and impacted teeth bilaterally in both the jaws. This case report becomes unique as both mother and her child presented with more than 30 supernumerary impacted teeth.

Multiple impacted permanent teeth, an indicator for early detection of hypoparathyroidism: A rare case report

Eruption is a process of continuous movement of the developing tooth bud from its developmental location to functional location. Teeth that cease to erupt before emergence to their functional position in the oral cavity are termed as impactions. In permanent dentition, third molars are the most frequently impacted teeth followed by the canines. When impaction involves few teeth, the condition is localized but when it involves multiple teeth, the condition becomes generalized and is often associated with some derangement of the normal physiological processes. Factors causing impactions may be localized, pertaining to the area or, systemic or, generalized including bone disorders such as cleidocranial dysplasia and/or some sort of endocrinological disturbance such as hypoparathyroidism. Hypoparathyroidism is a rare endocrinological disorder accompanied by anomalies of various systems including bones and teeth. The dental defects due to hypoparathyroidism may present as hypocalcemia, aplasia and/or hypoplasia, defects of mineralization, short and blunted roots, delayed eruptions, and clinically missing or impacted teeth. This report describes an interesting and unusual case where multiple impacted permanent teeth and retained primary teeth accompanied by other clinical manifestations in a 16-year-old female patient probed the clinicians for further investigations which, eventually, aided in early diagnosis of hypoparathyroidism.

A rare nonsyndromic case of adenomatoid odontogenic tumor associated with multiple impacted supernumerary teeth

Adenomatoid odontogenic tumour (AOT) is a rare benign odontogenic tumour characterized by a progressively slow growing pattern and symptomless behavior. The differential diagnosis between AOT and other odontogenic tumours, such as ameloblastoma, should be well conducted in order to avoid extensive ablative surgery. The present case report is of a 27 year old female who reported with a chief complaint of mild intermittent pain and a swelling which was gradually increasing in size, on the left mid-facial region since 6 months. Radiographic Investigations revealed a round uni-locular radiolucent image of an intra-osseous lesion with a well defined border in the left maxilla. The tumor was encapsulated and was attached with 2 impacted supernumerary teeth which were fused and shaped as maxillary premolars. The images also showed multiple impacted supernumerary teeth in the maxilla and mandible. The clinical and radiographic diagnostic hypothesis of Adenomatoid odontogenic cyst and a differential diagnosis of Dentigerous Cyst was given. Surgical enucleation of the lesion was done under General Anaethesia. The histological sections were consistent with AOT.

Management of a rare case of idiopathic multiple unerupted impacted permanent teeth in an adult female patient

This clinical case report describes the multi-disciplinary approach in the management of an unusual presentation of idiopathic multiple unerupted impacted permanent teeth in a 20-year-old female patient. The case was unique in that, not only were there multiple missing permanent teeth, but also over retained deciduous teeth and attrited existing permanent teeth with loss of vertical dimension of occlusion. Since the patient was young, it was decided to retain all the erupted permanent teeth and extract the infected deciduous teeth with the objective of fabricating overlay complete dentures. This is a simple, reversible and an economical treatment modality, which satisfies both the esthetic and functional demands where the extraction of teeth is not generally indicated and, in addition, provides a stable occlusion.

Primary failure of eruption combined with bilateral transmigration of mandibular canines, transposition, torus palatinus, and class III incisor relationship: A rare case report

Eruption disorders are numerous varying from delayed to complete failure of eruption. Primary failure of eruption (PFE) is a rare condition that involves arrested eruption of teeth with the absence of local or general contributory factors. Another rare and clinically challenging phenomenon is canine transmigration which is the intra-osseous movement of impacted canines across the midline. This report presents the first case of combined failure of eruption of multiple teeth with bilateral mandibular canine transmigration, transposition of upper canine and the first premolar, torus palatinus, and class III incisor relationship in a 33-year-old asymptomatic and nonsyndromic female patient.

Combined Orthodontic-surgical Treatment for Skeletal Class III Malocclusion with Multiple Impacted Permanent and Supernumerary Teeth: Case Report

In this report we describe a combined orthodontic and surgical treatment for a 14-year-old boy with severe skeletal class III deformity and dental problem. His upper posterior primary teeth in the left side were over-retained and 6 maxillary teeth (bilateral central incisors and canines, left first and second premolars) were impacted, together with 5 supernumerary teeth in both arches. The treatment protocol involved extraction of all the supernumerary and deciduous teeth, surgical exposure and orthodontic traction of the impacted teeth, a bimaxillary orthognathic approach including Lefort I osteotomy. Bilateral sagittal split ramus osteotomy (BSSRO) and genioplasty was performed to correct skeletal problem. After treatment, all of the impacted teeth were brought to proper alignment in the maxillary arch. A satisfied profile and good posterior occlusion was achieved. Treatment mechanics and consideration during different stages are discussed.

Prevalence of impacted teeth in a Brazilian subpopulation

The objective of this study was to estimate the prevalence of impacted teeth in a subpopulation of Brazilian patients based on the retrospective analysis of panoramic radiographs obtained at an oral radiology clinic. Out of 1,977 panoramic radiographs, 1,352 fulfilled inclusion criteria, and 22,984 teeth were assessed. Data were statistically analyzed using Kolmogorov-Smirnov's and Levene's tests; significance was set at 5%. The number of impacted teeth was assessed using analysis of variance and Tukey's post-hoc test. Our results showed significant differences for tooth type and patient age when analyzed separately (p < 0.05); gender did not show significant results (p > 0.05). Correlations between age and gender showed significant differences (p < 0.05), as did the correlations between age, gender and tooth type (p < 0.05). Mandibular molars were the teeth most frequently affected (p < 0.05), followed by maxillary molars (p < 0.05). Other tooth types did not present significant differences among themselves (p > 0.05). Patients aged 22 years or younger were the most frequent ones (p < 0.05). No significant differences were observed between age groups 37 and 51 years and 52+ (p > 0.05). According to the methodology here employed, gender did not affect tooth impaction, whereas age (22-36 years) and tooth type (mandibular third molars) strongly influenced results.

Nonsyndromic bilateral multiple impacted supernumerary mandibular third molars: a rare and unusual case report

A supernumerary tooth is that which is present additionally to the normal series and can be found in any region of the dental arch. An impacted tooth is defined as the one which is embedded in the alveolus, so that its eruption is prevented, or the tooth is locked in position by bone or the adjacent teeth. The occurrence of multiple supernumerary teeth in only one patient in the absence of an associated systemic condition or syndrome is considered as a rare phenomenon. The occurrence of supernumerary teeth in the lower molar region is rare. A prevalence of less than 2% of cases occurring in this region has been estimated. Their occurrence presents a clinical problem for orthodontists and oral surgeons. The cause, frequency, complications, and surgical operation of impacted teeth are always interesting subjects for study and research. An impacted tooth can result in caries, pulp disease, periapical and periodontal disease, temporomandibular joint disorder, infection of the fascial space, root resorption of the adjacent tooth, and even oral and maxillofacial tumours. The management of impacted wisdom teeth has changed over the past 20 years from removal of nonsymptomatic third molars to simple observation. The aim of this paper is to present a rare case of bilateral multiple impacted supernumerary mandibular third molars.

Idiopathic multiple impacted unerupted teeth: Case report and discussion

Multiple impacted permanent teeth are usually related to syndromes, metabolic and hormonal disorders. However, in some cases, impaction of multiple teeth is not associated with any syndrome. In this report, we present a case of 17-year-old male patient with missing teeth. Radiographs revealed multiple impacted permanent teeth, though medical and family history along with physical examination was not suggestive of any syndromes. If other investigations are negative, an idiopathic case of multiple impacted teeth is suggested to be the possible diagnosis. The objective of this report is to increase awareness of such cases especially in the absence of hereditary/genetic/metabolic factors usually inherent in such scenarios. The patient management in such cases needs to be planned specifically from a multidisciplinary standpoint.

Multiple bilateral impactions in an adolescent girl

This article describes a patient whose permanent canines and premolars had not erupted at age 14 years, although their root formation was complete, with closed apices. Surgical and orthodontic treatment was planned to correct the multiple impactions. The orthodontic traction used 5 strategic teeth and allowed for the eruption of all 12 impacted teeth. The surgical-orthodontic treatment of many impacted teeth yielded good esthetic and periodontal results, as shown by the patient's satisfaction and the periodontal probing 2 years after the treatment. Multiple impacted teeth are a rare eruption disturbance that requires early detection: no signs of a genetic syndrome or an endocrine disorder had been found, or failure to move along the eruption path, which is a characteristic of another syndrome, primary failure of eruption.

Downregulation of matrix metalloproteinases in hyperplastic dental follicles results in abnormal tooth eruption

In this study, we compared the gene expression profiles of non-syndromic hyperplastic dental follicle (HDF) fibroblasts and normal dental follicle (NDF) fibroblasts using cDNA microarrays, quantitative PCR, and immunohistochemical staining. Microarray analysis showed that several collagens genes were upregulated in the HDFos, including collagen types I, IV, VIII, and XI and TIMP-1, -3, and -4 (fold ratio > 2.0). In contrast, the expression of MMP-1, -3, -10, and -16 together with IL-8 was more than two fold downregulated. The differential expression of the genes encoding alkaline phosphatase, MMP-1, -3, -8, and IL-8 was confirmed by quantitative RT-PCR, while that of 24 HDFs and 18 NDFs was confirmed by immunohistochemical analysis. However, HDFs showed stronger expression of MMP-3 than NDFs (P < 0.001). Collectively, these results indicate that defective regulation of MMPs mediating connective tissue remodeling may be responsible for abnormal tooth eruption.

Junctional epidermolysis bullosa associated with hypoplastic enamel and pervasive failure of tooth eruption: Oral rehabilitation with use of an overdenture

This report describes a previously unreported case of generalized hypoplastic enamel and failure of eruption of the permanent maxillary teeth and only partial eruption of the permanent mandibular teeth in an 18-year-old male diagnosed with junctional epidermolysis bullosa. Similar anomalies were reported to have affected the deciduous dentition. Beginning at 4 years of age, oral rehabilitation has been conservatively managed with the fabrication of various maxillary complete overdentures. The use of this prosthesis has provided an economical, nonsurgical treatment option when oral soft tissue permits and with relative ease of construction.

Idiopathic failure of eruption of multiple permanent teeth: report of 2 adults with a highlight on molecular biology

Multiple unerupted teeth with no obvious etiology is a rare dental anomaly. Various local and systemic factors have been implicated in the failure of eruption of multiple permanent teeth. But the localization of the genetic defect in the phenotype of failure of eruption is largely unknown at present. Our aims in this article were to consolidate and organize the available information regarding the molecular biology of tooth eruption and to corroborate the current evidence with the report of 2 adult cases of failure of eruption of multiple permanent teeth without a known cause.