Crown Diameters of Deciduous Teeth in Jordanians

Odonotmetic data on the deciduous dentition of Jordanians are lacking and such data on Arabs are geenrally scarce. The aim of this study was to proivde a detailed description of crown-size dimensions in the deciduous dentition of Jordanians and to compare the findings with those of other populations. Measurements of mesiodistal (MD) and buccolingual (BL) crown diamters were obtained from dental casts of 84 males and females aged 2.9 to 5.8 years. The differences in crown size (MD and BL diameters) between the right and left sides of the dental arch were not significant. All antimeric teeth showed high correlation coefficients in their crown dimensions (p<0.001). These findings suggest that either right or left side measurements can be taken to represent the tooth size of the populations. The relative variability in crown size showed that the lateral incisors were the most variable teeth (coefficient of variation: CV=7.5%), while the second molars were the most stable teeth (CV=4.7%). The MD diameters were more variable in the males for all teeth except the mandibular first molars, whereas variabilities in BL dimensions showed a similar pattern in both sexes. No significant differences in crown size measurements were found between males and females. Male means exceeded female means only by 0.05 mm. The central incisors displayed the greatest percentage of sexual dimorphism, while the second molars were the least dimorphic teeth. No specific pattern of percentages of sexual dimorphism were noted between the MD and BL diamters. The percentage of sexual dimorphism in the present sample was considerably lower than those of other ethnic groups. Jordanian children had tooth size that was larger than their Egyptian and North American counterparts, close to those of Japanese, and smaller than those of British children. 

Tooth Crown Size of the Permanent Dentition in Subjects with Thalassemia Major

Thalassemia refers to a group of hereditary anemias resulting from defects in synthesis of either alpha or the beta polypeptide chains of hemoglobin. The homozygous form of beta thalassemia (thalassemia major) exhibits the most severe clinical symptoms. Odontometric analysis of subjects with thalassemia are lacking, despite the wide distribution of the disease and its orofacial characteristics. The aim of this study was to provide detailed descriptions of tooth crown size in the permanent dentition of subjects with thalassemia major and to compare the findings with those of the same population. Dental casts of 46 thalassemic subjects, 25 males and 21 females, aged 7.3 to 23.7 years, were measured for the mesiodistal and buccolingual crown diameters. Crown size variability, correlations, sexual dimorphism, and summary measurements are presented. All means for mesiodistal and buccolingual dimensions in males exceeded those in females, with 18 of the 28 comparisons statistically significant (ranged from P<0.05 to P<0.001, t-test). With the exception of maxillary central and lateral incisors and mandibular first molars, all other teeth exhibited greated buccolingual diameters than mesiodstal. No specific pattern of percentages of sexual dimorphism was noted between the mesiodistal and buccolingual diameters. Comparison of the mesiodistal crown diameters in thalassemic subjects with unaffected control group showed that thalassemic males and females have significantly smaller dimensions than their controls, with 9 of the 24 comparisons being highly significant.

Caries risk in patients with thalassaemia major

AIM

The aim of this study was to assess the prevalence and distribution of dental caries in subjects with thalassaemia major.

DESIGN

Clinical examination for dental caries, diagnosed according to the WHO criteria.

PARTICIPANTS

A total of 54 thalassaemic patients, 23 aged 6-9 (14 males and 9 females) and 31 aged 12-18 (17 males and 14 females) were examined.

OUTCOME MEASURES

dmft, DMFT and plaque scores.

RESULTS

The mean dmft was 6.92 for 6-7 year olds and 4.72 for 8-9 year olds. The DMFT values were 6.57 and 5.95 for ages 12-14 and 15-18, respectively. There was no statistically significant difference in caries prevalence (dmft/DMFT) between gender or between primary and permanent teeth. Only 17.4 per cent of the children aged 6-9 and 21.4 per cent of 12-18 years olds were caries free. The prevalence of dental caries in the thalassaemia patients was considerably higher (22.7 per cent) than that reported in a normal Jordanian sample (DMFT 6.26 vs 4.84). Very few fillings (1.4 per cent of the examined teeth) were observed, indicating a negligible rate of conservative treatment. More than half (61.1 per cent) of the patients had poor oral hygiene (plaque score > or = 2.0).

CONCLUSIONS

The need for effective preventive measures, education and dental treatment need to be stressed for this caries risk group.

Etiology and diagnosis of tooth wear: a literature review and presentation of selected cases

PURPOSE

This article presents an overview of etiologies associated with tooth wear.

MATERIALS AND METHODS

Specific types of wear based on clinical findings and patient history are described.

RESULTS

The occurrence and pattern of tooth wear are related to cultural, dietary, occupational, and geographic factors. Examples of tooth wear related to these factors with regional specificity are presented.

CONCLUSION

The dental practitioner should recognize the characteristic signs of tooth wear, as they may be the first to discuss the problem with the patient. Management should be based on accurate diagnosis.

Localisation of a gene for prepubertal periodontitis to chromosome 11q14 and identification of a cathepsin C gene mutation

Prepubertal periodontitis (PPP) is a rare and rapidly progressive disease of young children that results in destruction of the periodontal support of the primary dentition. The condition may occur as part of a recognised syndrome or may occur as an isolated finding. Both autosomal dominant and recessive forms of Mendelian transmission have been reported for PPP. We report a consanguineous Jordanian family with four members affected by PPP in two nuclear sibships. The parents of the affected subjects are first cousins. We have localised a gene of major effect for PPP in this kindred (Zmax=3.55 for D11S901 at theta=0.00) to a 14 cM genetic interval on chromosome 11q14 flanked by D11S916 and D11S1367. This PPP candidate interval overlaps the region of chromosome 11q14 that contains the cathepsin C gene responsible for Papillon-Lefèvre and Haim-Munk syndromes. Sequence analysis of the cathepsin C gene from PPP affected subjects from this Jordanian family indicated that all were homozygous for a missense mutation (1040A-->G) that changes a tyrosine to a cysteine. All four parents were heterozygous carriers of this Tyr347Cys cathepsin C mutation. None of the family members who were heterozygous carriers for this mutation showed any clinical findings of PPP. None of the 50 controls tested were found to have this Tyr347Cys mutation. This is the first reported gene mutation for non-syndromic periodontitis and shows that non-syndromic PPP is an allelic variant of the type IV palmoplantar ectodermal dysplasias.

Delayed eruption of maxillary primary cuspid associated with compound odontoma

Impaction of primary teeth is very rare especially in the maxillary anterior teeth. A four-year-old male child with the complaint of delayed eruption of right maxillary primary cuspid due to the presence of odontoma is presented.

Oral manifestations of Ellis-van Creveld syndrome: report of two siblings with unusual dental anomalies

Ellis-van Creveld syndrome (EvC), also called chondroectodermal dysplasia, is a rare occurrence inherited as an autosomal recessive disease. Despite the fact that oral manifestations play an important role in the diagnosis criteria for EvC, few detailed reports have been published in the dental literature. This articles presents two siblings with EvC, a boy aged 9 years and a girl aged 7 1/2 years, a product of unaffected first cousin parents. The patients manifests: chondrodysplasia of tubular bones resulting in disproportionate dwarfism, polydactyly and syndactyly of hands and feet, severe dystrophic nails, multiple broad labial frenula with abnormal attachments, congenital missing incisors, anomalous teeth, bilateral partial clefts of the alveolar bone, and malocclusion. Other features noted in either cases are: congenital heart defect, median notch of the upper lip, shovel-shaped incisors and taurodontism. Of the unusual dental findings observed in our patients are talon cusp, reduced crown size, supernumerary tooth, and early eruption of teeth. Because half of the cases with EvC have cardiac malformation, dental treatment must be performed under prophylactic antibiotic coverage. Dentists play an important role in early diagnosis and control of dental problem of this condition.

Solitary maxillary central incisor in the midline associated with systemic disorders

A single maxillary central incisor in the midline is a rare developmental anomaly. The appearance of a single incisor in place of two teeth may occur as an isolated dental finding that can be related to fusion of two neighboring teeth or to agenesis of a tooth germ. However, the condition has also been reported to occur in association with autosomal dominant holoprosencephaly, growth retardation, and midline developmental defects. This article reports on other systemic defects that can be found in association with a single maxillary central incisor.

Bilateral talon cusps on primary central incisors: a case report

Talon cusp is an uncommon anomaly in the primary dentition. The present report describes a case of bilateral talon cusps on the maxillary primary central incisors of a 17-month-old Jordanian-Arab boy, bringing to seven the total cases reported in the literature. Both central incisors exhibited a sharp prominent accessory cusp on the palatal surface which extended from the cemento-enamel to the incisal edge. The cusp on the right incisor was attached to tooth surface, forming a T-shape crown outline. whereas the cusp on the left incisor projected away from the rest of the crown. The anomalous cusps were a source of tongue irritation and occlusal interference.

Unusual nasal foreign body detected on routine dental radiography: case report

This report describes an unusual nasal foreign body in a 4-year-old boy discovered incidentally in a routine dental radiograph. A small piece of rubber eraser was lodged in the right nasal cavity, causing unilateral nasal obstruction and discharge, sneezing, snoring and breathing difficulty. In this case, discovery of unknown intranasal object was diagnostic for a condition suspected of pathological origin. Dentists may play a significant role in the diagnosis of intranasal foreign objects in children, through careful clinical examination and interpretation of dental radiographs. Early diagnosis is emphasized in order to avoid complications.

Papillon-Lefèvre syndrome: a review of the literature and report of 4 cases

This report describes 4 cases of Papillon-Lefèvre syndrome (PLS) affecting 2 Jordanian families with a total of 8 children. In family A, 3 girls out of 6 siblings were affected; and in family B, the eldest of 2 brothers. The patients were between 4 1/2 and 12 years old, and their parents, who are first cousins, were not affected. Diagnosis was determined by history, and clinical, laboratory, and radiographic examinations. All present cases exhibited the typical clinical features of PLS: hyperkeratosis of the palms and soles and the presence of advanced destructive periodontitis resulting in early loss of both the primary and permanent dentitions. In Case 4, cutaneous lesions were noticed at age 6 months and the child was edentulous by the age of 12 years. In all cases, there was a relationship between increased severity of skin lesions and seasonal variations and intensified periodontal destruction. There was an early eruption of the permanent teeth. The teeth were caries-free with no sign of root resorption. Dentists play a significant role in the diagnosis and management of PLS patients.

In vitro studies of the effect of a dental explorer on the formation of an artificial carious lesion

This project deals with in vitro mechanical damage of early carious lesion (enamel lesion) in artificial U-shaped grooves caused by a sharp dental explorer. The lesions were formed in enamel grooves in 3 percent by weight cellulose solution in 0.1 M lactic acid containing 1.08 M KH2PO4 and 1.8 mM CaCl2 buffer to pH 4.28 after two weeks of demineralization. A relatively intact surface layer was observed in all the grooves. Three demineralized grooves were probed with different forces 100 g, 300 g and 500 g. The traumatic damage was assessed by using microradiography. There was no damaging effect in the sound enamel grooves probed with a sharp explorer up to a force of 500 g. Breakdown of the surface layer was assessed in all probed demineralized enamel grooves, converting the white spot lesion with apparently a sound surface layer into a cavity. Explorer penetration into the lesion was found to be strongly related to the force applied. The use of a sharp dental explorer should be reconsidered in examination and diagnosis of early carious lesions in pits and fissures and an alternative technique should be sought.

Talon cusp--clinical significance and management: case reports

Talon cusp is a rare dental anomaly manifested as an accessory cusplike structure on the tooth crown. This article reports four cases of talon cusp that caused clinical problems related to appearance, occlusal interference, tooth displacement, caries, and tongue irritation. The cases presented were associated with other dental abnormalities, suggesting per se that genetic inheritance may be the causative factor. Clinical and radiographic characteristics of this developmental anomaly and modes of treatment are described.