Association between Hypodontia and Angle’s Malocclusions among Orthodontic Patients in Kathmandu, Nepal

Background. Disturbances during the early tooth development stages may result in the congenital absence of teeth. The purpose of this study was to assess the relationship between hypodontia and Angle’s malocclusions. Materials and Methods. The sample comprised 601 orthodontic patients’ pretreatment records (242 men and 259 women), selected from the achieved orthodontic records. Developmental anomalies of teeth affecting the number were examined on dental panoramic radiographs. Based on Angle’s classification, pretreatment dental casts were assessed and classified into different classes of malocclusion. The relationship between hypodontia and different classes of malocclusion was evaluated using the chi-square test. Results. The prevalence of tooth agenesis was 7.48%, that is, 45 out of 601 samples. There were a total of 72 (0.42%) missing teeth, excluding the third molars. The most frequent missing tooth was the maxillary lateral incisor (35, 48.61%), followed by the mandibular lateral incisor (14, 19.44%), the mandibular central incisor (6, 8.33%), the mandibular second premolar (5, 6.294%), and the maxillary second premolar (4, 5.55%). Hypodontia was more common in the upper jaw. Although hypodontia was mostly seen in Class I malocclusion patients (7.87%), followed by Class II malocclusion patients (6.99%) and least in Class III malocclusion patients. However, there was no significant difference in hypodontia among different classes of malocclusions (p = 0.352). Conclusion. The most frequently missing tooth was the maxillary lateral incisor, followed by lateral and central mandibular incisors and mandibular second premolars, while excluding the third molars. The present study did not find any association between various types of malocclusions and hypodontia.

Evaluating the Prevalence and Distribution of Dental Anomalies in the Permanent Dentition of Patients Seeking Dental Care

BACKGROUND

 Disturbances seen during tooth formation result in developmental dental anomalies presenting in the oral cavity. These anomalies manifest as discrepancies in the number, color, size, and shape of the teeth. These dental anomalies can either be acquired, congenital, or developmental. Their early detection and management are necessary as they affect aesthetics and occlusion. The study had the aim of gauging the prevalence of developmental anomalies in the permanent dentition of Indian subjects.

METHODS

A total of 1192 participants recruited from the institute for study purposes, comprising males and females, were examined clinically and radiographically, and their dental casts were also evaluated. These subjects were assessed for anomalies in position, structure, number, and/or shape. Anomalies in the position include transmigration, transportation, and/or ectopic position; anomalies in the structure, including dentinogenesis imperfecta or amelogenesis imperfecta; anomalies in number, including hyperdontia or hypodontia; and anomalies in shape, including peg laterals, taurodontism, fusion, dens evaginatus, talon cusp, and/or microdontia.

RESULTS

A statistically significant difference was seen in unilateral microdontia and dentinogenesis imperfecta between males and females, with attained p-values of 0.003 and 0.06, respectively. The results of the present study showed that 9.89% (n = 118) study subjects, whereas 1% (n = 12) study subjects had two dental anomalies in their permanent dentitions, with no subject presenting more than two dental anomalies, showing that various dental anomalies have a low prevalence in the Indian population.

CONCLUSION

The present study has led to the conclusion that the prevalence of dental anomalies is low in Indian subjects. However, these anomalies should be detected and treated early to prevent them from causing further complications.

Prevalence of dental anomalies in different facial patterns and malocclusions in an Iranian population

Objective

This study aimed to evaluate the prevalence and association of dental anomalies with different types of malocclusions and facial patterns.

Methods

In this cross-sectional study, the records of patients referred to the Orthodontics Department at 12-20 years of age were collected. The patients were classified into four types of malocclusion: Cl I, Cl II div 1, Cl II div 2, and Cl III, and three types of facial patterns: normal, long, and short. Fifteen dental anomalies were searched within the documents. The statistical analysis of data was performed with chi-squared and Fisher's exact test.

Results

Among 602 patients evaluated in this study, 28.6% were males, and 71.4% were females. The prevalence of Cl I, Cl II div1, Cl II div 2, and Cl III was 58.3%, 28.7%, 5.5%, and 7.5%, respectively. The normal facial pattern was most prevalent (47.2%), followed by the long facial pattern (41.4%) and short facial pattern (11.5%); 60.7% of the study population had at least one dental anomaly. Dilaceration was the most common anomaly (27.7%), followed by impaction (21.8%) and hypodontia (18.9%). Most dental anomalies were found in females, Cl II malocclusion, and long face samples. A statistically significant association was found between transposition and male gender (P = 0.006) and between short roots and Cl II malocclusion (P = 0.047). No significant association was found between dental anomalies and facial patterns.

Conclusion

Significant associations were reported between transposition and male gender and between short roots and Cl II malocclusion. In our population, dilaceration was the most common dental anomaly.

Comparative Study of Malocclusions between Cancer Patients and Healthy Peers

Background. There is lack of data related to dental occlusion among children cured from cancer. The aim of our study was to compare the prevalence of malocclusion in cancer survivors and in healthy peers. Methods. A cross-sectional study was conducted on 225 children aged between 4 and 18 years, including 75 cancer survivors, and 150 sex and age-matched controls. All patients were orthodontically examined and malocclusion traits were recorded. In the cancer group, 75 panoramic radiographs were used to evaluate the prevalence of dental anomalies and dental age using the Demirjian scale. Data were analyzed by univariate statistical analysis with p-values p < 0.05 considered as statistically significant. Results. Malocclusion was found in 49 (65.33%) cancer survivors and 99 (65.56%) controls (p > 0.05). The cancer group demonstrated significantly higher likelihood of crossbite (p < 0.01) and malalignment of teeth (p = 0.031). The healthy controls were more likely to demonstrate open bite (p = 0.038). Cancer patients with posterior crossbite (p = 0.023) or dental malalignment had a more advanced dental age (p = 0.022). Survivors with crossbite had more teeth with short roots (p = 0.016). Those who were older when they started their cancer therapy were more likely to suffer from tooth disturbances (p = 0.019). Conclusion. Oncological treatment can alter the development of occlusion in cancer patients.

Prediction methods of maxillary canine impaction: a systematic review

OBJECTIVE

To describe and assess the available evidence of prediction methods of maxillary canine impaction (MCI).

MATERIAL AND METHODS

A systematic search was conducted through PubMed, Cochrane Library, Embase, EBSCOhost, Scopus, ScienceDirect, Bireme and Scielo until December 2020. This systematic review was conducted according to the PRISMA statement. The methodology of the selected studies was assessed using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2).

RESULTS

A total of 2391 articles were identified in the first approach and after a 2-phase selection, 11 studies were included in qualitative analysis. Prediction methods were constructed using equation-based models, geometric measurements and computational methods from clinical and imaging data to predict palatal/buccal MCI. The quality of evidence was low to moderate due to the presence of risk of bias in most of the studies included. Three cohort studies with the best methodological quality proposed prediction models based on geometric measurements, canine position and facial growth pattern that would allow predicting MCI from CBCT, lateral and panoramic radiographs.

CONCLUSIONS

The evidence is limited and most of the studies present a low methodological quality. However, it is possible to suggest that some prediction methods based on the position of the canine and facial growth pattern could predict palatal/buccal MCI in mixed dentition. Cohort studies with better methodological quality and long-term follow-up are needed to better validate a prediction model.

Investigating prevalence of dental anomalies in Eastern Province of Saudi Arabia through digital orthopantomogram

Objective

The aim of this study was to investigate the prevalence of dental anomalies in the Eastern Province of Saudi Arabia using the digital Orthopantomography (OPG).

Methods

A retrospective radiographic study was performed in which digital OPGs of 1189 subjects, ages ranging between 7 and 65 years were reviewed, and 1104 fulfilled inclusion criteria. Statistical analysis was performed. The OPGs were reviewed for congenitally missing teeth, impactions, ectopic eruption, supernumerary teeth, odontomas, dilacerations, taurodontism, dens in dente, gemination and fusion.

Results

OPGs of 1104 patients with mean age 35.32 ± 16.63 were included. The total prevalence of developmental anomalies in this study was 36.3% (401/1104). Male and female subjects with anomalies were 133 (33.2%) and 268 (66.8%) respectively. The prevalence of dilacerated teeth 300 (30.2%), congenitally missing teeth was 246 (24.7%), supernumerary teeth 18 (1.8%), talon cusp and taurodontism were seen in one patient each 1 (0.1%). Of these, a total of 15 (1.5%) anomalies were noted in pediatric patients.

Conclusions

Dilaceration was the most prevalent anomaly (30.2%) in the studied sample followed by congenitally missing teeth (23.4%). Talon cusp, concrescence/fusion, and taurodontism were the least prevalent anomalies.

Factors influencing different types of malocclusion and arch form-A review

AIM

This review intends to highlight malocclusion as a multifactorial issue and review the different factors that influence different types of malocclusion and arch form.

METHODS

An online article search was performed on the factors influencing malocclusion and arch form from January 1990 through April 2020. The search was performed within the Google, Rutgers library, PubMed, MEDLINE databases via OVID using the keywords mentioned in the PubMed and MeSH headings for the English language published articles January 1990 through April 2020, which evaluated different factors that influence malocclusion and arch form.

RESULTS

Of the 300 articles found in initial search results, 31 articles met the inclusion criteria set for this review. These 31 studies were directly related to the factors that impact malocclusion and different arch forms.

CONCLUSION

Genetic inheritance, genetic mutations, age, gender, ethnicity, dental anomalies like macrodontia, congenital diseases, muscular diseases, hormone imbalance, and human behaviour are all factors that influence malocclusion and arch forms. The elements within the individual's control like behaviours can aid in preventing malocclusion. However, it seems as if the underlying reason for most of these factors indicates that malocclusion is a by-product of genetics and pathology.

Odontomas are associated with impacted permanent teeth in orthodontic patients

Background

Odontomas are the most frequent odontogenic tumors in the oral cavity and can result in failure of eruption of permanent teeth or be associated with impacted teeth.

Material and Methods

The present study evaluated the prevalence of complex and compound odontomas in non-syndromic patients prior to the onset of orthodontic treatment. Panoramic radiographs of 4,267 non-syndromic patients were evaluated; 22 cases were included being 54.5% complex and 45.4% compound odontomas.

Results

The sample was composed predominantly by White males with mean age of 14.5 years. Complex odontomas were commonly found in the maxilla (83.3%) while compound type was mostly located on mandible (60%), presenting a significant association (P=0.027). Moreover, odontomas were significantly associated with impacted teeth (P<0.0001). The most frequently odontoma-associated impacted teeth were lower canines, followed by upper central incisors and upper canines, while impacted teeth with no odontoma were predominantly upper canines, lower second premolars and upper second premolars. Compound and complex odontomas showed mean size of 10.5 and 7.25 mm, respectively, presenting significant association between lesion size and odontoma type (P=0.021).

Conclusions

Odontomas affected mainly White male patients with mean age of 14.5 years, being the complex type commonly found in the maxilla and the compound type mostly located on mandible. Furthermore, odontomas were significantly associated with impacted teeth, affecting mainly lower canines. Early diagnosis and correct treatment are essential to avoid any complications, such as prolonged retention of primary teeth and delayed eruption of permanent teeth.

Key words:Odontoma, odontogenic tumors, dental anomalies.

Dental anomalies in craniofacial microsomia: A systematic review

Objective: To provide an overview on the prevalence and types of dental anomalies in patients with craniofacial microsomia (CFM). Eligibility criteria: Inclusion criteria were CFM and dental anomalies. The following data were extracted: number of patients, methodology, mean age, sex, affected side, severity of mandibular hypoplasia, dentition stage and dental anomalies. Information sources: Cochrane, EMBASE, PubMed, MEDLINE Ovid, Web of Science, CINAHL EBSCOhost and Google Scholar, searched until the 30 August 2019. Risk of bias: The quality was examined with the OCEBM Levels of Evidence. Included studies: In total, 13 papers were included: four retrospective cohort studies, four prospective cohort studies, four case‐control studies and one case series. Synthesis of results: The studies reported information on dental agenesis, delayed dental development, tooth size anomalies, tooth morphology and other dental anomalies. Description of the effect: Dental anomalies are more often diagnosed in patients with CFM than in healthy controls and occur more often on the affected than on the non‐affected side. Strengths and limitations of evidence: This is the first systematic review study on dental anomalies in CFM. However, most articles were of low quality. Interpretation: Dental anomalies are common in CFM, which might be linked to the development of CFM. The pathophysiology of CFM is not entirely clear, and further research is needed.

Unerupted permanent incisors and associated dental anomalies

AIM

The aim of the present study was to investigate the association between unerupted permanent incisors and dental anomalies among children and adolescents.

METHODS

The clinical records of patients between January 2005 and December 2014 were retrieved to identify those with unerupted permanent incisors. A retrospective audit on the presence or absence of any dental anomalies was done from all available records of the included patients.

RESULTS

A total of 266 patients with 320 unerupted permanent incisors were identified from the 15 987 patients in the study. Among the unerupted permanent incisors, 222 (69.4%) were associated with dental anomalies, which was significantly higher than those showing an absence of dental anomalies (N = 98, 30.6%, P < 0.001). For the unerupted maxillary central incisors, a significantly higher proportion was associated with supernumerary teeth (P < 0.001). For the unerupted maxillary lateral incisors, a significantly higher proportion was associated with the ectopic eruption of permanent canines when compared with other dental anomalies (P < 0.001). The presence of the ectopic eruption of permanent canine, double teeth, and hyperdontia was significantly higher among male patients with unerupted permanent incisors.

CONCLUSIONS

Unerupted permanent incisors were associated with supernumerary teeth and ectopic eruption of permanent canines. Specifically, a higher proportion of unerupted maxillary central incisors was associated with the presence of supernumerary teeth, whereas a higher percentage of unerupted maxillary lateral incisors was associated with the ectopic eruption of permanent canines.

Taurodontism and its forensic value: a case report

Taurodontism is an anomaly that affects posterior teeth, vertically increasing the size of the pulp chamber, mimicking the shape of bovine teeth, being only evidenced in diagnostic images. This report describes a case of taurodontism in a mandibular second molar, highlighting the forensic importance of this dental anomaly with relevant potential for human identification, not only for its morphological aspect but also for its relatively low frequency in mandibular second molars. In the case under study, the individual did not have any restored teeth. Thus, the set of diverse imaging modalities is fundamental to identify the anatomy of teeth and roots, the only information that could be used in a hypothetical identification situation, assigning to this anomaly an exceptional relevance as a potential characteristic for positive identification.

Association between Tooth Agenesis and Skeletal Malocclusions

Objectives

The aim of this study was to evaluate the association between tooth agenesis and skeletal malocclusions in Brazilian non-syndromic orthodontic patients.

Material and Methods

Pretreatment orthodontic records of 348 patients of both genders and with various skeletal malocclusions were examined. Tooth agenesis was evaluated in panoramic radiographs. Angular measurements were taken from lateral cephalometric radiographs to classify the patient’s malocclusion as skeletal Class I, Class II and Class III. Subjects were divided into 2 groups, “with tooth agenesis” and “without tooth agenesis”. Chi-square or Fisher exact test was used to compare categorical data. ANOVA with Tukey’s post-test was used for means comparisons. An alpha of 5% was established.

Results

From 348 analysed patients, 28 presented tooth agenesis. There was no difference between genders (P = 0.27) nor mean age (P = 0.16). The most prevalent skeletal malocclusion was Class I (63.11%), followed by Class II (25.94%), and Class III (10.95%). The mean of congenitally missing teeth was 1.3 (SD 0.13). Thirteen subjects had premolar agenesis, 13 upper lateral incisor agenesis, 4 lower incisor agenesis and 2 molars agenesis. The group with tooth agenesis presented A point-nasion-B point (ANB) angle smaller (1.66 [SD 2.52]) than the group without tooth agenesis (2.86 [SD 2.49]) (P = 0.01). ANB angle had a negative correlation with the number of congenitally missing teeth (P = 0.039; r = -0.39).

Conclusions

Tooth agenesis is associated with a smaller A point-nasion-B point angle and is negatively correlated with the number of congenitally missing teeth.

Impacted Maxillary Canine Prevalence and Its Association with Other Dental Anomalies in a Mexican Population

Objective. We quantified the prevalence of impacted maxillary canines (IMC) and their association with other dental anomalies (DAs). Materials and Methods. A retrospective study was done with 860 patients 12 to 39 years of age. The prevalence of IMC was calculated and compared by sex. The sample was divided into a control group and an impaction group, and the prevalence was calculated in both for a series of anomalies: agenesis, supernumerary teeth, shape anomalies of the upper laterals (microdontia, peg and barrel shape, and talon cusp), fusion, gemination, other impacted teeth, transposition, and amelogenesis imperfecta. The prevalence values for both groups were compared (Pearson's χ² test, p ≤ 0.05). Results. IMC were present in 6.04% of the sample with no difference by sex (p = 0.540). Other DAs occurred in 51.92% of the IMC group and in 20.17% of the controls (p < 0.05). Significant associations (p < 0.05) were identified between IMC and four other DAs: microdontia, barrel shape, other impacted teeth, and transposition. The prevalence of all anomalies was lower in the control group. Conclusion. IMC were seen in 6.04% of patients. Patients with this condition also had a higher prevalence of other DAs. These other anomalies should be used as risk indicators for early diagnosis.